The " inflammation cancer transformation" in chronic gastritis is a complex process that involves multiple factors,stages,and mechanisms. As the disease progresses,morphological changes occur in the gastric mucosal gland orifices and capillary vessels,and pathologically,it is characterized by a reduction in the number of glands,structural disarray,or cellular atypia. In traditional Chinese medicine,the onset of chronic gastritis is believed to be related to external pathogenic factors invading the stomach or the internal generation of various pathogenic factors. The disease process is considered to progress from qi to blood,and from meridians to collaterals,which is in line with the theory of "prolonged disease invading collaterals". This article explores the pathogenesis,prevention,and treatment of the "inflammation cancer transformation" in chronic gastritis based on the theory of the stomach collaterals,summarizing the characteristics of the disease evolution as follows:the stomach collaterals are invaded by pathogenic factors,leading to disharmony of qi and collaterals;obstruction of the stomach collaterals,resulting in the internal production of turbid toxins;and deficiency of the stomach collaterals,leading to the loss of nourishment and masses. Clinically,the therapeutic methods include expelling pathogenic factors,regulating qi,and activating collaterals;resolving stasis and detoxifying to unblock collaterals;and replenishing deficiency and eliminating masses to nourish the collaterals,thereby ensuring the patency of the stomach collaterals and the nourishment of the stomach. Starting from the theory of the stomach collaterals and integrating modern scientific research,this article aims to provide theoretical reference and practical guidance for the differential diagnosis and dynamic comprehensive management of the "inflammation cancer transformation" in chronic gastritis.

Objective:To provide evidence-based recommendations for the prevention and management of lower limb ischemia in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients during treatment according to search, evaluate, and summarize the best evidence on the prevention and management of lower limb ischemia in patients with VA-ECMO.Methods:Based on the PIPOST framework (population, intervention, professional, outcome, setting, and type of evidence), an evidence-based question was formulated. A systematic search was conducted according to the "6S" evidence pyramid model in both domestic and international databases, as well as professional association websites, for all evidence related to the prevention and management of lower limb ischemia in VA-ECMO patients (aged ≥18 years). The types of evidence included clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and original studies. The search was conducted from the construction of the databases to February 2024. Two researchers independently conducted a literature quality evaluation, extracted and summarized evidence from the studies that met the quality criteria.Results:A total of 13 articles were included, consisting of 3 clinical decisions, 3 guidelines, 3 expert consensus, 3 systematic reviews, and 1 randomized controlled trial. A total of 18 pieces of evidence in 7 dimensions were summarized, including risk factors of VA-ECMO lower limb ischemia, evaluation before catheterization, evaluation and monitoring during treatment, prevention of lower limb ischemia, treatment of lower limb ischemia, management of distal perfusion catheter (DPC), and monitoring after VA-ECMO weaning.Conclusion:This evidence summary provides evidence-based recommendations for the prevention and management of lower limb ischemia in VA-ECMO patients, aiming to assist clinical healthcare professionals in developing tailored strategies for the prevention and management of lower limb ischemia based on during VA-ECMO support.

Multiple system atrophy (MSA) is a rare neurodegenerative disease with complex clinical manifestations, presenting substantial challenges in clinical diagnosis and treatment. Its symptoms and the eight extraordinary meridians are potentially correlated; therefore, this article explores the association between MSA symptom clusters and the eight extraordinary meridians based on their circulation and physiological functions, as well as their treatment strategies. The progression from deficiency to damage in the eight extraordinary meridians aligns with the core pathogenesis of MSA, which is characterized by "the continuous accumulation of impacts from the vital qi deficiency leading to eventual damage". Liver and kidney deficiency and the emptiness of the eight extraordinary meridians are required for the onset of MSA; the stagnation of qi deficiency and the gradual damage to the eight extraordinary meridians are the key stages in the prolonged progression of MSA. The disease often begins with the involvement of the yin and yang qiao mai, governor vessel, thoroughfare vessel, and conception vessel before progressing to multiple meridian involvements, ultimately affecting all eight extraordinary meridians simultaneously. The treatment approach emphasizes that "the direct method may be used for joining battle, but indirect method will be needed in order to secure victory" and focuses on "eliminate pathogenic factors and reinforce healthy qi". Distinguishing the extraordinary meridians and focusing on the primary symptoms are pivotal to improving efficacy. Clinical treatment is aimed at the target, and tailored treatment based on careful clinical observation ensures precision in targeting the disease using the eight extraordinary meridians as the framework and core symptoms as the specific focus. Additionally, combining acupuncture, daoyin therapy, and other method may help prolong survival. This article classifies clinical manifestations based on the theory of the eight extraordinary meridians and explores treatment.