ObjectiveTo investigate the efficacy of Xingpi capsules （XPC） in treating diarrhea-predominant irritable bowel syndrome （IBS-D） with spleen deficiency and elucidate its potential molecular mechanisms. MethodsA rat model of IBS-D with spleen deficiency was established by administering senna leaf in combination with restrained stress and swimming fatigue for 14 d. Ten specific pathogen free （SPF）-grade healthy rats were used as the normal control group. After successful modeling， SPF-grade rats were randomly divided into a model group， a pinaverium bromide group （1.5 mg·kg^-1）， and low- and high-dose XPC groups （0.135 and 0.54 g·kg^-1）， with 10 rats in each group. Rats in the normal control group and the model group were given distilled water by gavage， while the remaining groups were administered corresponding drug solutions by gavage once a day for 14 consecutive days. The rat body weights and fecal condition were observed every day， and the Bristol score was recorded. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of 5-hydroxytryptamine （5-HT） in serum and colon tissue. Transmission electron microscopy was used to observe the microvilli and tight junctions in the colon. The integrity of the colonic barrier， intestinal motility， and expression of related pathway proteins were evaluated by hematoxylin-eosin （HE） staining， immunohistochemistry， and Western blot. ResultsCompared with those in the normal control group， rats in the model group showed a significantly decreased body weight and increased diarrhea rate， diarrhea grade， and Bristol score （P<0.01）. HE staining revealed incomplete colonic mucosa in the model group， with evident congestion and edema observed. Electron microscopy results indicated decreased density and integrity of the colonic barrier， shedding and disappearance of microvilli， and significant widening of tight junctions. The expression levels of colonic tight junction proteins Occludin and Claudin-5 were downregulated （P<0.01）， and the levels of 5-HT in serum and colon tissue were elevated （P<0.01）. The small intestine propulsion rate significantly increased （P<0.01）， and the expression of contractile proteins Ras homolog family member A （RhoA） and Rho-associated coiled-coil containing protein kinase 2 （ROCK2） in colon and phosphorylation of myosin light chain （MLC₂₀） were upregulated （P<0.01）. Compared with the model group， the treatment groups showed alleviated diarrhea， diarrhea-associated symptoms， and pathological manifestations of colon tissue to varying degrees. Specifically， high-dose XPC exhibited effectively relieved diarrhea， promoted recovery of colonic mucosal structure， significantly reduced congestion and edema， upregulated expression of Occludin and Claudin-5 （P<0.01）， decreased levels of 5-HT in serum and colon tissue （P<0.05，P<0.01）， significantly slowed small intestine propulsion rate （P<0.01）， and significantly downregulated expression of contractile proteins RhoA and ROCK2 in colon and phosphorylation of MLC₂₀ （P<0.05，P<0.01）. ConclusionXPC effectively alleviates symptoms of spleen deficiency and diarrhea and regulates the secretion of brain-gut peptide. The characteristics of XPC are mainly manifested in alleviating IBS-D with spleen deficiency from the aspects of protecting intestinal mucosa and inhibiting smooth muscle contraction， and the mechanism is closely related to the regulation of the 5-HT-RhoA/ROCK2 pathway expression.

OBJECTIVE: To explore the clinical application of transurethral steam thermal ablation of the prostate as an ultra-minimally invasive treatment of benign prostatic hyperplasia (BPH). METHODS: We treated 18 BPH patients by transurethral steam thermal ablation of the prostate in our hospital, and followed them up for 6－12 months after operation. We obtained the IPSS, maximum urinary flow rate (Qmax), IIEF-5 scores, Male Sexual Health Questionnaire-Ejaculatory Dysfunction-Short Form (MSHQ-EjD-SF) scores and quality of life (QOL) scores from the patients and compared them before and after surgery. RESULTS: Operations were successfully completed in all the cases, with no intraoperative complications, and all the patients were discharged on the second day after surgery. At the 6-month follow-up after surgery, the Qmax increased from (10.08 ± 2.06) ml/s before surgery to (7.51 ± 3.21) ml/s, the IPSS decreased from 23.72 ± 1.87 to 8.06 ± 1.39, and the QOL score decreased from 5.11 ± 0.58 before surgery to 1.28 ± 0.46. The differences in these indicators were statistically significant (P<0.05). And these is no significant difference in the MSHQ-EjD-SF and IIEF-5 score(P>0.05). CONCLUSION Transurethral steam thermal ablation of the prostate is a safe, effective and almost non-invasive surgical strategy for the treatment of BPH, with a good prospect of clinical application.
Humans ; Male ; Prostatic Hyperplasia/surgery* ; Aged ; Middle Aged ; Treatment Outcome ; Steam ; Transurethral Resection of Prostate/methods* ; Quality of Life

OBJECTIVES: To explore the bioactive components in Jiawei Xiaoyao Pills (JWXYP) and their mechanisms for alleviating depression-like behaviors. METHODS: The active compounds, key targets, and pathways of JWXYP were identified using TCMSP and TCMIP databases. Thirty-six SD rats were randomized equally into 6 groups including a control group and 5 chronic unpredictable mild stress (CUMS)-induced depression groups. After modeling, the 5 model groups were treated with daily gavage of normal saline, 1.8 mg/kg fluoxetine hydrochloride (positive control drug), or JWXYP at 1.44, 2.88, and 4.32 g/kg. The depression-like behaviors of the rats were evaluated using behavioral tests, and pathological changes in the liver and hippocampus were examined with HE staining. The biochemical indicators in the serum and brain tissues were detected using ELISA. Serum metabolomics analysis was performed to identify the differential metabolites using OPLS-DA, and gut microbiota changes were analyzed using 16S rDNA sequencing. RESULTS: Network pharmacology revealed that menthone and paeonol in JWXYP were capable of penetrating the blood-brain barrier to regulate inflammatory pathways and protect the nervous system. In the rat models subjected to CUMS, treatment with JWXYP significantly improved body weight loss, sucrose preference and open field activities, reduced liver inflammation, alleviated structural changes in the hippocampal neurons, decreased serum levels of TNF‑α, IL-1β, IL-6 and LBP, and increased 5-HT and VIP concentrations in the serum and brain tissue, and these effects were the most pronounced in the high-dose group. Metabolomics analysis showed changes in such metabolites as indole-3-acetamide and acetyl-L-carnitine in JWXYP-treated rats, involving the pathways for bile acid biosynthesis and amino acid metabolism. 16S rDNA analysis demonstrated increased gut microbiota diversity and increased abundance of Lactobacillus species in JWXYP-treated rats. CONCLUSIONS JWXYP alleviates depression-like symptoms in rats by regulating the neurotransmitters, inhibiting inflammation and oxidation, and modulating gut microbiota.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Gastrointestinal Microbiome/drug effects* ; Rats, Sprague-Dawley ; Depression/drug therapy* ; Neurotransmitter Agents/metabolism* ; Rats ; Inflammation ; Male ; Hippocampus ; Behavior, Animal/drug effects*

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

Objective:To investigate the effect of different temperature and time treatment of Xiaoying Fang on wound healing after mixed hemorrhoid surgery.Methods:A total of 160 patients with mixed hemorrhoids who underwent surgical treatment in Fuyang Hospital of Traditional Chinese Medicine from September 2020 to October 2023 were prospectively selected as the study objects, according to the random number table method and the patients who withdrew were excluded, and 157 cases were finally enrolled, and the patients were divided into observation group 1 (39 cases), observation group 2 (40 cases), observation group 3 (38 cases) and observation group 4 (40 cases). The four groups were all treated with Xiaoying Fang hip bath after surgery. The temperature and time of hip bath in group 1 were observed at 38 - 41 ℃ for 10 min, group 2 at 38 - 41 ℃ for 15 min, group 3 at 42 - 45 ℃ for 10 min, and group 4 at 42 - 45 ℃ for 15 min. Wound pain, edema, wound granulation growth and wound healing were compared between the four groups after treatment.Results:At the 3rd and 5th day of treatment, the visual analogue scale (VAS) scores in the observation group 1 and observation group 2 were lower than those in the observation group 3 and observation group 4: (4.33 ± 1.19), (4.43 ± 1.13) scores vs. (5.15 ± 1.05), (5.40 ± 1.26) scores; (2.46 ± 1.25), (2.63 ± 0.54) scores vs. (3.61 ± 1.22), (3.85 ± 1.05) scores, there were statistical differences ( P<0.05). The wound edema scores in the observation group 2 were lower than that in the observation group 1, observation group 3 and observation group 4: (1.43 ± 0.50) scores vs. (2.21 ± 0.83), (2.05 ± 0.84), (1.98 ± 0.86) scores; (0.88 ± 0.22) scores vs. (1.38 ± 0.54), (1.00 ± 0.23), (0.93 ± 0.25) scores, there were statistical differences ( P<0.05). On the 3rd, 5th and 7th day of treatment, the wound granulation growth scores in the observation group 2 was lower than that in the observation group 1, observation group 3 and observation group 4: (0.80 ± 0.08) scores vs. (1.36 ± 0.13), (1.42 ± 0.13), (1.53 ± 0.15) scores; (0.65 ± 0.18) scores vs. (1.08 ± 0.17), (1.07 ± 0.21), (1.03 ± 0.10) scores; (0.35 ± 0.08) scores vs. (0.74 ± 0.17), (0.97 ± 0.15), (0.78 ± 0.09) scores, there were statistical differences ( P<0.05). There was significant difference in wound healing among the four groups after operation 7 d ( H = 9.84, P<0.05). The total effective rate of wound healing in the observation group 2 was the highest, which was 92.50% (37/40). Conclusions:The optimal temperature and treatment time of Xiaoying Fang hip bath are 38 - 41 ℃ and 15 min.

Carrying the pan-mast cell markers IgE immunoglobulin high-affinity receptor(FcεRI)and SCF receptor c-kit,mast cell-derived exosomes are rich in sphingomyelin,lipid-associated proteins,and loaded with MHC-Ⅱ molecules and transfer functional mRNAs and miRNAs to the receptor of CD34+progenitor cells and mast cells.Activated mast cell-derived exosomes contain a large number of functional mast cell-specific mediators and may vary in size,protein,lipid,RNA and DNA contents.Mast cell exosomes can recruit B cells and T cells to the lungs,regulating immune and inducing the activation of other asthma-related cells.Also,mast cell-derived exosomes interact with airway smooth muscle cells and induce the release of pro-inflammatory cytokines,allowing asthma symptoms to persist.Immune complexes(IgE and antigens)present on mast cell-derived exosomes exacer-bate local allergic reactions by a self-amplification mechanism meanwhile deliver antigens to other immune cells.Mast cell-derived exosomes may be potential targets for the treatment of bronchial asthma,and their purification and optimization be needed further to research.This article will review the mechanism of mast cell-derived exosomes in bronchial asthma,so as to provide new ideas for the prevention and treatment of bronchial asthma.