Chronic obstructive pulmonary disease（COPD） is a common chronic respiratory disorder frequently accompanied by diaphragmatic dysfunction during its course， which significantly increases respiratory burden and impairs quality of life. As the primary inspiratory muscle， the diaphragm is prone to fatigue， atrophy， inflammation， and fibrosis during the long-term progression of COPD. Its pathological mechanisms involve multiple pathways such as inflammatory responses， oxidative stress， mitochondrial dysfunction， apoptosis， ion channel abnormalities， epigenetic regulation， autophagy disorder， and protein metabolism imbalance. In recent years， traditional Chinese medicine（TCM） has demonstrated multi-targeted and systemic regulatory advantages in improving diaphragmatic function in COPD. However， related studies remain fragmented， and integrated mechanistic understanding is lacking. This paper focuses on the mechanism-target-TCM intervention framework， systematically summarizing the molecular mechanisms of diaphragmatic dysfunction， while incorporating the TCM theory of Zongqi（ancestral Qi）. It highlights the therapeutic effects of Chinese herbal formulas， single herbs， and active components in modulating inflammation， oxidative stress， mitochondrial function， ion channels， epigenetic processes， autophagy， and protein homeostasis. Additionally， the review outlines existing challenges， including insufficient study volume， unbalanced selection of herbal prescriptions， limited mechanistic depth， inconsistent disease models and experimental designs， lack of standardized diaphragmatic function assessment， and weak clinical validation. Future research should strengthen the integration of TCM and modern medicine， identify additional therapeutic targets， deepen mechanistic research， and establish unified and standardized experimental systems to advance the theoretical foundation and clinical application of TCM in the prevention and treatment of COPD-related diaphragmatic dysfunction.

Chronic obstructive pulmonary disease（COPD） is a common chronic respiratory disorder frequently accompanied by diaphragmatic dysfunction during its course， which significantly increases respiratory burden and impairs quality of life. As the primary inspiratory muscle， the diaphragm is prone to fatigue， atrophy， inflammation， and fibrosis during the long-term progression of COPD. Its pathological mechanisms involve multiple pathways such as inflammatory responses， oxidative stress， mitochondrial dysfunction， apoptosis， ion channel abnormalities， epigenetic regulation， autophagy disorder， and protein metabolism imbalance. In recent years， traditional Chinese medicine（TCM） has demonstrated multi-targeted and systemic regulatory advantages in improving diaphragmatic function in COPD. However， related studies remain fragmented， and integrated mechanistic understanding is lacking. This paper focuses on the mechanism-target-TCM intervention framework， systematically summarizing the molecular mechanisms of diaphragmatic dysfunction， while incorporating the TCM theory of Zongqi（ancestral Qi）. It highlights the therapeutic effects of Chinese herbal formulas， single herbs， and active components in modulating inflammation， oxidative stress， mitochondrial function， ion channels， epigenetic processes， autophagy， and protein homeostasis. Additionally， the review outlines existing challenges， including insufficient study volume， unbalanced selection of herbal prescriptions， limited mechanistic depth， inconsistent disease models and experimental designs， lack of standardized diaphragmatic function assessment， and weak clinical validation. Future research should strengthen the integration of TCM and modern medicine， identify additional therapeutic targets， deepen mechanistic research， and establish unified and standardized experimental systems to advance the theoretical foundation and clinical application of TCM in the prevention and treatment of COPD-related diaphragmatic dysfunction.

Objective: To map the research landscape of artificial intelligence (AI)-assisted tongue diagnosis through bibliometric analysis and to quantify its diagnostic accuracy and clinical interpretability through a diagnostic test accuracy (DTA) meta-analysis. Methods: For the bibliometric analysis, the Web of Science Core Collection (WoSCC) was queried for English-language articles and reviews on AI-assisted tongue diagnosis published between January 1, 2014 and December 31, 2025, and analysed using Bibliometrix, VOSviewer, and CiteSpace, with major output dimensions including annual publication output and disciplinary distribution, journal and citation characteristics, country/region and institutional collaboration, author networks, keyword co-occurrence, and keyword burst detection. For the DTA meta-analysis, four databases [Scopus, PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI)] were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA) guidelines. A bivariate random-effects model hierarchical summary receiver operating characteristic (HSROC) was used to pool sensitivity and specificity, with subgroup analyses by disease category, AI model architecture, and sample-size strata. Methodological quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2) tool, and publication bias was evaluated by Deeks’ funnel plot asymmetry test. Results: A total of 198 publications met the bibliometric eligibility criteria. Annual output increased 24.5-fold (from 2 in 2014 to 49 in 2025), with the period 2022 – 2025 alone accounting for 65.2% of all publications. China contributed approximately 83.5% of all institutional affiliations, with Shanghai University of Traditional Chinese Medicine and Jiatuo Xu being the most productive institution and author, respectively. Keyword analysis identified four thematic clusters (AI and deep-learning architectures, image processing and segmentation, traditional Chinese medicine (TCM)-specific applications, and disease-specific applications) and a temporal evolution from traditional machine learning to deep learning and transformer-based, explainable, and multimodal AI architectures. Sixteen DTA meta-analysis studies (14 755 participants) covering metabolic and hepatic disorders, oncological and oral lesions, cardiovascular risk, diabetes, and other clinical applications were included in the DTA meta-analysis. The pooled sensitivity was 90.3% [95% confidence interval (CI): 86.7% – 93.1%] and the pooled specificity was 93.0% (95% CI: 90.6% – 94.7%); the area under the summary receiver operating characteristic (SROC) curve (AUC) was 0.961. Heterogeneity was substantial (I2 = 95.8% for sensitivity; I2 = 92.1% for specificity). Subgroup performance was broadly consistent across disease categories, AI architectures, and sample-size strata, and Deeks’ test indicated no significant publication bias (P = 0.258). Conclusion AI-assisted tongue diagnosis has progressed rapidly and shows pooled diagnostic performance comparable to established screening modalities, supporting its potential as a complementary and easily accessible decision-support tool.

Elderly patients with tumors face unique challenges due to age-related decline in organ function, multiple comorbidities, and poor tolerance to treatment, often limiting the applicability of the traditional “maximum tolerated therapy” approach in this population. This article aims to explore the “green therapy” system tailored for tumors in elderly patients. Proposed by Professor Hu Kaiwen in 2003, this system replaces “cure” with “control,” integrating modern minimally invasive techniques with holistic regulation from Traditional Chinese Medicine to form a treatment strategy that balances local and systemic approaches. This paper systematically elucidates the construction and application of this system in tumors in elderly patients, highlighting its core value of achieving long-term peaceful coexistence between patients and tumors through low-damage methods, thereby offering a new treatment option aligned with the physiological characteristics of this population.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

Objective:To investigate the diagnostic features of eosinophilic gastroenteritis (EGE) of the stomach and duodenum.Methods:A case-control study was conducted to retrospectively analyze 238 biopsy specimens of gastric and duodenal EGE (75 cases) and 133 biopsy specimens of chronic active gastroenteritis (97 cases) in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China from 2012 to 2023. The eosinophil count, infiltration site and other pathological features (e.g., infiltration of neutrophils into the epithelium, edema, and increase of background lymphocytes and plasma cells) were examined under a microscope. Chi-square test, chi-square multiple comparison ( Bonferroni method) and modified Poisson regression were used to analyze the data. Results:The results showed that there were significant differences in eosinophil count ( χ2=43.926, P<0.01), location ( χ2=31.391, P<0.01), neutrophilic infiltration of the epithelium ( χ2=5.199, P=0.023), edema ( χ2=3.934, P=0.047), and lymphoplasmacytosis ( χ2=36.813, P<0.01) between the EGE and control cases. The results of Chi-square multiple comparisons showed that eosinophils distributed in clusters or sheets (versus other grades of eosinophil presence) were statistically associated with EGE. When eosinophils infiltrated the epithelium (versus eosinophils in other locations of the mucosa), there was a statistically significant association with EGE. Modified Poisson regression also showed that EGE was more likely to have eosinophilic infiltration of epithelium [ RR=1.661, P=0.001,95% CI (1.397,1.973)] and that of muscularis mucosa [ RR=1.818, P<0.01,95% CI (1.491,2.216)]. Conclusions:The important pathological features for diagnosing EGE of the stomach and duodenum are that eosinophils are clustered or distributed in sheets with epithelial infiltration. However, epithelial infiltration by neutrophils, edema and background lymphoplasmacytosis are relatively rare.

Radiomics can provide a large number of features derived from medical images, which can be correlated with certain biological characteristics and clinical endpoints. Delta radiomics enables the analysis of feature changes across different acquisition time points, typically before and after treatment. Compared with traditional radiomics, delta radiomics allows the evaluation of changes in radiomic features at different time points to better guide clinical diagnosis and treatment, thereby facilitating the development of personalized treatment plans for patients. Delta radiomics offers certain advantages in the differential diagnosis, prognosis prediction, treatment response assessment, and side effect evaluation of oncological diseases. This article reviews the applications of delta radiomics in the diagnosis and treatment of head and neck tumors, lung cancer, gastrointestinal tumors, pancreatic cancer, prostate cancer, breast cancer, and soft tissue tumors.

Objective:To investigate the diagnostic features of eosinophilic gastroenteritis (EGE) of the stomach and duodenum.Methods:A case-control study was conducted to retrospectively analyze 238 biopsy specimens of gastric and duodenal EGE (75 cases) and 133 biopsy specimens of chronic active gastroenteritis (97 cases) in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China from 2012 to 2023. The eosinophil count, infiltration site and other pathological features (e.g., infiltration of neutrophils into the epithelium, edema, and increase of background lymphocytes and plasma cells) were examined under a microscope. Chi-square test, chi-square multiple comparison ( Bonferroni method) and modified Poisson regression were used to analyze the data. Results:The results showed that there were significant differences in eosinophil count ( χ2=43.926, P<0.01), location ( χ2=31.391, P<0.01), neutrophilic infiltration of the epithelium ( χ2=5.199, P=0.023), edema ( χ2=3.934, P=0.047), and lymphoplasmacytosis ( χ2=36.813, P<0.01) between the EGE and control cases. The results of Chi-square multiple comparisons showed that eosinophils distributed in clusters or sheets (versus other grades of eosinophil presence) were statistically associated with EGE. When eosinophils infiltrated the epithelium (versus eosinophils in other locations of the mucosa), there was a statistically significant association with EGE. Modified Poisson regression also showed that EGE was more likely to have eosinophilic infiltration of epithelium [ RR=1.661, P=0.001,95% CI (1.397,1.973)] and that of muscularis mucosa [ RR=1.818, P<0.01,95% CI (1.491,2.216)]. Conclusions:The important pathological features for diagnosing EGE of the stomach and duodenum are that eosinophils are clustered or distributed in sheets with epithelial infiltration. However, epithelial infiltration by neutrophils, edema and background lymphoplasmacytosis are relatively rare.

Objective To explore the clinical value of methylation at promoter sites of urine protein kinase Y-linked(PRKY)gene in the early diagnosis of prostate cancer(PCa).Methods Urine samples were collected from 50 suspected PCa patients.After extracting DNA,the methylation levels of the PRKY gene promoter sites cg05163709,cg08045599,and cg05618150 were detected using quantitative methylation-specific PCR(qMSP).Simultaneously,the patients were divided into the benign prostatic hyperplasia(BPH)group and the PCa group.The differences in clinical indicators between the two groups were analyzed,as well as the methylation status of the PRKY gene promoter sites in the urine of the two groups of patients.The receiver operating charac-teristic(ROC)curve of PRKY promoter sites methylation was established,and the area under the curve(AUC)was calculated to analyze the diagnostic value of PRKY promoter sites methylation in PCa,and to perform com-bined diagnosis with clinical indicators.Results The methylation rates of cg05163709 and cg05618150 in urine specimens of PCa patients were significantly higher than those of BPH patients.The AUC for cg05163709 methyla-tion in diagnosing PCa was 0.762,with a sensitivity of 86.70%.It showed better performance in early screening for PCa compared to total prostate specific antigen(tPSA),percentage free prostate specific antigen(f/tPSA)and prostate specific antigen density(PSAD)index.We found that the AUC for cg05618150 methylation in conjunc-tion with PSAD in diagnosing PCa was 0.787,with a sensitivity of 86.70%.The AUC of cg05163709 methylation and PSAD in the joint diagnosis of PCa was 0.855,and the specificity could reach 95.00%.Conclusion The methylation of urine PRKY gene promoter sites cg05163709 and cg05618150 shows high sensitivity and specificity in diagnosing PCa,making them promising biomarkers for early detection of PCa.

Opioid analgesics are currently known as the best analgesics. However， toxicity and side effects such as constipation， tolerance and addiction severely limit their clinical application. With the in-depth understanding of the signal transduction mechanism of opioid receptors and the continuous advancement of drug design technology， researchers have managed to develop many promising new methods to get low-toxic and more efficient opioid analgesics， which are different from the traditional morphine skeleton structure modifications. This article focuses on three new research strategies of G-protein biased activation，“ one drug-multiple targets” and peripheral activation. The basic principles of relative separation of analgesic activity and adverse drug reaction by each strategy are introduced， and the latest research progress of representative drugs is briefly reviewed. Among them， the recently approved novel opioid analgesics oliceridine and tegileridine are G-protein biased μ-opioid receptor agonists， Cebranopadol is a typical “one drug-multiple targets” analgesic， and NFEPP is a representative drug of peripheral opioid receptor agonists. The above several strategies complement each other and provide reference for the development of new opioid analgesic drugs.