Journal of Integrative Medicine-Jim最新文献

{"title":"A progression risk assessment model for pulmonary ground-glass nodules based on traditional Chinese medicine clinical symptoms combined with imaging","authors":"Ayidana Maolan ,&nbsp;Le-hua Yu ,&nbsp;Yue Li ,&nbsp;Zhao-shuai Yan ,&nbsp;Xing-hua Xiang ,&nbsp;Lin-feng Wang ,&nbsp;Qiu-jun Guo ,&nbsp;Jia-qi Hu ,&nbsp;Guang-hui Zhang ,&nbsp;Xiao-ling Ren ,&nbsp;Juan Li ,&nbsp;Tian-heng Sun ,&nbsp;Wei Yang ,&nbsp;Rui Liu ,&nbsp;Bao-jin Hua","doi":"10.1016/j.joim.2026.01.002","DOIUrl":"10.1016/j.joim.2026.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>Progressive ground-glass nodules (GGNs) are associated with a risk of malignancy. Early identification and intervention are crucial for lung cancer prevention. Traditional Chinese medicine (TCM) has advantages of syndrome differentiation, holistic adjustment, and whole-process management. In this study, we built a risk assessment model based on the integration of TCM symptoms and imaging features to identify risks of GGN progression and to guide personalized TCM management and treatment.</div></div><div><h3>Methods</h3><div>This study enrolled 864 patients with GGNs from January 2015 to December 2023. Assessment factors included general demographic information, TCM symptoms, and imaging features. Machine learning algorithms were used to screen risk factors, regression models were used to establish GGN progression risk assessment models, and a nomogram was used to assess the risk of progression.</div></div><div><h3>Results</h3><div>Age, second-hand smoke exposure, acid reflux, breast or abdominal pain, chest tightness, depression, heartburn, tongue with little coating, and the diameter of the largest pulmonary nodule were significant risk factors for GGN progression. In the nomogram model, the TCM symptom of acid reflux made the highest contribution. The constructed model using these key factors was used to assess the risk of GGN progression. The receiver operating characteristic curve showed that the area under the curve (AUC) in the training set was 0.70 (95% confidence interval [0.65, 0.75]), and the AUC in the test set was 0.74 (95% confidence interval [0.65, 0.82]).</div></div><div><h3>Conclusion</h3><div>This study was the first to establish a GGN progression risk assessment model using TCM clinical symptoms and imaging features. The model can help individuals and doctors better understand the health status and take timely preventive measures.</div><div><br>Please cite this article as: Maolan A, Yu LH, Li Y, Yan ZS, Xiang XH, Wang LF, Guo QJ, Hu JQ, Zhang GH, Ren XL, Li J, Sun TH, Yang W, Liu R, Hua BJ. A progression risk assessment model for pulmonary ground-glass nodules based on traditional Chinese medicine clinical symptoms combined with imaging. <em>J Integr Med</em>. 2026; 24(3):376–386.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 3","pages":"Pages 376-386"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photothermal effect of invasive laser acupuncture: A computational study with experimental validation.","authors":"Hyo-Jin Kim ,&nbsp;Jongwoo Kim ,&nbsp;Jin-Gyun Kim ,&nbsp;Seunghoon Lee ,&nbsp;Younbyoung Chae ,&nbsp;In-Seon Lee","doi":"10.1016/j.joim.2026.02.002","DOIUrl":"10.1016/j.joim.2026.02.002","url":null,"abstract":"<div><div>Invasive laser acupuncture (ILA) is an innovative integration of traditional acupuncture with precise laser stimulation delivered directly into acupoints, yet it is not widely used in clinical practice and lacks extensive clinical studies. In the era of digital healthcare and patient-specific treatment, computational predictive models have become essential tools for optimizing medical procedures and ensuring treatment safety. However, existing computational models for laser-based therapies primarily focused on skin surface treatments or ablation procedures, creating a significant gap in understanding unique characteristics of ILA. This study addressed this challenge by developing and validating a novel computational predictive model that incorporates the geometric characteristics of needle-integrated optical fiber delivery. The model was validated through ex vivo experiments using a 650 nm laser device, demonstrating good agreement in temporal temperature changes at the irradiation point with an average difference of 11.6%. Using this validated model, systematic investigation of ILA responses to varying laser parameters was conducted to analyze the photothermal effects in tissue. These quantitative insights into the relationships between laser parameters and photothermal responses provided a foundation for evidence-based selection of treatment parameters. This computational framework contributes to the advancement of ILA therapy by enabling more precise control of therapeutic outcomes and supporting the development of safety protocols.</div><div><br>Please cite this article as: Kim HJ, Kim J, Kim JG, Lee S, Chae Y, Lee IS. Photothermal effect of invasive laser acupuncture: A computational study with experimental validation. <em>J Integr Med.</em> 2026; 24(3):352–364.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 3","pages":"Pages 352-364"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of traditional Chinese medicine and machine learning: Opportunities, obstacles, and implications for future of healthcare","authors":"Xian Huang ,&nbsp;Hui Hwang Goh ,&nbsp;Ting-ting He ,&nbsp;Dong-dong Zhang ,&nbsp;Wei Dai ,&nbsp;Tonni Agustiono Kurniawan ,&nbsp;Kai Chen Goh ,&nbsp;Hin Yong Wong ,&nbsp;Mohammad Tariqul Islam ,&nbsp;Xue Liang","doi":"10.1016/j.joim.2026.02.004","DOIUrl":"10.1016/j.joim.2026.02.004","url":null,"abstract":"<div><div>Chinese herbal traditions, with a history of over 2000 years, emphasise the harmony between spirit, body and nature. Integrating these principles with machine learning (ML) offers transformative potential for traditional Chinese medicine (TCM). By leveraging technologies and data-driven models, TCM can evolve while preserving its accumulated wisdom. Knowledge graphs combined with deep learning can enhance diagnosis, treatment planning and prognosis evaluation. This paper reviews current ML applications in TCM and strategies for integration with conventional practices. It categorises key challenges and proposed solutions, focusing on deep learning-based algorithms. ML has demonstrated success in automating personalised herbal prescriptions, predicting diagnostic outcomes and identifying acupoints. However, major obstacles include data standardisation, ethical and legal frameworks, and fostering interdisciplinary collaboration. The development of high-quality, ethical artificial intelligence requires regulatory support and cooperation with TCM practitioners. This study supports the notion that a learning platform is essential for the education of TCM practitioners. ML and TCM may adopt this implementation approach, and the emergence of convex ML can substantially enhance testing algorithms in TCM, hence improving the effectiveness of future healthcare systems.</div><div><br>Please cite this article as: Huang X, Goh HH, He TT, Zhang DD, Dai W, Kurniawan TA, Goh KC, Wong HY, Islam MT, Liang X. Integration of traditional Chinese medicine and machine learning: Opportunities, obstacles, and implications for future of healthcare. <em>J Integr Med</em>. 2026; 24(3):295–309.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 3","pages":"Pages 295-309"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hierarchical and interpretable machine learning model for acupoint determination","authors":"Hang Yang ,&nbsp;Ren Wu ,&nbsp;Mitsuru Nakata ,&nbsp;Qi-wei Ge","doi":"10.1016/j.joim.2026.01.003","DOIUrl":"10.1016/j.joim.2026.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study used machine learning methods to develop a model that can offer personalized acupoint prescriptions for patients based on their symptoms, enhancing both the efficiency and effectiveness of acupuncture and moxibustion therapy (AMT).</div></div><div><h3>Methods</h3><div>We first preprocessed textual AMT data to build an acupoint prescription database designed for machine learning applications. Then, based on data analysis, we selected the hierarchical classification model hierarchical attention-based recurrent neural network (HARNN) to determine acupoint prescriptions based on symptoms. Computational experiments were conducted using 5-fold cross-validation to evaluate the model’s performance, with intersection over union (IoU) as the primary evaluation metric. Finally, to enhance model interpretability, the local interpretable model-agnostic explanation (LIME) method was applied to visualize prediction results and improve its clinical applicability.</div></div><div><h3>Results</h3><div>On the original dataset of 5000 samples, HARNN achieved an IoU of 0.883 in predicting acupoint prescriptions. After data augmentation, the IoU reached 0.954 in 5-fold cross-validation, and 0.932 on a test set of 1000 original samples. The use of LIME enabled intuitive visualization of the model’s prediction rationale, thereby enhancing the model’s reliability.</div></div><div><h3>Conclusion</h3><div>This study developed a hierarchical and interpretable machine learning model that predicts acupoint prescriptions based on symptoms, integrating HARNN for hierarchical classification and LIME for interpretability, which provides an effective technical approach and methodology for the intellectualization of AMT.</div><div><br>Please cite this article as: Yang H, Wu R, Nakata M, Ge QW. A hierarchical and interpretable machine learning model for acupoint determination. <em>J Integr Med</em>. 2026; 24(3):340–351.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 3","pages":"Pages 340-351"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iridoids in liver diseases: Mechanistic insights and molecular mechanism","authors":"Shagun Sanjivv Dogra ,&nbsp;Vikram Patial","doi":"10.1016/j.joim.2026.01.008","DOIUrl":"10.1016/j.joim.2026.01.008","url":null,"abstract":"<div><div>Over the past decade, the prevalence of hepatic disorders has shown a steady upsurge, raising serious public health concerns. Alcohol consumption, indiscriminate use of medications, a high-calorie diet and exposure to viral infections are all thought to be the primary risk factors for developing hepatic diseases. Due to the lack of effective treatments for hepatic disorders, such as metabolic dysfunction-associated fatty liver disease, alcoholic liver disease, liver fibrosis, cirrhosis and liver cancers, and the numerous side effects of existing therapies, medicinal plants are receiving increased attention as an alternative treatment for hepatic disorders. Iridoids are bitter-tasting secondary metabolites found in many medicinal plants. Numerous in vitro and in vivo studies have demonstrated that iridoids or extracts containing iridoids produce hepatoprotective effects by targeting inflammation, oxidative stress, apoptosis, and mitochondrial dysfunction. This comprehensive review discusses scientific research on the hepatoprotective effects of various iridoids and the targeted pathways involved in liver disorders. Research data on iridoids as hepatoprotective molecules were obtained through multiple databases such as ScienceDirect, Web of Science, PubMed, Wiley Online Library and Scopus using relevant keywords such as iridoids and hepatoprotective. Based on the available information, further research is required for the optimization of the targeted delivery of iridoids in therapeutic and toxicity studies and randomized clinical trials in humans.</div><div><br>Please cite this article as: Dogra S, Patial V. Iridoids in liver diseases: Mechanistic insights and molecular mechanism. <em>J Integr Med</em>. 2026; 24(3):310–326.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 3","pages":"Pages 310-326"},"PeriodicalIF":4.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of auriculotherapy for insomnia disorder: A randomized controlled trial","authors":"Hao Chen ,&nbsp;Xi-fen Zhang ,&nbsp;Zi-chun Yuan ,&nbsp;Xue-song Wang ,&nbsp;Yuan-bo Gao ,&nbsp;Xu-xin Li ,&nbsp;Jun-cha Zhang ,&nbsp;Michele Dias da Silva Oliveira ,&nbsp;Cynthia Assis de Barros Nunes ,&nbsp;Jun Liu ,&nbsp;Yan-fen She","doi":"10.1016/j.joim.2025.12.009","DOIUrl":"10.1016/j.joim.2025.12.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Auriculotherapy is a simple, convenient, nonpharmacological option that has shown positive effects for insomnia patients, but its efficacy and safety remain unknown.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this study is to evaluate the efficacy and safety of auricular therapy for insomnia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design, setting, participants and intervention&lt;/h3&gt;&lt;div&gt;An 18-week (2-week screening, 4-week treatment, and 12-week follow-up), recruiter- and assessor-blinded, randomized, sham-controlled trial was performed. Patients were recruited from outpatient settings at three clinical centers in China from 2 February 2023 to 26 January 2024. Participants had insomnia for more than 3 months and met the criteria classified in the &lt;em&gt;Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition)&lt;/em&gt;. Patients were randomly assigned in a 1:1 ratio to receive auricular therapy (AT) or sham AT (SAT) for 4 consecutive weeks, twice a week, and once every 3 days.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main outcome measures&lt;/h3&gt;&lt;div&gt;Primary outcome was the response rate at week 4 after treatment, defined as the percentage of patients with at least a 50% reduction in Pittsburgh Sleep Quality Index (PSQI) from baseline. Secondary outcomes consisted of response rates at other time points, PSQI and 4 related scales, actigraphy-recorded sleep efficiency, sleep arousal frequency, and total sleep time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 234 participants were screened, and 156 patients (122 female [78.2%]; mean [standard deviation] age, 37.2 [13.5] years) were included in the intention-to-treat analysis, with 78 participants randomized to each group. A total of 117 participants (75%) were followed up for 3 months. The AT group had a higher response rate at week 4 than the SAT group (39.73% [29/73] &lt;em&gt;vs&lt;/em&gt; 23.29% [17/73], &lt;em&gt;P&lt;/em&gt; = 0.03), and the response rates for the AT and SAT groups at week 2 were 28.38% (21/74) and 13.33% (10/75), respectively (&lt;em&gt;P&lt;/em&gt; = 0.02). The differences between the two groups in the PSQI at each time point (&lt;em&gt;P&lt;/em&gt; &lt; 0.05) and the Insomnia Severity Index at weeks 4 and 12 (both &lt;em&gt;P&lt;/em&gt; = 0.03) were also statistically significant. The other partial outcomes also showed statistically significant differences. Adverse events occurred in 2 cases in the AT group (2.60%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Four-week AT treatment was an effective and safe alternative therapy for insomnia, although the difference with the SAT treatment did not reach the minimal clinically important difference. Adverse events were mild or transient.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Trial registration&lt;/h3&gt;&lt;div&gt;Chinese Clinical Trial Registry, identifier ChiCTR2200065187.&lt;/div&gt;&lt;div&gt;&lt;br&gt;Please cite this article as: Chen H, Zhang XF, Yuan ZC, Wang XS, Gao YB, Li XX, Zhang JC, da Silva Oliveira MD, de Barros Nunes CA, Liu J, She YF. Efficacy and safety of auriculotherapy for insomnia disorder: A randomized controlled tr","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 2","pages":"Pages 174-181"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroacupuncture regulates histone acetylation to improve spatial memory impairment in rats with chronic cerebral hypoperfusion","authors":"Yan-yi Ding ,&nbsp;Wen-ju Wang ,&nbsp;Le-wen Chen ,&nbsp;Min-guang Yang ,&nbsp;Ya-ling Dai ,&nbsp;Rui Li ,&nbsp;Ya-jun Cao ,&nbsp;Si-nuo Wang ,&nbsp;Liu-mu Wang ,&nbsp;Bao Wu ,&nbsp;Li-ming Chen ,&nbsp;Wei-lin Liu","doi":"10.1016/j.joim.2025.11.008","DOIUrl":"10.1016/j.joim.2025.11.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Chronic cerebral hypoperfusion (CCH) can cause long-term changes in gene expression and increase susceptibility to spatial memory impairment, in which the histone acetylation plays a crucial role. Studies have found that electroacupuncture (EA), a non-drug therapy, is beneficial to alleviate spatial memory impairment. However, the underlying mechanism of the histone acetylation is not yet completely clear. The goal of this study was to investigate the mechanisms by which EA stimulation of acupoints on the head region ameliorates histone acetylation in CCH.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The spatial memory of CCH rats were evaluated before and after the EA intervention using two behavioral tests: Barnes maze (before EA treatment) and Morris water maze (after EA treatment). To further investigate the mechanism by which EA improves spatial memory, Western blotting, real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR), chromatin immunoprecipitation (ChIP), Golgi staining, and neuroelectrophysiology were used. Furthermore, we used Adeno-associated virus vector expressing cyclic AMP response element-binding protein (CBP)/E1A binding protein p300 (P300)-specific short hairpin RNAs (sh CBP/P300) to inhibit the acetylation levels of histones H3 and H4 in the hippocampus.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;CCH rats showed changes in spatial memory, including a decline in acquisition and maintenance. Compared to the sham group, there were significantly lower levels of total histone acetylation in the CCH rats and the acetylation levels of histone H3 and H4 in the hippocampus of rats decreased in the CCH group. The ChIP experiment results showed that the enrichment of acetylation tags of histone 3 at lysine 9 occurred at the promoter sites of Finkel–Biskis–Jinkins osteosarcoma oncogene (&lt;em&gt;c-Fos&lt;/em&gt;), early growth response 1 (&lt;em&gt;Egr1&lt;/em&gt;), and activity-regulated cytoskeleton-associated protein (&lt;em&gt;Arc&lt;/em&gt;). Western blotting and RT-qPCR detection showed that the transcriptional and expression level of &lt;em&gt;c-Fos&lt;/em&gt; and &lt;em&gt;Egr1&lt;/em&gt; decreased. Golgi staining showed that the density of dendritic spines decreased in the hippocampal cornu ammonis 1 area. In contrast, with the EA intervention, the behavior performance and molecular biological indexes were improved. Furthermore, we observed a significant decrease in the histone H3 and H4 acetylation after inhibition of CBP/P300 expression with sh CBP/P300, which resulted in the abrogation of EA’s beneficial effect.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;EA can improve spatial memory impairment in CHH rats by regulating the expression of the hippocampal imprinted genes &lt;em&gt;c-Fos&lt;/em&gt; and &lt;em&gt;Egr1&lt;/em&gt; and by enhancing synaptic plasticity through the epigenetic modification of histone H3 and H4 acetylation.&lt;/div&gt;&lt;div&gt;&lt;br&gt;Please cite this article as: Ding YY, Wang WJ, Chen LW, Yang MG, Dai YL, Li R, Cao YJ, Wang SN, Wang LM, Wu B, Chen LM, Liu WL","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 2","pages":"Pages 224-237"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioactive components of Xinyang and Xinyin tablets for treating chronic heart failure: Pharmacokinetics, network pharmacology and experimental validation","authors":"Yan-ling Lan ,&nbsp;Si-mian Chen ,&nbsp;Bin-xin Dai ,&nbsp;Cai-sheng Wu ,&nbsp;Yi Wei ,&nbsp;Lu Yang ,&nbsp;Jun-lue Yan ,&nbsp;Ya-qiong Guo ,&nbsp;Da-wei Wang ,&nbsp;Qing-guo Li ,&nbsp;Zhong-qi Yang ,&nbsp;Shao-xiang Xian ,&nbsp;Tian-hui Yuan","doi":"10.1016/j.joim.2025.12.005","DOIUrl":"10.1016/j.joim.2025.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>Xinyang Tablet (XYAT) and Xinyin Tablet (XYIT) have been used to treat chronic heart failure (CHF) for 20 years. This study investigated their pharmacodynamic material basis and underlying mechanisms of action.</div></div><div><h3>Methods</h3><div>Ultra-high-performance liquid chromatography-high-resolution mass spectrometry (UPLC-HRMS) was used to identify the components of XYAT and XYIT, and to profile their metabolites in plasma and urine samples from both rats and human volunteers. Furthermore, the prototype compounds and their pharmacokinetics were evaluated using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Network pharmacology predicted potential targets and pathways, which were subsequently validated through flow cytometry and Western blot. The efficacy of XYAT, XYIT and their active components was evaluated in oxidative stress and cardiotoxicity models.</div></div><div><h3>Results</h3><div>A total of 162 and 130 compounds were detected in XYAT and XYIT, respectively; among these, 148 from XYAT and 119 from XYIT were structurally identified. A validated HPLC-MS/MS method quantified 20 key exposure components, five of which showed high systemic exposure and underwent pharmacokinetic analysis. Pharmacokinetic results indicated that the systemic exposure of most compounds was higher for XYAT than for XYIT. Using network pharmacology, seven candidate active compounds were identified, along with their predicted therapeutic targets and associated signaling pathways. Flow cytometry and Western blot confirmed that XYAT, XYIT, and their bioactive components alleviate CHF by modulating calcium signaling and phosphoinositide 3-kinase/protein kinase B signaling. Pharmacodynamic assays demonstrated that XYAT provides protection against hydrogen peroxide-induced injury, while XYIT mitigates doxorubicin-induced cytotoxicity. Further validation confirmed that 20(S)-ginsenoside Rg2 and 20(R)-ginsenoside Rh1 effectively reduced the H₂O₂-induced oxidative stress, while 20(S)-ginsenoside Rg2 and calycosin-7-<em>O</em>-β-<span>d</span>-glucoside significantly protected against doxorubicin-induced cytotoxicity.</div></div><div><h3>Conclusion</h3><div>These findings provide mechanistic insights into the pharmacodynamic material basis and anti-CHF mechanisms of XYAT and XYIT. The integrated strategy established herein offers robust evidence that the superior systemic exposure of key components underpins the rationale for XYAT’s formulation and warrants its continued development in modern cardiology.</div><div><br>Please cite this article as: Lan YL, Chen SM, Dai BX, Wu CS, Wei Y, Yang L, Yan JL, Guo YQ, Wang DW, Li QG, Yang ZQ, Xian SX, Yuan TH. Bioactive components of Xinyang and Xinyin tablets for treating chronic heart failure: pharmacokinetics, network pharmacology and experimental validation. <em>J Integr Med.</em> 2026; 24(2):265–278.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 2","pages":"Pages 265-278"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of herbal medicines in Korean medicine clinics in Republic of Korea: A nationwide retrospective longitudinal cohort study","authors":"Eunbyul Cho ,&nbsp;Mi Mi Ko ,&nbsp;Changsop Yang ,&nbsp;Sungha Kim","doi":"10.1016/j.joim.2025.12.001","DOIUrl":"10.1016/j.joim.2025.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Laboratory tests are commonly used in Korean medicine (KM) clinics to monitor the safety of herbal medicine (HM). Although the incidence of herb-induced liver injury (HILI) in Republic of Korea has been reported, there is a lack of data from KM clinics, which account for over 90% of KM institutions. This absence is due to the lack of a systematic pharmacovigilance system for HMs. To partially understand this issue, this study investigated changes in liver function test (LFT) and renal function test (RFT) after HM prescriptions in primary settings.</div></div><div><h3>Methods</h3><div>This retrospective analysis utilized laboratory test results, including complete blood count, LFT and RFT, collected from 238 KM clinics across the Republic of Korea. The study population comprised patients who underwent laboratory testing before and after HM treatment between March 2020 and November 2021. We compared laboratory test results using paired <em>t</em>-tests or Wilcoxon signed-rank tests. Subgroup analyses were conducted by sex and elapsed time between tests. The McNemar test was used to compare the proportions of cases with abnormal LFT and RFT levels according to lifestyle habits and comorbidities. Additionally, the incidence of liver injury was estimated by identifying cases with aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels exceeding five times the upper limit of normal after HM prescription.</div></div><div><h3>Results</h3><div>A total of 2791 cases were included in the analysis. The levels of AST and ALT decreased significantly after HM prescription (<em>P</em> &lt; 0.0001). This result was consistent in subgroups stratified by sex and for test intervals of within 30 and 60 days (<em>P</em> &lt; 0.05). The proportion of cases with abnormal AST and ALT levels significantly decreased after HM prescription (<em>P</em> &lt; 0.001). Out of 2791 cases, only 2 (0.07%) were identified as having liver injury after HM prescription, but causality was not confirmed.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the use of HM in KM clinics in Republic of Korea is generally safe. While a small number of HMs may be associated with liver injury, causality remains uncertain. Establishing a national pharmacovigilance system is crucial for accurately monitoring the incidence and risk factors of HILI.</div><div>Please cite this article as: Cho E, Ko MM, Yang C, Kim S. Safety of herbal medicines in Korean medicine clinics in Republic of Korea: A nationwide retrospective longitudinal cohort study. <em>J Integr Med.</em> 2026; 24(2):192–200.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 2","pages":"Pages 192-200"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Honghua Ruyi Pill, a compound herbal medicine, improves endometriosis-related dysmenorrhea: A multicenter randomized, double-blind, placebo-controlled trial","authors":"Mei Han ,&nbsp;Xue-fang Liang ,&nbsp;Jing Gao ,&nbsp;Yan Wang ,&nbsp;Li-xing Cao ,&nbsp;Bao-jin Wang ,&nbsp;Yue Wang ,&nbsp;Zerang Zhuoma ,&nbsp;Jian-ping Liu ,&nbsp;Hui-lan Du","doi":"10.1016/j.joim.2025.12.011","DOIUrl":"10.1016/j.joim.2025.12.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Endometriosis is an estrogen-dependent, progesterone-resistant gynecological disorder, with dysmenorrhea being the most common manifestation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study evaluates the efficacy and safety of the Tibetan herbal medication Honghua Ruyi Pill (HHRY) in managing endometriosis-related dysmenorrhea.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design, setting, participants and interventions&lt;/h3&gt;&lt;div&gt;This is a multi-center, randomized, placebo-controlled, double-blinded clinical trial conducted in seven hospitals in China from July 2021 to January 2023. A total of 164 patients with endometriosis and moderate or severe dysmenorrhea (visual analog scale [VAS] score ≥ 4) were assigned to the treatment or placebo group in a 1:1 ratio by block randomization. Patients received HHRY or placebo twice a day for three consecutive menstrual cycles (MCs) and were followed up for three MCs after stopping the medication.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main outcome measures&lt;/h3&gt;&lt;div&gt;Primary outcomes were VAS score of the maximum (VAS&lt;sub&gt;max&lt;/sub&gt;) of dysmenorrhea, endometriosis health profile-5 (EHP-5) score, and 5-level EuroQoL 5-dimension version (EQ-5D-5L) score. Secondary outcomes were VAS&lt;sub&gt;max&lt;/sub&gt; of non-menstrual pelvic pain, days of leave taken, emergent use of nonsteroidal anti-inflammatory drugs (NSAIDs) and changes in uterine, cyst and nodule sizes. Safety profiles were assessed based on adverse events, vital signs, serology markers, urinalysis, and liver and kidney function indicators.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;VAS&lt;sub&gt;max&lt;/sub&gt; of dysmenorrhea, EHP-5 score, EQ-5D-5 L score, and VAS&lt;sub&gt;max&lt;/sub&gt; of non-menstrual pelvic pain were significantly lower in the HHRY group compared to the placebo group at the final follow-up (3.00 &lt;em&gt;vs&lt;/em&gt; 5.50, &lt;em&gt;P&lt;/em&gt; &lt; 0.001; 4.00 &lt;em&gt;vs&lt;/em&gt; 8.00, &lt;em&gt;P&lt;/em&gt; &lt; 0.001; 4.00 &lt;em&gt;vs&lt;/em&gt; 9.00, &lt;em&gt;P&lt;/em&gt; &lt; 0.001; 0.00 &lt;em&gt;vs&lt;/em&gt; 1.00, &lt;em&gt;P&lt;/em&gt; &lt; 0.001; respectively). The emergent use of NSAIDs for breakthrough pain showed no significant difference between groups (&lt;em&gt;P&lt;/em&gt; &gt; 0.999), but the number of patients who had taken time off was significantly different (5.00 &lt;em&gt;vs&lt;/em&gt; 14.00, &lt;em&gt;P&lt;/em&gt; = 0.028). Sonographic evaluations indicated no significant change in uterine size (&lt;em&gt;P&lt;/em&gt; = 0.183) but showed a significant reduction in cyst size (2.09 cm &lt;em&gt;vs&lt;/em&gt; 0.20 cm, &lt;em&gt;P&lt;/em&gt; = 0.027, sum of 3 diameters of cysts) and nodule size (0.70 cm &lt;em&gt;vs&lt;/em&gt; 0.00 cm, &lt;em&gt;P&lt;/em&gt; &lt; 0.001, maximum nodule diameter). Safety analysis showed no significant difference in the incidence of adverse events between groups (18.85% &lt;em&gt;vs&lt;/em&gt; 28.05%, &lt;em&gt;P&lt;/em&gt; = 0.059).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;HHRY can improve dysmenorrhea, chronic pelvic pain, and quality of life in patients with endometriosis. It has a good overall safety profile, and a 3-month treatment can maintain its effects for at least 3 months after the last dose. HHRY may be considered as a new ","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"24 2","pages":"Pages 182-191"},"PeriodicalIF":4.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}