AIM To study the chemical constituents from the leaves of Drynaria fortunei(Kunze)J.Sm.and their antioxidant activity.METHODS ODS-AG-HG,Sephadex LH-20 and semi-preparative HPLC were used for separation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The antioxidant activity was determined by DPPH mothod.RESULTS Fifteen compounds were isolated and identified as kaempferol-3-O-neohesperidoside(1),dihydrodehydrodiconiferyl alcohol(2),kaempferol-3,7-di-O-α-L-rahmnoside(3),astragalin(4),loliolid(5),trichothecene analogue(6),2,2-[bis-4-(2,3-dihydroxypropoxy)phenyl]propane(7),maculatin(8),trichothecin(9),4-[(Z)-but-2-enoyloxy]-8-chloro-12-hydroxy-7,13-epoxytrichothec-9-ene(10),8-deoxy-trichotecin(11),β-sitosterol(12),daucosterol(13),afzelin(14),samwinol(15).The IC50 values of the leaf and rhizome extracts against DPPH free radicals were(0.072±0.005),(0.287±0.012)mg/mL,respectively.CONCLUSION Compounds 1,2,5-11,15 are isolated from this plant for the first time.The leaves of D.fortunei exhibit strong antioxidant activity.

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups. Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients’ lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05). Conclusion This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.

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*

Aim To study whether intravenous injec-tion of miR-129-3p mimetic(agomir)can resist bone loss caused by hind limb disuse,and to provide new i-deas for preventing bone loss in microgravity environ-ment.Methods Forty-eight C57BL/6J male mice were randomly divided into the control group(CON),tail suspension model group(TS),tail suspension+miR-129-3p agomir administration group(miRNA)and tail suspension+miR-129-3p negative sequence agomir control group(NC).The miRNA group was given 4 mg·kg-1 miR-129-3p agomir by intravenous injection into the medial canthus twice a week.The NC agomir group were consistent with those in the miR-129-3p agomir group,and the CON and TS groups were given only equal volumes of normal saline.After four weeks,all mice were sacrificed and samples were collected.Micro-CT scan of femur,three-point femur bending test,serum bone metabolism index detection,oxidative stress index detection and osteogenesis-related protein expression analysis in bone tissue were per-formed.Results After four weeks,the number of tra-becular bone in the TS group was significantly re-duced,and Tb.BMD,Tb.Th,Tb.N,Tb.BS/TV and Tb.BV/TV were significantly lower than those in the CON group(P＜0.01).While Tb.Sp TS group was significantly higher than the CON group(P＜0.05),the maximum load and flexural strength of the femur significantly decreased(P＜0.01),the content of ser-um bone formation index PINP was significantly lower than that of the CON group(P＜0.01),and the con-tent of bone resorption index CTX-I was significantly higher than that of the CON group(P＜0.01),the content of serum oxidative damage indexes 8-iso-PGF2α and 8-OHdG significantly increased(P＜0.01),and the expression of osteogenesis-related pro-teins in bone tissue markedly decreased(P＜0.01).However,the increase or decrease of all indexes in miRNA group was significantly lower than that in TS group.Conclusions miR-129-3p mimetic can signifi-cantly reduce bone loss caused by hind limb disuse.This experiment provides a new idea and method for preventing bone loss in microgravity environment.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To investigate the effect of laparoscopic high ligation of spermatic cord vein in patients with chronic prostatitis and varicocele prostatitis.Methods:A total of 90 varicocele patients were selected from January 2016 to December 2020,including 33 patients with chronic prostatitis.Changes of white blood cell count,National Institutes of Health chronic prostatitis symp-tom index(NIH-CPSI)score and serum testosterone level in the expressed prostate secretion(EPS)were observed before and after the operation of laparoscopic high ligation of spermatic vein.Results:All patients were followed up three months after the surgery.There was no significant difference in the white blood cell counts in EPS,NIH-CPSI score,and serum testosterone level in patients with vari-cocele-only who underwent high ligation surgery after the operation.However,the white blood cell count in the EPS of patients with chronic prostatitis was lower than that before 3 months of operation([12.39±4.23]× 10 9/L vs[21.36±5.05]× 10 9/L).The NIH-CPSI score was significantly lower than that before operation([12.71±6.21]vs[26.76±8.43]).And the serum testosterone level was higher than that before operation([4.34±1.77]ng/ml vs[2.36±1.05]ng/ml).Conclusion:Laparoscopic high liga-tion of the spermatic vein in patients with chronic prostatitis and varicocele could effectively reduce the number of white blood cells in the EPS,boost the level of serum testosterone and improves symptoms of chronic prostatitis.

Objective To explore the effect and mechanism of knockdown of mitochondrial transcription factor A(TFAM)on the growth of gastrointestinal stromal tumor(GIST)cells mediated by tumor-associated macrophages(TAMs)polarization.Methods Human acute leukemia mononuclear macrophage cell line THP-1 induced by phobate and interleukin(IL)-4 was used to establish TAMs,lentivirus shRNA TFAM and negative control shRNA NC were transfected into TAMs,which were recorded as TAMs+sh-TFAM group and TAMs+sh-NC group,respectively,the untransfected cells were recorded as the TAMs group.The mRNA expression of TFAM,IL-10 and arginase-1(Arg-1)was detected by qRT-PCR.The TFAM protein expression was detected by Western blot.The expression level of CD206 was detected by flow cytometry.The human GIST cell line GIST-T1 were divided into GIST-T1 group,TAMs+GIST-T1 group,TAMs+sh-NC+GIST-T1 group,TAMs+sh-TFAM+GIST-T1 group,and treated with fresh medium containing different TAMs culture supernatants.The cell proliferation and apoptosis levels were detected by CCK-8,EdU staining and Annexin V-FITC/PI double staining respectively.Results Compared with TAMs group and TAMs+sh-NC group,the TFAM mRNA and protein expression levels of THP-1 cells in TAMs+sh-TFAM group were significantly down-regulated(P<0.05).Compared with control group,the expression levels of CD206 and IL-10 and Arg-1 mRNA of THP-1 cells in TAMs group were significantly increased(P<0.05).Compared with TAMs+sh-NC group,the expression levels of CD206 and IL-10 and Arg-1 mRNA of THP-1 cells in TAMs+sh-TFAM group were significantly decreased(P<0.05).Compared with GIST-T1 group,the proliferative activity of GIST-T1 cells and EdU positive cells rate in TAMs+GIST-T1 group were significantly increased(P<0.05),while the apoptosis rate was significantly decreased(P<0.05).Compared with TAMs+sh-NC+GIST-T1 group,the proliferative activity of GIST-T1 cells and EdU positive cells rate in TAMs+sh-TFAM+GIST-T1 group were significantly decreased(P<0.05),while the apoptosis rate was significantly increased(P<0.05).Conclusion Knockdown of TFAM can inhibit the polarization of TAMs to M2 phenotype,thus inhibiting the proliferation of GIST cells,promoting cell apoptosis,and preventing the progression of GIST.

Objective:To investigate the expression of CSF-1 and CSF-1R in the peripheral blood of children with immune thrombocytopenia(ITP)and its clinical significance.Methods:Forty-four children with ITP treated in our hospital from February 2023 to January 2024 were selected as the observation group,and 40 healthy children were selected as the control group during the same period,and relevant clinical data were collected.Peripheral blood mononuclear cells(PBMC)of children with ITP and healthy children were separated,and the plasma levels of M1 macrophage-associated cytokines(TNF-α,IL-6),M2 macrophage-associated cytokines(IL-10,TGF-β),and CSF-1 were detected by ELISA in the children of both groups.The mRNA levels of M1 macrophage surface markers(CD86,iNOS),M2 macrophage surface markers(CD206,Arg-1)and CSF-1 R were detected by RT-PCR in PBMC of children in both groups.Western blot was used to detect the expression of CSF-1 R protein in PBMC of the two groups of children.The correlation between platelet count and CSF-1R mRNA expression in PBMC,TNF-α,IL-6,IL-10,TGF-β and CSF-1 in plasma was analyzed.Results:Compared with the control group,the levels of IL-10,TGF-β,CSF-1 and platelet count in plasma of children with ITP were significantly decreased(P＜0.01),and the levels of TNF-α and IL-6 were significantly increased(P＜0.01);the mRNA levels of the M1 macrophage surface markers(CD86,iNOS)in PBMC of children with ITP were significantly increased(P＜0.05),mRNA levels of M2 macrophage surface marker CD206 in PBMC of children with ITP were decreased compared with controls but the difference was not statistically significant(P＞0.05),mRNA levels of Arg-1 were decreased,the difference was statistically significant(P＜0.05).The mRNA and protein levels of CSF-1R in PBMC of ITP children were higher than that in controls.CSF-1R expression in PBMC of ITP was positively correlated with platelet count,IL-10,CSF-1 were positively correlated(r=0.822,0.481,0.405).Conclusion:CSF-1 is significantly reduced in the plasma of ITP,and CSF-1R mRNA and protein expression is significantly elevated in PBMC of ITP,which are involved in the regulation of macrophage M1/M2 imbalance,and could serve as a potential therapeutic target for ITP.