[摘 要] 目的：探讨IL-22通过STAT3信号轴损害NK细胞功能并促进膀胱癌细胞耐药的机制。方法：常规培养T24细胞，用梯度递增法构建耐药T24/顺铂（DDP）细胞。将细胞分为对照组（不处理）、DDP组、IL-22组、IL-22 + DDP组、IL-22 + anti-IL-22组、IL-22 + DDP + Stattic（STAT3抑制剂）组。qPCR法检测各组T24细胞中IL-22、cyclin D1、Bcl-2 mRNA的表达，WB法检测各组细胞中BAX、BCL2和p-STAT3的表达，CCK-8法检测各组细胞的增殖活性，流式细胞术检测各组细胞的凋亡，ELISA检测各组细胞上清液中乳酸脱氢酶（LDH）、TNF-α、IFN-γ、颗粒酶B（GzmB）和穿孔素（PRF）蛋白的水平。结果：T24/DDP细胞对DDP敏感性降低（P < 0.05）；其耐药相关基因P-糖蛋白（P-gp）、肺耐药蛋白（LRP)、多药耐药相关蛋白1（MRP1）和IL-22及其受体表达水平均明显升高（均P < 0.05），说明T24/DDP细胞构建成功。与对照组比较，DDP组T24细胞的增殖活力明显降低、凋亡率升高、BAX蛋白表达升高、BCL2表达下降（均P < 0.05）；与DDP组比较，IL-22 + DDP组T24细胞的增殖活明显升高、凋亡率明显下降、BAX蛋白表达降低、BCL2表达升高（均P < 0.05），表明IL-22通过调节BAX/Bcl-2的表达促进T24细胞对DDP耐药性。与对照组比较，IL-22组T24细胞总细胞和核中p-STAT3表达水平均明显升高（均P < 0.05）；与IL-22组比较，IL-22 + anti IL-22组T24细胞中 p-STAT3水平明显降低（P < 0.05），说明IL-22激活T24细胞中STAT3的磷酸化过程，并促进其转核。与对照组比较，DDP组T24与NK92细胞共培养上清液中LDH、TNF-α、IFN-γ、GzmB及PRF蛋白水平均明显升高（均P < 0.05），与DDP组比较，IL-22 + DDP组共培养上清液中上述蛋白水平均明显降低（均P < 0.05）；与对照组比较，IL-22组共培养上清液中LDH、TNF-α、IFN-γ、GzmB及PRF蛋白水平明显降低（均P < 0.05）；与IL-22组比较，IL-22 + Stattic组共培养上清液中上述蛋白水平均明显升高（均P < 0.05），说明IL-22可降低NK92细胞对T24细胞的毒性，STAT3抑制剂可逆转此作用。与DDP组比较，IL-22 + DDP组T24细胞增殖活力明显升高（P < 0.05）；与IL-22 + DDP组比较，IL-22 + DDP + Stattic组T24细胞增殖活力明显降低（P < 0.05）；与DDP组比较，IL-22 + DDP组T24细胞的凋亡率明显升高（P < 0.05）；与IL-22 + DDP组比较，IL-22 + DDP + Stattic组T24细胞的凋亡率明显升高（P < 0.05），说明IL-22调控STAT3影响T24细胞DDP耐药性及NK细胞免疫功能。结论： IL-22通过激活STAT3信号轴促进T24细胞的DDP耐药性，抑制NK细胞功能。

BACKGROUND:The Ilizarov technique is very effective in the treatment of congenital brachymetatarsia of the fourth,but there are still some complications.The optimal proportion of lengthening of the fourth metatarsal is still controversial.OBJECTIVE:To explore the clinical efficacy of Ilizarov technique in the treatment of congenital brachymetatarsia of the fourth and the optimal lengthening ratio.METHODS:Medical records of patients with congenital brachymetatarsia of the fourth treated with Ilizarov technique in Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2021 to October 2023 were collected.American Orthopaedic Foot and Ankle Society scores before and after the treatment,length of the fourth metatarsal before and after surgery,and postoperative complications were evaluated.The prolongation ratio was analyzed by subgroups to assess the best suitable length for the operative conditions.RESULTS AND CONCLUSION:(1)A total of 16 patients were included.The length of the fourth metatarsal before treatment was(43.51±3.75)mm,and the shortening length was(12.53±2.82)mm;the lengthening time during the treatment period was(36.95±4.12)days,and the time with external fixation bracket was(102.30±32.74)days,and the lengthening length after the treatment was(13.90±3.47)mm,and the prolongation ratio was(32.30±9.10)％.(2)American Orthopaedic Foot and Ankle Society scores were significantly increased at the last follow-up compared with that before treatment(t=0.763,P＜0.01).(3)The main postoperative complications were bone nonunion,metatarsophalangeal joint dislocation,metatarsophalangeal joint narrowing,and excessive lengthening of the fourth metatarsal.All patients were free of infection and abnormal sensation in the toe.(4)Subgroup analysis based on prolongation ratio showed that the rate of complications in patients in the prolongation ratio ≤ 35.36％group(17％)was significantly lower than the prolongation ratio＞35.36％group(100％)(t=14.008,P＜0.01).Meanwhile,the postoperative American Orthopaedic Foot and Ankle Society score of patients in the prolongation ratio ≤ 35.36％group(90.25±3.01)was higher than that of patients in the prolongation ratio＞35.36％group(82.00±9.97)(t=2.254,P=0.037).(5)It is concluded that Ilizarov technique for the treatment of congenital brachymetatarsia of the fourth is less traumatic surgery,can significantly improve the foot deformity of patients,especially suitable for the treatment of patients whose prolongation ratio does not exceed 35.36％,with low complication rate and satisfactory results.

Objective:To evaluate the safety and effectiveness of fuzuloparib for the treatment of ovarian epithelial cancer patients in the real world setting.Methods:A retrospective analysis was conducted on the baseline data of 4 620 ovarian cancer patients who had received fuzuloparib monotherapy or combination therapy. Another 224 ovarian cancer patients who were willing to receive fuzuloparib monotherapy or combination therapy were prospectively enrolled, and their baseline characteristics, drug effectiveness, and safety data were analyzed.Results:(1) Among the 4 620 patients in the retrospective cohort, the median age of patients was 60 years; tumor types: 89.8% (4 149/4 620) had ovarian cancer. Among patients with clearly documented information, the vast majority had a histological type of serous carcinoma (82.9%, 3 770/4 546) and International Federation of Gynecology and Obstetrics (FIGO) staging of Ⅲ-Ⅳ (90.9%, 1 537/1 691). (2) Among the 224 patients in the prospective cohort, the median age of patients was 57 years; tumor types: 83.9% (188/224) had ovarian cancer. Among patients with clearly documented records, the predominant pathologic type was serous carcinoma (91.9%, 193/210), and FIGO stage was Ⅲ-Ⅳ in 79.9% (139/174). (3) Among the 224 prospective patients: 84 patients received first-line fluzoparib maintenance therapy, 92 patients received fluzoparib maintenance therapy after platinum-sensitive recurrence, 23 patients received direct fluzoparib treatment after platinum-sensitive recurrence, 19 patients received direct fluzoparib treatment after platinum-resistant recurrence. The median follow-up durations were 8.5, 8.7, 7.9, and 6.7 months, respectively. The median durations of fluzoparib treatment were 6.7, 4.8, 3.1, and 1.9 months, respectively. The median progression-free survival (PFS) times were not reached during follow-up, 12.6 months, not reached during follow-up, and 4.8 months, respectively. The 1-year PFS rates were 84.1%, 55.0%, 69.8%, and 45.5%, respectively. The remaining 6 patients received other fluzoparib regimens. (4) Among the 224 patients in the prospective dataset, 205 had safety data recorded. Of these, 127 patients (62.0%, 127/205) experienced treatment-related adverse events, with common events including anemia (24.4%, 50/205), thrombocytopenia (21.0%, 43/205), and leukopenia (19.5%, 40/205). Among the 205 patients, 43 (21.0%, 43/205) experienced grade 3 or higher treatment-related adverse events, with common events including anemia (8.3%, 17/205) and thrombocytopenia (8.3%, 17/205).Conclusions:The effectiveness of fuzuloparib in clinical application is generally consistent with other drugs in the same class, with good safety. This study provids new clinical evidence for the treatment of ovarian cancer with fuzuloparib.

Objective To explore the change of nucleoplasm distribution of glucocorticoid receptor alpha(GRα)in peripheral blood of children with primary nephrotic syndrome(PNS)during the course of the disease,aiming at evaluating the correlation between nuclear transport abnormality and different GC responses.Methods A total of 45 children with PNS were enrolled as subjects in this prospective study,and divided into steroid-sensitive nephrotic syndrome(SSNS,n=36)and steroid-resistant nephrotic syndrome(SRNS,n=9)groups,according to their response to GC.The SSNS group was further subclassified into non-frequently relapsing nephrotic syndrome(NFRNS,n=21)and frequently relapsing nephrotic syndrome(FRNS,n=15)based on relapse frequency during 12-month follow-up.Peripheral blood samples were collected before GC treatment,6-week and 6-month after GC treatment.GRα nuclear localization was detected by immunofluorescence assay,and their correlations with clinical-laboratory indicators were analyzed.Results Before the GC treatment,the average fluorescence intensity showed no significantly difference among different groups(P＞0.05),the GRαin the three groups were localized mainly in cytoplasm,and the nucleocytoplasmic ratio showed no significantly difference among the three groups(P＞0.05).6-week after the GC treatment,the average fluorescence intensity showed no significantly difference among the three groups(P＞0.05),the GRα in SSNS group were localized mainly in nucleus,while those in SRNS group were localized mainly in cytoplasm.Furthermore,nucleocytoplasmic ratio in NFRNS group and SRNS group demonstrated significant differences,while those in NFRNS group and FRNS group showed no significant difference(P＞0.05).6-month after the GC treatment,the average fluorescence intensity in NFRNS group and FRNS group showed no significant difference(P＞0.05),GRα in the two groups were localized mainly in nucleus,and their nucleocytoplasmic ratio had significantly differences(P＜0.05).The GRα nucleocytoplasmic ratio in children with PNS was negatively correlated with 24-hour urine protein(24 h-UTP),TNF-α,while positively correlated with serum albumin(Alb).Conclusion There are differences in nuclear transport ability among PNS children of SRNS,NFRNS and FRNS groups,and these differences are correlated with the differency of GC responses.

BACKGROUND:The Ilizarov technique is very effective in the treatment of congenital brachymetatarsia of the fourth,but there are still some complications.The optimal proportion of lengthening of the fourth metatarsal is still controversial.OBJECTIVE:To explore the clinical efficacy of Ilizarov technique in the treatment of congenital brachymetatarsia of the fourth and the optimal lengthening ratio.METHODS:Medical records of patients with congenital brachymetatarsia of the fourth treated with Ilizarov technique in Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2021 to October 2023 were collected.American Orthopaedic Foot and Ankle Society scores before and after the treatment,length of the fourth metatarsal before and after surgery,and postoperative complications were evaluated.The prolongation ratio was analyzed by subgroups to assess the best suitable length for the operative conditions.RESULTS AND CONCLUSION:(1)A total of 16 patients were included.The length of the fourth metatarsal before treatment was(43.51±3.75)mm,and the shortening length was(12.53±2.82)mm;the lengthening time during the treatment period was(36.95±4.12)days,and the time with external fixation bracket was(102.30±32.74)days,and the lengthening length after the treatment was(13.90±3.47)mm,and the prolongation ratio was(32.30±9.10)％.(2)American Orthopaedic Foot and Ankle Society scores were significantly increased at the last follow-up compared with that before treatment(t=0.763,P＜0.01).(3)The main postoperative complications were bone nonunion,metatarsophalangeal joint dislocation,metatarsophalangeal joint narrowing,and excessive lengthening of the fourth metatarsal.All patients were free of infection and abnormal sensation in the toe.(4)Subgroup analysis based on prolongation ratio showed that the rate of complications in patients in the prolongation ratio ≤ 35.36％group(17％)was significantly lower than the prolongation ratio＞35.36％group(100％)(t=14.008,P＜0.01).Meanwhile,the postoperative American Orthopaedic Foot and Ankle Society score of patients in the prolongation ratio ≤ 35.36％group(90.25±3.01)was higher than that of patients in the prolongation ratio＞35.36％group(82.00±9.97)(t=2.254,P=0.037).(5)It is concluded that Ilizarov technique for the treatment of congenital brachymetatarsia of the fourth is less traumatic surgery,can significantly improve the foot deformity of patients,especially suitable for the treatment of patients whose prolongation ratio does not exceed 35.36％,with low complication rate and satisfactory results.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective: To analyze characteristics of iron-deficient blood donors, implement targeted interventions, and evaluate their effectiveness, thereby providing a reference for formulating blood donor recruitment and care strategies. Methods: Based on serum ferritin (SF) test results, the apheresis platelet donors were divided into the low SF group (n=90; 45 males and 45 females) and the normal SF group (n=651; 510 males and 141 females). The results of related indicators of the two groups were compared and analyzed. Interventions for the low SF group included extending the blood donation interval to at least 45 days (group A) and oral iron supplementation combined with the extended donation interval implemented in group A (group B). Pre-intervention and post-intervention SF results were compared. Results: For both male and female donors, serum iron levels were significantly lower in the low SF group than those of the normal SF group, while the levels of transferrin, unsaturated iron binding capacity (UIBC) and total iron binding capacity (TIBC) were higher in the low SF group compared to the normal SF group. Some indicators related to red blood cells showed changes, with more evident alterations in females than in males. Twenty-eight donors in group A and 39 donors in group B completed the study after intervention. SF value in group A was (18.32±8.09) μg/L at baseline and (26.21±17.30) μg/L after intervention. Similarly, SF value in group B was (15.87±7.69) μg/L at baseline and (26.24±15.55) μg/L after intervention. In both groups, SF values after intervention were significantly higher than baseline values. However, the magnitude of change did not significantly differ between groups A and B. Conclusion: Other related indicators in blood donors with low ferritin have also experienced some changes, suggesting that some blood donors may have entered the stage of iron-deficient erythropoiesis. Extending blood donation interval facilitates the recovery of iron storage in low-ferritin apheresis platelet donors. Blood stations should develop care strategies for apheresis platelet donors, including, at a minimum, the prolonged blood donation interval for donors with low ferritin.

Acute lung injury (ALI) has been a kind of acute and severe disease that is mainly characterized by systemic uncontrolled inflammatory response to the production of huge amounts of reactive oxygen species (ROS) in the lung tissue. Given the critical role of ROS in ALI, a Fe₃O₄ loaded bovine serum albumin (BSA) nanocluster (BF) was developed to act as a nanomedicine for the treatment of ALI. Combining with NIR irradiation, it exhibited excellent ROS scavenging capacity. Significantly, it also displayed the excellent antioxidant and anti-inflammatory functions for lipopolysaccharides (LPS) induced macrophages (RAW264.7), and Sprague Dawley rats via lowering intracellular ROS levels, reducing inflammatory factors expression levels, inducing macrophage M2 polarization, inhibiting NF-κB signaling pathway, increasing CD4⁺/CD8⁺ T cell ratios, as well as upregulating HSP70 and CD31 expression levels to reprogram redox homeostasis, reduce systemic inflammation, activate immunoregulation, and accelerate lung tissue repair, finally achieving the synergistic enhancement of ALI immunotherapy. It finally provides an effective therapeutic strategy of BF + NIR for the management of inflammation related diseases.

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*

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.