Gout significantly impacts both physical health and quality of life,while current pharmacological treatments face notable limitations.TCM non-pharmacological therapies have shown promising potential in the management of gout,offering diverse approaches with favorable efficacy.This article summarized the characteristics,clinical efficacy and mechanisms of different TCM non-pharmacological therapies for treating gout.Recent studies suggest that these therapies may be applied across all clinical stages of gout.During the acute phase,they can rapidly reduce joint inflammation and relieve pain.In the intercritical phase,they help prevent recurrence,decrease the frequency of attacks,and shorten episode duration.In the chronic tophaceous phase,they alleviate persistent symptoms,improve joint function,and support minimally invasive tophi removal.TCM non-pharmacological therapies have their own characteristics and good safety,and can be combined for clinical use,providing TCM treatment strategies for gout.

Knee osteoarthritis is a common joint disease within osteoarthritis,characterized by pain,swelling,and limited functionality as the main clinical manifestations.In severe cases,it affects daily life and falls under the category of"impediment syndrome"or"bone impediment"in TCM.The author believes that the theory of"bones,tendons,and muscles"is closely related to this disease.Treatment should focus on simultaneously nourishing the liver,spleen and kidneys,considering tendons,bones and muscles,while also dispelling wind,cold and dampness.The clinical application of Sanbi Decoction has shown good efficacy,and this discussion aimed to provide ideas for the diagnosis and treatment of knee osteoarthritis.

Gout significantly impacts both physical health and quality of life,while current pharmacological treatments face notable limitations.TCM non-pharmacological therapies have shown promising potential in the management of gout,offering diverse approaches with favorable efficacy.This article summarized the characteristics,clinical efficacy and mechanisms of different TCM non-pharmacological therapies for treating gout.Recent studies suggest that these therapies may be applied across all clinical stages of gout.During the acute phase,they can rapidly reduce joint inflammation and relieve pain.In the intercritical phase,they help prevent recurrence,decrease the frequency of attacks,and shorten episode duration.In the chronic tophaceous phase,they alleviate persistent symptoms,improve joint function,and support minimally invasive tophi removal.TCM non-pharmacological therapies have their own characteristics and good safety,and can be combined for clinical use,providing TCM treatment strategies for gout.

Knee osteoarthritis is a common joint disease within osteoarthritis,characterized by pain,swelling,and limited functionality as the main clinical manifestations.In severe cases,it affects daily life and falls under the category of"impediment syndrome"or"bone impediment"in TCM.The author believes that the theory of"bones,tendons,and muscles"is closely related to this disease.Treatment should focus on simultaneously nourishing the liver,spleen and kidneys,considering tendons,bones and muscles,while also dispelling wind,cold and dampness.The clinical application of Sanbi Decoction has shown good efficacy,and this discussion aimed to provide ideas for the diagnosis and treatment of knee osteoarthritis.

Objective:To explore the effects of the fat mass and obesity-associated gene(FTO)on apoptosis and the inflammatory response of chondrocytes in osteoarthritis(OA).Methods:Differences in FTO expression between normal human cartilage tissue samples and OA cartilage tissue samples were examined.Primary OA chondrocytes were isolated and cultured, and a rat OA model was constructed.The expression of FTO was detected in clinical, animal and cellular samples.Cells were treated with an FTO knockdown lentivirus vector(sh-FTO)and an m 6A methylation inhibitor(cycloleucine). The amount of m 6A and the expression levels of inflammatory cytokines, interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α), were detected.Flow cytometry was used to detect apoptosis in OA chondrocytes, and Western blot was used to detect the expression levels of B-cell lymphoma 2(Bcl-2)and Bcl-2-associated X protein(Bax). Results:Compared with the normal control group, FTO mRNA and protein expression in human OA cartilage tissue, rat OA cartilage tissue and OA chondrocytes was significantly increased(all P<0.05). After FTO knockdown, the level of m 6A increased, the levels of IL-6 and TNF-α decreased considerably, the apoptosis rate decreased, the expression of the proapoptotic protein Bax decreased considerably, and the expression of Bcl-2 increased considerably in primary OA chondrocytes.However, cycloleucine intervention clearly reduced the level of m6A, increased the levels of IL-6 and TNF-α, promoted cell apoptosis and the expression of apoptosis-related proteins, and reversed the effect induced by the FTO knockdown lentivirus in OA chondrocytes(all P<0.05). Conclusions:FTO may be involved in mechanisms related to the action of m 6A to promote OA chondrocyte apoptosis and the inflammatory response, thus accelerating the progression of OA.

Objective To study the influence of long term simulated weightlessness on occurrence of laryngopharyngeal reflux(LPR)in healthy volunteers by detection of pepsin in saliva.Methods During a 90-day head-down tilt bed rest(HDTBR)experiment,11 volunteers(4 from the control group and 7 from the countermeasure group)were recruited in the study in the following seven sessions:before bed rest session(Pre),during bed rest sessions for 3 days(BR3),31 days(BR31),61 days(BR61),85 days(BR85)and post bed rest sessions for 7 days(R7)and 25 days(R25).During each testing session,saliva samples were collected for two consecutive days both in the morning and at night before sleeping.Then pepsin in the saliva was measured by enzyme-linked immunosorbent assay.Scale of otorhinolaryngological symptoms for the duration of"Pre-,During-and Post-"were retrospectively performed.Results Among 288 saliva samples of 11 volunteers,17 saliva samples of 8 volunteers were positive for pepsin.The incidence of LPR was 9.1%(1/11)in the Pre session,and it increased to 36.4%in the BR31 session which was higher than the following consequential sessions(0%in BR31,27.3%in BR61 and 27.3%in BR85).Intriguingly,it rose again to 45.5%in R7 session and decreased to 9.1%until in R25 session.There was no significant difference between the control group and the countermeasure group.Total scores for the scale of otorhinolaryngological symptoms showed that a slight elevation tendency emerged during HDTBR session,compared with the pre-HDTBR session.It recovered during the post bed rest sessions.Conclusion The laryngopharyngeal reflux was found in the Pre,During and Post HDTBR experiment.The incidence was significantly increased both in the BR3 and R7 sessions,which indicates that the change of the posture with the stimulation of gastrointestinal dynamic conditions,despite the changes from vertical to horizontal or from horizontal to vertical,might be the major impact factor contributing to the elevation tendency of the incidence of laryngopharyngeal reflux.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective Bibliometric approaches are used to investigate the characteristics and benefits of traditional Chinese medicine treatments for dominant diseases that can be applied in clinical therapy to effectively manage geriatric diseases.Methods Clinical research literature on the use of traditional Chinese medicine in the treatment of geriatric diseases within the past 10 years was retrieved from CNKI,Wanfang,VIP,and CBM databases.The research trends and clinical efficiency of each disease were statistically analyzed to determine the dominant diseases of TCM.Results A total of 22 859 articles were collected,with 3768 included in the research.In accordance with the International Statistical Classification of Diseases and Related Health Problems(ICD-11)of the World Health Organization,the diseases were classified into 17 categories and 149 diseases.The diseases primarily affect the circulatory system,skeletal musculoskeletal or connective tissue system,and digestive system.Conclusions Traditional Chinese medicine clinical trials on the treatment of geriatric illnesses cover a diverse spectrum of diseases,although the distribution of focus is unequal.Potential dominant illnesses were eventually identified to include osteoporosis,constipation,and hypertension,with heart failure,stroke,coronary heart disease,diabetes and its complications,and insomnia being potential sub-dominant diseases.

Objective To explore the clinical characteristics of patients with heart failure(HF)treated with lyophilized Yiqifumai injection based on real-world data,providing evidence for the rational and standardized use of Yiqifumai injection.Methods Hospitalized HF patients from 81 hospitals across China were included in this study between April and November 2023.We collected demographics information[sex,age,New York Heart Association(NYHA)functional classification],length of hospital stay,duration of medication use,and biomarkers such as N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),and left ventricular end-diastolic diameter(LVEDD).Clinical features of HF patients treated with Yiqifumai injection were analyzed,and comparisons were made among different HF subtypes.Results A total of 457 HF patients were included:96 with heart failure with reduced ejection fraction(HFrEF),70 with HF with mildly reduced ejection fraction(HFmrEF),and 291 with HF with preserved ejection fraction(HFpEF).The majority of HFpEF type and HFrEF type patients were classified as NYHA class Ⅲ[48.1％(140/291)and 54.2％(52/96),respectively],while most HFmrEF type patients were classified as class Ⅳ[41.4％(29/70)].The longest average hospital stay was recorded in HFmrEF type patients[(9.30±3.02)days],while the shortest was recorded in HFrEF type patients[(8.77±3.11)days].The shortest average medication duration was found in the HFrEF type[(8.54±2.95)days],while the longest was observed in HFpEF type patients[(8.82±2.82)days].Serum NT-proBNP levels were significantly decreased post-treatment in all three types[ng/L:HFrEF was 2 435.00(1 169.25,5 607.75)vs.5 334.00(2 077.33,9 108.88),HFmrEF type was 2 313.25(598.09,6 224.67)vs.4 559.21(1 325.75,8 922.75),HFpEF type was 824.00(169.46,2298.75)vs.1 265.00(215.00,3 458.80),all P<0.05],with the most pronounced decrease observed in the HFrEF type.LVEF was significantly improved in the HFrEF type[0.340(0.290,0.378)vs.0.336(0.280,0.360),P<0.05],while no significant changes were noted in the HFmrEF type and HFpEF type.No significant differences in LVEDD were found before and after treatment in any type(all P>0.05).Conclusion In the real-world setting,the advantages of Yiqifumai injection in treating HFrEF are more pronounced,while further evidence from evidence-based medicine is needed to support its use in other types of heart failure.

Hand osteoarthritis(HOA)is a disease of hand joint disorders,mainly manifested by hand interphalangeal joint and thumb carpal metacarpal joint pain,swelling,morning stiffness,limited movement,and even deformity,belonging to the category of TCM"bone arthralgia".The authors believe that HOA is more common with Taiyang Shaoyang disease,suitable for simultaneous treatment for Taiyang and Shaoyang,to operate the cardinal,regulate qi,blood,nutritive and defensive levels,dispel wind and cold,remove dampness and arthralgia,using modified Chaihu Guizhi Decoction,with confirmed efficacy.