搜索结果：Medicinal research reviews

Medicinal plants are rich in bioactive constituents and are extensively utilized in the healthcare sector, holding significant value for both industrial and daily applications. In the context of economic development and escalating environmental challenges, there is an increasing societal demand for medicinal plants with superior quality and enhanced environmental adaptability. Molecular breeding is emerging as a pivotal strategy for the genetic improvement of medicinal plants. Given that traditional breeding methods are often constrained by low efficiency and lengthy developmental cycles, the necessity for innovative approaches is underscored. Advancements in modern molecular breeding technologies, such as marker-assisted breeding, genetic engineering, and molecular design breeding, have revolutionized the paradigm of medicinal plant breeding. This article reviews the research progress in molecular breeding of medicinal plants, encompassing its characteristics, advantages, technical classifications and applications. Based on these advancements, we discuss the major challenges and future prospects in this field. It is evident that the rapid evolution of molecular breeding holds substantial potential for facilitating plant genetic improvement and effectively addressing the growing societal demands for high-quality medicinal plants.

The rhizome is the traditional medicinal part of Paris, renowned for its definite efficacy and significant medicinal value. Studies have indicated that beyond the rhizome, non-medicinal parts of Paris also contain abundant active compounds and have traditional folk applications in certain southeast Asian countries. In recent years, with the expansion of cultivation areas, the annual yield of Paris rhizomes has kept increasing. Consequently, the yield of its non-medicinal parts, which regenerate annually, has also grown significantly. However, due to the lack of effective utilization, these parts are often discarded as waste, resulting in substantial resource wastage. This paper systematically reviews the chemical constituents and pharmacological activities of non-medicinal parts, including stems, leaves, fruit peels, seeds, and fibrous roots, of Paris plants. It analyzes their potential application value and proposes feasible resource utilization strategies, aiming to provide theoretical support and practical references for the efficient development and comprehensive utilization of Paris resources.

Affecting approximately 85% of expectant mothers during the first trimester, nausea and vomiting of pregnancy (NVP) are frequently reported symptoms. Despite numerous existing systematic reviews and meta-analyses (SRMs), findings remain inconsistent. Consequently, this study assesses the quality of these prior SRMs and investigates the efficacy of ginger as a treatment for NVP. A comprehensive search was conducted across PubMed, Scopus, Cochrane, and Web of Science from their inception through December 30, 2024. This review includes peer-reviewed English-language SRMs investigating ginger as a therapeutic intervention for pregnancy-related nausea and vomiting. Methodological rigor was evaluated using the AMSTAR-2 checklist, while evidence quality was assessed via the GRADE approach. Findings are synthesized narratively through content analysis. The study protocol was prospectively registered in the PROSPERO database. This study analyzed 18 systematic reviews, of which eight (44%) incorporated meta-analyses. The Rhodes Index of Nausea and Vomiting (RINV) emerged as the primary tool for evaluating outcomes. Regarding study reporting and transparency, seven studies registered their protocols in PROSPERO, while eight adhered to the PRISMA checklist. Overall, the included reviews demonstrated low methodological quality, with a mean score of 11.77. Specifically, 28% (n = 5) were rated as high quality, 28% (n = 5) as moderate, 22% (n = 4) as low, and 22% (n = 4) as critically low. Taking ginger supplements (usually between 450 and 1950 mg daily) significantly decreases the severity and occurrence of nausea and vomiting compared to a placebo. This benefit is more noticeable for nausea than for vomiting, where the results are less consistent. Numerous studies have shown that ginger does not raise the risk of adverse effects, such as spontaneous abortion or side effects like heartburn and drowsiness, when compared to a placebo or vitamin B6. Current evidence clearly shows that ginger is a safe and effective treatment for nausea and vomiting during pregnancy, with effectiveness similar to vitamin B6 and some traditional medications, and it has a good safety profile. Ginger can be recommended as a dependable medicinal herb for women dealing with NVP, though more research is needed to determine the best doses and confirm long-term safety.

The three Caribbean medicinal plants Momordica charantia (cerasee/bitter melon), Annona muricata (soursop/graviola), and Petiveria alliacea (Guinea hen weed/anamu) have been traditionally used to treat inflammatory, metabolic, and neurological disorders. Although research in plant phytochemistry has increased, the evidence base in preclinical settings regarding neuroprotective and immunomodulating effects remains underexplored. This systematic review aimed to synthesize published preclinical evidence on the neuroprotective, immunomodulatory, and anti-inflammatory mechanisms of M. charantia, A. muricata, and P. alliacea and to assess their translational and public health relevance within Caribbean and resource-limited contexts. An exhaustive literature search was performed in PubMed, Scopus, Web of Science, and Cochrane Library through specific Boolean search strategies. Relevant articles were selected based on predefined inclusion criteria by one independent reviewer. Articles that met the inclusion criteria were defined as those consisting of original experimental studies (in vitro, in vivo, or both) involving mechanistic immunomodulatory, anti-inflammatory, and neuroprotective mechanisms. Systematic reviews and articles not containing any mechanistic information were ruled out. The methodological quality of the included papers was evaluated using the MMAT (McGill University, Montreal, Canada) and the JBI critical appraisal tool (JBI, Adelaide, Australia). Since the included studies were diverse, results were described descriptively. Out of a total of 1,182 sources, 13 articles were found to fulfill the criteria: nine on M. charantia, two on A. muricata, and two on P. alliacea. All three medicinal plants demonstrated similar anti-inflammatory effects: downregulation of pro-inflammatory cytokines, inhibition of ROS production, and regulation of key signaling cascades, including PI3K/AKT/NF-κB, MAPK, Nrf2/HO-1, and SIRT1/β-catenin. Neuroprotection included inhibition of neuronal apoptosis, promotion of neural stem cell differentiation, and increased permeability of the blood-brain barrier. Additionally, microbiome alteration and miRNA modulation were recognized as promising mechanisms. Dose-dependent cytotoxic effects were reported for certain compounds, while significant methodology heterogeneity hampered comparability between studies. The reviewed literature supports significant neuroprotective and immunomodulatory effects of these Caribbean medicinal herbs in preclinical settings. Nevertheless, translational research is needed to develop recommendations for the clinical use of these herbs, including pharmacological research and clinical trials.

Hirudo (HO) is the medicinal name for the dried whole body of leeches, including species such as Whitmania pigra Whitman, Hirudo nipponica Whitman, and Whitmania acranulata Whitman, all of which belong to the family Hirudidae. It is characterized by a salty, bitter taste and a neutral nature with mild toxicity. HO is traditionally used to activate blood circulation, regulate menstruation, and eliminate blood stasis, making it effective in treating conditions like blood stagnation with menstrual irregularities, abdominal masses, stroke sequelae, and traumatic injuries. This review aims to provide a comprehensive overview of HO from the perspectives of its zoological characteristics, traditional applications, processing methods, chemical composition, pharmacological activities, quality control, and toxicity. The goal is to offer a reference for the rational use of HO and to lay the foundation for related clinical research. This review searched the literature on HO in databases including ResearchGate, Web of Science, Baidu Scholar, Google Scholar, CNKI, and other databases using the keywords HO, zoology, compounds, pharmacology, and quality control. More than 140 chemical constituents have been identified in HO., including 65 types of peptides (1-65), 8 types of pteridines (66-73), 34 types of lipids (74-107), 17 types of amino acids (108-124), and 18 other chemical compounds (125-142). Among these, peptides are the main active ingredients of HO, exhibiting pharmacological effects such as anticoagulation, antithrombosis, anti-atherosclerosis, anti-tumor, anti-inflammatory, and anti-fibrotic activities. Notably, HO has shown significant efficacy in anticoagulation and antithrombosis. It can treat cardiovascular diseases through mechanisms such as inhibiting blood coagulation, preventing platelet aggregation, and promoting fibrinolysis. While HO demonstrates remarkable pharmacological activities, its distinct fishy odor may affect patient compliance, requiring further processing to eliminate this unpleasant scent. This review also systematically outlines the quality control standards, toxicity, and clinical applications of HO. This review systematically summarizes the zoological characteristics, traditional uses, processing methods, chemical composition, pharmacological activity, quality control, and toxicity of HO. Current research indicates that peptides are the primary bioactive components responsible for HO's anticoagulant, antithrombotic, anti-inflammatory, and anti-fibrotic activities, particularly in the treatment of cardiovascular diseases. This review also emphasizes the importance of establishing a robust quality control system and further elucidating the pharmacological mechanisms of HO to support its safe and rational clinical application.

The richness of flora and traditional medical knowledge in the West African country Benin translate into the integral role of medicinal plants in local healthcare. This study explored the current status of traditional medicine research in Benin by evaluating data from ethnopharmacological and ethnobotanical surveys carried out between 2014 and 2023 and identifying knowledge gaps within the sustainable use of plant-based remedies. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol was used to guide the execution of the review. A total of 129 studies identified in scientific databases were analysed. The top 20 cited plant species were subjected to a comprehensive literature review to evaluate the experimental evidence to support the reported traditional uses. A total of 765 plant species belonging to 141 botanical families were cited in the included studies to treat various animal and human diseases, including infectious diseases, digestive disorders and metabolic diseases. Severe gaps in the documentation of plant collection practices, preparation stability, and preservation techniques were observed. Khaya senegalensis A.Juss. (41 citing studies), Parkia biglobosa (Jacq.) R.Br. ex G. Don (37 citing studies) and Ocimum gratissimum L. (33 citing studies) were the most frequently cited plants. Comparison of the scientific literature on the 20 most cited plant species revealed a lack of experimental evidence, even for the most frequent traditional uses. This study illustrated the wide spectrum of plant species applied in Beninese traditional medicine and the critical lack of experimental evidence for their traditional applications and the conservation of medicinal preparations. These findings underscore the need for sustainable harvesting practices, community-based conservation measures, and evidence-based use of plant resources to preserve biodiversity and support long-term availability. This calls for a national database, quality standards, and better integration of traditional medicine into modern healthcare.

Ferrocene, which was a milestone organometallic compound discovered in 1951, remains of interest in medicinal chemistry due to its exceptional stability, redox activity, and ease of functionalization, etc. A variety of pharmacological activities were observed for the Ferrocene derivatives, and several reviews have appeared highlighting the increasing applications of Ferrocene in bio-organometallic chemistry. Novel ferrocene-conjugates of betulin, artemisinin, steroids, and alkaloids were reported, which showed enhanced biological potential. Notably, ferroquine is still in Phase IIb clinical trials, and a number of ferrocene-based anticancer agents demonstrate activity against multidrug resistance. Ferrocene, thus, is an ideal scaffold for next-generation therapeutics with unique structural and redox properties that will overcome current limitations of drug scaffolds. The methodology consists of a thorough literature survey of chemistry, structural modifications, pharmacological activities, pharmacokinetics, toxicity, and future prospects of compounds involving ferrocene. Recent developments on anticancer, antimalarial, antibacterial, and antiinflammatory applications with detailed Structure Activity Relationship (SAR) were highlighted. The results show that drug lipophilicity, cellular uptake, and redox activity are improved by the integration of ferrocene, which results in improved efficacy and resistance-overcoming ability. The main pharmaceutical results to date are the preparation of a successful antimalarial drug called ferroquine and a number of ferrocene derivatives with strong anticancer activity. Pharmacokinetic analysis shows good absorption, distribution, and metabolic stability, and the toxicity studies highlight the need for redox tuning to reduce side effects. New approaches such as prodrug design, targeting with nanoparticles, PEGylation, and targeted conjugates help overcome issues of solubility, selectivity, and safety. Ferrocene-based drug molecules are versatile and promising metallopharmaceuticals. It is hoped that ongoing interdisciplinary research and innovative delivery methods will further extend their clinical utility, especially in the treatment of multidrug resistance and their use in central nervous system and metabolic diseases. Ferrocene-based drug molecules exhibit remarkable potential in medicinal chemistry with respect to their stability, redox activity, and structural versatility. Their inclusion makes them more lipophilic, increases their uptake into cells, and improves their activity, especially in the fields of anticancer and antimalarial activity, as reflected in the discovery of Ferroquine as a milestone in the clinical field. The targeted delivery and prodrug approaches also further enhance safety and pharmacokinetic properties. In conclusion, ferrocene can be used as a good scaffold in the design of second-generation drugs that can overcome drug resistance.

The use of medicinal products derived from cannabis and its synthetic analogues has grown in recent years for various health conditions, which led to an increase in systematic reviews (SR) on the topic. The objective of this overview was to identify, synthesize, and critically appraise the evidence from SR on the benefits and harms of cannabis derivatives when used for therapeutic purposes in different health conditions. A comprehensive search was conducted to identify all relevant SR in Embase, Epistemonikos, MEDLINE, and Cochrane Database of Systematic Reviews. The inclusion criteria was SR assessing the effects of cannabis and its derivatives for any clinical condition that included only randomized controlled trials. A structured selection and extraction process was performed by two independent researchers. The methodological quality of the included SR was assessed using AMSTAR-2. This overview included 102 SR, 68.6% of which were of critically low quality and 17.6% were of high quality. There is low to moderate certainty of evidence of benefits from these interventions for ulcerative colitis, chronic non-cancer pain, Crohn's disease, multiple sclerosis, and post-chemotherapy nausea and vomiting. The results point to a lack of benefits for sleep disorders, chronic cancer pain refractory to opioids, pain related to radiotherapy, and pain in people receiving palliative care. For other conditions, the certainty of the evidence was very low or not assessed. This overview opens a broad and complex field for the development of primary studies to evaluate the effects of cannabinoids as primary or adjunctive therapy for different health conditions and reinforces the importance of safety assessment. Decision-makers and guideline developers can be guided by the results summarized in this overview. However, when making formal recommendations, it is essential to consider the quality of the SR and the certainty of the evidence identified for each outcome.

Leukemia represents a heterogeneous and refractory hematological malignancy, with current clinical therapies, including conventional chemotherapy, targeted therapy, and hematopoietic stem cell transplantation, still limited by drug resistance, off-target toxicity, and poor efficacy against high-risk subtypes. Indole/azaindole is a privileged heterocyclic scaffold in medicinal chemistry with versatile structural modification potential and inherent antileukemic bioactivity. Rational hybridization of indole/azaindole with diverse pharmacophores has become a core strategy for developing novel antileukemic agents, thereby enabling synergistic efficacy, reversal of drug resistance, and reduced toxicity. This review systematically summarizes the research progress of indole-based hybrids and closely related indole bioisosteres (azaindole hybrids) with antileukemic activity from 2021 to the present. Distinct from previous descriptive reviews, we stratified all candidate compounds by evidence hierarchy: in vitro antiproliferative activity, molecular mechanistic validation, and in vivo preclinical efficacy. This work focuses on structure-activity relationships (SARs), multi-target mechanisms, and preclinical pharmacological characteristics of indole- and azaindole-based antileukemic hybrids, aiming to provide targeted guidance for the rational design and clinical translation of novel indole- and azaindole-based antileukemic drugs.

Despite progress in enhancing secondary metabolite accumulation to support plant growth and stress tolerance, relatively few studies have established direct links between these increases and enhanced immunoregulatory outcomes in humans. Bridging this gap is essential for advancing pharmacological applications and the development of effective plant-based immune therapeutics. Unlike previous reviews that primarily focus on metabolite enhancement strategies in isolation, this review proposes an integrative translational framework linking plant metabolic reprogramming, metabolite bioavailability, and downstream human immunomodulatory relevance. This review evaluates genetic, biochemical, and ecological strategies used to enhance secondary metabolite accumulation in medicinal plants and assesses their potential to translate into immunomodulatory effects. The available evidence indicates that while elicitor- and biostimulant-based approaches consistently enhance metabolite accumulation, their translation into clinically relevant outcomes is constrained by factors such as bioavailability, metabolic stability, and dose-dependent effects. The review further highlights key limitations and knowledge gaps, emphasising the need for integrative and translational research frameworks to link plant metabolic enhancement with human immune outcomes.

Artificial intelligence (AI) is transforming synthetic chemistry from task-specific predictors into integrated platforms that unify retrosynthesis, reaction optimization, and closed-loop robotic automation. This review highlights how AI-assisted planning and robotic execution shorten cycle times, reduce step counts, and improve route sustainability in medicinal chemistry. Recent advances, including large language models (LLMs), template-free retrosynthesis, and Bayesian optimization, are evaluated alongside key limitations in dataset quality, reproducibility, and deployment costs. To ensure translational relevance, reproducible benchmarks such as step count, time-to-in vitro, and green metrics (E-factor, process mass intensity) are emphasized. This review proposes a hierarchical framework structured across three interconnected levels: cognitive planning, physical execution, and translational evaluation. Within this structure, key elements include LLM-based synthesis planning, robotic and closed-loop execution, interpretable decision-making, sustainability-by-design, advanced reaction optimization, and multi-objective retrosynthesis. Together, these components provide a conceptual basis for integrating digital intelligence with physical experimentation. By embedding green chemistry principles and regulatory awareness, AI is increasingly positioned not only as a predictive tool but also as an assistive collaborator supporting decision-making in medicinal chemistry workflows. The convergence of AI, robotics, and sustainability metrics highlights an emerging transition; however, realizing a future where every experiment reliably feeds back into autonomous learning loops requires overcoming significant current barriers in data standardization and hardware interoperability.

In recent years, cell-based medicinal products (CMPs) have emerged as novel therapeutics with specific potential to treat a wide range of diseases. These products should be produced in accordance with good manufacturing practices (GMPs) and follow specific guidelines to ensure their safety and meet standard quality control criteria. This manuscript reviews current standard methods for quality control and validation specific to CMPs intended for clinical applications. We summarize critical quality attributes, including safety assessments such as sterility, endotoxin, mycoplasma, viral testing, tumorigenicity, and genetic stability; quantitative parameters, including cell counts and dose determination; and quality characteristics encompassing cell viability, morphology, growth kinetics, and immunophenotyping. We also address purity evaluation, potency assays, and the importance of validating analytical methods to guarantee reproducible and reliable test results. Furthermore, this article discusses necessary considerations for donor screening, raw material sourcing, manufacturing environment monitoring, and stability testing to maintain product integrity throughout production and storage. Emphasis is placed on adherence to GMP and relevant regulatory guidelines as defined by international pharmacopeias and authorities, such as the Food and Drug Administration and the European Medicines Agency. Finally, we highlight challenges faced in standardizing quality control for CMPs and underscore the need for continued development of rapid and robust testing methods tailored to their unique characteristics. This comprehensive overview aims to support academic and industrial stakeholders in implementing effective quality control strategies for advanced cell-based therapies.

Polysaccharides are one of the most abundant biomacromolecules in nature and serve as the key material basis for the therapeutic effects of traditional Chinese medicinal materials. The structural characteristics of polysaccharides govern their biological activity, with monosaccharides serving as the fundamental building blocks. Compared to fine structural characteristics, they also represent one of the simplest and most readily detectable indicators of polysaccharide composition. This paper reviews methods for determining the monosaccharide composition of natural carbohydrates and the related structure-activity relationships. Among the available methods, high-performance anion-exchange chromatography coupled with pulsed amperometric detection (HPAEC-PAD) is a relatively accurate and convenient approach, which does not require derivatization and can provide information on acidic sugars. This study provides the first comprehensive comparison and summary of the structure-activity relationships regarding the monosaccharide composition and biological activity of polysaccharides derived from plants, microorganisms, algae, and animals. Analysis indicates that acidic polysaccharides exhibit higher activity than neutral polysaccharides. Among neutral polysaccharides, those rich in galactose, arabinose, and glucose typically demonstrate higher biological activity. Future efforts should focus on developing high-throughput, multimodal structural analysis techniques. Additionally, more accurate predictive models should be constructed using methods such as machine learning to advance the rational design of polysaccharide-based drugs.

Bioreactor technology for medicinal plants provides a controllable platform for the conservation of rare and endangered resources, the production of high-value-added active ingredients, and green manufacturing of traditional Chinese medicine. Focusing on in vitro culture systems of medicinal plants, this article systematically reviews the application progress of stirred-tank, airlift, bubble column, wave-mixed, spray-type, temporary immersion, and photobioreactors in the culture of suspension cells, adventitious roots, hairy roots, shoots, and somatic embryos. Different from existing studies that mainly list reactor types, this review further provides a comprehensive analysis from the perspectives of physiological characteristics of the cultured objects, mass transfer and shear environment, medium and elicitor regulation, inoculation density, culture cycle, representative cases, and industrialization limitations. The results indicate that bioreactors can shorten production cycles, improve environmental controllability, and enhance product quality consistency; however, their large-scale application remains constrained by scale-up stability, metabolic fluctuations, downstream processing costs, GMP quality control, and commercial feasibility. Future research should shift from merely pursuing increased yield to integrated process development that is scalable, verifiable, low-cost, and quality-controllable.

Natural medicines play a significant role in disease prevention and treatment due to their diverse biological activities. However, their complex chemical composition, low concentrations of active compounds, and toxicity limit their clinical application. Traditional processing and extraction methods suffer from low efficiency, resource wastage, and inadequate utilisation of active ingredients. Recently, bidirectional fermentation has gained attention for its unique advantage of 'reducing toxicity while enhancing efficacy'. By using natural medicines as a matrix and leveraging the metabolic activity of medicinal fungi, this technology improves the dissolution and biotransformation of active ingredients, generates new bioactive compounds, and simultaneously achieves the dual goals of enhanced efficacy and reduced toxicity. This paper reviews research progress on bidirectional fermentation in enhancing the utilisation of natural drug components, optimising pharmacological effects, and expanding application fields. It also explores its potential applications in biomanufacturing, functional foods, and modern health products.

The "toxicity" of Traditional Chinese Medicines (TCMs) carries a dual connotation, referring both to the potent nature of certain medicinal substances and a critical constraint on their safe clinical application. Processing is the core approach to achieving the goal of "attenuating toxicity while preserving efficacy" for toxic TCMs. A systematic elucidation of the detoxification mechanisms of processing is essential for inheriting traditional processing theories and ensuring clinical medication safety. Current research predominantly focuses on individual toxic TCMs, specific toxic constituents, or single processing methods, a fragmented paradigm that hinders a comprehensive understanding of the complex detoxification mechanisms and the extraction of universal principles. Therefore, this paper systematically reviews the toxic TCMs listed in the Chinese Pharmacopoeia (2025 Edition), summarizing their natural sources, types of toxic constituents, and traditional processing methods for toxicity reduction. Furthermore, by integrating existing research evidence, the detoxification mechanisms of processing are categorized into three interrelated yet distinct levels: physical detoxification (including the physical removal of toxic constituents and changes in the physical properties of decoction pieces), chemical transformation of toxic constituents, and modulation of in vivo processes. At the chemical transformation level, common patterns within the same family or genus are explored based on natural sources. At the physical level, the focus is on universal processing methods across different families and genera; at the in vivo level, the focus is on common regulatory pathways across families and genera. This review aims to integrate fragmented research findings, reveal potential common patterns underlying processing‑induced detoxification, and propose an integrated research strategy combining "physical detoxification - chemical transformation of toxic constituents - modulation of in vivo processes." It thereby provides a theoretical basis for a deeper understanding of the scientific principles of processing‑induced detoxification and for guiding the optimization and innovation of processing technologies.

Liparis nervosa (Thunb.) Lindl. (L. nervosa), a species belonging to the genus Liparis within the Orchidaceae family, is known as "Jian-Xueqing" or "Jian-Xueqin" in traditional Chinese medicine (TCM). This plant has a long history of medicinal use in TCM, valued for its diverse therapeutic properties for treating hemoptysis, hematemesis, cough due to lung heat, rheumatic arthralgia, infantile convulsions, and abscesses. Externally, it is applied for traumatic bleeding, boils, contusions, dermatitis, and snakebites. However, no systematic review of L. nervosa has been reported so far. This paper aims to provide a comprehensive review of the research progress on L. nervosa regarding its botany, traditional uses, phytochemistry, pharmacological activities, toxicology, and clinical applications. By bridging traditional knowledge with modern scientific evidence, this review seeks to offer new perspectives for future research of L. nervosa. This paper uses "Liparis nervosa", "Jian-Xueqing" and "Jian-Xueqin" as the keywords to conduct all the relevant information from PubMed, Web of Science, SciFinder, CNKI, China Master's Doctoral Thesis, Wanfang, Google Scholar, and ancient books. We retrieved all literature (in Chinese and English) from the establishment date of the database up to February 2026, including articles, reviews, master's thesis, doctoral thesis, and technical reports, while excluding literature unrelated to L. nervosa. In total, 150 compounds have been isolated and identified from L. nervosa, including 36 benzoic acid derivatives, 27 alkaloids and their derivatives, 24 phenanthrenes, 21 phenylpropanoids, 7 flavonoids, 7 steroids and triterpenoids, 11 fatty acid derivatives, and 17 other compounds so far. Pharmacological studies have demonstrated that extracts and compounds derived from L. nervosa exhibit a broad range of bioactivities, such as hemostatic, anti-inflammatory, antinociceptive, antitumor, antioxidant, antibacterial, hypolipidemic, and immunosuppressive effects. In safety evaluations, no adverse effects or toxic activities were observed in acute toxicity studies. This review summarizes the recent advances in the phytochemistry, pharmacology, and clinical potentials of L. nervosa, and systematically categorizes its structure-activity-mechanism relationship. As a valuable traditional herb, L. nervosa contains diverse chemical constituents and exhibits various bioactivities. Several of its traditional uses have been supported by modern pharmacological research. However, most studies have been conducted only at the cellular and animal model levels, lacking more robust evidence from clinical studies. Furthermore, systematic safety data on L. nervosa are severely lacking. Further research is needed to elucidate the pharmacological mechanisms and ensure safe clinical applications. Moreover, as a valuable and endangered species, future investigations should focus on the cultivation techniques, product development, and sustainable utilization.

Decentralized clinical trials (DCTs) represent an emerging model in clinical research, accelerated by the restrictions imposed during the COVID-19 pandemic. By leveraging digital technologies and local health care resources, DCTs aim to increase accessibility and reduce participant burden compared to traditional site-based models, which often face recruitment failures and high attrition rates. While various regulatory initiatives in Europe, such as the Accelerating Clinical Trials in the European Union program and the European Medicines Regulatory Network recommendation paper (updated in October 2025), have sought to facilitate their implementation, the widespread adoption of DCTs remains limited due to significant operational, regulatory, and technological challenges, including platform fragmentation and gaps in digital literacy. This study aimed to identify and prioritize actionable solutions to the main challenges of DCT implementation in Europe from a multistakeholder perspective, gathering insights to address specific ethical, legal, and operational barriers. Building on a preceding strengths, weaknesses, opportunities, and threats analysis, a 2-round Delphi study was conducted, involving 26 experts in clinical trials, ethics, law, regulation, and patient engagement between March and May 2023. In the first round, 309 open-ended responses were collected via REDCap (Research Electronic Data Capture; Vanderbilt University) surveys and underwent systematic inductive content analysis using ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) with independent double coding. This process resulted in 244 unique proposals that were categorized according to 6 key challenges. In the second round, 39 synthesized proposals were evaluated using a 4-point Likert scale. Consensus was defined as ≥80% agreement on the appropriateness of each proposal. High levels of consensus were achieved, with 32 out of the 39 proposals reaching the threshold and 14 achieving 100% unanimity. Overall, 82% of the proposals were rated as "appropriate" or "very appropriate." Key recommendations included providing support and training for health care professionals, enhancing investigational medicinal product and biological sample logistics through validated technologies, improving collaboration with local health care providers, fostering regulatory harmonization while respecting national specificities, strengthening capacity-building initiatives, and promoting accessible, user-friendly digital tools supported by hybrid trial models. Conversely, proposals such as peer-to-peer participant support and the centralization of ethics reviews at the European Union level failed to reach consensus. The study offers a prioritized compilation of expert-driven recommendations for overcoming current barriers to DCT implementation in Europe. The adoption of these recommendations could support the development of more inclusive, efficient, and sustainable decentralized research frameworks across diverse health care systems.

Sanguisorba officinalis L. (S. officinalis) is a traditional Chinese medicine used to cool blood and stop bleeding, and its polysaccharides are among the important active components responsible for its efficacy. The anti-inflammatory, wound-healing, hemostatic, and immune-regulatory activities of S. officinalis polysaccharides align precisely with its traditional efficacy in cooling blood, promoting hemostasis, detoxifying, and astringing sores, providing modern scientific support for its medicinal value. This paper comprehensively reviews the extraction, structural characteristics, pharmacological activities, structure-activity relationships, future application potential, and challenges of S. officinalis polysaccharides. Key terms including "Sanguisorba officinalis L.", "S. officinalis" and "Sanguisorba officinalis L. polysaccharide" were systematically searched in databases such as PubMed, Web of Science, and Google Scholar (2000-2026) to ensure the comprehensiveness and accuracy of the retrieved literature. S. officinalis polysaccharides are mainly composed of glucose, galacturonic acid, arabinose, and galactose. The glycosidic bond types include →4)-α-Glcp, →4)-GalAp, and highly branched arabinogalactan. Some polysaccharide components have a triple helix conformation, which provides a basis for their pharmacological activities. This paper systematically reviews the research progress of S. officinalis polysaccharides, summarizing the qualitative correlations between structural characteristics and pharmacological activities. Existing studies are predominantly in vitro, and the structure-activity relationships lack quantitative analysis, while in vivo efficacy and safety data remain insufficient. On this basis, future research should focus on quantitative structure-activity relationships studies, as well as pharmacokinetic and safety evaluations, to facilitate the development and utilization of S. officinalis polysaccharides.