Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate...Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.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
BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges f...BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.展开更多
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of U...Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.展开更多
The interleukin-17 family is the key group of cytokines and displays a broad spectrum of biological functions,including regulating the inflammatory cascade in various autoimmune and inflammatory diseases,such as multi...The interleukin-17 family is the key group of cytokines and displays a broad spectrum of biological functions,including regulating the inflammatory cascade in various autoimmune and inflammatory diseases,such as multiple sclerosis,neuromyelitis optica spectrum disorder,myasthenia gravis,Guillain–Barre syndrome,acute disseminated encephalomyelitis,diabetes,inflammatory skin diseases,joint inflammation,and cancer.Although the function of the interleukin-17 family has attracted increasing research attention over many years,the expression,function,and regulation mechanisms of different interleukin-17 members are complicated and still only partially understood.Currently,the interleukin-17A pathway is considered a critical therapeutic target for numerous immune and chronic inflammatory diseases,with several monoclonal antibodies against interleukin-17A having been successfully used in clinical practice.Whether other interleukin-17 members have the potential to be targeted in other diseases is still debated.This review first summarizes the recent advancements in understanding the physicochemical properties,physiological functions,cellular origins,and downstream signaling pathways of different members and corresponding receptors of the interleukin-17 family.Subsequently,the function of interleukin-17 in various immune diseases is discussed,and the important role of interleukin-17 in the pathological process of immune diseases is demonstrated from multiple perspectives.Then,the current status of targeted interleukin-17 therapy is summarized,and the effectiveness and safety of targeted interleukin-17 therapy are analyzed.Finally,the clinical application prospects of targeting the interleukin-17 pathway are discussed.展开更多
The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published s...The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.展开更多
Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and...Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.展开更多
Osteoarthritis(OA)is a degenerative joint disease with significant clinical and societal impact.Traditional diagnostic methods,including subjective clinical assessments and imaging techniques such as X-rays and MRIs,a...Osteoarthritis(OA)is a degenerative joint disease with significant clinical and societal impact.Traditional diagnostic methods,including subjective clinical assessments and imaging techniques such as X-rays and MRIs,are often limited in their ability to detect early-stage OA or capture subtle joint changes.These limitations result in delayed diagnoses and inconsistent outcomes.Additionally,the analysis of omics data is challenged by the complexity and high dimensionality of biological datasets,making it difficult to identify key molecular mechanisms and biomarkers.Recent advancements in artificial intelligence(AI)offer transformative potential to address these challenges.This review systematically explores the integration of AI into OA research,focusing on applications such as AI-driven early screening and risk prediction from electronic health records(EHR),automated grading and morphological analysis of imaging data,and biomarker discovery through multi-omics integration.By consolidating progress across clinical,imaging,and omics domains,this review provides a comprehensive perspective on how AI is reshaping OA research.The findings have the potential to drive innovations in personalized medicine and targeted interventions,addressing longstanding challenges in OA diagnosis and management.展开更多
Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now en...Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.展开更多
The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the p...The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
The Chinese government promotes smoking cessation through smoking cessation clinics(SCCs).This study aimed to identify factors associated with relapse and provide evidence to inform interventions that reduce relapse r...The Chinese government promotes smoking cessation through smoking cessation clinics(SCCs).This study aimed to identify factors associated with relapse and provide evidence to inform interventions that reduce relapse risk.Participants were SCC patients aged≥18 years who enrolled between June 2019 and December 2021,completed follow-up assessments at one and three months,and reported abstinence at one month.Short-term relapse was defined as self-reported smoking at the three-month follow-up.Treatments included counseling,first-line cessation medications,and traditional Chinese medicine(TCM).Logistic regression was used to identify factors associated with short-term relapse.Among 10,724 eligible SCC patients,11.6%experienced short-term relapse.Factors positively associated with relapse included the number of previous quit attempts(1–5 attempts:OR=1.422,95%CI:1.254–1.613,>5 attempts:OR=1.382,95%CI:1.057–1.808),high perceived difficulty in quitting(OR=1.297,95%CI:1.061–1.586),and moderate(OR=1.383,95%CI:1.174–1.629)or weak(OR=1.517,95%CI:1.251–1.841)willingness to quit.Factors negatively associated with relapse included having a college degree or higher(OR=0.796;95%CI:0.650–0.973),high confidence in quitting(OR=0.786;95%CI:0.629–0.983),and use of TCM(OR=0.276;95%CI:0.158–0.482).Enhancing self-efficacy in quitting appears crucial for preventing short-term relapse.The use of TCM may reduce relapse risk and warrants further investigation.展开更多
Objective:To explore the application effect of scenario simulation teaching method based on Debriefing-GAS mode in the teaching of clinical nursing students in neurosurgery and its influence on critical thinking,clini...Objective:To explore the application effect of scenario simulation teaching method based on Debriefing-GAS mode in the teaching of clinical nursing students in neurosurgery and its influence on critical thinking,clinical practice ability and teaching satisfaction.Methods:A total of 100 nursing students who were doing their internship in the Department of Neurosurgery at a tertiary hospital in Sichuan Province from July 2024 to June 2025 were selected and divided into a control group and an experimental group,with 50 students in each group,using the historical control grouping method.The control group used the traditional teaching method for scenario simulation,while the experimental group used the Debriefing-GAS model for scenario simulation teaching.The teaching effect was evaluated using the DASH scale,the CIDI-CV scale,the clinical practice ability scale and the self-made teaching satisfaction questionnaire,and statistical analysis was conducted using SPSS 25.0.Results:The total DASH score of the experimental group(6.45±0.41)was significantly higher than that of the control group(5.12±0.47,t=14.01,p<0.001);The total score of critical thinking ability(338.6±22.5)was higher than that of the control group(307.8±24.1,t=6.55,p<0.001);The score of clinical practice ability(189.4±15.2)was significantly higher than that of the control group(168.7±14.9,t=6.49,p<0).Teaching satisfaction was 96%in the experimental group and 82%in the control group,statistically significant(χ^(2)=4.32,p=0.038).Conclusion:The scenario simulation teaching method based on the Debriefing-GAS model can significantly improve the learning initiative,reflective ability,critical thinking level and clinical practice ability of clinical nursing students,and enhance teaching satisfaction.展开更多
Background Medical informatics accumulated vast amounts of data for clinical diagnosis and treatment.However,limited access to follow-up data and the difficulty in integrating data across diverse platforms continue to...Background Medical informatics accumulated vast amounts of data for clinical diagnosis and treatment.However,limited access to follow-up data and the difficulty in integrating data across diverse platforms continue to pose significant barriers to clinical research progress.In response,our research team has embarked on the development of a specialized clinical research database for cardiology,thereby establishing a comprehensive digital platform that facilitates both clinical decision-making and research endeavors.Methods The database incorporated actual clinical data from patients who received treatment at the Cardiovascular Medicine Department of Chinese PLA General Hospital from 2012 to 2021.It included comprehensive data on patients'basic information,medical history,non-invasive imaging studies,laboratory test results,as well as peri-procedural information related to interventional surgeries,extracted from the Hospital Information System.Additionally,an innovative artificial intelligence(AI)-powered interactive follow-up system had been developed,ensuring that nearly all myocardial infarction patients received at least one post-discharge follow-up,thereby achieving comprehensive data management throughout the entire care continuum for highrisk patients.Results This database integrates extensive cross-sectional and longitudinal patient data,with a focus on higher-risk acute coronary syndrome patients.It achieves the integration of structured and unstructured clinical data,while innovatively incorporating AI and automatic speech recognition technologies to enhance data integration and workflow efficiency.It creates a comprehensive patient view,thereby improving diagnostic and follow-up quality,and provides high-quality data to support clinical research.Despite limitations in unstructured data standardization and biological sample integrity,the database's development is accompanied by ongoing optimization efforts.Conclusion The cardiovascular specialty clinical database is a comprehensive digital archive integrating clinical treatment and research,which facilitates the digital and intelligent transformation of clinical diagnosis and treatment processes.It supports clinical decision-making and offers data support and potential research directions for the specialized management of cardiovascular diseases.展开更多
Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock...Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock for the inheritance and development of TM.To meet the growing demand for high-quality healthcare,it is imperative to integrate TM with modern technology to address the issue of insufficient evidence for the efficacy of TM.展开更多
On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal dis...On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal disease(ESRD)at New York University(NYU)Langone Health.The UKidney is a genetically engineered porcine kidney incorporating 10 gene modifications-6 human gene insertions to enhance immunologic compatibility and 4 porcine gene knockouts to minimize rejection risk and control graft growth[1].In the context of the first xenotransplantation studies,“EXPAND”refers to the US Food and Drug Administration(FDA)“expanded access”program,often colloquially known as compassionate use.展开更多
[Objectives]To explore the correlation between the clinical internship environment and professional identity of undergraduate student nurses on clinical internship.[Methods]From September 8,2023 to January 8,2024,a qu...[Objectives]To explore the correlation between the clinical internship environment and professional identity of undergraduate student nurses on clinical internship.[Methods]From September 8,2023 to January 8,2024,a questionnaire survey was conducted among 315 undergraduate student nurses on clinical internship from 3 comprehensive third-grade class A hospitals in the region.The survey tools included General Information Questionnaire,Student Nurse Professional Identity Questionnaire,and Clinical Internship Environment Evaluation Scale.[Results]The total score of professional identity of the undergraduate student nurses on clinical internship was(59.55±12.78)points,and the total score of clinical internship environment was(129.31±16.02)points,both at medium to high levels.There was a significant positive correlation between clinical internship environment and professional identity(r=0.547,P<0.001).[Conclusions]The clinical internship environment is closely related to the professional identity of undergraduate student nurses on clinical internship.It is necessary to optimize the internship environment in a targeted manner to enhance the professional identity of student nurses,thereby stabilizing the nursing talent team.展开更多
Any new report on the anticancer properties of natural products always awakens new satisfaction and hope about the role of the international scientific community in its continuous contributions to human health,particu...Any new report on the anticancer properties of natural products always awakens new satisfaction and hope about the role of the international scientific community in its continuous contributions to human health,particularly when those reports contribute to both the understanding and therapeutics of cancer.For many de-cades,natural products have been pivotal in drug discovery programs because they offer a diverse array of anticancer therapeutic possibilities.Recently,two manuscripts published in the World Journal of Gastrointestinal Oncology added new data to the already extensive body of anticancer preclinical evidence for resvera-trol and senegenin,two compounds widely present in herbal preparations used in traditional Chinese medicine.The first one,with comprehensive and recognized anticancer properties,and the second one,shows a compelling body of evidence supporting its neuroprotective effects,but with emerging anticancer activities.Natural products have become key elements in the expanding and dynamic field of anticancer drug discovery.However,urgent and collective efforts are still needed to bridge the gap between preclinical and clinical research and thus bring new anticancer therapeutic breakthroughs.展开更多
The article by Granjeiro et al provided a thorough review of the role of stem cell models in the development of advanced therapy medicinal products.It emphasized the potential of stem cell models to refine preclinical...The article by Granjeiro et al provided a thorough review of the role of stem cell models in the development of advanced therapy medicinal products.It emphasized the potential of stem cell models to refine preclinical studies and align with regulatory requirements for clinical applications.This article introduced a new perspective on enhancing the transition of stem cell research into clinical practice,focusing on the importance of international regulatory harmonization and the need for standardization in stem cell-based therapies.展开更多
文摘Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.
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.
基金approved by King Abdullah International Medical Research Center Ethics Committee(approval No.0000074524).
文摘BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.
基金Supported by National Natural Science Foundation of China,No.82374200Construction of Traditional Chinese Medicine Inheritance and Innovation Development Demonstration Pilot Projects in Pudong New Area-High-Level Research-Oriented Traditional Chinese Medicine Hospital Construction,No.YC-2023-0901.
文摘Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.
基金supported by the National Natural Science Foundational of China(Key Program),No.U24A20692(to CJZ)the National Natural Science Foundational of China,Nos.82101414(to MLJ),82371355(to CJZ)+4 种基金the National Natural Science Foundational of China for Excellent Young Scholars,No.82022019(to CJZ)Sichuan Special Fund for Distinguished Young Scholars,No.24NSFJQ0052(to CJZ)The Innovation and Entrepreneurial Team of Sichuan Tianfu Emei Program,No.CZ2024018(to CJZ)Funding for Distinguished Young Scholars of Sichuan Provincial People’s Hospital,No.30420230005(to CJZ)Funding for Distinguished Young Scholars of University of Electronic Science and Technology of China,No.A1098531023601381(to CJZ)。
文摘The interleukin-17 family is the key group of cytokines and displays a broad spectrum of biological functions,including regulating the inflammatory cascade in various autoimmune and inflammatory diseases,such as multiple sclerosis,neuromyelitis optica spectrum disorder,myasthenia gravis,Guillain–Barre syndrome,acute disseminated encephalomyelitis,diabetes,inflammatory skin diseases,joint inflammation,and cancer.Although the function of the interleukin-17 family has attracted increasing research attention over many years,the expression,function,and regulation mechanisms of different interleukin-17 members are complicated and still only partially understood.Currently,the interleukin-17A pathway is considered a critical therapeutic target for numerous immune and chronic inflammatory diseases,with several monoclonal antibodies against interleukin-17A having been successfully used in clinical practice.Whether other interleukin-17 members have the potential to be targeted in other diseases is still debated.This review first summarizes the recent advancements in understanding the physicochemical properties,physiological functions,cellular origins,and downstream signaling pathways of different members and corresponding receptors of the interleukin-17 family.Subsequently,the function of interleukin-17 in various immune diseases is discussed,and the important role of interleukin-17 in the pathological process of immune diseases is demonstrated from multiple perspectives.Then,the current status of targeted interleukin-17 therapy is summarized,and the effectiveness and safety of targeted interleukin-17 therapy are analyzed.Finally,the clinical application prospects of targeting the interleukin-17 pathway are discussed.
文摘The Chinese Society of Clinical Oncology Non-small Cell Lung Cancer(CSCO NSCLC)guidelines were first published in 2016,ranking among the earliest-released guidelines within the CSCO series.In 2020 the CSCO published separate guidelines for NSCLC and small cell lung cancer(SCLC)for the first time to improve clinical usability.
文摘Clear aligner treatment is a novel technique in current orthodontic practice.Distinct from traditional fixed orthodontic appliances,clear aligners have different material features and biomechanical characteristics and treatment efficiencies,presenting new clinical challenges.Therefore,a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique.This expert consensus discusses case selection and grading of treatment difficulty,principle of clear aligner therapy,clinical procedures and potential complications,which are crucial to the clinical success of clear aligner treatment.
基金supported by the National Natural Science Foundation of China(82302757)Shenzhen Science and Technology Program(JCY20240813145204006,SGDX20201103095600002,JCYJ20220818103417037,KJZD20230923115200002)+1 种基金Shenzhen Key Laboratory of Digital Surgical Printing Project(ZDSYS201707311542415)Shenzhen Development and Reform Program(XMHT20220106001).
文摘Osteoarthritis(OA)is a degenerative joint disease with significant clinical and societal impact.Traditional diagnostic methods,including subjective clinical assessments and imaging techniques such as X-rays and MRIs,are often limited in their ability to detect early-stage OA or capture subtle joint changes.These limitations result in delayed diagnoses and inconsistent outcomes.Additionally,the analysis of omics data is challenged by the complexity and high dimensionality of biological datasets,making it difficult to identify key molecular mechanisms and biomarkers.Recent advancements in artificial intelligence(AI)offer transformative potential to address these challenges.This review systematically explores the integration of AI into OA research,focusing on applications such as AI-driven early screening and risk prediction from electronic health records(EHR),automated grading and morphological analysis of imaging data,and biomarker discovery through multi-omics integration.By consolidating progress across clinical,imaging,and omics domains,this review provides a comprehensive perspective on how AI is reshaping OA research.The findings have the potential to drive innovations in personalized medicine and targeted interventions,addressing longstanding challenges in OA diagnosis and management.
基金supported by the National Key Research and Development Program (No.2023YFC3502604)the National Natural Science Foundation of China (Nos.U23B2062, 82274352,82174533, 82374302, 82204941)+3 种基金the Noncommunicable Chronic Diseases-National Science and Technology Major Project (No.2023ZD0505700)the Beijing-Tianjin-Hebei Basic Research Cooperation Project (No.22JCZXJC00070)the State Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture (No.SKL2024Z0102)Key R&D project of Ningxia Autonomous Region (No.2022BEG02036).
文摘Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.
文摘The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
文摘The Chinese government promotes smoking cessation through smoking cessation clinics(SCCs).This study aimed to identify factors associated with relapse and provide evidence to inform interventions that reduce relapse risk.Participants were SCC patients aged≥18 years who enrolled between June 2019 and December 2021,completed follow-up assessments at one and three months,and reported abstinence at one month.Short-term relapse was defined as self-reported smoking at the three-month follow-up.Treatments included counseling,first-line cessation medications,and traditional Chinese medicine(TCM).Logistic regression was used to identify factors associated with short-term relapse.Among 10,724 eligible SCC patients,11.6%experienced short-term relapse.Factors positively associated with relapse included the number of previous quit attempts(1–5 attempts:OR=1.422,95%CI:1.254–1.613,>5 attempts:OR=1.382,95%CI:1.057–1.808),high perceived difficulty in quitting(OR=1.297,95%CI:1.061–1.586),and moderate(OR=1.383,95%CI:1.174–1.629)or weak(OR=1.517,95%CI:1.251–1.841)willingness to quit.Factors negatively associated with relapse included having a college degree or higher(OR=0.796;95%CI:0.650–0.973),high confidence in quitting(OR=0.786;95%CI:0.629–0.983),and use of TCM(OR=0.276;95%CI:0.158–0.482).Enhancing self-efficacy in quitting appears crucial for preventing short-term relapse.The use of TCM may reduce relapse risk and warrants further investigation.
基金2023 Teaching Reform Project of Chengdu University of Traditional Chinese Medicine(Project No.:JGJD202322)。
文摘Objective:To explore the application effect of scenario simulation teaching method based on Debriefing-GAS mode in the teaching of clinical nursing students in neurosurgery and its influence on critical thinking,clinical practice ability and teaching satisfaction.Methods:A total of 100 nursing students who were doing their internship in the Department of Neurosurgery at a tertiary hospital in Sichuan Province from July 2024 to June 2025 were selected and divided into a control group and an experimental group,with 50 students in each group,using the historical control grouping method.The control group used the traditional teaching method for scenario simulation,while the experimental group used the Debriefing-GAS model for scenario simulation teaching.The teaching effect was evaluated using the DASH scale,the CIDI-CV scale,the clinical practice ability scale and the self-made teaching satisfaction questionnaire,and statistical analysis was conducted using SPSS 25.0.Results:The total DASH score of the experimental group(6.45±0.41)was significantly higher than that of the control group(5.12±0.47,t=14.01,p<0.001);The total score of critical thinking ability(338.6±22.5)was higher than that of the control group(307.8±24.1,t=6.55,p<0.001);The score of clinical practice ability(189.4±15.2)was significantly higher than that of the control group(168.7±14.9,t=6.49,p<0).Teaching satisfaction was 96%in the experimental group and 82%in the control group,statistically significant(χ^(2)=4.32,p=0.038).Conclusion:The scenario simulation teaching method based on the Debriefing-GAS model can significantly improve the learning initiative,reflective ability,critical thinking level and clinical practice ability of clinical nursing students,and enhance teaching satisfaction.
基金Noncommunicable Chronic Diseases-National Science and Technology Major Project(2023ZD0503906)。
文摘Background Medical informatics accumulated vast amounts of data for clinical diagnosis and treatment.However,limited access to follow-up data and the difficulty in integrating data across diverse platforms continue to pose significant barriers to clinical research progress.In response,our research team has embarked on the development of a specialized clinical research database for cardiology,thereby establishing a comprehensive digital platform that facilitates both clinical decision-making and research endeavors.Methods The database incorporated actual clinical data from patients who received treatment at the Cardiovascular Medicine Department of Chinese PLA General Hospital from 2012 to 2021.It included comprehensive data on patients'basic information,medical history,non-invasive imaging studies,laboratory test results,as well as peri-procedural information related to interventional surgeries,extracted from the Hospital Information System.Additionally,an innovative artificial intelligence(AI)-powered interactive follow-up system had been developed,ensuring that nearly all myocardial infarction patients received at least one post-discharge follow-up,thereby achieving comprehensive data management throughout the entire care continuum for highrisk patients.Results This database integrates extensive cross-sectional and longitudinal patient data,with a focus on higher-risk acute coronary syndrome patients.It achieves the integration of structured and unstructured clinical data,while innovatively incorporating AI and automatic speech recognition technologies to enhance data integration and workflow efficiency.It creates a comprehensive patient view,thereby improving diagnostic and follow-up quality,and provides high-quality data to support clinical research.Despite limitations in unstructured data standardization and biological sample integrity,the database's development is accompanied by ongoing optimization efforts.Conclusion The cardiovascular specialty clinical database is a comprehensive digital archive integrating clinical treatment and research,which facilitates the digital and intelligent transformation of clinical diagnosis and treatment processes.It supports clinical decision-making and offers data support and potential research directions for the specialized management of cardiovascular diseases.
文摘Traditional Medicine(TM),particularly Traditional Chinese Medicine(TCM),is an indispensable component of the global healthcare system,offering unique insights to modern medical science.Clinical efficacy is the bedrock for the inheritance and development of TM.To meet the growing demand for high-quality healthcare,it is imperative to integrate TM with modern technology to address the issue of insufficient evidence for the efficacy of TM.
文摘On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal disease(ESRD)at New York University(NYU)Langone Health.The UKidney is a genetically engineered porcine kidney incorporating 10 gene modifications-6 human gene insertions to enhance immunologic compatibility and 4 porcine gene knockouts to minimize rejection risk and control graft growth[1].In the context of the first xenotransplantation studies,“EXPAND”refers to the US Food and Drug Administration(FDA)“expanded access”program,often colloquially known as compassionate use.
基金Supported by Teaching and Research Project of Hubei University of Medicine(2023041).
文摘[Objectives]To explore the correlation between the clinical internship environment and professional identity of undergraduate student nurses on clinical internship.[Methods]From September 8,2023 to January 8,2024,a questionnaire survey was conducted among 315 undergraduate student nurses on clinical internship from 3 comprehensive third-grade class A hospitals in the region.The survey tools included General Information Questionnaire,Student Nurse Professional Identity Questionnaire,and Clinical Internship Environment Evaluation Scale.[Results]The total score of professional identity of the undergraduate student nurses on clinical internship was(59.55±12.78)points,and the total score of clinical internship environment was(129.31±16.02)points,both at medium to high levels.There was a significant positive correlation between clinical internship environment and professional identity(r=0.547,P<0.001).[Conclusions]The clinical internship environment is closely related to the professional identity of undergraduate student nurses on clinical internship.It is necessary to optimize the internship environment in a targeted manner to enhance the professional identity of student nurses,thereby stabilizing the nursing talent team.
文摘Any new report on the anticancer properties of natural products always awakens new satisfaction and hope about the role of the international scientific community in its continuous contributions to human health,particularly when those reports contribute to both the understanding and therapeutics of cancer.For many de-cades,natural products have been pivotal in drug discovery programs because they offer a diverse array of anticancer therapeutic possibilities.Recently,two manuscripts published in the World Journal of Gastrointestinal Oncology added new data to the already extensive body of anticancer preclinical evidence for resvera-trol and senegenin,two compounds widely present in herbal preparations used in traditional Chinese medicine.The first one,with comprehensive and recognized anticancer properties,and the second one,shows a compelling body of evidence supporting its neuroprotective effects,but with emerging anticancer activities.Natural products have become key elements in the expanding and dynamic field of anticancer drug discovery.However,urgent and collective efforts are still needed to bridge the gap between preclinical and clinical research and thus bring new anticancer therapeutic breakthroughs.
文摘The article by Granjeiro et al provided a thorough review of the role of stem cell models in the development of advanced therapy medicinal products.It emphasized the potential of stem cell models to refine preclinical studies and align with regulatory requirements for clinical applications.This article introduced a new perspective on enhancing the transition of stem cell research into clinical practice,focusing on the importance of international regulatory harmonization and the need for standardization in stem cell-based therapies.
