TNF and arthritic joint disease: The alcohol extract of Tiekuaizi can significantly reduce the levels of hypoxia-inducible factor 1-subunit alpha (HIF-1α) and tumor necrosis factor-α (TNF-α) in the serum, as well as the expression of joint matrix metallo proteinase-3 (MMP-3) and vascular endothelial growth factor (VEGF) related to joint swelling and destruction, in the treatment of arthritis in rats (Li et al., 2017; Li and Qian, 2016; Shan et al., 2023; Zhang et al., 2024).