SMYD5 is a ribosomal methyltransferase with SET and MYND structural domains， which is a member of the SMYD family and is expressed in a variety of tissues， including ovary and testis. This enzyme participates in biological processes such as gene expression regulation， cell development and differentiation， and maintenance of genomic stability through ribosomal protein methylation modification. In recent years， research on SMYD5 has increased in cancers including hepatocellular carcinoma， gastric adenocarcinoma， and lung cancer. Studies have revealed that SMYD5 exhibits high expression levels in various diseases including hepatocellular carcinoma， gastric adenocarcinoma， lung cancer， and inflammatory bowel disease， influencing the progression of these conditions. This review summarizes the role of SMYD5 in hepatocellular carcinoma， inflammatory bowel disease， and other biological functions， aiming to provide a reference for related disease research.

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

Objective:To investigate the expression of interleukin (IL)-22 in lung adenocarcinoma and its effect and possible mechanism for lung adenocarcinoma metastasis.Methods:The cancer tissues and paired adjacent normal tissues (>2 cm from the tumor edge) surgically removed from 27 lung adenocarcinoma patients in Tianjin Medical University Cancer Institute & Hospital from January to June 2023 were retrospectively collected. Flow cytometry was used to detect the expression levels of IL-22 in T cells of all tissues, and the expression levels of IL-22 in T cells were compared between cancer and adjacent tissues, as well as between lung cancer tissues of patients with and without lymph node metastasis. The cancer tissues and paired adjacent normal tissues were retrospectively collected from 6 patients with lung adenocarcinoma during the same period, and the expression level of IL-22 receptor IL-22RA1 in the tissues was detected by Western blotting. IL-22RA1 transcriptome data from cancer tissues of lung adenocarcinoma patients in 3 datasets in The Cancer Genome Atlas (TCGA) database and the Gene Expression Omnibus (GEO) database were collected. Using the R software survminer package to select the optimal critical value of IL-22RA1 that reflected the survival relationship, and patients were divided into high and low IL-22RA1 groups based on this. The survival package was used to draw the overall survival curve and log-rank test was performed for inter group comparison. Recombinant IL-22 was used to treat human lung adenocarcinoma A549 cells and mouse lung adenocarcinoma LLC cells, with cells not treated with IL-22 as controls; Transwell assay was used to detect the number of migrating cells in each group; Western blotting was used to detect the expression levels of ERK, AKT and STAT signaling pathways-related proteins, matrix metalloproteinase 9 (MMP-9) and epithelial cadherin (E-cad) in each group of cells. The expression levels of these proteins in A549 cells and LLC cells were also measured after the addition of STAT3 inhibitor C188-9, AKT inhibitor MK-2206 and ERK inhibitor SCH772984. A lung metastasis model of LLC cells was constructed using 10 C57BL/6 mice, the mice were randomly divided into the experimental group and the control group using simple randomization method. IL-22 neutralizing antibody (50 μg/mouse) and non-neutralizing control antibody (50 μg/mouse) were injected once every other day. On the 10th day, the mice were euthanized and dissected to count lung metastatic nodules. The metastatic lung tissue was stained with HE and the metastatic foci were counted. Flow cytometry was used to detect the proportion of CD4 + T cells and CD8 + T cells to immune cells in single cells prepared from metastatic lung tissue. Results:The flow cytometry analysis showed that the proportion of IL-22 + CD4 + T cells in T cells (labeled with CD3 and CD45) in 27 clinically collected lung adenocarcinoma tissues [ M ( Q1, Q3)] was higher than that in adjacent normal tissues [0.28% (0.04%, 1.00%) vs. 0.01% (0.00%, 0.25%)]. The proportion of IL-22 + CD4 + T cells in lung adenocarcinoma tissues of patients with metastasis (9 cases) was higher than that of patients without metastasis (18 cases) [1.06% (0.49%, 4.72%) vs. 0.15% (0.00%, 0.35%)], and the differences were statistically significant (both P < 0.01). Western blotting analysis showed that the relative expression level of IL-22RA1 protein in lung adenocarcinoma tissues was higher than that in adjacent normal tissues (1.03±0.25 vs. 0.35±0.10), and the difference was statistically significant ( P < 0.05). The overall survival of the IL-22RA1 low expression group in lung adenocarcinoma tissues was better than that of the IL-22RA1 high expression group in the TCGA database and GEO databases GSE42127, GSE29016 and GSE26939 datasets, and the differences were statistically significant (all P < 0.001). Transwell assay showed that A549 cells [(744±40) cells, (770±64) cells vs. (403±42) cells] and LLC cells [(167±39) cells, (246±80) cells vs. (31±5) cells] treated with 100 and 200 ng/ml IL-22 for 24 hours had fewer migration numbers than the control group, and the differences were statistically significant (both P < 0.01). Western blotting analysis showed that during treatment with 100 ng/ml recombinant IL-22 for 15-1 440 minutes, the levels of p-STAT3, p-ERK and p-AKT proteins in A549 and LLC cells were higher than those in the control group, while there was no difference in the levels of E-cad and MMP-9 proteins between the two groups. After the combined treatment of recombinant IL-22 and STAT3, AKT or ERK inhibitor, the corresponding levels of p-STAT3, p-AKT and p-ERK proteins in A549 and LLC cells were similar to those in cells without inhibitor and recombinant IL-22 treatment, but significantly lower than those in cells treated with recombinant IL-22 alone. In the dissected lung tissues of mice lung metastasis models, the experimental group had fewer metastatic lung nodules than the control group (2.3±0.6 vs. 7.0±2.0), and the difference was statistically significant ( t = 3.88, P = 0.018). In the morphological observation of lung metastasis tissues, the experimental group had fewer metastatic lesions than the control group (1.8±0.8 vs. 5.4±1.1), and the difference was statistically significant ( t = 5.69, P < 0.001). Flow cytometry analysis showed that the proportion of CD8 + T cells in immune cells in the lung tissues of mice in the experimental group (labeled with CD45) was higher than that in the control group [(27±5)% vs. (15±5)%], and the difference was statistically significant ( t = 3.01, P = 0.040). There was no statistically significant difference in the proportion of CD4 + T cells in immune cells between the two groups ( P > 0.05). Conclusions:The expression levels of IL-22 and its receptor IL-22RA1 in lung adenocarcinoma tissues are higher than those in adjacent normal tissues, and the high expression level of IL-22RA1 in cancer tissues may be associated with poor prognosis of patients; on the one hand, IL-22 may promote the migration of lung adenocarcinoma cells by activating the ERK, AKT and STAT3 signaling pathways, and on the other hand, it may promote lung adenocarcinoma metastasis by reducing CD8 + T cell infiltration in the immune microenvironment of lung adenocarcinoma.

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.

Objective To establish a collaborative governance framework model for the construction of National Medical Center and National Regional Medical Centers,offering insights for the expansion of premium medical resources and balanced regional healthcare service distribution.Methods Based on the Latent Dirichlet Allocation model and grounded theory,text semantic analysis and thematic coding were performed using Python and NVivo 12.0 Plus software.Results The collaborative construction of the"Dual Centers"hinges on six core elements:policy safeguards,talent cultivation,discipline advancement,teaching frameworks,research foundations,and information connectivity.These elements interplay synergistically,forming a collabortive governance framework model for"Dual Centers"construction.The model is structured into two dimensions:horizontal and vertical nested collaboration,encompassing three tiers:the support layer,driving layer,and action layer.It is characterized by its theoretical robustness,openness,and hierarchical organization.Conclusion Inter-embedded collaboration offers a viable solution to the governance challenges encountered by governments,output hospitals,and supporting hospitals during the"Dual Centers"construction,enhancing the efficacy of cross-sectoral collaborative governance.

Objective To establish a collaborative governance framework model for the construction of National Medical Center and National Regional Medical Centers,offering insights for the expansion of premium medical resources and balanced regional healthcare service distribution.Methods Based on the Latent Dirichlet Allocation model and grounded theory,text semantic analysis and thematic coding were performed using Python and NVivo 12.0 Plus software.Results The collaborative construction of the"Dual Centers"hinges on six core elements:policy safeguards,talent cultivation,discipline advancement,teaching frameworks,research foundations,and information connectivity.These elements interplay synergistically,forming a collabortive governance framework model for"Dual Centers"construction.The model is structured into two dimensions:horizontal and vertical nested collaboration,encompassing three tiers:the support layer,driving layer,and action layer.It is characterized by its theoretical robustness,openness,and hierarchical organization.Conclusion Inter-embedded collaboration offers a viable solution to the governance challenges encountered by governments,output hospitals,and supporting hospitals during the"Dual Centers"construction,enhancing the efficacy of cross-sectoral collaborative governance.

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.

Objective:To investigate the expression of interleukin (IL)-22 in lung adenocarcinoma and its effect and possible mechanism for lung adenocarcinoma metastasis.Methods:The cancer tissues and paired adjacent normal tissues (>2 cm from the tumor edge) surgically removed from 27 lung adenocarcinoma patients in Tianjin Medical University Cancer Institute & Hospital from January to June 2023 were retrospectively collected. Flow cytometry was used to detect the expression levels of IL-22 in T cells of all tissues, and the expression levels of IL-22 in T cells were compared between cancer and adjacent tissues, as well as between lung cancer tissues of patients with and without lymph node metastasis. The cancer tissues and paired adjacent normal tissues were retrospectively collected from 6 patients with lung adenocarcinoma during the same period, and the expression level of IL-22 receptor IL-22RA1 in the tissues was detected by Western blotting. IL-22RA1 transcriptome data from cancer tissues of lung adenocarcinoma patients in 3 datasets in The Cancer Genome Atlas (TCGA) database and the Gene Expression Omnibus (GEO) database were collected. Using the R software survminer package to select the optimal critical value of IL-22RA1 that reflected the survival relationship, and patients were divided into high and low IL-22RA1 groups based on this. The survival package was used to draw the overall survival curve and log-rank test was performed for inter group comparison. Recombinant IL-22 was used to treat human lung adenocarcinoma A549 cells and mouse lung adenocarcinoma LLC cells, with cells not treated with IL-22 as controls; Transwell assay was used to detect the number of migrating cells in each group; Western blotting was used to detect the expression levels of ERK, AKT and STAT signaling pathways-related proteins, matrix metalloproteinase 9 (MMP-9) and epithelial cadherin (E-cad) in each group of cells. The expression levels of these proteins in A549 cells and LLC cells were also measured after the addition of STAT3 inhibitor C188-9, AKT inhibitor MK-2206 and ERK inhibitor SCH772984. A lung metastasis model of LLC cells was constructed using 10 C57BL/6 mice, the mice were randomly divided into the experimental group and the control group using simple randomization method. IL-22 neutralizing antibody (50 μg/mouse) and non-neutralizing control antibody (50 μg/mouse) were injected once every other day. On the 10th day, the mice were euthanized and dissected to count lung metastatic nodules. The metastatic lung tissue was stained with HE and the metastatic foci were counted. Flow cytometry was used to detect the proportion of CD4 + T cells and CD8 + T cells to immune cells in single cells prepared from metastatic lung tissue. Results:The flow cytometry analysis showed that the proportion of IL-22 + CD4 + T cells in T cells (labeled with CD3 and CD45) in 27 clinically collected lung adenocarcinoma tissues [ M ( Q1, Q3)] was higher than that in adjacent normal tissues [0.28% (0.04%, 1.00%) vs. 0.01% (0.00%, 0.25%)]. The proportion of IL-22 + CD4 + T cells in lung adenocarcinoma tissues of patients with metastasis (9 cases) was higher than that of patients without metastasis (18 cases) [1.06% (0.49%, 4.72%) vs. 0.15% (0.00%, 0.35%)], and the differences were statistically significant (both P < 0.01). Western blotting analysis showed that the relative expression level of IL-22RA1 protein in lung adenocarcinoma tissues was higher than that in adjacent normal tissues (1.03±0.25 vs. 0.35±0.10), and the difference was statistically significant ( P < 0.05). The overall survival of the IL-22RA1 low expression group in lung adenocarcinoma tissues was better than that of the IL-22RA1 high expression group in the TCGA database and GEO databases GSE42127, GSE29016 and GSE26939 datasets, and the differences were statistically significant (all P < 0.001). Transwell assay showed that A549 cells [(744±40) cells, (770±64) cells vs. (403±42) cells] and LLC cells [(167±39) cells, (246±80) cells vs. (31±5) cells] treated with 100 and 200 ng/ml IL-22 for 24 hours had fewer migration numbers than the control group, and the differences were statistically significant (both P < 0.01). Western blotting analysis showed that during treatment with 100 ng/ml recombinant IL-22 for 15-1 440 minutes, the levels of p-STAT3, p-ERK and p-AKT proteins in A549 and LLC cells were higher than those in the control group, while there was no difference in the levels of E-cad and MMP-9 proteins between the two groups. After the combined treatment of recombinant IL-22 and STAT3, AKT or ERK inhibitor, the corresponding levels of p-STAT3, p-AKT and p-ERK proteins in A549 and LLC cells were similar to those in cells without inhibitor and recombinant IL-22 treatment, but significantly lower than those in cells treated with recombinant IL-22 alone. In the dissected lung tissues of mice lung metastasis models, the experimental group had fewer metastatic lung nodules than the control group (2.3±0.6 vs. 7.0±2.0), and the difference was statistically significant ( t = 3.88, P = 0.018). In the morphological observation of lung metastasis tissues, the experimental group had fewer metastatic lesions than the control group (1.8±0.8 vs. 5.4±1.1), and the difference was statistically significant ( t = 5.69, P < 0.001). Flow cytometry analysis showed that the proportion of CD8 + T cells in immune cells in the lung tissues of mice in the experimental group (labeled with CD45) was higher than that in the control group [(27±5)% vs. (15±5)%], and the difference was statistically significant ( t = 3.01, P = 0.040). There was no statistically significant difference in the proportion of CD4 + T cells in immune cells between the two groups ( P > 0.05). Conclusions:The expression levels of IL-22 and its receptor IL-22RA1 in lung adenocarcinoma tissues are higher than those in adjacent normal tissues, and the high expression level of IL-22RA1 in cancer tissues may be associated with poor prognosis of patients; on the one hand, IL-22 may promote the migration of lung adenocarcinoma cells by activating the ERK, AKT and STAT3 signaling pathways, and on the other hand, it may promote lung adenocarcinoma metastasis by reducing CD8 + T cell infiltration in the immune microenvironment of lung adenocarcinoma.

In the field of ethics,issues related to brain-computer interface(BCI)technology mainly focus on physical and mental ethics,as well as social ethics,including personal privacy rights,whether a person is a person in the complete sense,the attribution of social responsibility.The population involved includes patients,doctors,and the whole social group in which patients live.In addition to analyzing physical and mental ethical risks,this paper also analyzed the potential ethical issues that may exist in the future large-scale application of BCI based on the current research status,mainly including the right of informed consent,privacy,and decision-making of physical and mental ethical risks,the responsibility attribution and fairness of social ethical risks,the responsibility ascription and equity of social ethical risk,and the question that whether the brain is the carrier of machine or the machine is the continuation of the brain in future ethical risks.Solutions have been proposed in the three levels of individual,system,and institution to provide governance recommendations for the future development of BCI.In addition,local data was obtained by collecting and summarizing relevant opinions through social research.Based on these,the future risks of BCI were introduced for the first time,and from the perspective of ethics,solutions to future problems were explored.

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.