Objective To evaluate the efficacy and safety of Qixian Tongluo Formula in the treatment of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome,and to preliminarily explore the molecular mechanism of Qixian Tongluo Formula in improving impaired motor function from the perspective of cross-kingdom regulation of Chinese medicine microRNA(miRNA).Methods A pragmatic randomized controlled trial was conducted with 102 patients in the recovery period of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome in our hospital.Patients were randomly divided into trial group and control group,with 51 cases in each group.The control group received standard Western medicine standard treatment,while the trial group received Qixian Tongluo Formula in addition to the standard treatment,with one dose per day,boiled in water,and taken warm after breakfast and dinner for a course of 2 months.The disability rate was used as the main efficacy indicator,and the incidence of adverse reactions was used as a safety indicator.miRNA from patient serum and Qixian Tongluo decoction were extracted respectively,and high-throughput sequencing was performed.The two sequences were compared to screen out the cross-kingdom gene transfer of Chinese medicine miRNA.Finally,its target genes of miRNA were predicted,and GO function and KEGG pathway enrichment analysis were carried out.Results A total of 67 patients completed the clinical trial,including 36 cases in the trial group and 31 cases in the control group;The disability rate in the trial group(13.9%)was lower than that in the control group(35.5%)(P<0.05);The incidence of adverse reactions was similar between the trial group(7.69%)and the control group(6.06%)(P>0.05);A total of 9530 Qixian Tongluo decoction miRNA sequences were screened,with 150 potentially involved in cross-kingdom gene transfer,including families such as miR-15 and miR-17;According to the target gene prediction of the top 10 miRNAs in cross-kingdom gene transfer of Chinese medicine,345 overlapping target genes were obtained;GO functional enrichment analysis revealed 16 biological processes,7 cellular components,and 2 molecular functions among the top 25 enriched functions,while KEGG pathway analysis mainly focused on the transforming growth factor-βsignaling pathway,neurotrophin signaling pathway,which are closely related to neural repair and functional recovery processes such as glial scar formation and synaptic plasticity after cerebral ischemia.Conclusion Qixian Tongluo Formula can significantly improve the functional independence level of patients with kidney deficiency and blood stasis syndrome in the recovery period of paralysis after cerebral infarction,offering a safe and effective treatment option for these patients;There were a large number of miRNAs in Qixian Tongluo decoction,some of which could cross-kingdom transferred into the human blood circulation,and promote the recovery of motor function in patients with cerebral infarction through multi-target,multi link and multi pathway gene network regulation.This study provides a new idea for subsequent clinical and basic research.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective To evaluate the efficacy and safety of Qixian Tongluo Formula in the treatment of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome,and to preliminarily explore the molecular mechanism of Qixian Tongluo Formula in improving impaired motor function from the perspective of cross-kingdom regulation of Chinese medicine microRNA(miRNA).Methods A pragmatic randomized controlled trial was conducted with 102 patients in the recovery period of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome in our hospital.Patients were randomly divided into trial group and control group,with 51 cases in each group.The control group received standard Western medicine standard treatment,while the trial group received Qixian Tongluo Formula in addition to the standard treatment,with one dose per day,boiled in water,and taken warm after breakfast and dinner for a course of 2 months.The disability rate was used as the main efficacy indicator,and the incidence of adverse reactions was used as a safety indicator.miRNA from patient serum and Qixian Tongluo decoction were extracted respectively,and high-throughput sequencing was performed.The two sequences were compared to screen out the cross-kingdom gene transfer of Chinese medicine miRNA.Finally,its target genes of miRNA were predicted,and GO function and KEGG pathway enrichment analysis were carried out.Results A total of 67 patients completed the clinical trial,including 36 cases in the trial group and 31 cases in the control group;The disability rate in the trial group(13.9%)was lower than that in the control group(35.5%)(P<0.05);The incidence of adverse reactions was similar between the trial group(7.69%)and the control group(6.06%)(P>0.05);A total of 9530 Qixian Tongluo decoction miRNA sequences were screened,with 150 potentially involved in cross-kingdom gene transfer,including families such as miR-15 and miR-17;According to the target gene prediction of the top 10 miRNAs in cross-kingdom gene transfer of Chinese medicine,345 overlapping target genes were obtained;GO functional enrichment analysis revealed 16 biological processes,7 cellular components,and 2 molecular functions among the top 25 enriched functions,while KEGG pathway analysis mainly focused on the transforming growth factor-βsignaling pathway,neurotrophin signaling pathway,which are closely related to neural repair and functional recovery processes such as glial scar formation and synaptic plasticity after cerebral ischemia.Conclusion Qixian Tongluo Formula can significantly improve the functional independence level of patients with kidney deficiency and blood stasis syndrome in the recovery period of paralysis after cerebral infarction,offering a safe and effective treatment option for these patients;There were a large number of miRNAs in Qixian Tongluo decoction,some of which could cross-kingdom transferred into the human blood circulation,and promote the recovery of motor function in patients with cerebral infarction through multi-target,multi link and multi pathway gene network regulation.This study provides a new idea for subsequent clinical and basic research.

Radix et Rhizoma Rhei is one of the major Chinese medicinal herbs,with a long medicinal history and extensive clinical application.It has the effects of purgation,clearing heat and fire,cooling blood and detoxifying,expelling stasis and channeling meridian,diuresis and retreating yellow,etc.Its chemical constituents mainly include anthraquinones,anthrones,stilbenes,benzophenones,polysaccharides,tannins,and volatile oils.The pharmacological effects mainly include purgation,anti-inflammation,anti-tumor,lipid regulation,renal protection,liver protection,and anti-angiogenesis.This article summarizes the main chemical constituents and modern pharmacological effects of Radix et Rhizoma Rhei,aiming to provide a reference for the research of clinical use and pharmacological effects of Radix et Rhizoma Rhei.

Objective:To establish a nomogram to evaluate the adequacy of bowel preparation before colonoscopy and to guide clinical decision-making.Methods:A total of 1 023 valid questionnaires from subjects who underwent diagnosis and treatment of colonoscopy at the digestive endoscopy center, Xiangya Hospital, Central South University from September 2020 to March 2021 were finally returned. The contents of the questionnaire mainly included the clinical characteristics, defecation habits, the number of defecation and the time of the last defecation after taking the medicine and the self-assessment results of bowel preparation before colonoscopy. Subjects' bowel preparation was graded with the Boston bowel preparation scale (BBPS) by a designated endoscopist in a single blinded method. Multivariate analyse was used to explore the influencing factors for bowel preparation adequacy, and a nomogram was drawn accordingly.Results:Based on BBPS scores, bowel preparation of 674 subjects were adequate and 349 were inadequate. Multivariate analyse identified the number of defecation per week ( OR=1.649,95% CI:1.233-2.204, P=0.001), the number of defecation after medication ( OR=3.963, 95% CI: 1.851-8.485, P<0.001), the time of the last defecation after medication ( OR=5.151, 95% CI: 1.152-23.037, P=0.032), and self-assessment of bowel preparation before examination ( OR=8.284, 95% CI: 2.042-33.601, P=0.003) were influencing factors for the adequacy of bowel preparation for colonoscopy. The area under the receiver operating characteristic curve of assessment of colonoscopic bowel preparation adequacy with nomogram visualization according to influencing factors was 0.913, optimal cutoff value was 0.824, the sensitivity was 0.746, and the specificity was 0.971 under the internal validation cohort. Conclusion:The nomogram based on the number of defecation per week, the number of defecation after medication, the time of the last defecation after medication, and self-assessment of bowel preparation before examination could evaluate the adequacy of bowel preparation before colonoscopy, which is worthy of application.

ObjectiveTo evaluate the efficacy and safety of topical Bisaitong （鼻塞通） in treating moderate-to-severe allergic rhinitis （AR）. MethodsA randomized， positive-controlled， non-inferiority clinical trial design was adopted. Totally， 108 cases of moderate-to-severe AR were randomly divided into Bisaitong group and mometasone furoate group，with 54 cases in each group. The Bisaitong group was treated with Bisaitong smeared at the nasal cavity twice a day， and the mometasone furoate group received inhalation of mometasone furoate nasal spray 100 μg in each nostril， once a day. Both groups were treated for 4 weeks and followed up after additional 4 weeks. Both groups were compared on the rhinoconjunctivitis quality of life questionnaire （RQLQ）， rhinoconjunctivitis total symptom score （RTSS）， visual analogue score （VAS） of sneezing， runny nose， nasal itching， nasal congestion degree， days of AR episodes at enrollment， after 2- and 4-week， and at follow-up. The peripheral blood eosinophil （EOS） count and percentage （EOS%）， serum eosinophil cationic protein （ECP）， serum dust mite， dermatophagoides farinae， and cockroach allergen-specific IgE （sIgE） levels were compared between groups at enrollment and after 4-week treatment. Drug overuse rate was calculated， and the safety was evaluated. The analysis of all efficacy outcomes was based on both full analysis set （FAS） and per-protocol set （PPS）. ResultsThe lower limit of the 95% confidence interval for the differences in RQLQ scores were greater than -0.6 measured after 2- and 4-week treatment and at follow-up compared to that measured at the enrollment in both groups， indicating of the Bisaitong group being non-inferior to the mometasone furoate group. There was no statistically significant difference between groups on RTSS score， VAS scores of sneezing， runny nose， nasal itching， nasal congestion degree and days of episodes at all timepoints （P＞0.05）， but each outcome changed significantly over time in both groups （P＜0.01）. The differences between groups in EOS count， EOS%， ECP levels， serum dust mite， dermatophagoides farinae， cockroach sIgE levels， and drug overuse rate were not statistically significant at enrollment and after 4-week treatment （P＞0.05）. Adverse events occurred in eight cases （15.10%） in the Bisaitong group and five cases （9.30%） in the mometasone furoate group， showing no significant difference between groups （P＞0.05）. ConclusionTopical Bisaitong is non-inferior to mometasone furoate nasal spray in the treatment of moderate to severe AR in terms of clinical symptom relief，reduction in the episodes， improvement of quality of life， and sound safety.

Boiling is a common processing method of Chinese medicine. Based on the book of Summary of Processing Methods Data of Traditional Chinese Medicine in Past Dynasties， the authors consulted herbal books in all ages， combined with modern processing laws and regulations in various provinces and cities， the boiling methods and Chinese medicine varieties in ancient and modern times， judgment method of the endpoint of processing， as well as the study on boiling methods of representative Chinese medicines were compiled and analyzed. After sorting， it was found that the application of boiling methods began in the Han dynasty， enriched and developed in the Northern and Southern dynasties， Tang， Song and Yuan dynasties， and reached its heyday in the Ming and Qing dynasties. However， the number of modern boiling varieties decreased and mainly focused on toxic Chinese medicines or those that need to change or moderate their medicinal properties， indicating the development of boiling methods entered a stable period. The varieties of excipients used in the modern age mainly considered factors such as convenience of use and easy access， and the boiling degree， time and times were commonly used to judge the endpoint of boiling process. The main purposes of using boiling method for Chinese medicines were to remove impurities， remove non-medicinal parts， change or moderate the medicinal properties， and eliminate or reduce adverse reactions， which can provide a reference for carrying out the common research of boiling method for Chinese medicines.

Objective:To explore the short-term outcomes of dual kidney transplantation and summarize its safety and feasibility.Methods:From September 2018 to September 2019, a total of 7 dual kidney transplantations were performed. And retrospective analysis was performed for baseline profiles, clinical data and postoperative complications.Results:The mean age was (62.7±8.5) years for donors and (43.9±9.3) years for recipients. The Remuzzi score of 6 paired kidneys ranged from 4 to 6 points. During follow-ups, the survival rate of 7 dual kidney transplantation grafts and recipients was 100%. The median follow-up period was 16 months. Renal function of 6 recipients normalized within 1 week and delayed graft function (DGF) occurred in one case. All of them underwent unilateral kidney transplantation with an average operative duration of (5.6±1.4) hours. There was no onset of operative complications. One case of rejection was not confirmed by biopsy. Among three patients of lung infections, there was one case of severe pneumonia. In 3 cases, lateral plasma flow of transplanted kidney exceeded that of medial plasma flow.Conclusions:Dual kidney transplantation in adults is both safe and feasible so as to expand the availability of donated kidney.

Objective To explore the safety and effectiveness of central venous catheter for thoracic drainage after esoph-agectomy.Methods We prospectively analyzed 95 patients who underwent esophagectomy for esophageal carcinoma in our de-partment from August 2016 to August 2017.Forty-six patients with central venous catheter drainage were observation group, and 49 patients with traditional chest-tube closed drainage were control group.Compared the differences of drainage amount, pain score, postoperative patient quality of life score, duration of drainage and chest tube incision healing between the two groups.Results There were no significant differences in daily drainage volume and patency of drainage tube between the two groups(P>0.05).Compared with the control group, the duration of thoracic drainage in the observation group was significant shorter, the pain intensity score was significant lower , and the emotional function of postoperative patient quality of life was sig-nificant better(P<0.01).There were more patients suffered uncomfortable symptoms, such as nausea, vomiting, pain, in-somnia in the control group(P<0.05).Conclusion The application of central venous catheter in thoracic drainage can de-crease the postoperative pain and improve the postoperative quality of life for esophageal carcinoma patients after esophagecto-my.It is safe and feasible for thoracic drainage after esophagectomy .

Objective To explore the interaction between folate and the expression of HPV16 E6/E7 mRNA in the progression of cervix carcinogenesis.Methods Subjects were selected from the participants who were diagnosed pathologically,including 64 patients with cervical squamous cell carcinoma (SCC),55 patients with low-grade cervical intraepithelial neoplasm (CIN1),55 patients with high-grade cervical intraepithelial neoplasm (CIN2 +) and 80 with normal cervix (NC).The levels of serum folate and RBC folate were detected by microbiological assay,and the expression levels of HPV16 E6/E7 mRNA were measured,using the real-time polymerase chain reaction (real-time PCR).Data was analyzed by methods as chi-square test,analysis of variance (ANOVA),Welch test,Kruskal-Wallis H test and ordinal logistic regression.Spearman correlation was tested using the SPSS statistical software (version 16.0) while the interaction effects were evaluated by additive model.Results There was a positive correlation seen between the serum folate and RBC folate (r=0.41,P＜0.001).The levels of serum folate and RBC folate decreased gradually along with the severity of cervical lesions (x2=32.71,P＜0.001;x2=16.32,P＜0.001).The expression levels of HPV 16 E6/E7 mRNA increased gradually with the severity of cervical lesions (x2 =30.11,P＜ 0.001;x2 =38.99,P＜0.001).There was a negative correlation between the levels of RBC folate,expression levels of HPV16 E6 (E6:r=-0.14,P=0.009) and HPV16 E7 mRNA (E7:r=-0.21,P=0.001),respectively.Both RBC folate deficiency and HPV16 E6/E7 mRNA high expression showed additive interaction in CIN 1,CIN2 + and SCC.Conclusion Folate deficiency and high expression of HPV16 E6/E7 mRNA might increase the risk of cervical cancer and cervix precancerous lesions,and having a synergistic action in the progression of cervix carcinogenesis.