Objective:Sarcomas are a group of rare malignancies with various subtypes.Patients with metastatic sarcoma who have failed traditional treatments can possibly achieve better prognoses from using novel therapies,includ...Objective:Sarcomas are a group of rare malignancies with various subtypes.Patients with metastatic sarcoma who have failed traditional treatments can possibly achieve better prognoses from using novel therapies,including anti-programmed death-1(PD-1)-based therapies.Methods:We retrospectively analyzed clinical data of 24 metastatic sarcoma patients from June 15,2016 to December 30,2019.These patients mainly received angiogenesis inhibitors combined with anti-PD-1 therapy after they became resistant to traditional treatments.Furthermore,8 patients underwent panel DNA and whole transcript sequencing.Results:Six patients received 2 cycles of anti-PD-1 therapy and were included in the safety evaluation only group.The median follow-up time was 5.77 months.The median progression-free survival was 7.59 months,the overall response rate was 16.7%and the disease control rate was 55.6%.Based on whole exome and transcript sequencing data,there was no association between TMB,TNB,MSI,HLA-LOH,and PD-L1 expressions and sarcoma types with clinical responses.Immunotherapy efficacy and bioinformatics analyses indicated higher intratumoral heterogeneity(ITH)in progressive disease(PD)patients and lower ITH in partial response(PR)and stable disease patients.A higher percentage of immune cell infiltration,especially monocytes,was observed in PR patients.Active stromal gene expression was increased in PD patients but decreased in PR patients.Enrichment analysis revealed that an increased TGF-βsignaling pathway was reversely correlated with anti-PD-1 efficacy,while a decreased inflammatory response signaling pathway was positively correlated with anti-PD-1 efficacy.Conclusions:Our study showed PD-1 inhibitors combined with anti-angiogenesis agents were effective and well-tolerated.ITH,monocyte ratio,stroma subtypes,and the status of immune-associated signaling pathways may be related with anti-PD-1 based therapy.展开更多
[Objective]The paper was to screen the effective agents for effectively controlling the occurrence and prevalence of taro soft rot.[Method]The fungicidal effects of 11 fungicides on taro soft rot were determined by in...[Objective]The paper was to screen the effective agents for effectively controlling the occurrence and prevalence of taro soft rot.[Method]The fungicidal effects of 11 fungicides on taro soft rot were determined by inhibition zone method.[Result]0.3%Tetramycin,25%bromothalonil,3%Zhongshengmycin and 30%zinc thiazole had better antifungal effect on Pectobacterium aroidearum at recommended concentration.The indoor toxicity of four fungicides showed that the EC50 of 0.3%tetramycin AS was the smallest of 0.6μg/mL,indicating that tetramycin had the largest toxicity and the best inhibitory effect against P.aroidearum;followed by 25%bromothalonil EC and 3%Zhongshengmycin WP,with the EC_(50) of 2.57 and 97.72μg/mL,respectively;the inhibitory effect of 30%zinc thiazole SC against P.aroidearum was the poorest.[Conclusion]The study provides a reference for screening out new and efficient chemical agents against taro soft rot.展开更多
The discovery and characterization of molecular targets from traditional Chinese medicine(TCM)represents a paradigm shift in contemporary drug development.This approach systematically bridges empirical TCM knowledge w...The discovery and characterization of molecular targets from traditional Chinese medicine(TCM)represents a paradigm shift in contemporary drug development.This approach systematically bridges empirical TCM knowledge with modern pharmacological principles,establishing a robust framework for rational drug design.Through integrative systems-chemical biology approaches,we can now mechanistically elucidate the therapeutic basis of TCM's bioactive properties,facilitating the accelerated identification of both novel molecular targets and conserved pharmacological pathways.This multidisciplinary strategy significantly enhances drug development efficiency while advancing therapeutic innovation to address critical unmet medical needs.With the rapid advancement of next-generation target deconvolution technologies and AI-driven computational platforms,TCM is poised to make increasingly substantial contributions to modern pharmacotherapy.展开更多
To enhance the anti-resistance efficacy of our previously disclosed naphthyl-triazine 5,structure-based drug design strategy was rationally conducted to design a series of novel biphenyl-piperidine-triazinecontaining ...To enhance the anti-resistance efficacy of our previously disclosed naphthyl-triazine 5,structure-based drug design strategy was rationally conducted to design a series of novel biphenyl-piperidine-triazinecontaining non-nucleoside reverse transcriptase inhibitors.Remarkably,several of these compounds demonstrated single-digit nanomolar antiviral potency against both wild-type(WT)human immunodeficiency virus-1(HIV-1)and five clinically relevant mutant strains.Among these,compound 11s emerged as the most potent inhibitor,showing remarkable efficacy against WT HIV-1(50%effective concentration(EC_(50))=2 nmol/L)and five mutant strains(EC_(50)=0.003-0.073μmol/L),which was significantly superior to that of compound 5.This optimized derivative demonstrated substantially improved pharmacological properties compared to existing drugs etravirine(ETR)and rilpivirine(RPV),showing a 4-fold reduction in cytotoxicity alongside 6-fold enhancement in selectivity index(50%cytotoxic concentration(CC_(50))=19.69μmol/L,selectivity index(SI)=7438).The compound's metabolic profile revealed exceptional stability,with an elimination half-life(t_(1/2)=41.4 min)more than double that of RPV(t_(1/2)=16.03min).Comprehensive safety evaluation indicated minimal cytochrome P450(CYP)enzymes interference,low cardiac ion channel activity,and no observable acute toxicity,collectively suggesting a reduced risk profile for therapeutic applications.These promising characteristics significantly advance the development potential of biphenyl-piperidine-triazine derivatives as next-generation non-nucleoside reverse transcriptase inhibitors(NNRTIs),offering enhanced efficacy,improved safety,and favorable pharmacokinetic properties for antiretroviral therapy.展开更多
Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hosp...Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.展开更多
Objective:To retrospectively evaluate the diagnostic efficacy of traditional MRI and T2 Mapping quantitative imaging technology for knee joint cartilage injury,clarify the differences in diagnostic value of the two im...Objective:To retrospectively evaluate the diagnostic efficacy of traditional MRI and T2 Mapping quantitative imaging technology for knee joint cartilage injury,clarify the differences in diagnostic value of the two imaging methods in different injury grades and different cartilage subregions,and provide evidence-based basis for the accurate diagnosis of clinical cartilage injury.Methods:Clinical and imaging data of 286 patients with knee joint lesions admitted to the Affiliated Hospital of Xiangtan Medicine and Health Vocational College from January 2020 to June 2023 were collected retrospectively.All patients underwent both traditional MRI sequences and T2 Mapping sequences.The knee joint cartilage was divided into 14 subregions.Two senior radiologists independently diagnosed the images of the two imaging technologies using a blind method and recorded the cartilage injury grades.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and area under the receiver operating characteristic curve(AUC)of the two technologies for diagnosing cartilage injury were calculated and compared,and the differences in their diagnostic efficacy in different injury grades and different subregions were analyzed.Results:A total of 4004 cartilage subregions from 286 patients were included in the analysis,including 1836 injured subregions and 2168 normal subregions.The overall sensitivity(89.7%),accuracy(91.2%),and AUC(0.946)of T2 Mapping quantitative imaging for diagnosing cartilage injury were significantly higher than those of traditional MRI(76.3%,82.5%,and 0.852 respectively),with statistically significant differences(p<0.001);there was no significant difference in specificity between the two(93.5%vs 90.8%,p=0.062).Subgroup analysis showed that T2 Mapping had the most significant diagnostic advantage in early cartilage injury(Grade 1),with sensitivity(78.5%)33.2%higher than that of traditional MRI(45.3%)(p<0.001).Conclusion:The diagnostic efficacy of T2 Mapping quantitative imaging for knee joint cartilage injury is significantly superior to that of traditional MRI,especially in the detection of early cartilage injury and accurate evaluation of weight-bearing area injury.Data verify its clinical applicability and reliability.It can be used as an important supplementary method to traditional MRI,and is recommended for the early diagnosis,grading evaluation,and clinical follow-up of cartilage injury.展开更多
Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urolo...Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urology,First Affiliated Hospital of Jinan University,were selected and treated with electrophysiological therapy.They were randomly divided into three groups:the fixed-parameter AA7 treatment group,the P2+P4 treatment group,and the precision treatment group(individualized parameter treatment).Pain scores of patients in each group were compared before and after treatment,with a pain score of 0 indicating cure.The cure rate of each group was observed.Results:The average ages of the AA7 group,P2+P4 group,and precision treatment group were 34±14.17 years,35.58±12.57 years,and 35.5±11.27 years,respectively.There was no significant difference in age among the three groups(p>0.05).Before treatment,the pain scores of the AA7 group,P2+P4 group,and precision treatment group were 4.14±1.74,4.64±1.72,and 3.50±1.89,respectively,with no significant differences among the groups(p>0.05).After treatment,the pain scores were 0.71±0.99 for the AA7 group(cure rate:57%),0.49±0.79 for the P2+P4 group(cure rate:67%),and 0.50±0.77 for the precision treatment group(cure rate:64%),with no significant differences among the groups(p>0.05).The cure rates for different pain locations were as follows:83%for lower abdominal pain,74%for perineal pain,62%for dysuria,49%for testicular pain,and 75%for inguinal pain.Conclusion:The pathogenesis of CPPS is complex and diverse,with numerous treatment options and uncertain efficacy,posing significant challenges to clinical practice.This study showed that electrophysiological therapy under different parameter modes significantly reduced pain scores before and after treatment,indicating significant therapeutic effects on CPPS.All three modes demonstrated good cure rates.Individualized precision treatment and fixed-mode P2+P4 or AA7 treatment were safe and effective in CPPS treatment and are worth promoting.Fixed-mode P2+P4 and AA7,due to their easier standardization of parameters and patch modes,reduced the learning curve and had better potential for widespread application.展开更多
Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal ...Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.展开更多
Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional ...Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.展开更多
Objective:This study aims to systematically evaluate the clinical efficacy and safety of diuretic therapy in patients with liver cirrhosis ascites.Method:60 patients with liver cirrhosis ascites diagnosed from January...Objective:This study aims to systematically evaluate the clinical efficacy and safety of diuretic therapy in patients with liver cirrhosis ascites.Method:60 patients with liver cirrhosis ascites diagnosed from January 2024 to May 2025 were prospectively included and randomly divided into a furosemide monotherapy group(20 cases),a spironolactone monotherapy group(20 cases),and a combination therapy group(20 cases).The intervention period is 28 days,and the main observation indicators include 24-hour urine output,changes in abdominal circumference,weight loss,serum electrolyte levels,renal function indicators,and incidence of adverse reactions.All study subjects received standardized dietary management and sodium restriction intervention(daily sodium intake<5 g).Result:The total effective rate(significant+effective)of the combination therapy group in reducing ascites was 95%(19/20),significantly higher than the 75%(15/20)of the furosemide group and the 70%(14/20)of the spironolactone group(p<0.01).On the 28th day of treatment,the mean urine output in the combination group was 2450±210 mL/d,which was higher than that in the monotherapy group(1850±195 mL/d in the furosemide group);Spironolactone group 1560±180 mL/d.The blood sodium levels of the three groups were maintained at 135-140 mmol/L,but the incidence of hypokalemia in the combination group(10%)was significantly lower than that in the furosemide group(35%).Conclusion:The combination of furosemide and spironolactone has a synergistic effect in the treatment of ascites in cirrhosis,with a 39.2%increase in diuretic effect and a reduction in the risk of electrolyte imbalance;Individualized dose adjustment combined with strict sodium restriction is the core strategy to ensure treatment safety.展开更多
Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medic...Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.展开更多
BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,...BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,their role as neoadjuvant therapy remains understudied.This study investigates sintilimab combined with nabpaclitaxel/S-1 as preoperative treatment for locally advanced gastric cancer(LAGC),addressing an unmet need for effective neoadjuvant strategies.AIM To explore the efficacy and safety of combination treatment with sintilimab and nab-paclitaxel plus S-1 as neoadjuvant therapy for LAGC.METHODS Clinical data from 82 patients diagnosed with LAGC,who underwent preoperative treatment and surgery between April 2020 and December 2022,were included.Patients were divided into 2 groups according to treatment regimen:ICI(sintilimab+nab-paclitaxel+S-1);and non-ICI(nab-paclitaxel+S-1).Imaging and pathological efficacy,intra-and postoperative conditions,molecular subtypes,short-term survival outcomes,and safety were compared between the 2 groups.RESULTS Imaging evaluation of therapeutic efficacy revealed that the inclusion of ICI yielded a significantly higher complete response rate(13.2%vs 0.0%;P=0.048),and objective response rate(69.8%vs 31.0%,P=0.001)compared with non-ICI treatment.Pathological evaluation revealed that the ICI group exhibited a significantly higher pathological complete response rate(13.2%vs 0.0%;P=0.048)and major pathological response rate(35.8%vs 13.8%;P=0.041)than those in the non-ICI group.The two-year disease-free survival rate in the ICI group was greater than that in the non-ICI group(83.0%vs 55.2%;P=0.043).The use of ICI did not increase the incidence of adverse reactions(47.2%vs 41.4%;P=0.614)or perioperative adverse events(18.9%vs 13.8%;P=0.761).CONCLUSION The combination of sintilimab with nab-paclitaxel+S-1 for neoadjuvant treatment of LAGC improved efficacy in patients without increasing adverse drug reactions and perioperative adverse events,suggesting that this treatment regimen is safe and feasible.展开更多
Network pharmacology has gained widespread application in drug discovery,particularly in traditional Chinese medicine(TCM)research,which is characterized by its“multi-component,multi-target,and multi-pathway”nature....Network pharmacology has gained widespread application in drug discovery,particularly in traditional Chinese medicine(TCM)research,which is characterized by its“multi-component,multi-target,and multi-pathway”nature.Through the integration of network biology,TCM network pharmacology enables systematic evaluation of therapeutic efficacy and detailed elucidation of action mechanisms,establishing a novel research paradigm for TCM modernization.The rapid advancement of machine learning,particularly revolutionary deep learning methods,has substantially enhanced artificial intelligence(AI)technology,offering significant potential to advance TCM network pharmacology research.This paper describes the methodology of TCM network pharmacology,encompassing ingredient identification,network construction,network analysis,and experimental validation.Furthermore,it summarizes key strategies for constructing various networks and analyzing constructed networks using AI methods.Finally,it addresses challenges and future directions regarding cell-cell communication(CCC)-based network construction,analysis,and validation,providing valuable insights for TCM network pharmacology.展开更多
Objective The analgesic effect of acupuncture has been widely accepted.Nevertheless,the mechanism behind its analgesic effect remains elusive,thus impeding the progress of research geared toward enhancing the analgesi...Objective The analgesic effect of acupuncture has been widely accepted.Nevertheless,the mechanism behind its analgesic effect remains elusive,thus impeding the progress of research geared toward enhancing the analgesic effect of acupuncture.This paper investigated the role of acupuncture needle surface textures on acupuncture’s analgesic effect by creating four experimental acupuncture needles with different patterns of surface augmentation.Methods Four types of acupuncture needles with different surface textures(the lined needle,circle needle,sandpaper needle,and threaded needle)were designed.Additionally,the force/torque measurement system used a robot arm and mechanical sensor to measure the force on the needle during insertion and manipulation.To perform acupuncture analgesia experiments,four experimental acupuncture needles and a normal needle were inserted into the Zusanli(ST36)acupoint of rats with inflammatory pain.By comparing the force and torque and the analgesic efficacy of the different acupuncture needles,these experiments tested the role of acupuncture needle body texture on acupuncture analgesia.Results The analgesic effects of different acupuncture needle body textures varied.Specifically,the force required to penetrate the skin with the lined needle was not greater than that for the normal needle;however,the needle with inscribed circles and the sandpaper-roughened needle both required greater force for insertion.Additionally,the torque of the lined needle reached 2×10^(-4)N·m under twisting manipulation,which was four times greater the torque of a normal needle(5×10^(-5)N·m).Furthermore,the lined needle improved pain threshold and mast cell degranulation rate compared to the normal needle.Conclusion Optimizing the texture of acupuncture needles can enhance acupuncture analgesia.The texture of our experimental acupuncture needles had a significant impact on the force needed to penetrate the skin and the torque needed to manipulate the needle;it was also linked to variable analgesic effects.This study provides a theoretical basis for enhancing the analgesic efficacy of acupuncture through the modification of needles and promoting the development of acupuncture therapy.展开更多
Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-bli...Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-blind,placebo-controlled trial was conducted at the Third Central Hospital of Tianjin,China from March to December 2023.A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days.Efficacy was assessed through measures such as the total melasma area,reduced melasma area,reduction rate of melasma area,melasma color score,Melasma Area and Severity Index(MASI)score,and traditional Chinese medicine(TCM)symptom score scale.Safety assessments included routine blood and biochemical tests.Results:Participants in both groups were aged 52-63 years,with no significant differences.After the 2-month intervention,the total melasma area decreased in both groups;however,a greater reduction was observed in the test group[462.50 mm^(2)(12.81%)vs.100.00 mm2(3.11%),P<.001].Moreover,LDBG treatment significantly reduced the MASI and melasma color scores in the test group(P<.05).The total TCM symptom evaluation score significantly decreased(test group:6.00 vs.placebo group:7.00,P=.001),with significant relief in symptoms such as improvement in dark lips,nails,and waist soreness in the test group,compared with that in the placebo group(P<.05).Within-group comparisons revealed that TCM syndrome was significantly alleviated in the test group(P<.05).Conclusion:LDBG intervention shows promising effectiveness in reducing female melasma and alleviating TCM syndromes.展开更多
Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affec...Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.展开更多
Objective To observe the efficacy of Shugan Tiaoshen(liver-soothing and mind-regulating)needling method in the treatment of patients with postherpetic neuralgia(PHN).Methods A total of 66 patients with PHN were random...Objective To observe the efficacy of Shugan Tiaoshen(liver-soothing and mind-regulating)needling method in the treatment of patients with postherpetic neuralgia(PHN).Methods A total of 66 patients with PHN were randomly divided into acupuncture group and control group,33 cases in each one,by the random number table method.The acupuncture group received Shugan Tiaoshen needling method plus gabapentin,whereas the control group received the oral administration of gabapentin and sham acupuncture.Numerical Rating Scale(NRS),State-Trait Anxiety Inventory(STAI)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate the pain condition,anxiety symptom and sleep quality.The effective rate and adverse events were also evaluated and recorded during the treatment.Results After eight weeks of treatment,the NRS scores of the two groups were significantly lower than those before treatment(P<0.05)at all time points,with statistically significant difference between the groups(P<0.05).The scores of STAI and PSQI of the acupuncture group were significantly lower than the scores before treatment(P<0.05).The scores of STAI for anxiety symptom and PSQI of the acupuncture group were significantly lower than the control group(P<0.05),and the effective rate of the acupuncture group was significantly higher than that of the control group(P<0.05).The incidence of adverse reactions in the acupuncture group was significantly lower than that in the control group(P<0.05).Conclusion Shugan Tiaoshen needling method showed satisfactory efficacy in treating PHN,and could alleviate the pain,relieve the anxiety symptoms,promote sleep,and reduce the adverse reactions of gabapentin in patients with PHN.展开更多
Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy live...Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy liver tissues.This review meticulously synthesizes current evidence regarding the clinical efficacy,underlying therapeutic mechanisms,patient selection criteria,and comparative advantages of Y-90 therapy.Clinical studies consistently demonstrate significant improvements in overall survival and progression-free survival,coupled with robust tumor response rates and manageable adverse events.The therapy’s efficacy is substantially enhanced by advanced dosimetric techniques,enabling precise radiation delivery tailored to individual tumor profiles.Comparative analyses reveal that Y-90 therapy provides superior local tumor control and a preferable safety profile compared to conventional treatments such as transarterial chemoembolization and external beam radiation therapy.Additionally,its clinical outcomes are comparable to those achieved with contemporary systemic therapies.Ongoing research into combination treatments incorporating Y-90 with systemic therapies,including targeted agents and immune checkpoint inhibitors,suggests promising advancements in comprehensive HCC management.Future directions highlight the necessity for continued refinement of dosimetry and patient stratification approaches,aiming to further optimize therapeutic outcomes.展开更多
In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explai...In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explains the core principles and clinical applications of TCM in treating these conditions,furthering the discourse through an examination of integrated TCM strategies,as demonstrated in the study by Zhou et al.While TCM has shown promising clinical outcomes,it encounters significant hurdles in standardization,mechanistic research,and clinical validation.Future investigations should aim to solidify the scientific underpinnings of TCM and expand its use in gastrointestinal disease management,striving for a seamless fusion of traditional and contemporary medical practices.展开更多
BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the cli...BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the clinical symptoms of achalasia associated with increased LES pressure.AIM To identify the safety and efficacy of POEM for patients with normal LES integrated relaxation pressure(LES-IRP).METHODS The clinical data of patients who underwent POEM successfully in The First Medical Center of Chinese PLA General Hospital were retrospectively analyzed.A total of 481 patients who underwent preoperative high-resolution manometry(HRM)at our hospital were ultimately included in this research.According to the HRM results,the patients were divided into two groups:71 patients were included in the normal LES-IRP group(LES-IRP<15 mmHg)and 410 patients were included in the increased LES-IRP group(LES-IRP≥15 mmHg).Clinical characteristics,procedure-related parameters,adverse events,and outcomes were compared between the two groups to evaluate the safety and efficacy of POEM for patients with normal LES-IRP.RESULTS Among the 481 patients included in our study,209 were males and 272 were females,with a mean age of 44.2 years.All patients underwent POEM without severe adverse events.The median pre-treatment Eckardt scores of the normal LES-IRP and increased LES-IRP groups were 7.0 and 7.0(P=0.132),respectively,decreasing to 1.0 and 1.0 post-treatment(P=0.572).The clinical success rate of the normal LES-IRP group was 87.3%(62/71),and that of the increased LES-IRP group was 91.2%(374/410)(P=0.298).Reflux symptoms were measured by the GerdQ questionnaire,and the percentages of patients with GerdQ scores≥9 in the normal LES-IRP and increased LES-IRP groups were 8.5%and 10.7%,respectively(P=0.711).After matching,the rates of clinical success and the rates of GerdQ score≥9 were not significantly different between the two groups.CONCLUSION Our results suggest that POEM is safe and effective for achalasia and patients with normal LES-IRP.In addition,in patients with normal LES-IRP,compared with those with increased LES-IRP,POEM was not associated with a greater incidence of reflux symptoms.展开更多
文摘Objective:Sarcomas are a group of rare malignancies with various subtypes.Patients with metastatic sarcoma who have failed traditional treatments can possibly achieve better prognoses from using novel therapies,including anti-programmed death-1(PD-1)-based therapies.Methods:We retrospectively analyzed clinical data of 24 metastatic sarcoma patients from June 15,2016 to December 30,2019.These patients mainly received angiogenesis inhibitors combined with anti-PD-1 therapy after they became resistant to traditional treatments.Furthermore,8 patients underwent panel DNA and whole transcript sequencing.Results:Six patients received 2 cycles of anti-PD-1 therapy and were included in the safety evaluation only group.The median follow-up time was 5.77 months.The median progression-free survival was 7.59 months,the overall response rate was 16.7%and the disease control rate was 55.6%.Based on whole exome and transcript sequencing data,there was no association between TMB,TNB,MSI,HLA-LOH,and PD-L1 expressions and sarcoma types with clinical responses.Immunotherapy efficacy and bioinformatics analyses indicated higher intratumoral heterogeneity(ITH)in progressive disease(PD)patients and lower ITH in partial response(PR)and stable disease patients.A higher percentage of immune cell infiltration,especially monocytes,was observed in PR patients.Active stromal gene expression was increased in PD patients but decreased in PR patients.Enrichment analysis revealed that an increased TGF-βsignaling pathway was reversely correlated with anti-PD-1 efficacy,while a decreased inflammatory response signaling pathway was positively correlated with anti-PD-1 efficacy.Conclusions:Our study showed PD-1 inhibitors combined with anti-angiogenesis agents were effective and well-tolerated.ITH,monocyte ratio,stroma subtypes,and the status of immune-associated signaling pathways may be related with anti-PD-1 based therapy.
基金Supported by Research and Demonstration of Key Technologies for Rhizome Disease Control in Yimeng Tobacco Area(201906)Science and Technology Innovation Project of Chinese Academy of Agri-cultural Sciences(ASTIP-TRIC04)Demonstration of Green Degradation Technology and Resource Utilization of Tobacco Straw(202013)。
文摘[Objective]The paper was to screen the effective agents for effectively controlling the occurrence and prevalence of taro soft rot.[Method]The fungicidal effects of 11 fungicides on taro soft rot were determined by inhibition zone method.[Result]0.3%Tetramycin,25%bromothalonil,3%Zhongshengmycin and 30%zinc thiazole had better antifungal effect on Pectobacterium aroidearum at recommended concentration.The indoor toxicity of four fungicides showed that the EC50 of 0.3%tetramycin AS was the smallest of 0.6μg/mL,indicating that tetramycin had the largest toxicity and the best inhibitory effect against P.aroidearum;followed by 25%bromothalonil EC and 3%Zhongshengmycin WP,with the EC_(50) of 2.57 and 97.72μg/mL,respectively;the inhibitory effect of 30%zinc thiazole SC against P.aroidearum was the poorest.[Conclusion]The study provides a reference for screening out new and efficient chemical agents against taro soft rot.
基金supported by the National Key R&D Program of China(No.2024YFC3506600)the National Natural Science Foundation of China(Nos.82474198 and 82274184)。
文摘The discovery and characterization of molecular targets from traditional Chinese medicine(TCM)represents a paradigm shift in contemporary drug development.This approach systematically bridges empirical TCM knowledge with modern pharmacological principles,establishing a robust framework for rational drug design.Through integrative systems-chemical biology approaches,we can now mechanistically elucidate the therapeutic basis of TCM's bioactive properties,facilitating the accelerated identification of both novel molecular targets and conserved pharmacological pathways.This multidisciplinary strategy significantly enhances drug development efficiency while advancing therapeutic innovation to address critical unmet medical needs.With the rapid advancement of next-generation target deconvolution technologies and AI-driven computational platforms,TCM is poised to make increasingly substantial contributions to modern pharmacotherapy.
基金financially supported by National Natural Science Foundation of China(No.82304297)the State Key Laboratory of Natural and Biomimetic Drugs(No.K202408)。
文摘To enhance the anti-resistance efficacy of our previously disclosed naphthyl-triazine 5,structure-based drug design strategy was rationally conducted to design a series of novel biphenyl-piperidine-triazinecontaining non-nucleoside reverse transcriptase inhibitors.Remarkably,several of these compounds demonstrated single-digit nanomolar antiviral potency against both wild-type(WT)human immunodeficiency virus-1(HIV-1)and five clinically relevant mutant strains.Among these,compound 11s emerged as the most potent inhibitor,showing remarkable efficacy against WT HIV-1(50%effective concentration(EC_(50))=2 nmol/L)and five mutant strains(EC_(50)=0.003-0.073μmol/L),which was significantly superior to that of compound 5.This optimized derivative demonstrated substantially improved pharmacological properties compared to existing drugs etravirine(ETR)and rilpivirine(RPV),showing a 4-fold reduction in cytotoxicity alongside 6-fold enhancement in selectivity index(50%cytotoxic concentration(CC_(50))=19.69μmol/L,selectivity index(SI)=7438).The compound's metabolic profile revealed exceptional stability,with an elimination half-life(t_(1/2)=41.4 min)more than double that of RPV(t_(1/2)=16.03min).Comprehensive safety evaluation indicated minimal cytochrome P450(CYP)enzymes interference,low cardiac ion channel activity,and no observable acute toxicity,collectively suggesting a reduced risk profile for therapeutic applications.These promising characteristics significantly advance the development potential of biphenyl-piperidine-triazine derivatives as next-generation non-nucleoside reverse transcriptase inhibitors(NNRTIs),offering enhanced efficacy,improved safety,and favorable pharmacokinetic properties for antiretroviral therapy.
文摘Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.
基金Application Research of MRI Physiological Quantitative Imaging Technology in the Diagnosis of Cartilage Injury(Project No.:RCYJ2021-04)。
文摘Objective:To retrospectively evaluate the diagnostic efficacy of traditional MRI and T2 Mapping quantitative imaging technology for knee joint cartilage injury,clarify the differences in diagnostic value of the two imaging methods in different injury grades and different cartilage subregions,and provide evidence-based basis for the accurate diagnosis of clinical cartilage injury.Methods:Clinical and imaging data of 286 patients with knee joint lesions admitted to the Affiliated Hospital of Xiangtan Medicine and Health Vocational College from January 2020 to June 2023 were collected retrospectively.All patients underwent both traditional MRI sequences and T2 Mapping sequences.The knee joint cartilage was divided into 14 subregions.Two senior radiologists independently diagnosed the images of the two imaging technologies using a blind method and recorded the cartilage injury grades.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and area under the receiver operating characteristic curve(AUC)of the two technologies for diagnosing cartilage injury were calculated and compared,and the differences in their diagnostic efficacy in different injury grades and different subregions were analyzed.Results:A total of 4004 cartilage subregions from 286 patients were included in the analysis,including 1836 injured subregions and 2168 normal subregions.The overall sensitivity(89.7%),accuracy(91.2%),and AUC(0.946)of T2 Mapping quantitative imaging for diagnosing cartilage injury were significantly higher than those of traditional MRI(76.3%,82.5%,and 0.852 respectively),with statistically significant differences(p<0.001);there was no significant difference in specificity between the two(93.5%vs 90.8%,p=0.062).Subgroup analysis showed that T2 Mapping had the most significant diagnostic advantage in early cartilage injury(Grade 1),with sensitivity(78.5%)33.2%higher than that of traditional MRI(45.3%)(p<0.001).Conclusion:The diagnostic efficacy of T2 Mapping quantitative imaging for knee joint cartilage injury is significantly superior to that of traditional MRI,especially in the detection of early cartilage injury and accurate evaluation of weight-bearing area injury.Data verify its clinical applicability and reliability.It can be used as an important supplementary method to traditional MRI,and is recommended for the early diagnosis,grading evaluation,and clinical follow-up of cartilage injury.
文摘Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urology,First Affiliated Hospital of Jinan University,were selected and treated with electrophysiological therapy.They were randomly divided into three groups:the fixed-parameter AA7 treatment group,the P2+P4 treatment group,and the precision treatment group(individualized parameter treatment).Pain scores of patients in each group were compared before and after treatment,with a pain score of 0 indicating cure.The cure rate of each group was observed.Results:The average ages of the AA7 group,P2+P4 group,and precision treatment group were 34±14.17 years,35.58±12.57 years,and 35.5±11.27 years,respectively.There was no significant difference in age among the three groups(p>0.05).Before treatment,the pain scores of the AA7 group,P2+P4 group,and precision treatment group were 4.14±1.74,4.64±1.72,and 3.50±1.89,respectively,with no significant differences among the groups(p>0.05).After treatment,the pain scores were 0.71±0.99 for the AA7 group(cure rate:57%),0.49±0.79 for the P2+P4 group(cure rate:67%),and 0.50±0.77 for the precision treatment group(cure rate:64%),with no significant differences among the groups(p>0.05).The cure rates for different pain locations were as follows:83%for lower abdominal pain,74%for perineal pain,62%for dysuria,49%for testicular pain,and 75%for inguinal pain.Conclusion:The pathogenesis of CPPS is complex and diverse,with numerous treatment options and uncertain efficacy,posing significant challenges to clinical practice.This study showed that electrophysiological therapy under different parameter modes significantly reduced pain scores before and after treatment,indicating significant therapeutic effects on CPPS.All three modes demonstrated good cure rates.Individualized precision treatment and fixed-mode P2+P4 or AA7 treatment were safe and effective in CPPS treatment and are worth promoting.Fixed-mode P2+P4 and AA7,due to their easier standardization of parameters and patch modes,reduced the learning curve and had better potential for widespread application.
基金supported by the Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.
文摘Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.
文摘Objective:This study aims to systematically evaluate the clinical efficacy and safety of diuretic therapy in patients with liver cirrhosis ascites.Method:60 patients with liver cirrhosis ascites diagnosed from January 2024 to May 2025 were prospectively included and randomly divided into a furosemide monotherapy group(20 cases),a spironolactone monotherapy group(20 cases),and a combination therapy group(20 cases).The intervention period is 28 days,and the main observation indicators include 24-hour urine output,changes in abdominal circumference,weight loss,serum electrolyte levels,renal function indicators,and incidence of adverse reactions.All study subjects received standardized dietary management and sodium restriction intervention(daily sodium intake<5 g).Result:The total effective rate(significant+effective)of the combination therapy group in reducing ascites was 95%(19/20),significantly higher than the 75%(15/20)of the furosemide group and the 70%(14/20)of the spironolactone group(p<0.01).On the 28th day of treatment,the mean urine output in the combination group was 2450±210 mL/d,which was higher than that in the monotherapy group(1850±195 mL/d in the furosemide group);Spironolactone group 1560±180 mL/d.The blood sodium levels of the three groups were maintained at 135-140 mmol/L,but the incidence of hypokalemia in the combination group(10%)was significantly lower than that in the furosemide group(35%).Conclusion:The combination of furosemide and spironolactone has a synergistic effect in the treatment of ascites in cirrhosis,with a 39.2%increase in diuretic effect and a reduction in the risk of electrolyte imbalance;Individualized dose adjustment combined with strict sodium restriction is the core strategy to ensure treatment safety.
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A00806High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023086the Fundamental Research Funds for the Central Public Welfare Research Institutes,No.ZZ17-XRZ-041.
文摘Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.
基金Supported by the Wu Jieping Medical Fund,No.320.6750.2022-09-14the Climbing Fund of PhD Workstation,Zhangzhou Affiliated Hospital of Fujian Medical University,No.PDB202412。
文摘BACKGROUND Gastric cancer is a leading global cause of cancer mortality,with poor survival in locally advanced stages.While immune checkpoint inhibitors(ICIs)like sintilimab have improved outcomes in advanced disease,their role as neoadjuvant therapy remains understudied.This study investigates sintilimab combined with nabpaclitaxel/S-1 as preoperative treatment for locally advanced gastric cancer(LAGC),addressing an unmet need for effective neoadjuvant strategies.AIM To explore the efficacy and safety of combination treatment with sintilimab and nab-paclitaxel plus S-1 as neoadjuvant therapy for LAGC.METHODS Clinical data from 82 patients diagnosed with LAGC,who underwent preoperative treatment and surgery between April 2020 and December 2022,were included.Patients were divided into 2 groups according to treatment regimen:ICI(sintilimab+nab-paclitaxel+S-1);and non-ICI(nab-paclitaxel+S-1).Imaging and pathological efficacy,intra-and postoperative conditions,molecular subtypes,short-term survival outcomes,and safety were compared between the 2 groups.RESULTS Imaging evaluation of therapeutic efficacy revealed that the inclusion of ICI yielded a significantly higher complete response rate(13.2%vs 0.0%;P=0.048),and objective response rate(69.8%vs 31.0%,P=0.001)compared with non-ICI treatment.Pathological evaluation revealed that the ICI group exhibited a significantly higher pathological complete response rate(13.2%vs 0.0%;P=0.048)and major pathological response rate(35.8%vs 13.8%;P=0.041)than those in the non-ICI group.The two-year disease-free survival rate in the ICI group was greater than that in the non-ICI group(83.0%vs 55.2%;P=0.043).The use of ICI did not increase the incidence of adverse reactions(47.2%vs 41.4%;P=0.614)or perioperative adverse events(18.9%vs 13.8%;P=0.761).CONCLUSION The combination of sintilimab with nab-paclitaxel+S-1 for neoadjuvant treatment of LAGC improved efficacy in patients without increasing adverse drug reactions and perioperative adverse events,suggesting that this treatment regimen is safe and feasible.
基金supported by the“Pioneer”and“Leading Goose”R&D Program of Zhejiang(No.2024C03106,X.F.)the National Natural Science Foundation of China(No.82474160,X.S.)+2 种基金the Joint Funds of the Zhejiang Provincial Natural Science Foundation of China(No.LBZ24H270001,X.P.)the Major Joint Projects Supported by the National Administration of TCM and Zhejiang Province(No.GZY-ZI-KJ-23037,X.P.)the Ningbo Top Medical and Health Research Program(No.2022030309,X.P.)。
文摘Network pharmacology has gained widespread application in drug discovery,particularly in traditional Chinese medicine(TCM)research,which is characterized by its“multi-component,multi-target,and multi-pathway”nature.Through the integration of network biology,TCM network pharmacology enables systematic evaluation of therapeutic efficacy and detailed elucidation of action mechanisms,establishing a novel research paradigm for TCM modernization.The rapid advancement of machine learning,particularly revolutionary deep learning methods,has substantially enhanced artificial intelligence(AI)technology,offering significant potential to advance TCM network pharmacology research.This paper describes the methodology of TCM network pharmacology,encompassing ingredient identification,network construction,network analysis,and experimental validation.Furthermore,it summarizes key strategies for constructing various networks and analyzing constructed networks using AI methods.Finally,it addresses challenges and future directions regarding cell-cell communication(CCC)-based network construction,analysis,and validation,providing valuable insights for TCM network pharmacology.
基金funded by National Natural Science Foundation of China(No.12172092,82174488,and 82305416)Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function(No.21DZ2271800)+1 种基金Shanghai Municipal Science and Technology Commission(No.23YF1418300)Scientific Research Project on Traditional Chinese Medicine of Shanghai Municipal Health Commission—Youth Guidance Category(No.2022QN018).
文摘Objective The analgesic effect of acupuncture has been widely accepted.Nevertheless,the mechanism behind its analgesic effect remains elusive,thus impeding the progress of research geared toward enhancing the analgesic effect of acupuncture.This paper investigated the role of acupuncture needle surface textures on acupuncture’s analgesic effect by creating four experimental acupuncture needles with different patterns of surface augmentation.Methods Four types of acupuncture needles with different surface textures(the lined needle,circle needle,sandpaper needle,and threaded needle)were designed.Additionally,the force/torque measurement system used a robot arm and mechanical sensor to measure the force on the needle during insertion and manipulation.To perform acupuncture analgesia experiments,four experimental acupuncture needles and a normal needle were inserted into the Zusanli(ST36)acupoint of rats with inflammatory pain.By comparing the force and torque and the analgesic efficacy of the different acupuncture needles,these experiments tested the role of acupuncture needle body texture on acupuncture analgesia.Results The analgesic effects of different acupuncture needle body textures varied.Specifically,the force required to penetrate the skin with the lined needle was not greater than that for the normal needle;however,the needle with inscribed circles and the sandpaper-roughened needle both required greater force for insertion.Additionally,the torque of the lined needle reached 2×10^(-4)N·m under twisting manipulation,which was four times greater the torque of a normal needle(5×10^(-5)N·m).Furthermore,the lined needle improved pain threshold and mast cell degranulation rate compared to the normal needle.Conclusion Optimizing the texture of acupuncture needles can enhance acupuncture analgesia.The texture of our experimental acupuncture needles had a significant impact on the force needed to penetrate the skin and the torque needed to manipulate the needle;it was also linked to variable analgesic effects.This study provides a theoretical basis for enhancing the analgesic efficacy of acupuncture through the modification of needles and promoting the development of acupuncture therapy.
基金funded by the National Key Research and Development Plan of the Traditional Chinese Medicine Modernization Research Key Project(2018YFC1706800).
文摘Objective:To investigate the potential efficacy and safety of Lutai Danshen Baishao granules(LDBG)for treating female melasma associated with kidney deficiency and blood stasis patterns.Methods:A randomized,double-blind,placebo-controlled trial was conducted at the Third Central Hospital of Tianjin,China from March to December 2023.A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days.Efficacy was assessed through measures such as the total melasma area,reduced melasma area,reduction rate of melasma area,melasma color score,Melasma Area and Severity Index(MASI)score,and traditional Chinese medicine(TCM)symptom score scale.Safety assessments included routine blood and biochemical tests.Results:Participants in both groups were aged 52-63 years,with no significant differences.After the 2-month intervention,the total melasma area decreased in both groups;however,a greater reduction was observed in the test group[462.50 mm^(2)(12.81%)vs.100.00 mm2(3.11%),P<.001].Moreover,LDBG treatment significantly reduced the MASI and melasma color scores in the test group(P<.05).The total TCM symptom evaluation score significantly decreased(test group:6.00 vs.placebo group:7.00,P=.001),with significant relief in symptoms such as improvement in dark lips,nails,and waist soreness in the test group,compared with that in the placebo group(P<.05).Within-group comparisons revealed that TCM syndrome was significantly alleviated in the test group(P<.05).Conclusion:LDBG intervention shows promising effectiveness in reducing female melasma and alleviating TCM syndromes.
基金Supported by National Science and Technology Major Project,No.2024ZD0521002The Innovation Team Project of Traditional Chinese Medicine of Liaoning Province,No.LNZYYCXTD-CCCX-003+1 种基金General Program of the National Natural Science Foundation of China,No.82074296Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China,No.[2022]No.75.
文摘Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.
基金Supported by the project on the management of TCM in Guangdong Province:No.20231213Key Construction Project of TCM Discipline of Guangdong Pharmaceutical University:No.2022-8.
文摘Objective To observe the efficacy of Shugan Tiaoshen(liver-soothing and mind-regulating)needling method in the treatment of patients with postherpetic neuralgia(PHN).Methods A total of 66 patients with PHN were randomly divided into acupuncture group and control group,33 cases in each one,by the random number table method.The acupuncture group received Shugan Tiaoshen needling method plus gabapentin,whereas the control group received the oral administration of gabapentin and sham acupuncture.Numerical Rating Scale(NRS),State-Trait Anxiety Inventory(STAI)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate the pain condition,anxiety symptom and sleep quality.The effective rate and adverse events were also evaluated and recorded during the treatment.Results After eight weeks of treatment,the NRS scores of the two groups were significantly lower than those before treatment(P<0.05)at all time points,with statistically significant difference between the groups(P<0.05).The scores of STAI and PSQI of the acupuncture group were significantly lower than the scores before treatment(P<0.05).The scores of STAI for anxiety symptom and PSQI of the acupuncture group were significantly lower than the control group(P<0.05),and the effective rate of the acupuncture group was significantly higher than that of the control group(P<0.05).The incidence of adverse reactions in the acupuncture group was significantly lower than that in the control group(P<0.05).Conclusion Shugan Tiaoshen needling method showed satisfactory efficacy in treating PHN,and could alleviate the pain,relieve the anxiety symptoms,promote sleep,and reduce the adverse reactions of gabapentin in patients with PHN.
文摘Yttrium-90(Y-90)microsphere therapy,known as radioembolization,has emerged as a pivotal treatment modality for hepatocellular carcinoma(HCC),delivering targeted radiation with minimal collateral damage to healthy liver tissues.This review meticulously synthesizes current evidence regarding the clinical efficacy,underlying therapeutic mechanisms,patient selection criteria,and comparative advantages of Y-90 therapy.Clinical studies consistently demonstrate significant improvements in overall survival and progression-free survival,coupled with robust tumor response rates and manageable adverse events.The therapy’s efficacy is substantially enhanced by advanced dosimetric techniques,enabling precise radiation delivery tailored to individual tumor profiles.Comparative analyses reveal that Y-90 therapy provides superior local tumor control and a preferable safety profile compared to conventional treatments such as transarterial chemoembolization and external beam radiation therapy.Additionally,its clinical outcomes are comparable to those achieved with contemporary systemic therapies.Ongoing research into combination treatments incorporating Y-90 with systemic therapies,including targeted agents and immune checkpoint inhibitors,suggests promising advancements in comprehensive HCC management.Future directions highlight the necessity for continued refinement of dosimetry and patient stratification approaches,aiming to further optimize therapeutic outcomes.
基金Supported by the 2023 Government Funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.H202423105.
文摘In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explains the core principles and clinical applications of TCM in treating these conditions,furthering the discourse through an examination of integrated TCM strategies,as demonstrated in the study by Zhou et al.While TCM has shown promising clinical outcomes,it encounters significant hurdles in standardization,mechanistic research,and clinical validation.Future investigations should aim to solidify the scientific underpinnings of TCM and expand its use in gastrointestinal disease management,striving for a seamless fusion of traditional and contemporary medical practices.
文摘BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the clinical symptoms of achalasia associated with increased LES pressure.AIM To identify the safety and efficacy of POEM for patients with normal LES integrated relaxation pressure(LES-IRP).METHODS The clinical data of patients who underwent POEM successfully in The First Medical Center of Chinese PLA General Hospital were retrospectively analyzed.A total of 481 patients who underwent preoperative high-resolution manometry(HRM)at our hospital were ultimately included in this research.According to the HRM results,the patients were divided into two groups:71 patients were included in the normal LES-IRP group(LES-IRP<15 mmHg)and 410 patients were included in the increased LES-IRP group(LES-IRP≥15 mmHg).Clinical characteristics,procedure-related parameters,adverse events,and outcomes were compared between the two groups to evaluate the safety and efficacy of POEM for patients with normal LES-IRP.RESULTS Among the 481 patients included in our study,209 were males and 272 were females,with a mean age of 44.2 years.All patients underwent POEM without severe adverse events.The median pre-treatment Eckardt scores of the normal LES-IRP and increased LES-IRP groups were 7.0 and 7.0(P=0.132),respectively,decreasing to 1.0 and 1.0 post-treatment(P=0.572).The clinical success rate of the normal LES-IRP group was 87.3%(62/71),and that of the increased LES-IRP group was 91.2%(374/410)(P=0.298).Reflux symptoms were measured by the GerdQ questionnaire,and the percentages of patients with GerdQ scores≥9 in the normal LES-IRP and increased LES-IRP groups were 8.5%and 10.7%,respectively(P=0.711).After matching,the rates of clinical success and the rates of GerdQ score≥9 were not significantly different between the two groups.CONCLUSION Our results suggest that POEM is safe and effective for achalasia and patients with normal LES-IRP.In addition,in patients with normal LES-IRP,compared with those with increased LES-IRP,POEM was not associated with a greater incidence of reflux symptoms.
