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*

The conversion of abundant and low-cost biomass waste into highly efficient two-electron oxygen reduction(ORR)electrocatalyst is an important link in the degradation of pollutants in industrial wastewater through the electro-Fenton process.In this work,porous biocarbon materials doped with manganese and nitrogen(MnNBC)were prepared from corn stalk.The H2O2 selectivity of MnNBC in acidic media was up to 81% @0.6 Vvs RHE,also MnNBC exhibited a long-term stability in a 10-h uninterrupted lifetime test.The ORR activity of MnNBC could be attributed to the synergistic effect of the hierarchical porous structure,improved defect level and heteroatom doping.Moreover,MnNBC as a cathode material for the electro-Fenton system could completely degrade four kinds of common organic dye pollutants,e.g.,Rhodamine B,methyl orange,methylene blue and crystal violet(25 mg/L),respectively,within 40?60 min.The present study provided valuable insights into the transformation of corn stalk waste into efficient cathode materials for the electro-Fenton process.

Sarin(GB)is a typical representative of nerve agents with high toxicity,and very low amount can cause death.GB can cause water and atmospheric environment poisoning,so the detection of GB in water and air is of great significance.In this work,a colorimetric sensor array(CSA)based on GB inhibition of cholinesterase activity was constructed to detect GB with high selectivity.A 4×4 colorimetric array was constructed using acetylcholinesterase(AChE),butyryl cholinesterase(BuChE)and the corresponding substrate acetylthiocholine iodide(S-ACh),butyryl thiocholine iodide(S-BCh),acetylcholine chloride(ACh),butyryl choline chloride(BCh)and 2,6-dichloroindophenol ethyl ester(DCIE).The linear curve of the sensor was Y=131.3×lgC+271.6(R2=0.997),where Y was the array response Euclidean distance,C was the concentration of GB(mg/L),the linear range was 0.03?0.32 mg/L,and the detection limit was 27.6 μg/L.The method could effectively distinguish chemical warfare agents(CWA)such as VX,Soman(GD),mustard gas(HD),Louie reagent(L),and had high anti-interference ability,sensitivity and good repeatability.It was successfully applied to the detection of GB in simulated water and simulated air samples,and the sample recovery rate was 97.2% ?100.9%.This method would be potentially applied to the field rapid detection of nerve agents.

Objective:To evaluate the clinical efficacy of Cai's gynecological nourishing kidney therapy for patients with diminished ovarian reserve (DOR).Methods:A randomly controlled trail was conducted. A total of 63 patients with DOR who were treated in the gynecology outpatient clinic of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine from September 2020 to January 2022 were set as observation subjects, and were divided into control group ( n=31) and observation group ( n=32) according to the random number table method. The patients in the control group were treated with Femoston, and the patients in the observation group were treated with Cai's gynecological nourishing kidney therapy on the basis of Femoston treatment. Both groups were treated for 3 menstrual cycles. Both antral follicle count (AFC) was performed by vaginal ultrasound, serum levels of TGF-β1, IL-1β, IL-2, IL-6 and IL-21 were detected by ELISA, and serum levels of FSH, LH, E2, anti-Müllerian hormone (AMH) and MDA were detected by biochemical methods. The TCM syndrome score was used to evaluate the severity of symptoms, and the menstrual score was used to evaluate the abnormal menstruation. Clinical efficacy was evaluated. Results:The total effective rate was 87.50% (28/32) in the observation group and 58.06% (18/31) in the control group, with statistical significance ( χ2=8.42, P=0.004). After treatment, the AFC in the observation group (3.93±2.32 vs. 2.21±2.18, t=3.03) was higher than that of the control group ( P<0.01). After treatment, the serum FSH level of the observation group [10.05 (8.35, 21.48) IU/L vs. 20.60 (8.00, 43.30) IU/L, Z=2.18] was lower than that of the control group ( P<0.05), and the level of AMH [0.19 (0.03, 0.47) μg/L vs. 0.02 (0.01, 0.24) μg/L, Z=-1.54] in the observation group was higher than that of the control group ( P<0.05). The serum levels of TGF-β1 [(68.27±11.76) ng/L vs. (55.33±13.03) ng/L, t=4.14] and IL-1β [(58.00±7.53) ng/L vs. (52.31±8.06) ng/L, t=2.89] in the observation group were higher than those in the control group, and the levels of IL-6 [(33.26±7.45) ng/L vs. (40.69±11.69) ng/L, t=3.02], the level of IL-21 [(118.37±15.56) ng/L vs. (140.43±25.51) ng/L, t=-4.04] was lower than that of the control group ( P<0.01). Conclusions:Cai's gynecological nourishing kidney therapy combined with Fenmaotong can effectively increase the AFC of DOR patients and improve clinical efficacy. Its mechanism of action may be related to reducing serum FSH and LH levels and increasing E2 levels.

Objective To analyze the incidence,colonization pathways,and predictive factors of bacterial colonization of epidural analgesia catheters in patients with chronic pain.Methods A total of 150 patients with chronic pain who underwent continuous epidural catheterization(catheter in-dwelling time of 7 to 10 days)were selected as study subjects.Samples from three sites were collect-ed for bacterial culture.Clinical data of the patients were collected,and the positive rate of bacterial culture,characteristics of bacterial species distribution,and bacterial colonization pathways were ana-lyzed.The efficacy of predictive factors was assessed using the receiver operating characteristic(ROC)curve.Results The positive rates of bacterial culture in samples from the skin swabbing fluid around the puncture site,the subcutaneous segment of the catheter,and the catheter tip were 22.0％,7.3％,and 8.7％,respectively.Staphylococcus epidermidis was the predominant colonizing bacterial species.Spearman correlation coefficient analysis showed a significant correlation between the results of bacterial culture from the skin around the puncture site and catheter tip colonization(r=0.47,P＜0.01).ROC curve analysis revealed that the area under the curve of bacterial culture results from the skin around the puncture site in predicting catheter tip bacterial colonization was 0.843,with a sensitivity of 84.9％and a specificity of 84.6％.Conclusion Bacterial migra-tion along the catheter is the main pathway for catheter tip bacterial colonization,and the results of bacterial culture from the skin around the puncture site are an effective predictive factor for the risk of bacterial colonization.

This study aims to explore the synergistic effects of the main components in salvianolic acids for Injection(SAFI) on key pathological events in cerebral ischemia, elucidating the pharmacological characteristics of SAFI in neuroprotection. Two major pathological gene modules related to endothelial injury and neuroinflammation in cerebral ischemia were mined from single-cell data. According to the topological distance calculated in network medicine, potential synergistic component combinations of SAFI were screened out. The results showed that the combination of caffeic acid and salvianolic acid B scored the highest in addressing both endothelial injury and neuroinflammation, demonstrating potential synergistic effects. The cell experiments confirmed that the combination of these two components at a ratio of 1∶1 significantly protected brain microvascular endothelial cells(bEnd.3) from oxygen-glucose deprivation/reoxygenation(OGD/R)-induced reperfusion injury and effectively suppressed lipopolysaccharide(LPS)-induced neuroinflammatory responses in microglial cells(BV-2). This study provides a new method for uncovering synergistic effects among active components in traditional Chinese medicine(TCM) and offers novel insights into the multi-component, multi-target acting mechanisms of TCM.
Brain Ischemia/metabolism* ; Neuroprotective Agents/pharmacology* ; Animals ; Drugs, Chinese Herbal/administration & dosage* ; Benzofurans/pharmacology* ; Mice ; Drug Synergism ; Caffeic Acids/pharmacology* ; Polyphenols/pharmacology* ; Humans ; Alkenes/pharmacology* ; Endothelial Cells/drug effects* ; Depsides

The gut microbiota regulates intestinal nutrient absorption, participates in modulating host glucolipid metabolism, and contributes to ameliorating glucolipid metabolism disorder. Dysbiosis of the gut microbiota can compromise the integrity of the intestinal mucosal barrier, induce inflammatory responses, and exacerbate insulin resistance and abnormal lipid metabolism in the host. Dangua Humai Oral Liquid, a hospital-developed formulation for regulating glucolipid metabolism, has been granted a national invention patent and demonstrates significant clinical efficacy. This study aimed to investigate the effects of Dangua Humai Oral Liquid on gut microbiota and the intestinal mucosal barrier in a mouse model with glucolipid metabolism disorder. A glucolipid metabolism disorder model was established by feeding mice a high-glucose and high-fat diet. The mice were divided into a normal group, a model group, and a treatment group, with eight mice in each group. The treatment group received a daily gavage of Dangua Humai Oral Liquid(20 g·kg~(-1)), while the normal group and model group were given an equivalent volume of sterile water. After 15 weeks of intervention, glucolipid metabolism, intestinal mucosal barrier function, and inflammatory responses were evaluated. Metagenomics and untargeted metabolomics were employed to analyze changes in gut microbiota and associated metabolic pathways. Significant differences were observed between the indicators of the normal group and the model group. Compared with the model group, the treatment group exhibited marked improvements in glucolipid metabolism disorder, alleviated pathological damage in the liver and small intestine tissue, elevated expression of recombinant claudin 1(CLDN1), occluding(OCLN), and zonula occludens 1(ZO-1) in the small intestine tissue, and reduced serum levels of inflammatory factors lipopolysaccharides(LPS), lipopolysaccharide-binding protein(LBP), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α). At the phylum level, the relative abundance of Bacteroidota decreased, while that of Firmicutes increased. Lipid-related metabolic pathways were significantly altered. In conclusion, based on the successful establishment of the mouse model of glucolipid metabolism disorder, this study confirmed that Dangua Humai Oral Liquid effectively modulates gut microbiota and mucosal barrier function, reduces serum inflammatory factor levels, and regulates lipid-related metabolic pathways, thereby ameliorating glucolipid metabolism disorder.
Animals ; Gastrointestinal Microbiome/drug effects* ; Mice ; Intestinal Mucosa/microbiology* ; Male ; Drugs, Chinese Herbal/administration & dosage* ; Mice, Inbred C57BL ; Humans ; Glycolipids/metabolism* ; Lipid Metabolism/drug effects* ; Administration, Oral ; Disease Models, Animal

OBJECTIVE: To study the efficacy of lumbar oblique manipulation in the treatment of lumbar disc herniation with different herniation locations based on MSU classification. METHODS: A total of 272 patients with lumbar disc herniation who were treated from June 2023 to December 2023 were divided into central type group, paracentral type group, and far lateral type group. Among them, there were 73 cases in the central type group, including 41 males and 32 females, with an age of (46.39±6.89) years;161 cases in the paracentral type group, including 88 males and 73 females, with an age of (37.14±5.89) years;and 38 cases in the far lateral type group, including 22 males and 16 females, with an age of (28.56±4.89) years. The visual analogue scale (VAS) and straight leg raising angle of the three groups of patients before treatment, after treatment, and at 1 and 3 months after treatment were recorded, and inter-group, intra-group, and correlation comparisons were made. RESULTS: A total of 272 patients were followed up, with a follow-up time of (3.0±0.2) months. The VAS score of central type patients after treatment was 2(2, 3) points, which was lower than 4(3, 5) points before treatment, and the difference was statistically significant (P<0.05). There was no statistically significant difference between 1 month and 3 months after treatment and before treatment (P>0.05). The VAS score of paracentral type patients after treatment 2(2, 3) points and 1 month after treatment 3(2, 4) points were lower than that before treatment 5(4, 6) points, and the differences were statistically significant (P<0.05). There was no statistically significant difference in VAS between 3 months after treatment and before treatment (P>0.05). There were no statistically significant differences in VAS scores of far lateral type patients before treatment, after treatment, and at 1 and 3 months after treatment (P>0.05). The straight leg raising angle of central type patients after treatment 64(58, 69) and 1 month after treatment 58(52, 65) were significantly different from that before treatment 44(40, 51) (P<0.05);there was no statistically significant difference between 3 months after treatment and before treatment (P>0.05). The straight leg raising angle of paracentral type patients after treatment 61(55, 67)°, 1 month after treatment 61(53, 66)°, and 3 months after treatment 47(41, 56)° were significantly different from that before treatment 44(36, 52)° (P<0.05). There were no statistically significant differences in the straight leg raising angle of far lateral type patients before treatment, after treatment, and at 1 and 3 months after treatment (P>0.05). There was a correlation between VAS and straight leg raising angle in the three groups of patients, but there was no linear relationship. CONCLUSION Lumbar oblique manipulation has a better effect in treating patients with central and paracentral lumbar disc herniation, but a poor effect in treating far lateral type;after treatment, the curative effect of paracentral type patients lasts longer than that of central type patients.
Humans ; Male ; Female ; Intervertebral Disc Displacement/physiopathology* ; Adult ; Lumbar Vertebrae/physiopathology* ; Middle Aged ; Manipulation, Spinal

OBJECTIVES: To determine the pharmacological impact of hesperidin, the main component of Citri Reticulatae Pericarpium, on depressive behavior and elucidate the mechanism by which hesperidin treats depression, focusing on the gut-brain axis. METHODS: Fifty-four Sprague Dawley male rats were randomly allocated to 6 groups using a random number table, including control, model, hesperidin, probiotics, fluoxetine, and Citri Reticulatae Pericarpium groups. Except for the control group, rats in the remaining 5 groups were challenged with chronic unpredictable mild stress (CUMS) for 21 days and housed in single cages. The sucrose preference test (SPT), immobility time in the forced swim test (FST), and number in the open field test (OFT) were performed to measure the behavioral changes in the rats. Enzyme-linked immunosorbent assay was used to determine the levels of 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) in brain tissue, and the histopathology was performed to evaluate the changes of colon tissue, together with sequencing of the V3-V4 regions of 16S rRNA gene on feces to explore the changes of intestinal flora in the rats. RESULTS: Compared to the control group, the rats in the model group showed notable reductions in body weight, SPF, and number in OFT (P<0.01). Hesperidin was found to ameliorate depression induced by CUMS, as seen by improvements in body weight, SPT, immobility time in FST, and number in OFT (P<0.05 or P<0.01). Regarding neurotransmitters, it was found that at a dose of 50 mg/kg hesperidin treatment upregulated the levels of 5-HT and BDNF in depressed rats (P<0.05). Compared to the control group, the colon tissue of the model group exhibited greater inflammatory cell infiltration, with markedly reduced numbers of goblet cells and crypts and were significantly improved following treatment with hesperidin. Simultaneously, the administration of hesperidin demonstrated a positive impact on the gut microbiome of rats treated with CUMS, such as Shannon index increased and Simpson index decreased (P<0.01), while the abundance of Pseudomonadota and Bacteroidota increased in the hesperidin-treated group (P<0.05). CONCLUSION The mechanism responsible for the beneficial effects of hesperidin on depressive behavior in rats may be related to inhibition of the expressions of BDNF and 5-HT and preservation of the gut microbiota.
Animals ; Hesperidin/therapeutic use* ; Rats, Sprague-Dawley ; Depression/drug therapy* ; Male ; Stress, Psychological/drug therapy* ; Brain/metabolism* ; Brain-Derived Neurotrophic Factor/metabolism* ; Serotonin/metabolism* ; Gastrointestinal Microbiome/drug effects* ; Behavior, Animal/drug effects* ; Rats ; Brain-Gut Axis/drug effects* ; Chronic Disease ; Colon/drug effects*

Pien Tze Huang(PZH),a class-1 nationally protected traditional Chinese medicine(TCM),has been used to treat liver diseases such as hepatitis;however,the effect of PZH on the progression of sepsis is un-known.Here,we reported that PZH attenuated lipopolysaccharide(LPS)-induced sepsis in mice and reduced LPS-induced production of proinflammatory cytokines in macrophages by inhibiting the acti-vation of mitogen-activated protein kinase(MAPK)and nuclear factor-kappa B(NF-κB)signalling.Mechanistically,PZH stimulated signal transducer and activator of transcription 3(STAT3)phosphory-lation to induce the expression of A20,which could inhibit the activation of NF-κB and MAPK signalling.Knockdown of the bile acid(BA)receptor G protein-coupled bile acid receptor 1(TGR5)in macrophages abolished the effects of PZH on STAT3 phosphorylation and A20 induction,as well as the LPS-induced inflammatory response,suggesting that BAs in PZH may mediate its anti-inflammatory effects by acti-vating TGR5.Consistently,deprivation of BAs in PZH by cholestyramine resin reduced the effects of PZH on the expression of phosphorylated-STAT3 and A20,the activation of NF-κB and MAPK signalling,and the production of proinflammatory cytokines,whereas the addition of BAs to cholestyramine resin-treated PZH partially restored the inhibitory effects on the production of proinflammatory cytokines.Overall,our study identifies BAs as the effective components in PZH that activate TGR5-STAT3-A20 signalling to ameliorate LPS-induced sepsis.