Objective To explore enteral nutrition support and analyze its influencing factors in elderly patients with ischemic stroke. Methods A total of 328 patients with ischemic stroke in General Hospital of Western Theater Command were enrolled for nutritional screening between July 2020 and February 2024. Corresponding nutritional support plans were selected to investigate the compliance of patients with enteral nutrition support. Patients were divided into a standard group (n=140) and a non-standard group (n=97) based on whether their calorie intake met the standard. The effects of different clinical characteristics on enteral nutrition support were explored, and logistic analysis was used to analyze the influencing factors of non-standard enteral nutrition support. Results In the 328 patients with ischemic stroke, proportions of total parenteral nutrition support, total enteral nutrition support, and parenteral/enteral nutrition support were 25.30%, 27.74% and 46.95%, respectively. The proportions of vomiting or regurgitation, gastric residual volume >100 mL, mechanical ventilation and use of antibiotics >2 in the non-standard group were higher than those in the standard group (P<0.05). Logistic analysis showed that the above clinical characteristics were risk factors influencing patients with enteral nutrition support and parenteral/enteral nutrition support. Conclusion Vomiting or regurgitation , gastric residual volume, mechanical ventilation, and amount of antibiotics used are important influencing factors of enteral nutrition support in patients. Clinicians should pay attention to the above clinical characteristics.

Objective: To systematically analyze the revisions content and technological development trends of microbiological standards in the Chinese Pharmacopoeia (ChP) 2025 Edition, and explore its novel requirements in risk-based pharmaceutical product lifecycle management.
Methods: A comprehensive review was conducted on 26 microbiological-related standards to summarize the revision directions and scientific implications from perspectives including the revision overview, international harmonization of microbiological standards, risk-based quality management system, and novel tools and methods with Chinese characteristics.
Results: The ChP 2025 edition demonstrates three prominent features in microbiological-related standards: enhanced international harmonization, introduced emerging molecular biological technologies, and established a risk-based microbiological quality control system.
Conclusion: The new edition of the Pharmacopoeia has systematically constructed a microbiological standard system, which significantly improves the scientificity, standardization and applicability of the standards, providing a crucial support for advancing the microbiological quality control in pharmaceutical industries of China.

The study aimed to construct the second and third generation chimeric antigen receptor T cells (CAR-T) targeting the c-mesenchymal-epithelial transition factor (c-Met) protein, and observe their killing effect on human serous ovarian cancer cell SKOV-3. The expression of MET gene in ovarian serous cystadenocarcinoma, the correlation between MET gene expression and the abundance of immune cell infiltration, and the effect of MET gene expression on the tissue function of ovarian serous cystadenocarcinoma were analyzed by bioinformatics. The expression of c-Met in ovarian cancer tissues and adjacent tissues was detected by immunohistochemical staining. The second and third generation c-Met CAR-T cells, namely c-Met CAR-T(2G/3G), were prepared by lentivirus infection, and the cell subsets and infection efficiency were detected by flow cytometry. Using CD19 CAR-T and activated T cells as control groups and A2780 cells with c-Met negative expression as Non target groups, the kill efficiency on SKOV-3 cells with c-Met positive expression, cytokine release and cell proliferation of c-Met CAR-T(2G/3G) were explored by lactate dehydrogenase (LDH) release, ELISA and CCK-8 respectively. The results showed that MET gene expression was significantly up-regulated in ovarian cancer tissues compared with normal tissues, which was consistent with the immunohistochemistry results. However, in all pathological stages, there was no obvious difference in MET expression and no correlation between MET gene expression and the race and age of ovarian cancer patients. The second generation and third generation c-Met CAR-T cells were successfully constructed. After lentivirus infection, the proportion of CD8⁺ T cells in c-Met CAR-T(2G) was upregulated, while there was no significant change in the cell subsets of c-Met CAR-T(3G). The LDH release experiment showed that the kill efficiency of c-Met CAR-T(2G/3G) on SKOV-3 increased with the increase of effect-target ratio. When the effect-target ratio was 20:1, the kill efficiency of c-Met CAR-T(2G) reached (42.02 ± 5.17)% (P < 0.05), and the kill efficiency of c-Met CAR-T(3G) reached (51.40 ± 2.71)% (P < 0.05). ELISA results showed that c-Met CAR-T released more cytokine compared to CD19 CAR-T and activated T cells (P < 0.05). Moreover, the cytokine release of c-Met CAR-T(3G) was higher than c-Met CAR-T(2G) (P < 0.01). The CCK-8 results showed that after 48 h, the cell number of c-Met CAR-T(2G) was higher than that of c-Met CAR-T(3G) (P < 0.01). In conclusion, both the second and third generation c-Met CAR-T can target and kill c-Met-positive SKOV-3 cells, with no significant difference. c-Met CAR-T(2G) has stronger proliferative ability, and c-Met CAR-T(3G) releases more cytokines.
Humans ; Female ; Ovarian Neoplasms/immunology* ; Proto-Oncogene Proteins c-met/metabolism* ; Receptors, Chimeric Antigen/immunology* ; Cell Line, Tumor ; Cystadenocarcinoma, Serous/immunology* ; T-Lymphocytes/immunology*

OBJECTIVES: To explore the relationship between white matter injury (WMI) and cerebral perfusion in preterm infants using arterial spin labeling (ASL). METHODS: A total of 293 preterm infants (gestational age <34 weeks) hospitalized at the Third Affiliated Hospital of Zhengzhou University between June 2022 and June 2024 were included. After achieving clinical stability, the infants underwent brain magnetic resonance imaging (MRI) and ASL. Based on MRI findings, infants were classified into WMI (n=66) and non-WMI (n=227) groups. Cerebral perfusion parameters were compared between groups, and the association between WMI and perfusion alterations was evaluated. RESULTS: The WMI group showed a higher incidence of mild intraventricular hemorrhage (IVH) than the non-WMI group (P<0.05). Significantly lower cerebral perfusion was observed in the WMI group across bilateral frontal, temporal, parietal, and occipital lobes, as well as the basal ganglia and thalamus (P<0.05). After adjusting for gestational age, corrected gestational age at ASL scan, and mild IVH, WMI remained significantly associated with reduced regional perfusion (P<0.05). CONCLUSIONS WMI in preterm infants correlates with localized cerebral hypoperfusion. ASL-detected perfusion abnormalities may provide novel insights into WMI pathogenesis.
Humans ; White Matter/blood supply* ; Infant, Newborn ; Spin Labels ; Infant, Premature ; Female ; Male ; Cerebrovascular Circulation ; Magnetic Resonance Imaging

Progressive pulmonary fibrosis (PPF) is a progressive and lethal condition with few effective treatment options. Improvements in quality of life for patients with PPF remain limited even while receiving treatment with approved antifibrotic drugs. Traditional Chinese medicine (TCM) has the potential to improve cough, dyspnea and fatigue symptoms of patients with PPF. TCM treatments are typically diverse and individualized, requiring urgent development of efficient and precise design strategies to identify effective treatment options. We designed an innovative Bayesian adaptive two-stage trial, hoping to provide new ideas for the rapid evaluation of the effectiveness of TCM in PPF. An open-label, two-stage, adaptive Bayesian randomized controlled trial will be conducted in China. Based on Bayesian methods, the trial will employ response-adaptive randomization to allocate patients to study groups based on data collected over the course of the trial. The adaptive Bayesian trial design will employ a Bayesian hierarchical model with "stopping" and "continuation" criteria once a predetermined posterior probability of superiority or futility and a decision threshold are reached. The trial can be implemented more efficiently by sharing the master protocol and organizational management mechanisms of the sub-trial we have implemented. The primary patient-reported outcome is a change in the Leicester Cough Questionnaire score, reflecting an improvement in cough-specific quality of life. The adaptive Bayesian trial design may be a promising method to facilitate the rapid clinical evaluation of TCM effectiveness for PPF, and will provide an example for how to evaluate TCM effectiveness in rare and refractory diseases. However, due to the complexity of the trial implementation, sufficient simulation analysis by professional statistical analysts is required to construct a Bayesian response-adaptive randomization procedure for timely response. Moreover, detailed standard operating procedures need to be developed to ensure the feasibility of the trial implementation. Please cite this article as: Zhang C, Nie YS, Zhang CT, Yang HJ, Zhang HR, Xiao W, Cui GF, Li J, Li SJ, Huang QS, Yan SY. An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design. J Integr Med. 2025; 23(2): 138-145.
Female ; Humans ; Male ; Bayes Theorem ; Disease Progression ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional/methods* ; Pulmonary Fibrosis/therapy* ; Quality of Life ; Randomized Controlled Trials as Topic ; Research Design ; Adaptive Clinical Trials as Topic

OBJECTIVE: Varied acupoint selections represent a potential cause of the uncertainty surrounding the efficacy of acupuncture for knee osteoarthritis (OA). Skin temperature, a guiding factor for acupoint selection, may help to address this issue. This study explored thermal sensitization of acupoints used for the treatment of knee OA. METHODS: This cross-sectional case-control study enrolled cases aged 45-75 years with symptomatic knee OA and age- and gender-matched non-knee OA controls in a 1:1 ratio. All participants underwent infrared thermographic imaging. The primary outcome was the relative skin temperature of acupoint (STA), and the secondary outcome was the absolute STA of 11 acupoints. The Z test was used to compare the relative and absolute STAs between the groups. Principal component analysis was used to extract the common factors (CFs, acupoint cluster) in the STAs. A general linear model was used to identify factors affecting the STA in the knee OA cases. For the group comparisons of relative STA, P < 0.0045 (adjusted for 11 acupoints through Bonferroni correction) was considered to indicate statistical significance. For other analyses, P < 0.05 was used as the threshold for statistical significance. RESULTS: The analysis included 308 participants, consisting of 151 cases (mean age: [64.58 ± 6.67] years; male: 25.83%; mean body mass index: [25.70 ± 3.16] kg/m²) and 157 controls (mean age: [63.37 ± 5.96] years; male: 26.11%; mean body mass index: [24.47 ± 2.84] kg/m²). The relative STAs of ST34 (P = 0.0001), EX-LE2 (P < 0.0001), EX-LE5 (P = 0.0006), SP10 (P < 0.0001), BL40 (P = 0.0012) and GB39 (P = 0.0037) were higher in the knee OA group. No difference was found in the STAs of ST35, ST36, SP9, GB33 and GB34. Four CFs were identified for relative STA in both groups. The acupoints within each CF were consistent between the groups. The mean values of the relative STAs across each CF were higher in the knee OA group. In the knee OA cases, no factors were observed to affect the relative STA, while age and gender were found to affect the absolute STA. CONCLUSION Among patients with knee OA, thermal sensitization occurs in the acupoints of the lower extremity, exhibiting localized and regional thermal consistencies. The thermally sensitized acupoints that we identified in this study, ST34, SP10, EX-LE2, EX-LE5, GB39 and BL40, may be good choices for the acupuncture treatment of knee OA. Please cite this article as: Tu JF, Wang XZ, Yan SY, Wang YR, Yang JW, Shi GX, Zhang WZ, Jing LN, Yang LS, Liu DH, Wang LQ, Mi BH. Thermal sensitization of acupoints in patients with knee osteoarthritis: A cross-sectional case-control study. J Integr Med. 2025; 23(3): 289-296.
Humans ; Osteoarthritis, Knee/physiopathology* ; Male ; Cross-Sectional Studies ; Middle Aged ; Female ; Acupuncture Points ; Case-Control Studies ; Aged ; Skin Temperature ; Acupuncture Therapy

OBJECTIVE: The results of limited studies on the relationship between environmental pollution and dementia have been contradictory. We analyzed the combined effects of PM _2.5 and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population. METHODS: We assessed 24,117 individuals along with the annual average PM _2.5 concentrations from 2012 to 2016. Dementia was confirmed in the baseline survey at a qualified clinical facility, and newly suspected dementia was assessed in 2017, after excluding cases of suspected dementia in 2015. National census data were used to weight the sample data to reflect the entire population in China, with multiple logistic regression performed to analyze the combined effects of PM _2.5 and smoking frequency on dementia and cognitive impairment. RESULTS: Individuals exposed to the highest PM _2.5 concentration and smoked daily were at higher risk of dementia than those in the lowest PM _2.5 concentration group ( OR, 1.603; 95% CI [1.626-1.635], P < 0.0001) and in the nonsmoking group ( OR, 1.248; 95% CI [1.244-1.252]; P < 0.0001). Moderate PM _2.5 exposure and occasional smoking together increased the short-term risk of cognitive impairment. High-level PM _2.5 exposure and smoking were associated with an increased risk of dementia, so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns. CONCLUSION High-level PM _2.5 exposure and smoking were associated with an increased risk of dementia. Lowering the ambient PM _2.5, and smoking cessation are recommended to promote health.
Humans ; Dementia/etiology* ; Male ; Aged ; Female ; Cognitive Dysfunction/etiology* ; China/epidemiology* ; Particulate Matter/analysis* ; Smoking/epidemiology* ; Air Pollutants/analysis* ; Aged, 80 and over ; Environmental Exposure/adverse effects* ; Prevalence ; Middle Aged

Cells undergo glucose metabolism reprogramming under the influence of the inflammatory microenvironment, changing their primary mode of energy supply from oxidative phosphorylation to aerobic glycolysis. This process is involved in all stages of inflammation-related diseases development. Glucose metabolism reprogramming not only changes the metabolic pattern of individual cells, but also disrupts the metabolic homeostasis of the body microenvironment, which further promotes aerobic glycolysis and provides favourable conditions for the malignant progression of inflammation-related diseases. The metabolic enzymes, transporter proteins, and metabolites of aerobic glycolysis are all key signalling molecules, and drugs can inhibit aerobic glycolysis by targeting these specific key molecules to exert therapeutic effects. This paper reviews the impact of glucose metabolism reprogramming on the development of inflammation-related diseases such as inflammation-related tumours, rheumatoid arthritis and Alzheimer's disease, and the therapeutic effects of drugs targeting glucose metabolism reprogramming on these diseases.

Objective To analyze the therapeutic effect and mechanism of Cangfu Daotan Decoction on obese polycystic ovary syndrome(PCOS)rats.Methods Fifteen female SD rats were randomly divided into normal group,model group and Chinese medicine group,with five rats in each group.In addition to the normal group,the remaining rats were treated with Letrozole Solution by gavage combined with high-fat diet to construct an obese PCOS model.After successful modeling,the rats in the Chinese medicine group were given Cangfu Daotan Decoction by gavage for 30 days.At the end of administration,the ovarian protein expression of rats in each group was detected by non-standard proteomics quantitative technique,and the results of differential protein function,gene ontology(GO)enrichment,Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment and differential protein KEGG pathway clustering were compared.Results The functions of differential proteins between the model group and the normal group were mainly concentrated in lipid transport,metabolism and post-translational modification,and protein transcription,and the cluster analysis results of KEGG pathway enrichment and pathway enrichment were mainly concentrated in the degradation of valine,leucine and isoleucine,arginine and proline metabolism,tryptophan metabolism pathway enrichment and renin angiotensin system.The functions of differential proteins between the Chinese medicine group and the model group were concentrated in information storage and processing,especially in transformation,ribosomal structure and signal transduction mechanism,and the cluster analysis results of KEGG pathway enrichment and pathway enrichment were mainly concentrated in ribosome metabolism,drug metabolism-cytochrome P450,methyl butyrate metabolism,and vitamin B6 metabolism.The functional classification of differential proteins between Chinese medicine group and normal group was mainly in signal transduction mechanism,lipid transport and metabolism,and the clustering analysis results of KEGG pathway enrichment and pathway enrichment were mainly concentrated in ribosome,protein digestion and absorption,steroid hormone biosynthesis pathway,cell adhesion molecule,glycerol lipid metabolism and gastric acid secretion.Conclusion Cangfu Daotan Decoction may play a role in the treatment of obese PCOS by regulating branched-chain amino acid metabolism,renin-angiotensin-aldosterone system and steroid hormone synthesis pathway.

AIM:To investigate the inhibitory effect of mogroside V(MV)on ferroptosis of human neuroblas-toma SH-SY5Y cells induced by RAS-selective lethal 3(RSL3),and to explore its possible mechanism.METHODS:To establish a model of ferroptosis,the SH-SY5Y cell was induced by RSL3.The cell viability and cellular morphology were determined by MTT assay and inverted microscopy,respectively.The intracellular ferrous ion content was measured by ferrous ion fluorescence probe FerrOrange.Mitochondrial membrane potential(MMP)was detected by mitochondrial red fluorescent probe MitoTracker Red CMXRos.The intracellular and mitochondrial reactive oxygen species(ROS)were de-tected by superoxide anion fluorescent probe dihydroethidium and mitochondrial superoxide red fluorescent probe MitoSOX Red,respectively.The cellular glutathione(GSH)and malondialdehyde(MDA)levels were tested by microplate assay.The protein levels of acyl-coenzyme A synthetase long-chain family member 4(ACSL4),cyclooxygenase-2(COX-2),glu-tathione peroxidase 4(GPX4)and solute carrier family 7 member 11(SLC7A11)were detected by Western blot.Molecu-lar docking techniques were employed to predict the targeting relations between MV and ACSL4/COX-2/GPX4/SLC7A11.RESULTS:Compared with control group,the SH-SY5Y cell viability,the MMP and the GSH level in RSL3 group were significantly reduced(P<0.01),while the intracellular ferrous ion level,the intracellular and mitochondrial ROS levels and the MDA level were significantly increased(P<0.05 or P<0.01).The protein levels of ACSL4 and COX-2 in RSL3 group were significantly increased,while the protein levels of GPX4 and SLC7A11 were significantly decreased(P<0.01),indicating the establishment of cell ferroptosis model.Compared with RSL3 group,the viability of SH-SY5Y cells,the MMP,the GSH level,and the GPX4 and SLC7A11 protein levels in RSL3+MV groups were significantly in-creased(P<0.05 or P<0.01),while the intracellular ferrous ion level,the intracellular and mitochondrial ROS levels,the MDA level,and the ACSL4 and COX-2 protein levels were significantly decreased(P<0.05 or P<0.01).The binding sites between MV and ferroptosis core proteins(ACSL4,COX-2,GPX4 and SLC7A11)were found by molecular docking.CONCLUSION:Treatment with MV alleviates RSL3-induced ferroptosis of SH-SY5Y cells,and the underlying mecha-nism may be associated with the activation of SLC7A11/GPX4 and the inhibition of ACSL4/COX-2.