Objective To establish,evaluate and validate the Nomogram prediction model of radiation pneumonitis(RP)in intensity modulated radiotherapy(IMRT)with TCM syndrome elements.Methods 257 patients with locally advanved non-small cell lung cancer receiving IMRT were analyzed retrospectively.The total population was randomly divided into a training set and a validation set by 7:3.A prediction model was established by Lasso-Logistic regression analysis,and then visualized by Nomogram to evaluate and validate the model.Results Independent risk factors included in the prediction model included tumor stage(OR=6.576;P=0.003),position(OR=2.935;P=0.016),MLD of the affected lung(OR=1.001;P<0.001)and Yin deficiency(OR=3.861;P=0.003).Based on the above factors,the prediction model was constructed and visualized.The C-index of the training set and the validation set were 0.865 and 0.867,respectively.The calibration curves of the two sets had a good fit and had certain clinical usefulness.Conclusion Based on the clinical elements of Chinese and Western medicine,tumor stage,position,lung MLD and Yin deficiency,the model can accurately predict the occurrence of≥grade 2 RP,and provide a reference for clinical screening of high-risk patients and further improvement of treatment plan.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Objective To explore the causal association between immune cells and allergic rhi-nitis using Mendelian randomization(MR)approach.Methods GWAS data for 731 types of im-mune cells and allergic rhinitis were obtained from genome-wide association study(GWAS)databas-es.A two-sample bidirectional MR analysis was conducted,with the inverse-variance weighted(IVW)method as the primary analytical approach,and the weighted median method,MR-Egger re-gression,simple mode method,and weighted mode method as supplementary approaches.Sensitivity analyses,including heterogeneity tests,pleiotropy tests,and the leave-one-out method,were per-formed.Bonferroni correction was applied to the preliminary results to enhance their reliability and rigor.Results The two-sample forward MR analysis revealed correlations between 67 immune cell phenotypes and allergic rhinitis.After Bonferroni correction,four immune cell phenotypes were finally identified.Among them,the expression of CD3 on CD39-positive activated CD4 regulatory T cells(OR=0.953,95％CI,0.931 to 0.978,P＜0.001,Padj=0.007),the expression of herpesvirus entry mediator(HVEM)on CD45RA-negative CD4+T cells(OR=0.965,95％CI,0.948 to 0.983,P＜0.001,Padj=0.008),and the percentage of human leukocyte antigen class DR(HLA-DR)-high-expressing monocytes among leukocytes(OR=0.929,95％CI,0.885 to 0.974,P=0.002,Padj=0.157)were protective factors for allergic rhinitis.In contrast,the percentage of transitional B cells among B cells(OR=1.094,95％CI,1.032 to 1.161,P=0.003,Padj=0.183)was a risk factor for allergic rhinitis.The reverse MR analysis showed no causal relationship between allergic rhinitis and the four immune cell phenotypes.Conclusion The two-sample forward MR analysis confirms a caus-al link between immune cells and allergic rhinitis.MR analysis has the advantages of reducing con-founding factor interference and avoiding reverse causation,providing a theoretical basis for in-depth research on immune mechanisms,sensitive biomarkers,and drug treatment targets of allergic rhinitis.

Objective To establish,evaluate and validate the Nomogram prediction model of radiation pneumonitis(RP)in intensity modulated radiotherapy(IMRT)with TCM syndrome elements.Methods 257 patients with locally advanved non-small cell lung cancer receiving IMRT were analyzed retrospectively.The total population was randomly divided into a training set and a validation set by 7:3.A prediction model was established by Lasso-Logistic regression analysis,and then visualized by Nomogram to evaluate and validate the model.Results Independent risk factors included in the prediction model included tumor stage(OR=6.576;P=0.003),position(OR=2.935;P=0.016),MLD of the affected lung(OR=1.001;P<0.001)and Yin deficiency(OR=3.861;P=0.003).Based on the above factors,the prediction model was constructed and visualized.The C-index of the training set and the validation set were 0.865 and 0.867,respectively.The calibration curves of the two sets had a good fit and had certain clinical usefulness.Conclusion Based on the clinical elements of Chinese and Western medicine,tumor stage,position,lung MLD and Yin deficiency,the model can accurately predict the occurrence of≥grade 2 RP,and provide a reference for clinical screening of high-risk patients and further improvement of treatment plan.

Objuective To analyze the evaluation indicators of TCM syndrome efficacy in patients with angina pectoris at a clinical research center,and to preliminarily form a pool of items to evaluate the efficacy of TCM syndromes in angina pectoris,with the aim of providing a reference for evaluating the efficacy of TCM syndromes in angina pectoris.Metods By searching the literature on the clinical efficacy of angina pectoris published from January 1,2008,to December 31,2023,in the China National Knowledge Infrastructure(CNKI),VIP database(VIP),and Wanfang database(WF),the eligible literature was sorted and summarized,and items such as syndrome type,symptoms,and physical signs were recorded one by one in Excel to establish a database.SPSS Modeler 18.0 was used to perform Bayesian network model and association rule analysis on the evaluation items.The items that met both the Bayesian network model and association rule conditions were combined to preliminarily form a pool of items to evaluate the efficacy of TCM in angina pectoris.Results A total of 94 qualified articles were included,containing 21 types of differential diagnoses,with a total frequency of 100.Except for qi deficiency and blood stasis syndrome(28 times,28%),phlegm and blood stasis syndrome(14 times,14%),blood flow stasis obstruction syndrome(14 times,14%),and qi stagnation and blood stasis syndrome(10 times,10%),the frequency of other syndromes was relatively low,so only the first four syndromes were data mined.There were a total of 38 types of symptoms and physical signs for clinical efficacy evaluation,with a total frequency of 599 times.A preliminary pool of items for evaluating the efficacy of TCM in four types of angina pectoris was formed:① Qi deficiency and blood stasis syndrome main items included chest pain(contribution rate 0.96);secondary items included chest tightness(contribution rate 0.93),palpitations(contribution rate 0.77),dark purple(light purple)tongue or ecchymosis(contribution rate 0.77),and shortness of breath(contribution rate 0.83).② Phlegm and blood stasis syndrome main items included chest pain(contribution rate:0.94);secondary items included chest tightness(contribution rate:0.94)and palpitations(contribution rate:0.69).③ Blood flow stasis obstruction syndrome,main items include chest pain(contribution rate 0.94);secondary items include chest tightness(contribution rate 0.81),palpitations(contribution rate 0.69),purple dark(light purple)tongue or ecchymosis(contribution rate 0.94),rough pulse(contribution rate 0.81),fixed pain location,refusal to press,and aggravation at night(contribution rate 0.81).④ Qi stagnation and blood stasis syndrome,main items include chest pain(contribution rate 0.92);secondary items include chest tightness(contribution rate 0.92),palpitations(contribution rate 0.83),purple dark(light purple)tongue or ecchymosis(contribution rate 0.75),rough pulse(contribution rate 0.67),costal pain(contribution rate 0.75).Conclusion The pool of evaluation indicators for the efficacy of TCM syndromes in patients with angina pectoris can provide a reference for conducting scientific and standardized evaluations of the efficacy of TCM syndromes,provide a basis for selecting core indicators,and lay the foundation for further building a core indicator set(COS).

Objuective To analyze the evaluation indicators of TCM syndrome efficacy in patients with angina pectoris at a clinical research center,and to preliminarily form a pool of items to evaluate the efficacy of TCM syndromes in angina pectoris,with the aim of providing a reference for evaluating the efficacy of TCM syndromes in angina pectoris.Metods By searching the literature on the clinical efficacy of angina pectoris published from January 1,2008,to December 31,2023,in the China National Knowledge Infrastructure(CNKI),VIP database(VIP),and Wanfang database(WF),the eligible literature was sorted and summarized,and items such as syndrome type,symptoms,and physical signs were recorded one by one in Excel to establish a database.SPSS Modeler 18.0 was used to perform Bayesian network model and association rule analysis on the evaluation items.The items that met both the Bayesian network model and association rule conditions were combined to preliminarily form a pool of items to evaluate the efficacy of TCM in angina pectoris.Results A total of 94 qualified articles were included,containing 21 types of differential diagnoses,with a total frequency of 100.Except for qi deficiency and blood stasis syndrome(28 times,28%),phlegm and blood stasis syndrome(14 times,14%),blood flow stasis obstruction syndrome(14 times,14%),and qi stagnation and blood stasis syndrome(10 times,10%),the frequency of other syndromes was relatively low,so only the first four syndromes were data mined.There were a total of 38 types of symptoms and physical signs for clinical efficacy evaluation,with a total frequency of 599 times.A preliminary pool of items for evaluating the efficacy of TCM in four types of angina pectoris was formed:① Qi deficiency and blood stasis syndrome main items included chest pain(contribution rate 0.96);secondary items included chest tightness(contribution rate 0.93),palpitations(contribution rate 0.77),dark purple(light purple)tongue or ecchymosis(contribution rate 0.77),and shortness of breath(contribution rate 0.83).② Phlegm and blood stasis syndrome main items included chest pain(contribution rate:0.94);secondary items included chest tightness(contribution rate:0.94)and palpitations(contribution rate:0.69).③ Blood flow stasis obstruction syndrome,main items include chest pain(contribution rate 0.94);secondary items include chest tightness(contribution rate 0.81),palpitations(contribution rate 0.69),purple dark(light purple)tongue or ecchymosis(contribution rate 0.94),rough pulse(contribution rate 0.81),fixed pain location,refusal to press,and aggravation at night(contribution rate 0.81).④ Qi stagnation and blood stasis syndrome,main items include chest pain(contribution rate 0.92);secondary items include chest tightness(contribution rate 0.92),palpitations(contribution rate 0.83),purple dark(light purple)tongue or ecchymosis(contribution rate 0.75),rough pulse(contribution rate 0.67),costal pain(contribution rate 0.75).Conclusion The pool of evaluation indicators for the efficacy of TCM syndromes in patients with angina pectoris can provide a reference for conducting scientific and standardized evaluations of the efficacy of TCM syndromes,provide a basis for selecting core indicators,and lay the foundation for further building a core indicator set(COS).

Metabolic dysfunction-associated steatotic liver disease(MASLD)is the most prevalent chronic liver disease globally,with only one Food and Drug Administration(FDA)-approved drug for its treatment.Given MASLD's complex pathophysiology,ther-apies that simultaneously target multiple pathways are highly desirable.One promising approach is dual-modulation of the famesoid X receptor(FXR),which regulates lipid and bile acid metabolism.However,FXR agonists alone are insufficient due to their limited anti-inflammatory effects.This study aimed to dto identify natural products capable of both FXR activation and inflammation inhibition to provide a comprehensive therapeutic approach for MASLD.Potential FXR ligands from the Natural Product Library were predicted via virtual screening using the Protein Preparation Wizard module in Schrodinger(2018)for molecular docking.Direct binding and regulation of candidate compounds on FXR were analyzed using surface plasmon resonance(SPR)binding assay,reporter gene ana-lysis,and reverse transcription-polymerase chain reaction(RT-PCR).The anti-inflammatory properties of these compounds were eval-uated in AML12 cells treated with tumor necrosis factor-alpha(TNF-α).Dual-function compounds with FXR agonism and inflamma-tion inhibition were further identified in cells transfected with Fxr siRNA and treated with TNF-α.The effects of these dual-function compounds on lipid accumulation and inflammation were evaluated in cells treated with palmitic acid.Results revealed that 17 natural products were predicted via computational molecular docking as potential FXR agonists,with 15 exhibiting a strong affinity for FXR recombinant protein.Nine isoflavone compounds significantly enhanced FXR reporter luciferase activity and the mRNA expressions of Shp and Ostb.Structure-activity relationship analysis indicated that introducing isopropyl or methoxy groups at the C7 position or a methoxy group at the C6 position could enhance the agonistic efficacy of isoflavones.Three compounds(2,6,and 8)were identified as dual-function natural products functioning as FXR agonists and inflammatory inhibitors,while one compound(12)acted as an FXR agonist to inhibit inflammation.These natural products protected hepatocytes against palmitic acid-induced lipid accumulation and in-flammation.In conclusion,compounds 2,6,and 8(genistein,biochanin A,and 7-methoxyisoflavone,respectively)were identified as dual-function bioactive products that transactivate FXR and inhibit inflammation,serving as potential candidates or lead compounds for MASLD therapy.

Objective:To comprehensively evaluate the clinical efficacy and safety of pulse radiofrequency therapy for knee osteoarthritis (KOA) with cardiovascular disease (CVD).Methods:A total of 132 patients with knee osteoarthritis (KOA) and cardiovascular disease (CVD) admitted to the First Affiliated Hospital of Xi′an Jiaotong University from March 2022 to February 2024 were randomly divided into two groups using a random number table method. Group A (65 cases) received ultrasound-guided pulse radiofrequency treatment of the hidden nerve, while group B (67 cases) received oral etoposide tablets and intra-articular injection of sodium hyaluronate. Basic data such as age, gender, height, weight, body mass index (BMI), knee joint function grading (K-L grading), and distribution of cardiovascular disease types were recorded between the two groups. The degree of knee joint pain [Visual Analog Scale (VAS) score] and Knee Joint Function Score (OKS), Athens Insomnia Scale (AIS) scores and incidence of complications. were compared between the two groups at 1 week, 1 month, 3 months, and 6 months after treatment.Results:The VAS score of group A showed a slow decreasing trend from 1 week to 6 months after treatment. The VAS score of group B decreased to the lowest level one week after treatment and gradually increased within 6 months after treatment. The VAS scores of both groups improved after 1 week of treatment and at 1, 3, and 6 months of treatment compared to preoperative levels ( F=703.955, P<0.001), and the degree of postoperative pain improvement in the group A was better than that in the group B ( F=106.575, P<0.001). The OKS of both groups decreased significantly after 1 week of treatment and at 1, 3, and 6 months of treatment, and the time effect was statistically significant ( F=2 233.447, P<0.001). The OKS of the group A was lower than that of group B after 1 week of treatment and at 1, 3, and 6 months of treatment, and the difference was statistically significant ( F=141.214, P<0.001). The AIS scores improved significantly after 6 months of treatment compared to preoperative levels ( F=1 044.424, P<0.001), and the group A had better AIS scores than the group B at 1, 3, and 6 months of treatment, with statistically significant differences ( F=124.864, P<0.001). There was no statistically significant difference in postoperative complications between the two groups ( P>0.05). Conclusions:Ultrasound guided pulsed radiofrequency treatment of KOA with CVD can significantly alleviate postoperative pain, improve joint mobility and sleep quality, and is more effective than traditional conservative treatment of oral etoposide tablets combined with intra-articular injection of sodium hyaluronate.

Objective To evaluate the effects of Baihe Gujin Decoction on long-term survival in patients with non-small cell lung cancer(NSCLC)receiving radiotherapy(RT)in the real world.Methods Retrospective data from patients with NSCLC receiving RT in the Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine(TCM)and data from patients in the Surveillance,Epidemiology and End Results(SEER)database were collected and grouped as the TCM+conventional Western medicine(CWM)cohort and CWM cohort,respectively.Propensity score matching(PSM)was used to balance confounders between groups.Kaplan-Meier curve and Cox regression model were used to estimate the effects of Baihe Gujin Decoction on survival outcomes of patients receiving RT.Results Totally 190 samples with a balance between groups were obtained using PSM.Overall survival(OS)analysis showed that the TCM+CWM cohort had significantly longer OS than the CWM cohort(P=0.004).Subgroup analysis showed that the Baihe Gujin Decoction was more advantageous in the characteristic population of age≥65 years(P=0.027),male(P=0.010),T3-T4 stage(P<0.001),N2-N3 stage(P=0.026),M1 stage(P<0.001),not receiving chemotherapy(P<0.001),and not undergoing surgery(P<0.001).Multivariate Cox regression confirmed that treatment group(P=0.003),T(P=0.003)and M stages(P=0.002)may be the independent prognostic factors for OS of NSCLC patients treated with RT.Conclusion Baihe Gujin Decoction probably can improve the long-term prognosis in NSCLC patients treatment with RT.

The reprogramming of lipid metabolism is a significant factor influencing various aspects of head and neck squamous cell carcinoma,including its occurrence,development,metastasis,and resistance to radio-chemotherapy.There is a considerable elevation in the expression levels of enzymes and genes related to lipid metabolism in tumor tissues compared to normal tissues.This up-regulation is associated with both treatment resistance and a poor prognosis.This review focuses mainly on alterations in lipid metabolism in head and neck squamous cell carcinoma.It systematically explores the atypical expression and clinical significance of lipid metabolism-related enzymes,evaluates their influence on treatment resistance,elucidates the underlying mechanisms of this resistance,and discus-ses current and potential targeted therapeutic approaches.The comprehensive analysis comprises four pivotal aspects:de novo lipogene-sis,fatty acid oxidation,glycerophospholipids metabolism,and mevalonate and cholesterol synthesis pathways.Feasible strategies,such as the adjustment of dietary structure,the administration of multi-target drugs,and the utilization of combination treatment thera-pies,are deliberated as potential interventions to modulate lipid metabolism,reverse treatment resistance,and enhance the efficacy of anti-cancer treatments.