With the increasing utilization of cancer therapy, the incidence of lung injury associated with these treatments continues to rise. The recognition of pulmonary toxicity related to cancer therapy has become increasingly critical, for which interstitial lung disease (ILD) is a common cause of mortality. Cancer therapy-related ILD (CT-ILD) can result from a variety of treatments including chemotherapy, targeted therapy, immune checkpoint inhibitors, antibody-drug conjugates, and radiotherapy. CT-ILD may progress rapidly and even be life-threatening; therefore, prompt diagnosis and timely treatment are crucial for effective management. This review aims to provide valuable information on the risk factors associated with CT-ILD; elucidate its underlying mechanisms; discuss its clinical features, imaging, and histological manifestations; and emphasize the clinical-related views of its diagnosis. In addition, this review provides an overview of grading, typing, and staging treatment strategies used for the management of CT-ILD.
Humans ; Lung Diseases, Interstitial/diagnosis* ; Neoplasms/therapy* ; Risk Factors ; Immune Checkpoint Inhibitors/adverse effects* ; Antineoplastic Agents/therapeutic use*

OBJECTIVES: To explore the mechanism through which moxibustion promotes endometrial repair in rats with in thin endometrium (TE). METHODS: Female SD rats were randomized into control group, 95% anhydrous ethanol-induced TE model group and moxibustion (at "Guan Yuan") group. High-throughput sequencing was used to identify the target genes of TE, and the targeting relationship between miR-223-3p and NLRP3 was verified using a dual luciferase assay. Histopathological of rat uterus was observed with HE staining, and expressions of miR-223-3p and NLRP3 were detected using RT-qPCR; serum levels of IL-1β and IL-18 of the rats were detected using ELISA, and protein expressions of NLRP3, ASC, caspase-1 and GSDMD in the uterus were detected with Western blotting. The pregnancies of the rats after treatment were counted. RESULTS: Enrichment analysis of the differential genes suggested up-regulated inflammatory response in TE, and dual luciferase assay verified targeted inhibition of NLRP3 expression by miR-223-3p. The rat models of TE had significantly decreased endometrial thickness and reduced endometrial glands and blood vessels with enhanced mRNA expression of NLRP3, increased serum levels of IL-1β and IL-18, up-regulated protein expressions of NLRP3, ASC, caspase-1 and GSDMD, lowered pregnancy rates on both the affected and unaffected sides and the overall number of pregnancies. Treatment of the rat models with mo-xibustion obviously increased the endometrial thickness and the density of glands and blood vessels, up-regulated miR-223-3p expression, lowered serum IL-1β and IL-18 levels and the protein expressions of NLRP3, ASC, caspase-1 and GSDMD, and significantly increased the number of pregnancies. CONCLUSIONS Moxibustion at "Guan Yuan" acupoint up-regulates the expression of miR-223-3p, which results in targeted inhibition of NLRP3 to suppress pyroptosis and promote endometrial repair in rat models of TE.
Animals ; Female ; MicroRNAs/genetics* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Endometrium/pathology* ; Rats, Sprague-Dawley ; Rats ; Moxibustion ; Pyroptosis ; Up-Regulation ; Interleukin-1beta/metabolism* ; Interleukin-18 ; Caspase 1/metabolism*

Objective To observe the clinical efficacy of Shengdi Xiexin Decoction combined with proton pump inhibitors(PPIs)in the treatment of acute non-variceal upper gastrointestinal bleeding(ANVUGIB)with stomach-heat congestion syndrome.Methods Sixty-two patients with ANVUGIB of stomach-heat congestion syndrome admitted to Dongguan Hospital of Guangzhou University of Chinese Medicine between January and December 2024 were randomly divided into a treatment group(n=31)and a control group(n=31)using a random number table.The control group received conventional western therapy(e.g.,Omeprazole Sodium),while the treatment group additionally received Shengdi Xiexin Decoction.Both groups were treated for 7 days,followed by 8 weeks of follow-up.The changes in traditional Chinese medicine(TCM)syndrome scores,hematological parameters[hemoglobin(Hb),red blood cells(RBC),hematocrit(Hct),albumin(ALB)],tissue perfusion and metabolic markers[blood urea nitrogen/creatinine ratio(BUN/Cr),lactate(Lac)levels],hemostasis time,time to resume oral diet,hospital stay duration,hospitalization costs,and rebleeding rates were observed to evaluate the clinical efficacy and drug safety.Results(1)After 7 days of treatment,the total effective rate was significantly higher in the treatment group(90.32％,28/31)than that in the control group(74.19％,23/31).The intergroup comparison(by chi-square test)showed that the treatment group,efficacy was superior to that of the control group(P＜0.05).(2)The treatment group showed significantly short hemostasis time,time to resume oral diet,and hospital stay duration(P＜0.05),as well as significantly low hospitalization costs(P＜0.05)compared to the control group.(3)Both groups exhibited significant reductions in the scores of epigastric burning pain,abdominal distension,acid regurgitation,restlessness,excessive thirst,scanty dark uring and dry stools,and total TCM syndrome scores(P＜0.05).The treatment group demonstrated significantly greater improvements in the scores of abdominal distension,acid regurgitation,restlessness,dark uring and dry stools,and total TCM syndrome scores(P＜0.05),while no significant differences were observed in epigastric burning pain and excessive thirst(P＞0.05).(4)Hb and Hct levels increased significantly in both groups(P＜0.05),with a greater increase in the treatment group(P＜0.05).Although RBC and ALB levels showed an upward trend,no significant differences were observed between groups(P＞0.05).Following treatment,intergroup comparisons revealed that the treatment group demonstrated significantly greater increases in Hb and Hct levels than the control group(P＜0.05).In contrast,the two groups showed comparable effects in elevating RBC and ALB levels,with no statistically significant differences(P＞0.05).(5)BUN/Cr ratio and Lac levels decreased significantly in both groups(P＜0.05),with a more pronounced reduction in the treatment group(P＜0.05).(6)No significant differences were found in early or delayed rebleeding rates between groups(P＞0.05).(7)Neither group experienced significant adverse events.Conclusion Shengdi Xiexin Decoction combined with PPIs significantly improves clinical outcomes in ANVUGIB patients with stomach-heat congestion syndrome.It is effective on enhancing hematological parameters,correcting tissue hypoperfusion,alleviating symptoms,shortening hemostasis time and hospitalization durations,and reducing medical costs,demonstrating excellent safety.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

The 2021 version of the Baveno Ⅶ consensus on portal hypertension and the 2023 guidelines from the European Association for the Study of the Liver define recompensated cirrhosis as the restoration and stabilization of liver function, improvement of liver fibrosis, and absence of decompensated cirrhosis for a long time following effective treatment of the underlying etiology of cirrhosis. Recompensated cirrhosis has become an important research direction in the field with the gradually increasing number of these patients. Temporary recompensation, stable recompensation, and long-term recompensation are the three stages into which patients with cirrhosis are divided, based on varying recompensation stages. Clinical characteristics and prognosis are significantly different among different stages. Patients in the temporary compensation stage have significant fluctuations in their condition and poor stability, with a high risk of recurrent complications. The prognosis of patients in the stable recompensation stage is significantly affected by the cause and the type of initial decompensation event, while the condition of patients in the long-term recompensation stage is more stable, and the long-term prognosis is close to that of compensated cirrhosis. This article aims to summarize and explore the recompensation rates at different stages of liver cirrhosis, the occurrence risk of various complications and liver cancer, and long-term management and treatment following recompensation, providing new directions for future research in this field.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

The 2021 version of the Baveno Ⅶ consensus on portal hypertension and the 2023 guidelines from the European Association for the Study of the Liver define recompensated cirrhosis as the restoration and stabilization of liver function, improvement of liver fibrosis, and absence of decompensated cirrhosis for a long time following effective treatment of the underlying etiology of cirrhosis. Recompensated cirrhosis has become an important research direction in the field with the gradually increasing number of these patients. Temporary recompensation, stable recompensation, and long-term recompensation are the three stages into which patients with cirrhosis are divided, based on varying recompensation stages. Clinical characteristics and prognosis are significantly different among different stages. Patients in the temporary compensation stage have significant fluctuations in their condition and poor stability, with a high risk of recurrent complications. The prognosis of patients in the stable recompensation stage is significantly affected by the cause and the type of initial decompensation event, while the condition of patients in the long-term recompensation stage is more stable, and the long-term prognosis is close to that of compensated cirrhosis. This article aims to summarize and explore the recompensation rates at different stages of liver cirrhosis, the occurrence risk of various complications and liver cancer, and long-term management and treatment following recompensation, providing new directions for future research in this field.

Objective To assess the effectiveness and safety of CYP2C19 genotype test to guide clopi-dogrel individualized therapy in treating ischemic stroke.Methods The databases of PubMed,Embase,Co-chrane Library,Web of Science,Clinical Trail,CBM,CNKI,Wanfang database and VIP database were compre-hensively retrieved.The retrieval time was from the database establishment to August 2023.The randomized controlled trials (RCT) of CYP2C19 gene guiding clopidogrel anti-platelet therapy in the patients with ische-mic stroke were collected.The meta analysis was conducted by adopting the RevMan 5.3 software.Results A total of eleven RCT and 8729 patients with ischemic stroke were included.The meta analysis results showed that there was statistically significant difference in the recurrence rate risk of stroke (OR=0.48,95％CI:0.28-0.83,P=0.008),cardiovascular events incidence rate (OR=0.52,95％CI:0.33-0.82,P=0.005) and incidence rate of all-cause death (OR=0.57,95％CI:0.31-1.06,P=0.070) between clopidogrel individ-ualized anti-platelet treatment based on CYP2C19 genotype detection guidance and conventional anti-platelet treatment.In terms of safety,there were no statistically significant difference in the incidence rate of bleeding between the two groups (OR=1.16,95％CI:0.53-2.50,P=0.710).Conclusion CYP2C19 genotype detec-tion guided clopidogrel personalized anti-platelet therapy could significantly reduce the recurrent rate of stroke and incidence rate of vascular events compared with conventional anti-platelet treatment based on the existing evidence,moreover without increasing the risk of bleeding event occurrence

Objective To compare the reparative effects of moxibustion at"Guanyuan"and"Shenshu"points in rats with a thin endometrium.Methods Thirty-two female Sprague-Dawley rats were divided randomly into control(CON),model(MOD),Guanyuan(GY),and Shenshu(SS)groups.A thin endometrium model was established using 95％anhydrous alcohol.The Guanyuan and Shenshu groups underwent moxibustion at the Guanyuan and Shenshu points,respectively,and the other two groups of rats were fixed in the same way.Temperature changes at the acupoint area were measured at different time points.The pathological morphology of the uterus was observed by hematoxylin and eosin(HE)staining,and serum levels of inflammatory factors and hormone levels were detected by enzyme-linked immunosorbent assay(ELISA).Expression levels of proliferation and endometrial receptivity factors were detected by immunohistochemistry(IHC),and angiogenesis factors were detected by Western blot.Results The temperatures immediately after moxibustion and after 5 min were higher at the Shenshu compared with the Guanyuan acupoint(P＜0.01).Endometrial thickness and numbers of glands and blood vessels were decreased in the MOD group compared with the CON group(P＜0.01),serum interleukin 1 β(IL-1 β)was increased(P＜0.01)and PROG was decreased(P＜0.01),and Ki67,proliferating cell nuclear antigen(PCNA),leukemia inhibitory factor(LIF),integrin β3(ITG-β3),angiopoietin-1(ANG-1),and CD34 protein in uterine tissue were all decreased(P＜0.01).Endometrial thickness and numbers of glands and blood vessels were increased in the GY and SS groups compared with the MOD group(P＜0.01),while serum IL-1 β was decreased(P＜0.05),E2 and PROG were increased(P＜0.05),and serum interleukin 10(IL-10)was increased in the SS group(P＜0.05).Ki67,PCNA,LIF,and ITG-β3 were all increased in both treatment groups compared with the MOD group(P＜0.01).PCNA was higher in the GY group compared with the SS group(P＜0.05),while LIF and ITG-β3 were higher in the SS group compared with the GY group(P＜0.01,P＜0.05,respectively).CD34 and VEGFA levels were increased in the two treatment groups compared with the model group(P＜0.01).ANG-1 was higher in the GY group than that in the SS group(P＜0.01),while CD34 was higher in the SS group than that in the GY group(P＜0.05).Conclusions Moxibustion at the Guanyuan and Shenshu points could help to repair the pathological thin endometrium in rats.The GY group may be superior to the SS group for reducing the levels of serum IL-1 β,increasing E2,and promoting the expression of proliferation factors,while the SS group may be superior to the GY group for increasing the levels of PROG and promoting the expression of endometrium receptor-related factors.Both acupoints can promote the expression of angiogenesis factors,potentially acting via different pathways.

Objective To compare the reparative effects of moxibustion at"Guanyuan"and"Shenshu"points in rats with a thin endometrium.Methods Thirty-two female Sprague-Dawley rats were divided randomly into control(CON),model(MOD),Guanyuan(GY),and Shenshu(SS)groups.A thin endometrium model was established using 95％anhydrous alcohol.The Guanyuan and Shenshu groups underwent moxibustion at the Guanyuan and Shenshu points,respectively,and the other two groups of rats were fixed in the same way.Temperature changes at the acupoint area were measured at different time points.The pathological morphology of the uterus was observed by hematoxylin and eosin(HE)staining,and serum levels of inflammatory factors and hormone levels were detected by enzyme-linked immunosorbent assay(ELISA).Expression levels of proliferation and endometrial receptivity factors were detected by immunohistochemistry(IHC),and angiogenesis factors were detected by Western blot.Results The temperatures immediately after moxibustion and after 5 min were higher at the Shenshu compared with the Guanyuan acupoint(P＜0.01).Endometrial thickness and numbers of glands and blood vessels were decreased in the MOD group compared with the CON group(P＜0.01),serum interleukin 1 β(IL-1 β)was increased(P＜0.01)and PROG was decreased(P＜0.01),and Ki67,proliferating cell nuclear antigen(PCNA),leukemia inhibitory factor(LIF),integrin β3(ITG-β3),angiopoietin-1(ANG-1),and CD34 protein in uterine tissue were all decreased(P＜0.01).Endometrial thickness and numbers of glands and blood vessels were increased in the GY and SS groups compared with the MOD group(P＜0.01),while serum IL-1 β was decreased(P＜0.05),E2 and PROG were increased(P＜0.05),and serum interleukin 10(IL-10)was increased in the SS group(P＜0.05).Ki67,PCNA,LIF,and ITG-β3 were all increased in both treatment groups compared with the MOD group(P＜0.01).PCNA was higher in the GY group compared with the SS group(P＜0.05),while LIF and ITG-β3 were higher in the SS group compared with the GY group(P＜0.01,P＜0.05,respectively).CD34 and VEGFA levels were increased in the two treatment groups compared with the model group(P＜0.01).ANG-1 was higher in the GY group than that in the SS group(P＜0.01),while CD34 was higher in the SS group than that in the GY group(P＜0.05).Conclusions Moxibustion at the Guanyuan and Shenshu points could help to repair the pathological thin endometrium in rats.The GY group may be superior to the SS group for reducing the levels of serum IL-1 β,increasing E2,and promoting the expression of proliferation factors,while the SS group may be superior to the GY group for increasing the levels of PROG and promoting the expression of endometrium receptor-related factors.Both acupoints can promote the expression of angiogenesis factors,potentially acting via different pathways.