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*

Objective To clarify and analyze the reasons for failure in screening healthy menopausal female in a bioequivalence trial.Methods To summarize and clarify the data of 185 healthy menopausal female subjects participating in a bioequivalence trial of estradiol valerate conducted,and summarize the reasons for screening failure.Results The main reasons for screening failure include laboratory tests(32.04％),gynecological transvaginal color Doppler ultrasound(16.57％),vital signs(14.36％),chest computed tomography(CT,11.60％),and medical history/medication history(7.73％).Conclusion Screening failures in healthy menopausal female subjects were characterized mainly by abnormal gynecological transvaginal color Doppler ultrasound and non-compliance with basal hormone levels compared to generally healthy subjects.

Objective:To develop a continuous non-invasive blood pressure measurement device(NC-BPM)and verify the accuracy of that in monitoring blood pressure.Methods:A NC-BPM type of non-invasively continuous blood pressure measurement device(NC-BPM for short)was developed.The entire system consisted of four modules included one sensor which shape was finger cot,one unit of signal acquisition and pressure control,one calibration system for height and one host.The Omron J760 electronic sphygmomanometer(J760)and the CNAP Monitor500 continuous non-invasive blood pressure monitoring system(CNAP Monitor500)were used as the reference sphygmomanometer of verifying accuracy of the monitored blood pressure.The blood pressures of 25 subjects at three stages included static stage,blood pressure change stage and stage post calibration were respectively measured according to the standard test procedure of wearable sleeveless blood pressure measurement device of Institute of Electrical and Electronics Engineers(IEEE).Results:Both NC-BPM and CNAP Monitor500 collected 13753 data points,and there were high correlation in systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean blood pressure(MAP)between the two devices(r=0.96,0.97,0.98,P<0.05).A total of 379 data points were collected by Omron J760,and there were high correlation in SBP and DBP between NC-BPM and Omron J760(r=0.98,0.95,P<0.05).According to the standards of British Hypertension Society(BHS)and the American Association for the Advancement of Medical Instrumentation(AAMI)to conduct grade evaluation,and the proportions of the SBP differences between NC-BPM and CNAP Monitor500 within the ranges of 0～5 mmHg,0～10 mmHg and 0～15 mmHg were respectively 85.01%,97.60%and 99.47%,and the proportions of the DBP differences between them within the three ranges were respectively 84.34%,99.85%and 100%,and the proportions of the MAP differences were respectively 92.66%,99.72%and 99.96%,all of which belonged to BHS grade A.The pressure difference values of measured SBP,DBP and MAP between the two devices were respectively(0.67±5.07)mmHg,(2.43±2.87)mmHg and(1.43±2.89)mmHg,which were within the(5±8)mmHg of AAMI standard range.The proportions of the SBP differences between NC-BPM and Omron J76 within the ranges of 0～5 mmHg,0～10 mmHg and 0～15 mmHg were respectively 79.95%,97.36%and 100%,and the proportions of the DBP differences between them within the three ranges were respectively 89.71%,99.74%and 100%,all of which belonged to BHS grade A.The difference values of systolic and diastolic blood pressures of brachial artery between the two devices were respectively(1.57±4.18)mmHg and(0.57±5.20)mmHg,which were within the(5±8)mmHg of AAMI standard range.Conclusion:The NC-BPM device has passed the first stage of clinical trials in accordance with IEEE standards,which can proceed to the next stage of clinical verification trials.

Objective:To investigate the expression level of small nucleolar RNA(snoRNA)SNORA63 in bone marrow of patients with acute leukemia(AL)and its significance in the clinical diagnosis,treatment and prognosis of AL patients.Methods:Bone marrow samples of 53 newly diagnosed AL patients and 29 healthy subjects in the Affiliated Hospital of Guangdong Medical University from March 2018 to December 2021 were collected.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the relative expression level of SNORA63 in bone marrow mononuclear cells of the two groups.The median expression level of SNORA63 in AL patients was used as the boundary value to divide the patients into SNORA63 high and low expression groups,and the relationship between the expression level of SNORA63 and the clinical characteristics,clinical indicators and prognosis of AL patients was analyzed and discussed.Results:The relative expression level of SNORA63 in AL patients was significantly lower than that in healthy control group[0.3018(0.0244-1.2792)vs 1.0882(0.2797-1.9889)](P＜0.01).The expression level of SNORA63 in AL patients without remission after initial treatment was significantly lower than that in healthy controls and the patients who received complete remission(CR)(P＜0.01),while there was no statistical difference in the expression level of SNORA63 between AML and ALL groups(P＞0.05).The abnormal low expression of SNORA63 was closely related to fever,hemorrage,poor prognosis,efficacy,platelets(PLT),lactate dehydrogenase(LDH),albumin(ALB),and molecular biological abnormalities of AL patients(P＜0.05),but not significantly correlated with sex,age,AL subtype,pallor,fatigue,extramedullary infiltration,white blood cell count(WBC),hemoglobin(HGB),C-reactive protein(CRP),procalcitonin(PCT),fibrinogen(FIB)or chromosome karyotype(P＞0.05).Meanwhile,overall survival(OS)and event-free survival(EFS)of AL patients in SNORA63 high-expression group were significantly higher than those in SNORA63 low-expression group(P＜0.05).Univariate Cox regression analysis showed that SNORA63,molecular biological abnormalities,fever,PLT and LDH were the factors influencing OS and EFS in AL patients(P＜0.05).Multivariate Cox regression analysis indicated that fever,molecular biological abnormalities and LDH were independent factors associated with OS and EFS in AL patients(P＜0.05).Conclusion:SNORA63 is significantly down-expressed in AL patients,which is a molecular marker of great clinical value for disease monitoring and prognosis evaluation in AL patients.

Objective:To explore and analyze the clinical features and prognostic factors of secondary intestinal diffuse large B-cell lymphoma(SI-DLBCL),in order to provide reference for the basic research and clinical diagnosis and treatment of secondary lymphoma of rare sites in the field of hematology.Methods:The clinical data of 138 patients with SI-DLBCL admitted to Fujian Medical University Union Hospital from June 2011 to June 2022 were collected and sorted,the clinical and pathological features,diagnosis,treatment and prognosis were analyzed.Cox regression risk model was used to conduct univariate and multivariate analysis on the prognostic risk factors.Results:Among the 138 patients with SI-DLBCL included in this study,85(61.59％)were male,53(38.41％)were female,the median age of onset was 59.5(16-84)years,the clinical manifestations lacked specificity,the first-line treatment regimen was mainly chemotherapy(67.39％),94 cases(68.12％)received chemotherapy alone,40 cases(28.98％)were treated with chemotherapy combined with surgery,and 4 cases(2.90％)were treated with surgery alone.The median follow-up time was 72(1-148)months.Among the 138 patients with SI-DLBCL,79(57.25％)survived,34(24.64％)died,25 cases(18.12％)lost to follow-up,the PFS rates of 1-year,3-year and 5-year were 57.97％,49.28％and 32.61％,and the OS rates of 1-year,3-year and 5-year were 60.14％,54.35％and 34.06％,respectively.The results of univariate Cox regression analysis showed that age,Lugano stage and IPI score were the influencing factors of OS in SI-DLBCL patients,and age,Lugano stage and IPI score were the influencing factors of PFS in SI-DLBCL patients.The results of multivariate Cox analysis showed that Lugano stage was an independent prognostic factor affecting OS and PFS in SI-DLBCL patients.Conclusion:Patients with SI-DLBCL are more common in middle-aged and elderly men,and the early clinical manifestations lack specificity,and the first-line treatment regimen is mainly R-CHOP chemotherapy,and Lugano stage is an independent prognostic factor affecting OS and PFS in SI-DLBCL patients.

To improve patient-centered pharmaceutical management and pharmaceutical service capabilities in the pharmaceutical department of medical institutions,automation and information technology are indispensable.The Pharmacy Administration-Automation and Information Technology is one of the social organization standards of the Chinese Hospital Association as part 4-4 of Pharmaceutical Administration and Pharmaceutical Practice in Healthcare,which standardizes 32 key elements in four aspects:basic requirements for automation construction in medical institutions,construction of automation hardware equipment,construction of intelligent information platform,and quality management and continuous improvement.It can be used to guide medical institutions at all levels to select and optimize pharmacy automation equipment and information platforms.This article introduced the construction methods and contents of the pharmacy automation and information technology standards,to deepen the understanding of peers on this standard and promote its implementation.This article aimed to promote the modernization,informatization,and intelligence of pharmaceutical services in medical institutions,and improve the quality and efficiency of overall medical pharmaceutical administration and service.

Objective To investigate disease characteristics and hospitalization costs of children with Mycoplasma Pneumoniae pneumonia(MPP)admitted to Shanghai municipal medical hospitals from 2019 to 2023.Methods Depending on the Shanghai Municipal Hospital Pediatric Alliance,we retrospectively investigated community acquired MPP pediatric patients hospitalized in 22 municipal hospitals with pediatric qualifications(including 4 children's hospitals)in Shanghai from Jan 2019 to Dec 2023.We collected the patients'diagnosis codes,gender,age,length of hospital stay,hospitalization costs,and whether they progressed to severe Mycoplasma pneumoniae pneumonia(SMPP).Results From 2019 to 2023,a total of 29 045 hospitalized children with MPP were treated,with 6 035 cases(20.8%)identified as SMPP in the 22 hospitals.Trend analysis revealed a rising trend with years in the proportion of SMPP patients(χ2trend=365.498,P<0.001).Among the 4 children's hospitals,there were 18 710 cases with MPP,including 4 078 cases(21.8%)of SMPP.The proportion of SMPP patients also showed an increasing trend with years(χ2trend=14.548,P<0.001),and the proportion in 2023(23.0%)was higher than that in previous years with statistical significance.There were statistical differences in the seasonal distribution of MPP cases between different years,with higher proportions in summer and autumn overall.The age distribution of hospitalized MPP children varied among different years,with school-age children accounting for the majority(56.8%)in 2023.There was no difference in the distribution of severe cases between different genders,but there were differences in the proportion of severe cases among different age groups in different years,with a gradual increase in severe cases among children aged 1 to 3 years(χ2trend=191.567,P<0.001).The average length of hospital stay for MPP during the epidemic was higher than that during non-epidemic periods,and there were statistically significant differences in the average length of hospital stay between different years(P<0.001).The individual hospitalization costs during the epidemic were higher than in other years,and there were statistically significant differences in individual hospitalization costs between different years(P<0.001).The total hospitalization costs were still higher in 2019 and 2023.The individual hospitalization costs for SMPP were higher than for non-SMPP cases.Conclusion MPP outbreaks occurred in Shanghai in 2019 and 2023,with the higher proportions in summer and autumn overall.Compared to previous years,the number of hospitalized MPP children in Shanghai was higher in 2023,with a higher proportion of SMPP cases,especially among children under 3 years old.The individual per capita hospitalization expenses for SMPP cases were higher than for non-SMPP cases.

Hemophagocytic syndrome(HPS),also known as hemophagocytic lymphohistiocytosis(HLH),is a rare and highly malignant hematologic disease with a poor prognosis.It can be divided into two categories:primary HLH and secondary HLH.HLH is characterized by a large number of abnormal immune cells that continuously activate and regulate out of control,leading to systemic inflammatory factor storm and multiple organ failure.Clinical manifestations mainly include persistent malignant hyperthermia,pancytopenia,hepatosplenomegaly,and hemophagocytosis in tissues and organs.The pathogenesis of adult HLH is complex,with rapid onset and rapid disease progression,and the fatality rate remains high.The main causes of death in HLH patients are multiple organ failure,abnormal coagulation and septic shock.Due to the specificity of HLH and the lack of effective understanding of the severity and prognosis in clinical practice,some HLH patients are misdiagnosed or overlooked,missing the best opportunity for diagnosis and treatment.Therefore,this review systematically explores and discusses the latest diagnostic and treatment progress of adult HLH,aiming to provide reference for clinical diagnosis,treatment and prognosis assessment of HLH.

OBJECTIVE: To retrospectively analyze the clinical efficacy of anterior cruciate ligament (ACL) reconstruction combined with anterolateral complex repair and ACL reconstruction combined with ALL reconstruction in the treatment of anterior cruciate ligament injuries with high-grade pivot shift. METHODS: From January 2018 to June 2022, 49 patients combined ACL and ALL injuries with high-grade pivot shift were retrospectively studied from three hospitals, 29 of them underwent ACL reconstruction with anterolateral complex repair (repair group), including 23 males and 6 females with an average age of (27.5±4.8) years old, ranged from 20 to 37 years old;the injured sides were 13 on the left and 16 on the right, and 11 patients were suffered with meniscus injury. The other 20 patients underwent ACL and ALL reconstruction (reconstruction group) including 17 males and 3 females with the mean age of (27.1±4.5) years old, ranged from 20 to 38 years old;the injured sides were 8 on the left and 12 on the right, and 6 patients were suffered with meniscus injury. Knee stability (pivot shift test, KT-2000), range of motion, knee function (Lysholm scoring scale, Cincinnati sports activity scale (CSAS) scoring scale, and Tegner activity level score between two groups were compared. RESULTS: A total of 49 patients were followed up, the repair group receiving 13 to 20(15.3±1.8) months and the reconstruction group receiving 12 to 21(16.0±2.2) months. There was no statistically significant difference in the preoperative pivot shift test grading distribution between two groups (P>0.05). At the last postoperative follow-up, there were 24 patients with grade 0 and 5 patients with grade 1 in the repair group, and there were 18 patients with grade 0 and 2 patients with grade 1 in the reconstruction group, there is no significant difference in the distribution of axial shift test grading between two groups(P>0.05). The preoperative KT-2000 tibial displacement of two groups were (9.39±0.77) mm (repair group) and (9.14±0.78) mm (reconstruction group) respectively, with no statistically significant difference (P>0.05). At the final postoperative follow-up, there were 24 patients with KT-2000 tibial displacement <3 mm and 5 patients with 3 to 5 mm in the repair group, while 18 patients with <3 mm and 2 patients with 3 to 5 mm in the reconstruction group, KT-2000 tibial displacement distribution of two groups was no significant difference (P>0.05), but the KT-2000 tibial displacement in the reconstruction group (1.30±0.86) mm was significantly smaller than that in the repair group (1.99±1.11) mm (P<0.05). The final postoperative follow-up range of motion of the contralateral side knee between two groups was no significant difference (P>0.05). The range of motion of the suffering knee in the repair group was less than that in the reconstruction group (P<0.05). There was no significant difference in preoperative Lysholm and CSAS scores between two groups (P>0.05). At the final postoperative follow-up, both groups showed significant improvement in Lysholm and CSAS scores, while the Lysholm and CSAS scores of the reconstruction group were better than those of the repair group, and the difference was statistically significant (P<0.05). Significant differences was found in Tegner scores between two groups, which 16 patients in the repair group returned to their pre-injury activity level, and 17 patients in the reconstruction group returned to their pre-injury level (P<0.05). CONCLUSION Compared to anterolateral complex repair, combined ACL and ALL reconstruction in the treatment of ACL injuries with high-grade pivot shift results in better knee joint function and stability. This is advantageous in reducing the risk of ACL reconstruction failure.
Humans ; Male ; Female ; Adult ; Anterior Cruciate Ligament Reconstruction/methods* ; Anterior Cruciate Ligament Injuries/surgery* ; Young Adult ; Retrospective Studies ; Anterior Cruciate Ligament/surgery* ; Range of Motion, Articular