Bladder tumor within inguinal bladder hernia is rare. This article reports a case of a male patient who was admitted to hospital due to gross hematuria，accompanied by lower abdominal pain when straining to urinate for two months. Physical examination revealed a irreducible mass in the left inguinal region. Ultrasound and MRI examinations suggested an inguinal bladder hernia complicated by multiple bladder lesions. Cystoscopy revealed extensive tumors，and pathological examination indicated high-grade urothelial carcinoma with carcinoma in situ. PET-CT confirmed pelvic lymph node metastasis. The patient underwent three cycles of neoadjuvant therapy followed by laparoscopic radical cystectomy combined with hernia repair. There was no evidence of recurrence of the hernia or tumor after one year of follow-up.

Bladder tumor within inguinal bladder hernia is rare. This article reports a case of a male patient who was admitted to hospital due to gross hematuria，accompanied by lower abdominal pain when straining to urinate for two months. Physical examination revealed a irreducible mass in the left inguinal region. Ultrasound and MRI examinations suggested an inguinal bladder hernia complicated by multiple bladder lesions. Cystoscopy revealed extensive tumors，and pathological examination indicated high-grade urothelial carcinoma with carcinoma in situ. PET-CT confirmed pelvic lymph node metastasis. The patient underwent three cycles of neoadjuvant therapy followed by laparoscopic radical cystectomy combined with hernia repair. There was no evidence of recurrence of the hernia or tumor after one year of follow-up.

BACKGROUND: Over 65 million people have long COVID. Evidence for using Chinese herbal medicine (CHM) to treat long COVID is growing. A systematic review of evidence for guiding clinical decision is warranted. OBJECTIVE: To examine the effects and safety of CHM in alleviating the severity of dyspnea, fatigue, exercise intolerance, depression, anxiety and insomnia in long COVID adults based on registered randomized clinical trials (RCT). SEARCH STRATEGY: World Health Organization International Clinical Trials Registry Platform and Chinese Clinical Trial Registry were searched for registered trial protocols from database inception to February 10, 2023. English (PubMed, Embase, AMED and CINAHL) and Chinese databases (CNKI, Wanfang Data and CQVIP) were then searched to identify relevant publications from December 2019 through April 6, 2023. INCLUSION CRITERIA: Registered RCTs that compared the effects of Chinese herbal medicines or Chinese herbal formulas against a control treatment (i.e., the placebo or usual care) in adults with persistent symptoms of long COVID. The primary outcome of dyspnea, and secondary outcomes of fatigue, exercise intolerance, depression, anxiety and insomnia were measured using validated tools at the end of the treatment. DATA EXTRACTION AND ANALYSIS: Data were extracted, and eligible RCTs were evaluated using version 2 of the Cochrane risk-of-bias tool for randomized trials and Grading of Recommendations, Assessment, Development and Evaluations independently by two researchers. Effect sizes were estimated by random-effects modelling and mean difference (MD). Heterogeneity between trials was quantified by I². RESULTS: Among the 38 registered clinical trials we identified, seven RCTs (1,519 patients) were included in the systematic review. One RCT had a low overall risk of bias. Compared to the control, CHM reduces dyspnea on the Borg Dyspnea Scale score (MD = -0.2, 95% confidence interval [CI] = -0.65 to 0.25) with moderate certainty, and reduces fatigue on the Borg Scale (MD = -0.48, 95% CI = -0.74 to -0.22) with low certainty. CHM clinically reduces depression on Hamilton Depression Rating Scale score (MD = -6.00, 95% CI = -7.56 to -4.44) and anxiety on Hamilton Anxiety Rating Scale score (MD = -6.10, 95% CI = -7.67 to -4.53), and reduces insomnia on the Insomnia Severity Index (MD = -4.86, 95% CI = -12.50 to 2.79) with moderate certainty. Meta-analysis of two RCTs (517 patients) showed that CHM clinically improves exercise intolerance by increasing 6-minute walking distance (MD = -15.92, 95% CI = -10.20 to 42.05) with substantial heterogeneity (I² = 68%) and low certainty. CONCLUSION CHM is associated with a post-treatment clinical reduction in depression and anxiety in long COVID adults, compared to the control, but it does not have a strong treatment effect on dyspnea and insomnia. Effects of CHM on exercise intolerance and fatigue are uncertain, and the safety of using CHM remains questionable. Please cite this article as: Tsang MS, Zhou IW, Zhang AL, Xue CC. Chinese herbal medicine for dyspnea and persistent symptoms of long COVID: A systematic review and meta-analysis of randomized controlled trials. J Integr Med. 2025; 23(2): 126-137.
Humans ; Dyspnea/etiology* ; Drugs, Chinese Herbal/therapeutic use* ; Randomized Controlled Trials as Topic ; COVID-19/complications* ; Fatigue/drug therapy* ; SARS-CoV-2 ; Anxiety/drug therapy* ; Depression/drug therapy* ; Sleep Initiation and Maintenance Disorders/drug therapy* ; Betacoronavirus

Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive'whole-evidence'approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO's Universal Health Coverage strategy.

The grading of evidence is an important factor in clinical decision-making. The current evidence grading system based on western medicine is limited in the clinical practice of traditional Chinese medicine （TCM）， therefore we propose the solutions to the development of grading system for TCM interventional evidence， following the international evidence grading standards， taking into considerations of the unique characteristics of TCM practice， based on the Grades of recommendation， assessment， development and evaluation （GARDE） evaluation system， and integrating with grading system regarding TCM classical literature and empirical evidence from modern famous doctors. The evidence from classical literature is suggested to be evaluated from three aspects including source of ancient medical records， comprehensive of treatment details， and the inheritance. The qualification of famous doctors， content integrity， and inheritance of experiences will be used to evaluate the evidence from famous doctors' experience. The multi-sourced evidence such as TCM classical literature， experience of modern famous doctors， and modern researches is mainly integrated in a qualitative way， and the overall level of evidence of TCM interventions will be graded consistently with the GRADE system based on modern research. The evidence from classical literature and modern famous doctors' experience will be assessed and considered as supplementary evidence， which will make the evaluation of clinical evidence more objectively and comprehensively， thereby guiding clinical practice further.

Objective:To investigate the effects of intervention mapping on cardiopulmonary function for patients with acute heart failure in compensatory period, so as to provide references for their early rehabilitation activities.Methods:A total of 90 patients with acute heart failure admitted to Fuwai Central China Cardiovascular Hospital from October 2018 to October 2019 were enrolled in the present study. They were divided into experimental group and control group according to draw-lots-method, with 45 cases in each group. The control group received the routine care and activity plan, while the experimental group implemented intervention mapping-based stage early rehabilitation program. The indicators included 6MWT, forced expiratory volume in one second (FEV 1), brain natriuretic peptide (BNP) as well as Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the intervention effects were compared between the two groups. Results:There were no significant differences in FEV 1, 6MWT, BNP and MLHFQ scores between the two groups at admission ( P>0.05). On discharge, FEV 1, 6MWT were (2.17±0.44) L, (273.09±55.80) m in the experimental group, significantly higher than (1.94 ± 0.39) L and (236.44 ± 50.99) m in the control group; the plasma BNP were (676.79 ± 78.75) ng/L in the experimental group, significantly lower than (736.05 ± 78.77) ng/L in the control group; in addition, the physical demention, emotional dimenson, other demension scores and total scores of MLHFQ in the experimental group were (65.39 ± 5.02), (67.56 ± 4.99), (66.05 ± 4.16) and (66.33 ± 2.63) points, significantly higher than (59.79 ± 5.94), (64.33 ± 5.93), (62.76 ± 4.47), (62.36 ± 2.98) points in the control group, the differences were statistically significant ( t values were 2.56-6.51, all P<0.05). Conclusions:Designing and implementing stage early rehabilitation program using intervention mapping can promote cardiopulmonary function and quality of life of patients with acute heart failure in compensatory period.

Modern Chinese medicine is rooted in classical literature and the legacies provided by ancient doctors and their patients.It is also grounded in the practices of expert clinicians and increasingly informed by clinical and experimental research.Considering Chinese medicine's stage of international development,a whole-evidence approach is an appropriate method for compiling and synthesizing different types and levels of evidence for specific types of interventions.This approach can be used for the wide range of clinical conditions that Chinese medicine commonly treats.

Objective:To explore the application effect of action learning for nursing ethic teaching in operating room.Methods:Total 94 nursing students were divided into two groups to compare the testing scores and the inci-dence of hidden security events .The control group underwent the traditional teaching method , and the experimental group taken Action learning .Results:The testing scores and the accurate rates of case analysis problem of the ex-perimental group were higher than those in the control group (P<0.05).While the rate of hidden danger events of the experimental group was significantly lower than that in the control group ( P <0 .05 ) .Conclusion: Action learning can stimulate students′learning potential , improve the effect of learning , and reduce the incidence of secu-rity events.

Objective To systematically review the effects of hospital-community integrated management mode in diabetes mellitus. Methods To comprehensively search the database including CNKI, Taiwan Airiti library, WanFang Data, WeiPu Data and PubMed, we manually searched the relevant references of literature for the RCTs on hospital-community integrated management mode in diabetes mellitus, and Meta-analysis was used by software Revman 5. 2, and making descriptive analysis of the outcomes which could not be merged. Results A total of 15 RCTs were included involving 3 in English and 12 in Chinese, and 7 studies with high-quality and 8 of them with low-quality. According to the 11 evaluation focused outcomes indexes, the result of Meta-analysis showed that compared with conventional management, the hospital-community integration mode could effectively improve patients′ biochemical indicators such as glycated hemoglobin (HbA1c)[MD= -0. 39, 95%CI(-0. 56, -0. 22),P<0. 001], fasting plasma glucose[MD=-0. 75, 95%CI (-1. 16, -0. 33),P<0. 001], triglycerides[MD= -0. 36, 95%CI ( -0. 63, -0. 10), P=0.007], high-density lipoprotein (HDL-C)[MD =0. 09, 95%CI (0. 04, 0. 14), P <0. 001], low density lipoprotein (LDL-C)[MD= -0. 15, 95%CI (-0. 23, -0. 06),P=0. 001], but there was no effect on total cholesterol[MD= -0. 27, 95%CI (-0. 58, 0. 03),P=0. 080]. At the same time, the descriptive analysis presented that the model could improve patients′ awareness rate of diabetes health knowledge and promote the correct behavior of medication and regular exercise, in addition it could increase the score of life quality and reduce medical expenses. Conclusions Diabetes hospital-community integrated management can effectively improve the level of blood glucose and blood lipids, reduce the occurrence and development of related complications and provide a reliable basis for the management of diabetic patients. There is a positive impact to improve the patients′ behavior and quality of life, but it requires more randomized controlled studies to be analyzed and verified.