ObjectiveTo observe the clinical efficacy and radiographic outcomes of manipulative reduction combined with small splint fixation in the treatment of distal radius fractures. MethodsThe clinical data of 1051 patients with distal radius fractures were retrospectively collected from five hospitals included in the Jiangsu Diagnosis and Treatment Data Platform for Traditional Chinese Medicine（TCM） Dominant Diseases. Propensity score matching at a 1∶4 ratio was applied， resulting in 580 cases selected for final analysis， which comprised 448 patients in the TCM group（manipulative reduction plus small splint fixation） and 132 in the surgical treatment group（open reduction and internal fixation）. Each group was further stratified into type A， B， and C subgroups based on AO fracture classification. Radiographic indicators including palmar tilt， radial inclination， and radial height were compared between groups before treatment and 1 day， 1 week， and 4-6 weeks after treatment， and pain visual analog scale（VAS） scores before treatment and 1 week and 4-6 weeks after treatment were also compared. Wrist joint function was assessed 12 weeks after treatment， using the Dienst wrist function score and the Gartland and Werley（G-W） wrist function score. Additionally， the radiographic indicators at different timepoints and the 12-week wrist function levels were compared between groups across different fracture types. ResultsNo statistically significant difference was observed in radiographic indicators and VAS scores at all timepoints before and after treatment， as well as wrist joint function grades assessed by the Dienst score and the G-W score at 12 weeks after treatment （P＞0.05）. Compared to those before treatment， both groups showed increased palmar tilt， radial inclination， and radial height 1 week and 4-6 weeks after treatment， and decreased VAS scores （P＜0.05）. Compared to those 1 week after treatment， both groups showed a decrease in palmar tilt， an increase in radial inclination and radial height， and a reduction in VAS score 4-6 weeks after treatment（P＜0.05）. In type A and B subgroups， the surgical treatment group had a higher radial inclination than the TCM group 4-6 weeks after treatment， while in the type C subgroup， a higher radial height was shown in the surgical treatment group than in the TCM group 4-6 weeks after treatment（P＜0.05）. In type C subgroup， there was significant difference between groups in the wrist joint function by G-W scores 12 weeks after treatment（P＜0.05）. ConclusionManipulative reduction combined with small splint fixation can maintain fracture alignment and alleviate pain in treating distal radius fractures， which achieves therapeutic outcomes comparable to surgical treatment. It is particularly suitable for type A and B fractures and can be considered an effective treatment option for distal radius fractures.

As one of the most common malignant tumors， digestive system tumors exhibit an increase in the incidence and mortality year by year. Its pathogenesis is complex， making it difficult to carry out early prevention. Autophagy is a process in which cells use lysosomes to degrade their organelles and macromolecules to maintain cellular homeostasis under the regulation of autophagy-related genes. Cellular autophagy has a dual regulatory effect on the tumor microenvironment， which always affects the occurrence and development of digestive system tumors. Therefore， the effect and mechanism of action of cellular autophagy on digestive system tumors have become a hot topic in tumor therapy in recent years. Meanwhile， the remarkable research results of targeted autophagy drugs indicate that cellular autophagy may become an important target for anti-digestive system tumors. Traditional Chinese medicine （TCM） has been widely used in the comprehensive treatment of digestive system tumors with good efficacy. A variety of active ingredients in TCM， such as flavonoids， glycosides， terpenoids， quinones， and alkaloids， can increase the expression of autophagy-associated proteins microtubule-associated protein 1 light chain 3 （LC3）Ⅱ/Ⅰ， autophagy-related gene （ATG）5， ATG7， inhibit the expression of autophagy-related protein p62 ， and induce autophagy in digestive system tumor cells， thereby exerting the anti-digestive system tumor effect. By summarizing the research results in recent years on the modulation of cell autophagy by active ingredients in TCM to fight against digestive system tumors， this paper analyzed the relevant signaling pathways， regulatory factors， and functional characteristics of cell autophagy modulation， so as to elucidate the mechanism by which active ingredients of TCM induce autophagy and to provide ideas and references for clinical application.

As one of the most common malignant tumors， digestive system tumors exhibit an increase in the incidence and mortality year by year. Its pathogenesis is complex， making it difficult to carry out early prevention. Autophagy is a process in which cells use lysosomes to degrade their organelles and macromolecules to maintain cellular homeostasis under the regulation of autophagy-related genes. Cellular autophagy has a dual regulatory effect on the tumor microenvironment， which always affects the occurrence and development of digestive system tumors. Therefore， the effect and mechanism of action of cellular autophagy on digestive system tumors have become a hot topic in tumor therapy in recent years. Meanwhile， the remarkable research results of targeted autophagy drugs indicate that cellular autophagy may become an important target for anti-digestive system tumors. Traditional Chinese medicine （TCM） has been widely used in the comprehensive treatment of digestive system tumors with good efficacy. A variety of active ingredients in TCM， such as flavonoids， glycosides， terpenoids， quinones， and alkaloids， can increase the expression of autophagy-associated proteins microtubule-associated protein 1 light chain 3 （LC3）Ⅱ/Ⅰ， autophagy-related gene （ATG）5， ATG7， inhibit the expression of autophagy-related protein p62 ， and induce autophagy in digestive system tumor cells， thereby exerting the anti-digestive system tumor effect. By summarizing the research results in recent years on the modulation of cell autophagy by active ingredients in TCM to fight against digestive system tumors， this paper analyzed the relevant signaling pathways， regulatory factors， and functional characteristics of cell autophagy modulation， so as to elucidate the mechanism by which active ingredients of TCM induce autophagy and to provide ideas and references for clinical application.

Objective To explore the anti-inflammatory mechanism of Tong-Xie-Yao-Fang's intervention on irritable bowel syndrome with diarrhea(IBS-D),the effects of Tong-Xie-Yao-Fang on farnesol receptor(FXR),nuclear factor-κB(NF-κB)and inflammatory factors in IBS-D model rats were observed.Methods Healthy SD rats were randomly divided into blank group(Control group),model group(Model group),low-dose group of Tong-Xie-Yao-Fang(TXYF-L group,4.977 g/kg),middle-dose group of Tong-Xie-Yao-Fang(TXYF-M group,9.954 g/kg),and high-dose group of Tong-Xie-Yao-Fang(TXYF-H group,19.908 g/kg),Pivium bromide group(PWXA group,0.018 g/kg),with 10 rats in each group.Except for the blank group,the IBS-D rat models of liver depression and spleen deficiency were established by chronic restraint stress and senna intragastric administration.After the model was successfully established,the intervention was continued for 14 days according to the corresponding group treatment method.The general situation,diarrhea rate,fecal moisture content,water injection when abdominal wall retraction reflex reaches 3 scores,sugar water preference rate and serum D-xylose level were observed.The morphological and structural changes of rat colon were observed by HE staining.The expression of FXR gene in colon tissue was detected by real-time fluorescence quantitative PCR,the expression of FXR protein and NF-κB protein in colon tissue was detected by protein Western blot,and the levels of serum IL-6,IL-8 and TNF-α were detected by ELISA.Results After the treatment of Tong-Xie-Yao-Fang,the weight of each dosage group of Tong-Xie-Yao-Fang increased,the fecal water content decreased,the sugar water preference rate increased,the water injection volume increased when the rats reached the third grade of abdominal retraction reflex score,the serum D-xylose content increased and the food intake increased.HE staining showed that villous or finger-like structures appeared in the mucosal epithelium of model group,and inflammatory cells infiltrated in the upper mucosa.After treatment,the mucosal epithelium in TXYF-M group was smooth,villous or finger-like structures disappeared,and the infiltration degree of inflammatory cells decreased.Compared with the model group,the expression of FXR mRNA and FXR protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang increased significantly,while the concentration of IL-6,IL-8 and TNF-α in serum and the expression of NF-κB protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang decreased.Conclusion The mechanism of Tong-Xie-Yao-Fang in treating low-grade inflammation of IBS-D intestinal mucosa may be related to activating the expression of FXR in colon,inhibiting the expression of NF-κB in colon tissue,and then reducing the concentration of pro-inflammatory factors IL-6,IL-8 and TNF-α in serum.

Objective To explore the anti-inflammatory mechanism of Tong-Xie-Yao-Fang's intervention on irritable bowel syndrome with diarrhea(IBS-D),the effects of Tong-Xie-Yao-Fang on farnesol receptor(FXR),nuclear factor-κB(NF-κB)and inflammatory factors in IBS-D model rats were observed.Methods Healthy SD rats were randomly divided into blank group(Control group),model group(Model group),low-dose group of Tong-Xie-Yao-Fang(TXYF-L group,4.977 g/kg),middle-dose group of Tong-Xie-Yao-Fang(TXYF-M group,9.954 g/kg),and high-dose group of Tong-Xie-Yao-Fang(TXYF-H group,19.908 g/kg),Pivium bromide group(PWXA group,0.018 g/kg),with 10 rats in each group.Except for the blank group,the IBS-D rat models of liver depression and spleen deficiency were established by chronic restraint stress and senna intragastric administration.After the model was successfully established,the intervention was continued for 14 days according to the corresponding group treatment method.The general situation,diarrhea rate,fecal moisture content,water injection when abdominal wall retraction reflex reaches 3 scores,sugar water preference rate and serum D-xylose level were observed.The morphological and structural changes of rat colon were observed by HE staining.The expression of FXR gene in colon tissue was detected by real-time fluorescence quantitative PCR,the expression of FXR protein and NF-κB protein in colon tissue was detected by protein Western blot,and the levels of serum IL-6,IL-8 and TNF-α were detected by ELISA.Results After the treatment of Tong-Xie-Yao-Fang,the weight of each dosage group of Tong-Xie-Yao-Fang increased,the fecal water content decreased,the sugar water preference rate increased,the water injection volume increased when the rats reached the third grade of abdominal retraction reflex score,the serum D-xylose content increased and the food intake increased.HE staining showed that villous or finger-like structures appeared in the mucosal epithelium of model group,and inflammatory cells infiltrated in the upper mucosa.After treatment,the mucosal epithelium in TXYF-M group was smooth,villous or finger-like structures disappeared,and the infiltration degree of inflammatory cells decreased.Compared with the model group,the expression of FXR mRNA and FXR protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang increased significantly,while the concentration of IL-6,IL-8 and TNF-α in serum and the expression of NF-κB protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang decreased.Conclusion The mechanism of Tong-Xie-Yao-Fang in treating low-grade inflammation of IBS-D intestinal mucosa may be related to activating the expression of FXR in colon,inhibiting the expression of NF-κB in colon tissue,and then reducing the concentration of pro-inflammatory factors IL-6,IL-8 and TNF-α in serum.

As a common malignant tumor of the respiratory system， the incidence and mortality of lung cancer are still rising year by year. Its pathogenesis is complex， the prognosis is poor， and it seriously affects human physical and mental health. Although existing Western medical treatments can inhibit tumor growth to a certain extent and relieve patients' painful symptoms， problems such as postoperative recurrence and metastasis， numerous adverse reactions， and the tendency to develop drug resistance make the overall therapeutic effect unsatisfactory. Therefore， it is urgent to seek more efficient and safer treatments. Adenosine monophosphate-activated protein kinase （AMPK） signaling pathway can regulate the growth， differentiation， apoptosis， and autophagy of lung cancer cells， and is extensively involved in the occurrence and development of lung cancer， thus being regarded as an important target for anti-lung cancer therapy. Traditional Chinese medicine （TCM） exerts anti-lung cancer effects through multiple pathways， mechanisms， and targets， with advantages such as preventing postoperative recurrence and metastasis， alleviating the adverse reactions of radiotherapy and chemotherapy， and improving quality of life. TCM has therefore become a key approach in current anti-lung cancer treatment. Studies have found that active components of Chinese medicine， including flavonoids， saponins， polyphenols， and terpenes， as well as Chinese medicine compound prescriptions such as Guiqi Yiyuan extract， Qingzao Jiufei decoction， and Yiqi Fuzheng formula， have significant regulatory effects on AMPK and its interacting signaling pathways. These effects include inducing autophagy and apoptosis of lung cancer cells， modulating macrophage polarization， inhibiting epithelial-mesenchymal transition， reversing drug resistance， and blocking the cell cycle， thereby exerting anti-lung cancer activity. This article reviews and summarizes recent studies on the anti-lung cancer effects of TCM， and discusses the mechanisms by which TCM regulates the AMPK signaling pathway in the treatment of lung cancer， with the aim of providing ideas and references for the development of new clinical anti-lung cancer drugs.

Objective To analyze the relevant factors affecting self-care ability recovery in patients with acute myocardial infarction after receiving percutaneous coronary intervention(PCI).Methods A total of 108 patients with acute ST-segment elevation myocardial infarction,who underwent PCI at Lu'an People's Hospital of China from January 2021 to December 2023,were selected for this study.The patients were divided into normal group(postoperative self-care ability returning to normal,n=78)and disabled group(postoperative self-care ability being dysfunctional,n=30).The clinical data were compared between the two groups.Multiple linear regression analysis was used to analyze the factors affecting the recovery of postoperative self-care ability in patients with acute myocardial infarction after receiving PCI.Results In the disabled group,the mean age was(73.5±5.2)years,63.33％of patients lived in the countryside,Killip grade Ⅰ or above accounted for 16.67％of patients,lack of postoperative rehabilitation training accounted for 73.33％of patients,the Gensini score was(21.35±1.82)points,all of which were higher than those in the normal group(all P＜0.05).The LVEF was(47.81±8.20)％and the MNA-HF score was(20.17±3.33)points,which were lower than those in the normal group(both P＜0.05).Multiple linear regression analysis revealed that age(B=-0.171,95％CI:-0.292 to-0.049),postoperative rehabilitation training(B=-3.946,95％CI:-6.469 to-1.422),LVEF(B=0.211,95％CI:0.085-0.338),MN A-HF score(B=0.318,95％CI:0.036-0.601),and Gensini score(B=—0.907,95％CI:-2.349 to—1.465)were the factors influencing the recovery of postoperative self-care ability in patients with acute myocardial infarction after receiving PCI(P＜0.05).The regression analysis model showed:R2=0.815,adjusted R2=0.802,Durbin-Watson statistic being 1.497,F=62.827,and the fit being good(P＜0.05).Conclusion The elderly,lack of postoperative rehabilitation training,decreased LVEF level,low MNA-HF score,and high Gensini score are the factors influencing the recovery of postoperative self-care ability in patients with acute myocardial infarction after receiving PCI.In clinical practice,targeted intervention measures should be timely taken to ensure the recovery of patient's self-care ability and improve the quality of life.

As a common malignant tumor of the respiratory system， the incidence and mortality of lung cancer are still rising year by year. Its pathogenesis is complex， the prognosis is poor， and it seriously affects human physical and mental health. Although existing Western medical treatments can inhibit tumor growth to a certain extent and relieve patients' painful symptoms， problems such as postoperative recurrence and metastasis， numerous adverse reactions， and the tendency to develop drug resistance make the overall therapeutic effect unsatisfactory. Therefore， it is urgent to seek more efficient and safer treatments. Adenosine monophosphate-activated protein kinase （AMPK） signaling pathway can regulate the growth， differentiation， apoptosis， and autophagy of lung cancer cells， and is extensively involved in the occurrence and development of lung cancer， thus being regarded as an important target for anti-lung cancer therapy. Traditional Chinese medicine （TCM） exerts anti-lung cancer effects through multiple pathways， mechanisms， and targets， with advantages such as preventing postoperative recurrence and metastasis， alleviating the adverse reactions of radiotherapy and chemotherapy， and improving quality of life. TCM has therefore become a key approach in current anti-lung cancer treatment. Studies have found that active components of Chinese medicine， including flavonoids， saponins， polyphenols， and terpenes， as well as Chinese medicine compound prescriptions such as Guiqi Yiyuan extract， Qingzao Jiufei decoction， and Yiqi Fuzheng formula， have significant regulatory effects on AMPK and its interacting signaling pathways. These effects include inducing autophagy and apoptosis of lung cancer cells， modulating macrophage polarization， inhibiting epithelial-mesenchymal transition， reversing drug resistance， and blocking the cell cycle， thereby exerting anti-lung cancer activity. This article reviews and summarizes recent studies on the anti-lung cancer effects of TCM， and discusses the mechanisms by which TCM regulates the AMPK signaling pathway in the treatment of lung cancer， with the aim of providing ideas and references for the development of new clinical anti-lung cancer drugs.

Gastrointestinal tumors （GTs）， including colorectal cancer， gastric cancer， liver cancer， pancreatic cancer， and esophageal cancer， are increasing in incidence worldwide and have become one of the major diseases threatening human health. Tumor stem cells （TSCs）， an undifferentiated subpopulation within tumor tissues， possess biological characteristics such as self-renewal， multidirectional differentiation， high tumorigenicity， and resistance to radiochemotherapy. They play an important role in the occurrence， progression， recurrence， and metastasis of GTs and have increasingly become a research hotspot in GT treatment. Although modern medicine has made remarkable progress， there remain many problems in therapeutic approaches targeting TSCs. In this context， traditional Chinese medicine （TCM）， with its favorable safety profile and multi-target mechanisms， has shown potential advantages and value in regulating TSCs. It can reduce TSC drug resistance， enhance the sensitivity of tumor cells to chemotherapeutic agents， inhibit tumor growth and metastasis， and has shown unique advantages in improving the quality of life and prolonging the survival of GT patients. Studies have found that active components of Chinese medicine， such as terpenoids， polyphenols， flavonoids， glycosides， and quinones， and Chinese medicine compound formulas， including Zuojin pills， Sijunzi decoction， Biejiajian pills， and Xuanfu Daizhe decoction， can inhibit TSCs-related signaling pathways such as the Notch signaling pathway， the Wnt/β-catenin signaling pathway， the phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway， and the Hippo signaling pathway. They also reduce the expression of TSC surface markers， including sex-determining region Y-box 2 （SOX2）， sex-determining region Y-box 9 （SOX9）， octamer-binding transcription factor 4 （OCT4）， prominin-1 （CD133）， cluster of differentiation 44 （CD44）， cluster of differentiation 24 （CD24）， and thyroid transmembrane protein 1 （CD90）， thereby hindering TSC differentiation， accelerating their metabolic processes， improving the tumor microenvironment， and consequently inhibiting GT growth. This study collects and analyzes recent research on the regulation of TSCs by TCM in the treatment of GT， aiming to provide a new theoretical basis for tumor therapy with TCM， expand its application in the comprehensive treatment of GT， and offer new therapeutic ideas and methods for clinical practice.

OBJECTIVE To investigate the improvement effect and potential mechanism of “Layers adjusting external application” paste on synovial fibrosis （SF） in rats with knee osteoarthritis （KOA）. METHODS Male SD rats were randomly divided into sham operation group， KOA group and Layers adjusting external application group， with 8 rats in each group. KOA model was induced by the anterior cruciate ligament disruption method in KOA group and Layers adjusting external application group. Fourteen days after modeling， the Layers adjusting external application group was given “Layers adjusting external application” paste [Sanse powder （8 g for every 100 cm2）， Compound sanhuang ointment （5 g for every 100 cm2）] on the knee joint， 8 h every day， for 28 d in total. After the last administration， the degree of synovitis and fibrosis in rats was observed， and Krenn scoring was performed in each group. The expressions of collagen Ⅰ， high mobility group protein B1 （HMGB1） and phosphorylated nuclear factor-κB p65 （p-NF-κB p65） were detected in the synovial membrane； the contents of interleukin-1β （IL- 1β）， IL-6 and tumor necrosis factor-α （TNF-α） in serum as well as the expressions of fibrosis-related and HMGB1/Toll-like receptor 4 （TLR4）/NF-κB signaling pathway-related proteins and mRNA were detected in synovial tissue. RESULTS Compared with the sham operation group， the synovial lining cells in the KOA group showed significant proliferation and disordered arrangement， the inflammatory cell infiltration and collagen fiber deposition were obvious； the positive expressing cells of collagen Ⅰ， HMGB1 and p-NF-κB p65 were increased significantly； the contents of IL-1β， IL-6 and TNF-α in serum， the expressions of fibrosis-related protein （transforming growth factor-β， collagen Ⅰ， tissue inhibitor of metalloproteinase 1， α-smooth muscle actin） and their mRNA as well as theexpressions of HMGB1， TLR4 protein and their mRNA， the expressions of p-NF-κB p65 protein and NF-κB p65 mRNA were all increased significantly in synovial tissues of rats （P＜0.01）. Compared with the KOA group， the pathological changes in the synovial tissue of rats in Layers adjusting external application group were significantly improved， and the above quantitative indicators were significantly reversed （P＜0.05 or P＜0.01）. CONCLUSIONS “Layers adjusting external application” paste could significantly improve SF in KOA rats， the mechanism of which may be associated with the inhibition of the activation of HMGB1/ TLR4/NF-κB signaling pathway.