Objective: To assess the efficacy and safety of combining traditional Chinese medicine (TCM), specifically Chinese herbal medicine (CHM), with Western medicine (WM), compared to WM alone to treat breast cancer endocrine therapy-related osteoporosis (BCET-OP) by meta-analysis. Methods: Thirty-eight randomized controlled trials involving 2170 participants were analyzed. Eight databases were searched for articles published between inception and December 2023. Quality assessment was performed using the Risk of Bias 2 tool. Results: Significant increases were observed in the TCM-WM group in lumbar vertebrae bone mineral density (BMD) (P < .001, mean difference (MD) = 0.07, 95% confidence interval (CI): 0.06 to 0.08), lumbar vertebrae T-score (P = .0005, MD = 0.21, 95%CI: 0.09 to 0.33) and collum femoris BMD (P = .01, MD = 0.10, 95%CI: 0.02 to 0.19). No significant difference was observed between the groups in the collum femoris T-score and estradiol levels. Bone gla-protein levels were significantly increased in the TCM-WM group (P = .0002, MD = 0.52, 95%CI: 0.25 to 0.79). Beta-CrossLaps decreased significantly in the TCM-WM group (P = .0008, MD = −0.10, 95%CI: −0.16 to −0.04). No significant difference was observed between the TCM-WM and WM groups in alkaline phosphatase, in procollagen type I N-terminal propeptide, and in the Kupperman index. The visual analog score (VAS) was decreased in the TCM-WM group compared to the WM group (P < .001, MD = −1.40, 95%CI: −1.94 to −0.87). No significant difference in adverse events was observed between the two groups. Conclusion Combining CHM with WM in patients with BCET-OP significantly improved BMD, T-score, and certain bone turnover markers and reduced the VAS score, indicating potential benefits for bone health and related pain. Adverse event analysis revealed no differences between the groups, supporting the feasibility of the combination therapy. However, further research, particularly in diverse populations, is required.

Objective:To provide objective basis for the diagnosis on liver metastasis from lung cancer by analysing contrast-enhanced ultrasonography(CEUS) characteristics.Methods:In a reprospective study, CEUS was performed in 78 cases with liver metastasis from lung cancer in Renmin Hospital of Wuhan University from January 2014 to March 2019. Patients were divided into three groups: the adenocarcinoma group( n=30), squamous cell carcinoma group ( n=20), and neuroendocrine neoplasm group( n=28). Conventional ultrasound and CEUS features were analyzed and the distinctions among the three groups were compared. Results:CEUS showed that 85.9%(67/78) of the liver metastasis from lung cancer with pattern of rapid wash-in and 89.7%(70/78) of rapid wash-out, so there was no statistical difference among the three groups( P>0.05). In the adenocarcinoma and squamous cell carcinoma group, 53.3%(16/30) and 55.0%(11/20) of cases were rim-like enhancement. And 71.4%(20/28) of the neuroendocrine neoplasm group with global enhancement that was different from the other groups(all P<0.05). At the peak of enhancement, most cases were hyperenhancement among the three groups, and the difference was not statistically significant( P>0.05). During the lesions of hyperenhancement, 73.7%(14/19) was global enhancement in the neuroendocrine neoplasm, compared to 75.0% (12/16) of the adenocarcinoma group and 72.7%(8/11) of the squamous cancer group with rim-like enhancement, which the differences was statistically significant(all P<0.05). At the peak of enhancement, 67.9%(19/28) lesions of the neuroendocrine neoplasm group were homogeneous enhancement, and only 21.4%(6/28) of the lesions was observed non-enhanced area, which was different from the other groups(all P<0.05). The times to iso-echogenity and hypo-echogenity were (33.2±7.6)s and (45.1±10.8)s respectively in the neuroendocrine neoplasm group, which were more than the other groups(all P<0.05). Capsule enhancement appeared in 32.1%(9/28) of the neuroendocrine neoplasm group in the delay phase, which was higher than 13.3%(4/30) of the adenocarcinoma group and 10.0%(2/20) of squamous cell carcinoma group (all P<0.05). Conclusions:CEUS can provide more diagnostic information for liver metastasis from lung cancer and may be a beneficial technique for differential diagnosis.

Spontaneous intracranial hypotension patients may have complications, such as cerebral venous thrombosis and intracranial subdural hematoma, while complicating with spinal epidural hematoma is rarely reported. A spontaneous intracranial hypotension patient, who started with orthostatic headache, followed by cerebral venous thrombosis , manifested as seizure, status epilepticus, and parenchymal hemorrhage, was admitted to Sir Run Run Shaw Hospital. Spinal evaluation showed lumbar epidural hematoma, without spinal cord compression symptoms. The patient improved with bed rest, fluid infusion, antiepileptic drug, and anticoagulation therapy. Three weeks after discharge, headache recurred without complete remission after lying flat. Cranial neuroimaging showed bilateral subdural hematoma. Anticoagulation was ceased. Subdural hematoma absorbed after treated with two epidural blood patches. The patient was headache-free during follow-up.

Objective To explore the regulation of Chaihuang Qingyi Huoxue Granule on intestinal microecological changes in rats with severe acute pancreatitis (SAP) and the potential mechanism for its treatment of SAP. Methods Forty-eight rats were randomly divided into sham operation group (SHAM),SAP model group (SAP),and Chaihuang Qingyi Huoxue Granule (CH)group,with 16 rats in each group. Each group was further divided into 12 h and 24 h subgroups. The SAP model was induced by retrograde injection of 5％ sodium taurocholate into the pancreaticobiliary duct through duodenal wall. The SHAM and SAP groups received normal saline by gavage,while the CH group received 1.2 g·kg-1 Chaihuang Qingyi Huoxue Granule solution by gavage every six hours. At 12 h and 24 h after operation,eight rats from each group were sacrificed to collect abdominal aortic blood,pancreatic and ileal tissues for analysis. Ascites,pancreatic and ileal tissues were observed. Serum amylase(AMY) and lipase (LPS) levels were measured biochemically. Pathological changes in pancreatic and ileal tissues were investigated by HE staining. Claudin-1 protein expression in ileal tissue was detected by Western Blot. Changes in the intestinal flora of ileocecal contents were analyzed by 16S rDNA high-throughput sequencing. Results Compared to the SHAM group at the same time points,the SAP group exhibited extensive pancreatic edema and necrosis. Serum AMY and LPS levels,pancreatic and ileal histopathological scores increased,and Claudin-1 protein expression in ileal tissue markedly decreased (all P<0.05). The differences in abundance of microbial community increased,while the evenness of community composition reduced. The microbial richness showed no significant change (P>0.05),but the microbial diversity decreased(P<0.05). Proteobacteria were dominant intestinal bacteria. Relative abundances of Oscillospira,Ruminococcus,Bifidobacterium,and Bacteroides S24-7 decreased,whereas relative abundances of Shigella and Allobaculum increased. The differences in abundance of microbial community reduced,and the evenness of community composition increased. The microbial richness showed no significant change(P>0.05),but the microbial diversity increased (P<0.05). Firmicutes and Bacteroidetes were the dominant intestinal bacteria. Relative abundances of Oscillospira,Ruminococcus,Bifidobacterium,and Bacteroides S24-7 increased,whereas relative abundances of Shigella and Allobaculum decreased. After the intervention of CH,pathological damage in ileal tissue was improved. The expression of Claudin-1 protein in the intestinal mucosal barrier increased compared to the model group(P<0.05). The differences in abundance of microbial community reduced,and the evenness of community composition increased. CH group showed an increase in some beneficial bacteria and decrease in pathogenic bacteria compared to model group. Conclusion Chaihuang Qingyi Huoxue Granule may reduce pancreas injury in rats with SAP,which may be involved in modulating the intestinal microecology and improving intestinal mucosal barrier function.