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*

ObjectiveTo investigate the drug-resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province. MethodsFrom 2015 to 2016, blood samples were collected from imported P. falciparum malaria patients returning from Equatorial Guinea to Shandong Province, and genome DNA of the malaria parasite was extracted. The drug-resistant Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum were amplified using a PCR assay, followed by DNA sequencing, and the sequences were aligned. Results The target fragments of all 5 drug-resistant genes of P. falciparum were successfully amplified and sequenced. There were 72.8%, 18.6%, and 8.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfcrt gene, respectively, and all mutant haplotypes were CVIET (the underline indicates the mutation site). There were 20.0%, 61.4% and 18.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfmdr1 gene, respectively, and the mutant haplotypes mainly included YF and NF (the underlines indicate the mutation sites). There were 1.4%, 98.6%, and 0 of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhfr gene, respectively, and AIRNI was the predominant mutant haplotype (the underline indicates the mutation site). There were 1.4%, 94.3%, and 4.3% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhps gene, respectively, and SGKAA was the predominant mutant haplotype (the underline indicates the mutation site). The complete drug-resistant IRNGE genotype consisted of 8.6% of the Pfdhfr and Pfdhps genes, and the K13 gene A578S mutation occurred in 1.4% of the parasite samples. Conclusions There are mutations in the Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum imported from Equatorial Guinea to Shandong Province, with a low frequency in the Pfcrt gene mutation and a high frequency in the Pfmdr1, Pfdhfr, and Pfdhps gene mutations, and the K13 gene A578S mutation is detected in the parasite samples.

With the introduction and development of evidence-based medicine in China, it has been spread rapidly in the area of integrative medicine (IM) and has become a new unique discipline. During almost 20 years, as one of the most important parts of evidence-based IM, systematic review (SR)/meta-analysis (MA) of IM have shown a good development momentum in the aspects of quantity, depth, breadth and influence, but also face the harsh situation of the uncontrolled quantity and quality, especially for SRs in Chinese. Therefore, how to supervise and standardize this area effectively becomes a problem to be solved. Based on the experience both at home and abroad, the authors put forward several kinds of solutions for laying the foundation for further development such as promoting the registration system of SR/MA of IM, effectively setting up the regulatory platform of quality and quantity, launching professional training for SR/MA reviewers, forming qualification registration, developing the data transfer and sharing platform to realize the transparency of evidence process.

Objective To investigate the effect of electroacupuncture on diaphragm function of chronic obstructive pulmonary disease (COPD) rats with muscular dystrophy, and to explore the regulatory mechanism. Methods Forty male rats were randomly divided into blank group, model group, electroacupuncture group, exercise group, electroacupuncture plus exercise group, 8 rats in each group. After successful establishment of COPD rat model with muscular dystrophy, the modeled rats in various intervention groups were given electroacupuncture and/or exercise treatment. After the last treatment, the changes of rat body mass were observed, the rat lung function was detected, and the mRNA expression levels of myosin heavy chains (MHC) of MHC-1, MHC-2 and diaphragmatic related signal proteins of Atrogin-1, muscle ring-finger protein-1(MuRF-1), MyoD were detected by real-time quantitative polymerase chain reaction (qPCR). Results (1) Compared with the blank group, inspiratory resistance (IR) and functional residual mass (FRC) in the model group were increased (P < 0.05) , and the dynamic lung compliance(Cydn) was decreased(P<0.05). Compared with the model group, IR and FRC in the intervention groups were decreased (P < 0.05), but the differences among the three intervention groups were insignificant(P>0.05). (2) Compared with the blank group, the mRNA expression levels of MHC-1, Atrogin-1, MuRF-1, MyoD in the model group were increased (P<0.05), and the mRNA expression level of MHC-2 was decreased (P < 0.05). Compared with the model group, the mRNA expression levels of MHC-1, Atrogin-1, MuRF-1, MyoD in the intervention groups were decreased (P < 0.05) , and the mRNA expression level of MHC-2 was increased(P<0.05). Compared with the exercise group, the mRNA expression levels of Atrogin-1, MuRF-1, MyoD in the electroacupuncture group were decreased (P<0.05), and the mRNA expression level of MHC-2 was increased (P<0.05) , but the above indexes in electroacupuncture plus exercise group showed no obvious changes(P>0.05). Conclusion Electroacupuncture can improve respiratory function of COPD rats with muscular dystrophy, and the possible mechanism is related with the increase of MHC-2 mRNA expression and with the decrease of Atrogin-1, MuRF-1, MyoD mRNA expression, which result into the regulation of ubiquitin proteasome pathway(UPP), reduction of myosin loss, and the relief of diaphragmatic atrophy.

Malaria remains a serious public health problem in Shandong Province, China; therefore, it is important to explore the characteristics of the current malaria prevalence situation in the province. In this study, data of malaria cases reported in Shandong during 2012-2014 were analyzed, and Plasmodium species were confirmed by smear microscopy and nested-PCR. A total of 374 malaria cases were reported, 80.8% of which were reported from 6 prefectures. Of all cases, P. falciparum was dominant (81.3%), followed by P. vivax (11.8%); P. ovale and P. malariae together accounted for 6.4% of cases. Notably, for the first time since 2012, no indigenous case had been reported in Shandong Province, a situation that continued through 2014. Total 95.2% of cases were imported from Africa. The ratio of male/female was 92.5:1, and 96.8% of cases occurred in people 20-54 years of age. Farmers or laborers represented 77.5% of cases. No significant trends of monthly pattern were found in the reported cases. All patients were in good condition after treatment, except for 3 who died. These results indicate that imported malaria has increased significantly since 2012 in Shandong Province, especially for P. falciparum, and there is an emergence of species diversity.
Africa ; China* ; Farmers ; Humans ; Malaria* ; Microscopy ; Plasmodium falciparum ; Plasmodium malariae ; Plasmodium ovale ; Plasmodium vivax ; Plasmodium* ; Prevalence ; Public Health

Objective To investigate the resistant mechanism of quinolones on multi-drug resistant Klebsiella caused pneumonia(MDR-KPN).Methods From August 2008 to May 2010,47 strains of MDR-KPN were collected from 6 hospitals in Hangzhou and Huzhou in Zhejiang province in China.Drug target genes to quinolones (gyrA,parC) and quinolone-resistance genes mediated by mobile genetic elements [qnrA,qnrB,qnrS,aac (6')-Ⅰ b-cr,qepA] were analyzed by PCR and verified by DNA sequencing.Results Positive results were found in 47 strains of MDR-KPN,43 strains (91.5％) of gyrA mutation,40 strains(85.1％) ofparC mutation,3 strains (6.4％) of qnrB2,1 strain (2.1％) ofqnrB 4,8 strains (17.0％) ofqnrS 1,5 strains (10.6％) of qnrS 4,2 strains (4.3％)of aac (6')-Ⅰ b-cr respectively.Moreover,5 novel variants of gyrA (GenBank accession number:JN811952,JN811953,JN811954,JN811955,JN811956),5 novel variants of parC (GenBank accession number:JN817432,JN817433,JN817434,JN817435,JN817436)were also identified.In addition,qnrS4 (GenBank accession number:JN836269) appeared to be the novel variants of qnrS.Conclusion Quinolone-resistance-determining region played a key role on the resistance to quinolones in this group of MDR-KPN,and quinolone-resistance genes mediated by mobile genetic elements [qnrB2,qnrB4,qnrS1,qnrS4,aac (6')-Ⅰ b-cr] showed positive in some parts of the strains.This was the first report on emergence of qnrS4 in the world.

Blood Coagulation Disorders ; drug therapy ; Child ; Child, Preschool ; Drug Therapy, Combination ; Female ; Heparin ; administration & dosage ; Humans ; Male ; Nephrotic Syndrome ; blood ; complications ; urine ; Urokinase-Type Plasminogen Activator ; administration & dosage

Objective To investigate the hope level and its influencing factors in chronic obstructive pulmonary disease(COPD)patients.Methods Questionnaires were randomly applied to investigate the hope level and its influencing factors of 76 patients with chronic obstructive pulmonary disease with acute exacerbation (AECOPD).Results The hope level scores were in the range of 21-45 interval,and the mean score was (34.92 ±4.89).97.37％ of AECOPD patients were in mid-high level.Univariate analyses showed that family relationship,monthly salary,activities of daily living(ADL),disease severity were influential factors(P＜0.05).HHI of AECOPD with different respiratory training was different(F =3.76,P ＜ 0.05),and the score of those never exercise was(34.29 ±5.12),(37.08 ± 1.00)in those exercise more often,and(41.50 ±3.54)of those exercise every day.HHI of patients with different oxygen-intake time was different(P ＜ 0.01).Multivariate multiple linear regression analysis showed that monthly salary and ADL were influential factors,and the more salary,and the more hope-level.ADL,oxygenintake time month salary,and disease severity were related to hope-level of patients by multivariate analyses in oxygenintake patients(P ＜ 0.01).Conclusions For nursing care of the COPD patients,attention should be paid on improving the hope level,interfering in the correlated influencing factor as soon as possible so as to continuously improve the quality of life.

OBJECTIVETo sum up the clinical experience of the diagnosis and treatment of intracerebral infiltration by monoclonal plasmacytoid cells in Waldenstrom's macroglobulinemia(Bing-Neel syndrome).

METHODSThe clinical data of the diagnosis and treatment of a case of Bing-Neel syndrome was analyzed.

RESULTSA 56-year-old male was diagnosed as Waldenstrom's macroglobulinemia one year ago, and presented with persistent headache during the treatment period. Magnetic resonance imaging showed a high intensity area on T2-weighed images in the right frontal lobe which was well enhanced by gadolinium-diethylenetriaminepenta-acetic acid. Infiltration of neoplastic cells was confirmed by biopsy. Immunohistochemical examination showed that mature plasmacytoid cells in the cerebral parenchyma were immunoglobulin M positive.

CONCLUSIONInfiltration in CNS (Bing-Neel syndrome) is uncommon in Waldenstrom's macroglobulinemia. As there is no effective therapy for this Bing-Neel syndrome, combination of radiation and chemotherapy should be considered for this situation.

Brain ; pathology ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Waldenstrom Macroglobulinemia ; pathology

OBJECTIVETo investigate the clinical effect of Pishen Bingbu Recipe (PBR) in treating patients with sympathetic cervical spondylosis (SCS) of qi-blood deficient syndrome type and its impact on heart rate variability (HRV).

METHODSFifty patients were randomized into the control group and the treatment group equally. Both were treated with mecobalamin, vitamin B1, neurotropin, and occipital - jaw band traction in the sitting posture, but to patients in the treatment group, PBR was given additionally. The course of treatment was 60 days. Therapeutic effect and changes of HRV indexes were observed.

RESULTSAfter treatment, in the treatment group, 5 patients (20%) were clinically cured, treatment was markedly effective in 12 patients (48%), effective in 7 (28%) and ineffective in 1 (4%), while the corresponding data in the control group were 2 (8%), 4 (16%), 18 (72%) and 1 (4%) respectively, demonstrating the efficacy in the treatment group was superior to that in the control group (P <0.05). Before treatment, the HRV indexes in the two groups were insignificantly different respectively (P >0.05). But after treatment, difference between groups was observed in terms of either time domain or frequency domain. Those of time domain were: standard deviation of NN intervals (SDNN, ms) 133.41 +/- 8.61 vs 115.61 +/- 13.49, average standard deviation of 5 min NN intervals (SDANN, ms) 126.90 +/- 9.99 vs 106.20 +/- 8.84, HRV trigonometric index (HRVTI) 35.10 +/- 4.48 vs 25.51 +/- 2.24; and those of frequency domain: low frequency (LF, ms2) 379.90 +/- 159.07 vs 477.70 +/- 396.91 high frequency (HF, ms2) 157.10 +/- 28.18 vs 122.10 +/- 101.90, and LF/HF ratio 2.37 +/- 0.52 vs 4.27 +/- 2.84. All were superior in the treatment group (P < 0.05).

CONCLUSIONPBR shows evidently clinical efficacy on SCS, it can significantly improve the functional activities of sympathetic nerve in patients.

Adult ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Heart Rate ; drug effects ; Humans ; Male ; Middle Aged ; Spondylosis ; drug therapy ; pathology ; physiopathology