Health behaviors, physical activity, and subjective well-being: rural-urban inequities among double first-class university graduate students in China.

Behçet’s disease (BD) is a variable vessel vasculitis and chronic inflammatory disease with prominent vascular involvement. Featuring highly heterogeneous multi-organ lesions, it affects mucocutaneous tissues, eyes, gastrointestinal tract, arthrosis, vascular tissues, cardiovascular, nervous, and hematological systems. The disease is classically characterized by oral ulcers, genital ulcers and uveitis. Recurrent painful oral and genital ulcers constitute the most prevalent symptomatic manifestations of BD, which markedly undermine patients’ physical comfort, mental health and overall quality of life (, ). For BD management, colchicine remains a first-line agent widely recommended by international guidelines for mucocutaneous manifestations owing to its well-documented anti-inflammatory and anti-neutrophilic activities (). Colchicine is a tropolone alkaloid originally extracted from L. (, family Colchicaceae, genus ) nearly two centuries ago (, ). It is particularly effective for cutaneous manifestations such as erythema nodosum and genital ulcers and serves as the standard first-line therapy for most BD patients with isolated mucocutaneous involvement (, ). In contrast, a large body of clinical practice in China has developed a distinctive treatment strategy that complements mainstream guideline recommendations: the combined administration of total glucosides of paeony (TGP) and colchicine for BD (). According to abundant ancient Chinese medical literatures, the raw root of Pall. (, family Paeoniaceae, genus ). can be made into Radix Paeoniae Alba and Radix Paeoniae Rubra after different Traditional Chinese Medicine (TCM) processing procedures, which possess different clinical indications. Historically, multiple ancient prescriptions centering on Radix Paeoniae Rubra have been widely applied to treat Behçet’s disease. On the basis of this traditional medicinal experience, total glucosides of paeony (TGP), the major bioactive component of Pall., has been successfully extracted and developed into a modern medicinal preparation by contemporary technological means (). Notably, this combined regimen, colloquially known as the “Two Flowers Therapy”(Shuang-hua Therapy) among Chinese clinicians—a name derived from the fact that both active pharmaceutical ingredients are extracted from flowering plants: colchicine from and TGP from — was first trialed in combination by clinicians in the 1990s and has been consistently and widely utilized in routine clinical settings across China for more than three decades, primarily through inter-physician knowledge sharing and clinical experience accumulation, which has been mostly passed down orally via mentorship among physicians rather than being documented in published papers (, –). , a perennial herbaceous plant native to Eastern Asia including China, Korea, and Japan, has been employed in TCM for nearly two thousand years, as first recorded in the Shennong Ben Cao Jing (Divine Farmer’s Materia Medica), the earliest extant comprehensive treatise on TCM compiled during the Eastern Han dynasty (25–220 CE) (–). In TCM theory, root has a bitter and slightly sour taste, a neutral nature, and enters the Liver and Spleen meridians. It is traditionally used to nourish blood, regulate menstruation, astringe yin, and alleviate pain, with well-documented effects in promoting blood circulation and dispersing blood stasis (–). Phytochemically, PRA contains a rich array of bioactive compounds, including monoterpenoids, monoterpene glycosides, tannins, paeonols, flavonoids, and polysaccharides (). In particular, monoterpene glycosides, which account for approximately 80-90% of the total bioactive components, are the major characteristic and pharmacologically active compounds of PRA (–). TGP is a standardized modern TCM extract product manufactured from the aqueous-ethanol extract of PRA (, ). It is officially approved by the National Medical Products Administration of China (Approval Number H20055058) and mainly composed of four major bioactive monoterpene glycosides: oxypaeoniflorin, albiflorin, benzoyl paeoniflorin and paeoniflorin (). Rooted in TCM theory, TGP possesses the classical effects of clearing heat, cooling blood, and resolving blood stasis, which precisely targets the core heat-toxin and stasis pathogenesis underlying recurrent inflammatory and mucosal lesions in BD (, ). Accumulated clinical evidence has proven its value in treating various inflammatory disorders, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and liver diseases (, ). Extensive preclinical and clinical studies have demonstrated that TGP exerts multifaceted pharmacological effects, including potent anti-inflammatory (, ), antioxidative () and immunoregulatory activities (). Specifically, TGP has been shown to inhibit pro-inflammatory cytokine production, regulate T-cell subsets, suppress neutrophil activation, and modulate NF-κB and MAPK signaling pathways (–). Owing to these prope