BACKGROUND: The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined. METHODS: All CTO vessels treated with successful anatomical PCI in patients from PANDA III trial were retrospectively measured for post-PCI QFR. The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs, composite of target vessel-related cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization). Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs, and all vessels were stratified by this optimal cutoff value. Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI. RESULTS: Among 428 CTO vessels treated with PCI, 353 vessels (82.5%) were analyzable for post-PCI QFR. 31 VOCEs (8.7%) occurred at 2 years. Mean value of post-PCI QFR was 0.92 ± 0.13. Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91. The incidence of 2-year VOCEs in the vessel with post-PCI QFR < 0.91 (n = 91) was significantly higher compared with the vessels with post-PCI QFR ≥ 0.91 (n = 262) (22.0% vs. 4.2%, HR = 4.98, 95% CI: 2.32-10.70). CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO. Achieving functionally optimal PCI results (post-PCI QFR value ≥ 0.91) tends to get better prognosis for patients with CTO lesions.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

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*

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

OBJECTIVE: To investigate changes of myeloid differentiation factor 2 (MD2) in inflammation-induced pain and acupuncture-mediated analgesia. METHODS: Mice were randomly divided into three groups by a random number table method: saline group (n=16), complete Freund's adjuvant (CFA) group (n=24) and CFA+electroacupuncture (EA) group (n=26). Inflammation-induced pain was modelled by injecting CFA to the plantar surface of the hind paw of mice and EA was applied to bilateral Zusanli (ST 36) to alleviate pain. Only mice in the CFA+EA group received EA treatment (30 min/d for 2 weeks) 24 h after modelling. Mice in the saline and CFA groups received sham EA. von-Frey test and Hargreaves test were used to assess the pain threshold. Brain and spinal tissues were collected for immunofluorescence staining or Western blotting to quantify changes of MD2 expression. RESULTS: CFA successfully induced plantar pain and EA significantly alleviated pain 3 days after modelling (P<0.01). Compared with the CFA group, the number of MD2⁺/c-fos⁺ neurons was significantly increased in the dorsal horn of the spinal cord 7 and 14 days after EA, especially in laminae I - II_o (P<0.01). The proportion of double positive cells to the number of c-fos positive cells and the mean fluorescence intensity of MD2 neurons were also significantly increased in laminae I - II_o (P<0.01). Western blotting showed that the level of MD2 was significantly decreased by EA only in the hippocampus on day 7 and 14 (both P<0.01) and no significant changes were observed in the cortex, thalamus, cerebellum, or the brainstem (P<0.05). Fluorescence staining showed significant decrease in the level of MD2 in periagueductal gray (PAG) and locus coeruleus (LC) after CFA injection on day 7 (P<0.01 for PAG, P<0.05 for LC) and EA significantly reversed this decrease (P<0.01 for PAG, P<0.05 for LC). CONCLUSION The unique changes of MD2 suggest that EA may exert the analgesic effect through modulating neuronal activities of the superficial laminae of the spinal cord and certain regions of the brain.
Animals ; Acupuncture Analgesia/methods* ; Male ; Central Nervous System/pathology* ; Freund's Adjuvant ; Mice ; Pain ; Proto-Oncogene Proteins c-fos/metabolism* ; Spinal Cord/metabolism* ; Mice, Inbred C57BL ; Electroacupuncture/methods* ; Inflammation/pathology*

Objective:To identifying risk factors of postoperative pulmonary infection(POI)in gastric cancer(GC)patients as well as generating an effective nomogram for the POI.Methods:Pa-tients with gastric cancer after surgery from 1st January 2010 to 31st December 2020 were retro-spectively analysed.Their clinical and pathological data were collected.Multiple logistic regression analysis was conducted to identify risk factors for POI and to generate the nomogram prediction model.Predictive accuracy,discriminatory capability,and clinical usefulness were evaluated by cali-bration curves,concordance index(C-index),and decision curve analysis(DCA).Results:Multivari-ate regression analysis revealed that age,smoking,chronic respiratory diseases,laparoscopic surgery,intraoperative blood loss and lung function exercise compliance were independent prognos-tic factors for POI in GC patients.The nomogram had a Cindex of 0.878(95％CI:0.801～0.956).The calibration curves showed good consistency between actual and nomogram-predicted probabilities.The area under the curve(AUC)was 0.878,while the cutoff value was-2.088 with a sensitivity of 80.6％and a specifificity of 82.9％.DCA showed that the nomogram had better clinical usefulness.Conclusions:The present study provides a nomogram developed with perioperative features to predict the incidence of POI in GC patients.

Objective To analyze the nutritional level, obesity status and the prevalence of frypertension in Blang, Deang and Va ethnic groups in Yunnan, to explore the relationship among nutritional physical index, obesity indicators and blood pressure, and use the cutoff value of related indicators to warn frypertension. Methods This paper was based on a statistical analysis of the 7 nutritional pfrysical indexes, 5 types of obesity status and frypertension status of 766 Blang, 570 Deang and 565 Va. Results We found that the nutritional pfrysique index of man)' items (4 items for men and 4 items for women) of Blang was significantly higher than that of Deang and Va (P<0. 05), the Erismann' s index and Pelidisi' s index of Deang female were significantly higher than those of Blang female and Va female (P<0. 05). The differences in the obesity rates determined by the three obesity determination indexes of waist circumference (WC), waist-to-hip ratio (WHR) and percent of bod)' fat (PBF) were statistically significant among the three ethnic groups (P < 0. 05), and the obesity rates determined by the three indexes of bod)' mass index (BMI), body adiposity index (BAI) and PBF were all the highest in the Blang, and the central obesity rates determined by the two indexes of WC and WHR were all the highest in Va. The rank of the prevalence of hypertension was Va > Blang > Deang and the difference was statistically significant (P<0. 05). Conclusion Pelidisi' s index, WHR, and PBF all have good early warning effects on frypertension in all three ethnic groups.

Objective To understand the body characteristics of adults from the Tibeto-Burman language group. Methods Totally 14 837 adults (6578 males and 8259 females) from 17 minorities were selected for investigation during 2015 to 2019 and these surveys were carried out in regions including Sichuan, Yunnan, Guizhou, Hubei, Hunan and Tibet Autonomous Region. Eight physical parameters (stature, sitting height, etc.) along with 4 corresponding indexes (stature-sitting index and the like) were carefully analyzed. The body characteristics of the Tibeto-Burman language group were then compared to those of certain minorities as well as Han in both northern and southern part of China based on our collected data. Results Among 17 minorities of the Tibeto-Burman language group, people from Pumi and Tibet were relatively tall and have longer trunk and limbs. The presence of wider trunk and thicker limbs appeared to be common in Tibetan individuals. Subjects from Lahu, Jino and Derung were in possession of shorter stature and limbs while the trunk of Naxi, Lisu and Achang people seemed wider. Compared with other ethnic groups in China, individuals from the Tibeto-Burman language group tended to own shorter stature accompanied by medium trunk width, probably sharing similar physical characteristics with those minorities in southern China, especially She and Li. Conclusion Among ethnic groups dotting in southern China, individuals from the Tibeto-Burman language group generally have medium stature, medium trunk height, and wide trunk whereas those from 3 Mon-Khmer groups, Va, Khmus and Blang, are shorter and smaller in width and height of the trunk.