The impact of hypertensive disorders of pregnancy(HDP)on maternal and fetal outcomes is well-established.However,the relationship between high-normal blood pressure(BP)and HDP,as well as its association with adverse maternal-fetal outcomes,remains unclear.This retrospective study analyzed singleton pregnancies delivered at Obstetrics and Gynecology Hospital,Fudan University from Jan 2021 to Dec 2021.Participants were categorized into a normal BP group(BP<130/80 mmHg before delivery admission)and two high-normal BP groups(BP:130-139/80-89 mmHg)with subgroup analysis based on gestational week of BP elevation before and after 20 weeks.Maternal characteristics,HDP incidence and adverse outcomes were compared across groups.The results demonstrated that compared with the normal BP group,both high-normal BP groups showed significantly increased HDP incidence,with more pronounced risk in the high-normal BP(after 20 weeks)group.The high-normal BP(before 20 weeks)group was associated with elevated risks of iatrogenic preterm birth and small for gestational age(SGA).This study provides a theoretical basis for implementing stricter BP monitoring strategies to reduce adverse maternal and neonatal outcomes.

Traditional Chinese medicine (TCM) is a well-accepted therapy for atopic dermatitis (AD). However, there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD, limiting the clinical application of such combined approaches. Therefore, the China Association of Chinese Medicine initiated the development of the current guideline, focusing on key issues related to the use of TCM in the treatment of AD. This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization. A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted. The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine. This guideline comprises 23 recommendations across seven major areas, including TCM syndrome differentiation and classification of AD, principles and application scenarios of TCM combined with Western medicine for treating AD, outcome indicators for evaluating clinical efficacy of AD treatment, integration of TCM pattern classification and Western medicine across disease stages, daily management of AD, the use of internal TCM therapies and proprietary Chinese medicines, and TCM external treatments. Please cite this article as: Du XR, Wu MY, Tao MC, Lin Y, Gu CY, Wu MF, Cao Y, Chen DC, Li W, Wang HW, Wang Y, Wang Y, Lu HZ, Liu X, Su XF, Li FL. Clinical practice guidelines for the diagnosis and treatment of atopic dermatitis with integrative traditional Chinese and Western medicine. J Integr Med. 2025; 23(6):641-653.
Dermatitis, Atopic/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Integrative Medicine ; Drugs, Chinese Herbal/therapeutic use* ; Practice Guidelines as Topic

The structure of intestinal tissue is complex. In vitro simulation of intestinal structure and function is important for studying intestinal development and diseases. Recently, organoids have been successfully constructed and they have come to play an important role in biomedical research. Organoids are miniaturized three-dimensional (3D) organs, derived from stem cells, which mimic the structure, cell types, and physiological functions of an organ, making them robust models for biomedical research. Intestinal organoids are 3D micro-organs derived from intestinal stem cells or pluripotent stem cells that can successfully simulate the complex structure and function of the intestine, thereby providing a valuable platform for intestinal development and disease research. In this article, we review the latest progress in the construction and application of intestinal organoids.
Organoids/cytology* ; Intestines/physiology* ; Humans ; Animals ; Pluripotent Stem Cells

Objective:To observe the efficacy and safety of polatuzumab vedotin(pola)combined with chemotherapy in the treatment of relapsed and refractory diffuse large B-cell lymphoma(R/R DLBCL).Methods:A total of 23 patients with R/R DLBCL treated at the First Affiliated Hospital of Zhejiang University and its Liangzhu Branch from April 2023 to March 2024 were retrospectively collected.All patients were treated with pola combined with chemotherapy regimens such as BR,R-GDP,R-CHOP,or other regimens.Results:All 23 patients were evaluable for efficacy,with 10 achieving complete response(CR),7 partial response(PR),3 stable disease(SD),and 3 progressive disease(PD).The most common adverse events included myelosuppression,fever,and pulmonary infection.No severe adverse events resulted in drug withdrawal.Conclusion:Pola combined with chemotherapy demonstrates promising efficacy and a favorable safety profile in the treatment of R/R DLBCL.

Objective:To analyze the relationship between social function and family support in young and middle-aged patients undergoing peritoneal dialysis (PD).Methods:In this cross-sectional study, the patients undergoing maintenance PD therapy for more than 3 months at the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University, from May to October 2023 were recruited retrospectively. The social dysfunction screening scale and family support self-rating scale were used to evaluate the social dysfunction and family support of PD patients, respectively. The social demographic and clinical data of the patients were collected. Logistic regression analysis model was used to identify associated factors of social dysfunction in PD patients.Results:A total of 359 PD patients were recruited with age of (42.6±9.5) years old. Among them, 197 patients (54.9%) were males, and 33 patients (9.2%) were complicated with diabetes. The dialysis age was 28.8 (13.5, 56.3) months. The score of social function was 2 (1, 4), and the score of family support was (10.5±2.2). There were 199 patients (55.4%) having social dysfunction. There were 224 patients (62.4%) employed after PD. Compared with the normal social function group, the social dysfunction group had significantly lower score in family support ( Z=-2.613, P=0.009), serum potassium ( t=-2.725, P=0.007), urea clearance index ( Z=-2.346, P=0.019) and proportions of married status ( χ2=6.847, P=0.009), pre-dialysis employment ( χ2=3.996, P=0.046) and post-dialysis employment ( χ2=8.331, P=0.004), and higher serum creatinine ( Z=2.175, P=0.030), and proportions of annual household income < 100 000 yuan ( χ2=6.270, P=0.012) and diabetes mellitus ( χ2=4.400, P=0.036). Multivariate logistic regression analysis revealed that family support ( OR=0.828, 95% CI 0.733-0.935, P=0.002), diabetes mellitus ( OR=3.551, 95% CI 1.456-8.658, P=0.005) and serum potassium ( OR=0.559, 95% CI 0.374-0.835, P=0.005) were independent correlated factors of social dysfunction in young and middle-aged PD patients. Conclusions:The prevalence of social dysfunction is 55.4%, and the employment rate is 62.4% in young and middle-aged PD patients. Poor family support, diabetes mellitus and decreased serum potassium level are independently associated with social dysfunction in young and middle-aged PD patients.

Head and neck squamous cell carcinoma(HNSCC)is a highly prevalent malignancy with poor prognosis.Treatment strategies to date have achieved limited success in significantly improving overall survival rates.γδ T cells,a unique subset of immune cells in the tumor microenvironment,can link adaptive and innate immune functions.While γδ T cells can effectively recognize and eliminate HNSCC tumor cells,certain subsets of these cells can secrete interleukin-17,contributing to tumor progression.Nevertheless,due to their remarkable cyto-toxic activity,γδ T cells have been identified as promising candidates for antitumor immunotherapy.This article reviews the biological back-ground of γδ T cells,their role in tumor immunity in HNSCC,and recent advances in γδ T cell immunotherapy,aiming to provide new in-sights into HNSCC diagnosis and treatment.

Objective To analyze the efficacy of autologous tissue repair for rectocele through the perineal approach in treating constipation and fecal incontinence in patients.Methods From January 2021 to November 2022,23 female patients with symptomatic rectal protrusion were treated with perineal autologous tissue repair.Preoperatively and at 12 months postoperatively,the Cleveland Clinic Constipation Score(CCCS),Cleveland Clinic Incontinence Score(CCIS),and Patient Assessment of Constipation Quality of Life(PAC-QOL)questionnaires were used to assess postoperative outcomes and quality of life.Results Among the 23 patients,with a median follow-up time of 12.6 months,CCCS decreased from 17.09±1.68 to 3.96±2.08(P＜0.05);CCIS decreased from 1.52±4.15 to 0.52±1.41(P＞0.05);PAC-QOL:physical discomfort decreased from 13.00±1.51 to 4.74±1.98;psychological discomfort decreased from 20.96±3.27 to 5.74±2.67;concern and anxiety decreased from 26.13±4.37 to 8.78±3.14;satisfaction decreased from 15.39±2.35 to 4.60±1.59(P＜0.05).All patients showed significant improvement in constipation and incontinence symptoms postoperatively,with no serious postoperative complications and a marked improvement in postoperative quality of life.Conclusion Rectocele repair with perineal approach using autologous tissue is an effective and safe method,avoiding potential potential complications associated with grafts.

Aim To reveal the mechanism of CIP4 homologs protein 1(RICH1)are involved in the regu-lation of myocardial fibrosis.Methods Mouse cardiac fibroblasts(MCFs)cells were treated with transforming growth factor-β(TGF-β1)to induce the formation of a myocardial fibrosis cell model;the level of the target protein was detected by Western blotting;and the RICH1 gene was detected by transfection of the cells with plasmid.The RICH1 gene was overexpressed(RICH 1 OE)using plasmid transfection;the RICH1 gene was silenced using siRNA fragment(siRICH1);and the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3 a1,and Acta2,were de-tected using RT-qPCR.Results RICH1 was signifi-cantly down-regulated in TGF-β1-treated MCFs;the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3a1,and Acta2,were down-regu-lated in the RICH1 OE+TGF-β1 group;and in the siRICH1+TGF-β1 group,myocardial fibrosis marker genes,such as Col1 a1,Col3a1 and Acta2 were up-regulated at the expression level;phosphorylated SMAD2(p-SMAD2)and phosphorylated SMAD3(p-SMAD3)levels were down-regulated in the siRICH1 OE+TGF-β1 group.p-SMAD2 and P-SMAD3 levels were upregulated in the siRICH1+TGF-β1 group.Conclusion RICH1 inhibits TGF-β1-induced myo-cardial fibrosis;RICH1 inhibits TGF-β1-induced myo-cardial fibrosis by negatively regulating the SMAD2/3 signaling pathway.

Aim To reveal the mechanism of CIP4 homologs protein 1(RICH1)are involved in the regu-lation of myocardial fibrosis.Methods Mouse cardiac fibroblasts(MCFs)cells were treated with transforming growth factor-β(TGF-β1)to induce the formation of a myocardial fibrosis cell model;the level of the target protein was detected by Western blotting;and the RICH1 gene was detected by transfection of the cells with plasmid.The RICH1 gene was overexpressed(RICH 1 OE)using plasmid transfection;the RICH1 gene was silenced using siRNA fragment(siRICH1);and the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3 a1,and Acta2,were de-tected using RT-qPCR.Results RICH1 was signifi-cantly down-regulated in TGF-β1-treated MCFs;the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3a1,and Acta2,were down-regu-lated in the RICH1 OE+TGF-β1 group;and in the siRICH1+TGF-β1 group,myocardial fibrosis marker genes,such as Col1 a1,Col3a1 and Acta2 were up-regulated at the expression level;phosphorylated SMAD2(p-SMAD2)and phosphorylated SMAD3(p-SMAD3)levels were down-regulated in the siRICH1 OE+TGF-β1 group.p-SMAD2 and P-SMAD3 levels were upregulated in the siRICH1+TGF-β1 group.Conclusion RICH1 inhibits TGF-β1-induced myo-cardial fibrosis;RICH1 inhibits TGF-β1-induced myo-cardial fibrosis by negatively regulating the SMAD2/3 signaling pathway.

The impact of hypertensive disorders of pregnancy(HDP)on maternal and fetal outcomes is well-established.However,the relationship between high-normal blood pressure(BP)and HDP,as well as its association with adverse maternal-fetal outcomes,remains unclear.This retrospective study analyzed singleton pregnancies delivered at Obstetrics and Gynecology Hospital,Fudan University from Jan 2021 to Dec 2021.Participants were categorized into a normal BP group(BP<130/80 mmHg before delivery admission)and two high-normal BP groups(BP:130-139/80-89 mmHg)with subgroup analysis based on gestational week of BP elevation before and after 20 weeks.Maternal characteristics,HDP incidence and adverse outcomes were compared across groups.The results demonstrated that compared with the normal BP group,both high-normal BP groups showed significantly increased HDP incidence,with more pronounced risk in the high-normal BP(after 20 weeks)group.The high-normal BP(before 20 weeks)group was associated with elevated risks of iatrogenic preterm birth and small for gestational age(SGA).This study provides a theoretical basis for implementing stricter BP monitoring strategies to reduce adverse maternal and neonatal outcomes.