IVF add-ons are optional tests, treatments or procedures offered in addition to standard IVF, often at additional cost and with uncertain evidence of benefit. In a commercialized fertility sector, patients must make complex reproductive decisions while navigating variable clinical information, online advice and peer-to-peer narratives. This study examined Reddit as a digital health environment shaping access to information and decision-making about IVF add-ons. Posts and comments from the r/IVF subreddit were extracted from 14 October to 13 November 2024, filtered using IVF add-on keywords, and manually reviewed for eligibility. Eligible content included anecdotes, claims about benefit or lack of benefit, and/or recommendations to use or avoid an add-on. Accuracy of claims was independently assessed by two researchers against evidence-based sources, including Cochrane reviews. Of 32 420 posts and comments screened, 1498 were eligible, comprising 2011 relevant statements: anecdotes (n = 1414), claims (n = 250), and recommendations (n = 347). The most frequently mentioned add-ons were preimplantation genetic testing for aneuploidy, aspirin, antioxidants, acupuncture, and growth hormone. Anecdotes more commonly described success than failure (64% vs 36%). Most claims asserted benefit (161/250, 64%), and most benefit claims were unsupported or contradicted by robust evidence (111/161, 69%). Recommendations overwhelmingly encouraged add-on use (280/347, 81%), despite limited supporting evidence. Online forums can provide valuable peer support, but may also amplify unsubstantiated benefit claims and commercially aligned treatment norms. Accessible, independent, evidence-based digital resources are needed to strengthen reproductive autonomy and informed decision-making in women's reproductive health.

Evidence shows the positive effects of acupuncture on the modulation of cytokines. However, findings are conflicting. The present systematic review aimed to clarify the effects of acupuncture on pro- and anti-inflammatory cytokines in adults. Five databases, including Scopus, PubMed, Web of Science, Embase, and Cochrane Library, were searched without language restrictions until July 1, 2024. Clinical trials that examine the effects of manual acupuncture on at least one of the inflammatory factors (IL-6, TNF-α, or hs-CRP/CRP) in adults, regardless of background disease, were included. Of 12,197 articles, finally 29 were included. All clinical trials examined the effects of acupuncture on both genders aged 21 to 72 years. Duration of the intervention varied between 2 and 12 weeks. The effects of acupuncture on inflammatory and anti-inflammatory parameters were examined on osteoarthritis/ rheumatoid arthritis (n = 8), obesity (n = 4), allergy (n = 4), healthy subjects (n = 3), and Crohn's disease (CD) (n = 2). For several diseases, only one eligible article was found. Risk of bias assessment revealed concerns in all studies across at least three of the six main domains. Acupuncture as an adjuvant therapy is likely modulate cytokine levels in patients with diverse disease backgrounds. Although the positive effects of this type of therapy were reported in most studies, some showed no or even negative effects on cytokine levels. Overall, due to concerns about a high or unclear risk of bias, the findings must be interpreted with great caution. Further high-quality clinical trials are needed to draw definitive conclusions.

The pathological mechanisms of chronic obstructive pulmonary disease(COPD) are complex, and current intervention strategies are difficult to control the overall progression of the disease. Guided by the treatment principle of syndrome differentiation and treatment, TCM treats COPD based on the core pathogenesis of deficiency in origin and excess in superficiality, showing the unique advantages of multiple targets and holistic regulation. This paper systematically summarized the pathological mechanisms of COPD and the clinical and basic research progress of TCM treatment. Based on the comprehensive analysis of the etiology, pathogenesis, and modern pathological changes of COPD, this paper also summarized the clinical efficacy of TCM in the prevention and treatment of COPD and elaborated its action mechanism in depth. Clinical studies have shown that TCM compound formulas with the effects of tonifying the lungs and strengthening the spleen, nourishing the lungs and kidneys, clearing heat and dissolving phlegm, as well as external treatment methods such as acupuncture, acupoint application, and acupoint injection, can effectively improve the symptoms of cough, phlegm, shortness of breath, reduce the number of acute exacerbations, improve lung function and exercise tolerance, and significantly improve the quality of life of patients. At the level of basic research, a variety of active components such as flavonoids, saponins, and polysaccharides contained in TCM, as well as compound formulas play a protective role by intervening with multiple signaling pathways and targets, including nuclear factor-κB(NF-κB)/NOD-like receptor family pyrin domain-containing 3(NLRP3), transforming growth factor-β(TGF-β)/Smad, nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase-1(HO-1), and phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt), thereby exerting multi-pathway protective effects in inhibiting inflammatory responses, alleviating oxidative stress, improving airway remodeling, regulating protease-antiprotease imbalance, and modulating programmed cell death. In addition, this paper pointed out the shortcomings in the current research field, aiming to provide new theoretical bases and research ideas for the comprehensive prevention and treatment of COPD and the modernized research of TCM.

This study aimed to explore the effects and mechanisms of Supplemented Shenqi Dihuang Decoction Formula(SSDDF) in ameliorating renal aging(RA) and tubulointerstitial fibrosis(TIF) in diabetic kidney disease(DKD) by inhibiting ferroptosis, in comparison with empagliflozin(EMPA), a novel hypoglycemic agent. For the in vivo experiment, a type 2 DKD rat model with histopathological characteristics of RA and TIF was established. After successful modeling, the model rats were divided into the low-dose SSDDF(SSDDF-L) group, high-dose SSDDF(SSDDF-H) group, EMPA group and normal saline control group, and were administrated by gavage for six consecutive weeks for intervention. For the in vitro experiment, a senescent model of renal tubular epithelial cells was constructed by treating NRK-52E cells with high glucose(HG), which was then intervened with SSDDF-L containing serum, SSDDF-H containing serum, EMPA, as well as ferroptosis and iron metabolism inhibitors. In both in vivo and in vitro studies, aging phenotypes and related physiological indicators including body weight(BW) and blood glucose(BG), renal injury indicators including serum creatinine(Scr), blood urea nitrogen(BUN) and urinary N-acetyl-β-D-glucosaminidase(UNAG), aging characteristics of renal tissues and cells including senescence-associated β-galactosidase(SA-β-gal) staining and protein expression of klotho and p16, TIF pathological features and cellular fibrotic injury, senescence-associated secretory phenotype(SASP), and ferroptosis characteristics(lipid peroxidation-dependent ferroptosis detected by Ferro Orange fluorescent probe and mitochondrial transmission electron microscopy) were examined and compared. Meanwhile, an "SSDDF-component-target" network was constructed via network pharmacology, and Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses were combined to screen the core signaling pathways. Non-targeted metabolomics was adopted to analyze the characteristics of renal tissues, screen potential biomarkers and enrich related metabolic pathways.The results indicated that the effect of SSDDF in ameliorating RA and TIF in DKD rats might be associated with the regulation of ferroptosis signaling pathways. In the in vivo experiment, SSDDF ameliorated the aging phenotypes, BW, BG, UNAG levels, as well as RA and TIF in DKD model rats, with SSDDF-H exerting a superior effect to SSDDF-L; notably, SSDDF-H showed a better effect than EMPA in improving Scr and BUN levels. SSDDF also ameliorated renal lipid peroxidation-dependent ferroptosis in DKD rats, where SSDDF-H had a better effect than SSDDF-L and an equivalent effect to EMPA. In the in vitro experiment, SSDDF-H containing serum multi-targetedly improved HG-induced senescence, fibrotic injury, SASP expression, ferroptosis marker levels and mitochondrial ultrastructural damage in renal tubular epithelial cells, with its effect comparable to that of ferroptosis or iron metabolism inhibitors. In conclusion, both SSDDF and EMPA can multi-targetedly ameliorate RA and TIF in DKD model rats with similar anti-aging and anti-fibrotic effects, and their core mechanism is the inhibition of renal lipid peroxidation-dependent ferroptosis. Based on this, the clinical establishment of a combined therapy regimen of SSDDF plus EMPA featured by "coordination of traditional Chinese and Western medicine" for elderly patients with DKD is expected to exert a dual synergistic effect in anti-aging and anti-fibrosis.

Toxic and adverse reactions associated with molecularly targeted anti-tumor drugs are highly prevalent and seriously affect the patients' quality of life. Drawing upon TCM meridian-collateral theory, this paper elucidated the essentials of TCM pathogenesis of toxic and adverse reactions associated with molecularly targeted anti-tumor drugs. It postulated a core pathological theory defined as " drug pathogens invade the meridians, resulting in disharmony of Qi and blood". The toxic and adverse reactions of molecularly targeted anti-tumor drugs are not isolated or disordered local injuries but display a well-defined and intrinsically interconnected pattern. Their dynamic progression follows a sequential transmission pattern of " skin and pores-collaterals-meridians-Zang-fu organs ". Pathologically, this manifests as an evolutionary process of wind-heat accumulation in the skin, heat-toxin congestion in the collaterals, Qi stagnation and blood stasis in the meridians, and imbalance of Yin and Yang, which is highly consistent with the pathogen transmission theory described in Miraculous Pivot: Treatise on Contralateral Puncture(Lingshu: Miuci Lun). Toxic and adverse reactions of different classes of molecularly targeted anti-tumor drugs also exhibit distinct affinity for meridians and collaterals. For example, anti-angiogenic drugs primarily affect the Shaoyin meridian system and are prone to inducing hand-foot syndrome, hypertension, and hypothyroidism. Epidermal growth factor receptor tyrosine kinase inhibitors predominantly involve the Yangming and Taiyang meridian systems, commonly leading to cutaneous rash, diarrhea, and interstitial pneumonia. Human epidermal growth factor receptor-2 inhibitors preferentially affect the heart and spleen meridian systems, with cardiac toxicity and anemia being the most frequently observed manifestations. Meridian-collateral theory offers a novel perspective for understanding the TCM pathogenesis of toxic and adverse reactions associated with molecularly targeted anti-tumor drugs, providing a theoretical basis for the clinical implementation of early intervention, meridian-based syndrome differentiation, and stage-specific treatment.