Bronchial asthma is a heterogeneous chronic inflammatory airway disease.Its pathogenesis is closely associated with abnormal immune responses within T-helper(Th)cell subsets,characterized by excessive effector Th cell activation and impaired immunosuppression by regulatory T cells.The concept of natural harmony of yin-yang epitomizes the understanding of traditional Chinese medicine(TCM)of the body's inherent capacity for autonomous regulation and homeostasis maintenance.Building upon the description in the Inner Canon of Yellow Emperor regarding asthma as"internal yin qi contention,external yang qi interference,"this study aims to bridge the TCM macro-level etiology and pathogenesis of"yin-yang disharmony"with the Western micro-level mechanism of loss of immune homeostasis control.The core pathogenesis of bronchial asthma involves yin-yang disorder in the body,leading to internal-external imbalance.Yang deficiency with a hidden yin pathogen and intermingled phlegm with blood stasis in the lungs is the root of pathogenesis.Pathogenic invading qi and yang hyperactivity induce bronchial asthma.These align with the Western medical concepts of imbalanced immunometabolic self-stabilization and defective immunotolerance.Based on the above content,corresponding therapeutic principles are proposed according to the disease stage.In the acute phase,dispelling wind pathogens and relieving cough are recommended.In chronic persistent asthma,calming yang disturbance and resolving the yin conflict are emphasized.In the clinical remission phase,kidney yang should be warmed and invigorated,thereby consolidating body resistance.The corresponding treatment methods are implemented based on the above content.In the acute phase,self-made Mahuang Qingyang Decoction is administered to dispel wind pathogens and ventilate lung qi.In chronic persistent asthma,self-made Qingfei Xiegan Decoction is administered to clear liver-fire and purge the lungs,self-made Xuanfu Qingwei Decoction is employed to harmonize the stomach for descending adverse yang qi,modified Suzi Jiangqi Decoction is applied to conduct deficient yang back to its source,and modified Erchen Decoction and Taohong Siwu Decoction are utilized to expel phlegm and blood stasis.In the clinical remission phase,modified Sijunzi Decoction,modified Mahuang Fuzi Xixin Decoction,and Erxian Decoction are administered to invigorate the spleen and kidney.These approaches ward off yang disturbance and resolve yin contention to restore the body's normal immune homeostasis.The ultimate therapeutic aim is to achieve a state of natural harmony of yin-yang,thereby ceasing wheezing and coughing spontaneously,and to provide new ideas for clinical treatment of bronchial asthma.

Bronchial asthma is a heterogeneous chronic inflammatory airway disease.Its pathogenesis is closely associated with abnormal immune responses within T-helper(Th)cell subsets,characterized by excessive effector Th cell activation and impaired immunosuppression by regulatory T cells.The concept of natural harmony of yin-yang epitomizes the understanding of traditional Chinese medicine(TCM)of the body's inherent capacity for autonomous regulation and homeostasis maintenance.Building upon the description in the Inner Canon of Yellow Emperor regarding asthma as"internal yin qi contention,external yang qi interference,"this study aims to bridge the TCM macro-level etiology and pathogenesis of"yin-yang disharmony"with the Western micro-level mechanism of loss of immune homeostasis control.The core pathogenesis of bronchial asthma involves yin-yang disorder in the body,leading to internal-external imbalance.Yang deficiency with a hidden yin pathogen and intermingled phlegm with blood stasis in the lungs is the root of pathogenesis.Pathogenic invading qi and yang hyperactivity induce bronchial asthma.These align with the Western medical concepts of imbalanced immunometabolic self-stabilization and defective immunotolerance.Based on the above content,corresponding therapeutic principles are proposed according to the disease stage.In the acute phase,dispelling wind pathogens and relieving cough are recommended.In chronic persistent asthma,calming yang disturbance and resolving the yin conflict are emphasized.In the clinical remission phase,kidney yang should be warmed and invigorated,thereby consolidating body resistance.The corresponding treatment methods are implemented based on the above content.In the acute phase,self-made Mahuang Qingyang Decoction is administered to dispel wind pathogens and ventilate lung qi.In chronic persistent asthma,self-made Qingfei Xiegan Decoction is administered to clear liver-fire and purge the lungs,self-made Xuanfu Qingwei Decoction is employed to harmonize the stomach for descending adverse yang qi,modified Suzi Jiangqi Decoction is applied to conduct deficient yang back to its source,and modified Erchen Decoction and Taohong Siwu Decoction are utilized to expel phlegm and blood stasis.In the clinical remission phase,modified Sijunzi Decoction,modified Mahuang Fuzi Xixin Decoction,and Erxian Decoction are administered to invigorate the spleen and kidney.These approaches ward off yang disturbance and resolve yin contention to restore the body's normal immune homeostasis.The ultimate therapeutic aim is to achieve a state of natural harmony of yin-yang,thereby ceasing wheezing and coughing spontaneously,and to provide new ideas for clinical treatment of bronchial asthma.

Allergen-specific Immunotherapy (AIT) is currently the only allopathic treatment capable of modifying the natural course of immunoglobulin E (IgE)-mediated allergic diseases. Currently, there is a lack of recognized clinical markers for evaluating and predicting the efficacy of AIT, and some biological markers may have some potential for application. This article will summarize the currently known indicators for evaluating and predicting the therapeutic effects of AIT, with the aim of providing assistance in evaluating and monitoring the efficacy of AIT.

The prevalence of allergic diseases is on the rise,posing a significant global health challenge.Allergen specific immunotherapy(AIT)is the only treatment capable of altering the natural course of allergic diseases,offering long-term efficacy and the potential to prevent disease progression.However,its widespread application is hindered by factors such as lengthy treatment duration,adverse reactions,and patient compliance issues.In recent years,biologics targeting type 2 inflammatory pathways have played a crucial role at various stages of different allergic diseases.Research indicates that for patients with moderate to severe allergic diseases,using biologics during or prior to AIT can significantly enhance the safety of AIT,reduce the time required to reach maintenance doses,and markedly improve symptom scores.This article elucidates the synergistic mechanisms and recent advancements in the combined application of biologics and AIT in the treatment of allergic diseases.The aim is to provide a reference for the standardized treatment of allergic diseases.

Post-traumatic stress disorder (PTSD) is a relatively common but complex mental illness with a range of diverse risk factors. Typical symptoms include the re-experience or avoidance of traumatic events, cognitive impairment, and hypervigilance. While the exact pathogenesis of PTSD is unclear, many studies indicate that epigenetic regulation plays a key role in its development. Specifically, numerous studies have indicated that the levels of histone acetylation and methylation, DNA methylation, and noncoding RNA are altered in PTSD patients. Further to this, natural products have been found to achieve epigenetic regulation of PTSD by regulating the expression of epigenetic enzymes, long noncoding RNA (lncRNA), and miRNA, thereby playing a role in improving PTSD symptoms. To date, however, no epigenetic regulation related drugs have been used in the treatment of PTSD. Furthermore, while natural products that can epigenetically regulate PTSD have received increasing levels of attention, there have not yet been any systematic reports on the topic. Here, we summarized the roles and mechanisms of natural products in the epigenetic regulation of PTSD, providing a novel and unique perspective that will help to guide the development and application of new PTSD treatments.

The prevalence of allergic diseases is on the rise,posing a significant global health challenge.Allergen specific immunotherapy(AIT)is the only treatment capable of altering the natural course of allergic diseases,offering long-term efficacy and the potential to prevent disease progression.However,its widespread application is hindered by factors such as lengthy treatment duration,adverse reactions,and patient compliance issues.In recent years,biologics targeting type 2 inflammatory pathways have played a crucial role at various stages of different allergic diseases.Research indicates that for patients with moderate to severe allergic diseases,using biologics during or prior to AIT can significantly enhance the safety of AIT,reduce the time required to reach maintenance doses,and markedly improve symptom scores.This article elucidates the synergistic mechanisms and recent advancements in the combined application of biologics and AIT in the treatment of allergic diseases.The aim is to provide a reference for the standardized treatment of allergic diseases.

Allergen-specific Immunotherapy (AIT) is currently the only allopathic treatment capable of modifying the natural course of immunoglobulin E (IgE)-mediated allergic diseases. Currently, there is a lack of recognized clinical markers for evaluating and predicting the efficacy of AIT, and some biological markers may have some potential for application. This article will summarize the currently known indicators for evaluating and predicting the therapeutic effects of AIT, with the aim of providing assistance in evaluating and monitoring the efficacy of AIT.

Objective To explore the efficacy of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with virtual reality interactive robot training in improving upper limb function of patients with stroke.Methods From February to December 2023,92 patients in the hos-pital were randomly divided into control group(n=30),virtual reality group(n=31),and com-bined group(n=31).The control group received conventional rehabilitation therapy;the virtual re-ality group received conventional rehabilitation therapy and virtual reality interactive robot training for upper limb;the combined group received low-frequency rTMS on the therapeutic basis of the virtual reality group.Before treatment and 4 weeks after treatment,the Upper Extremity Fugl-Meyer Assess-ment(UFMA)score,the Functional Test for the Hemiplegic Upper Extremity-Hong Kong Version(FTHUE-HK)score,motor evoked potential(MEP)amplitude,cortical latency(CL)value,and the ratio of root mean square of myoelectricity(RMS)of wrist dorsiflexor muscles between the affect-ed and unaffected sides were compared among the three groups.Results Four weeks after treatment,the UFMA and FTHUE-HK scores of the three groups significantly improved compared with those before treatment,the UFMA and FTHUE-HK scores of the combined group were significantly higher than those of the control group and the virtual reality group,and the UFMA score of the virtual reality group was significantly higher than that of the control group(P＜0.05);the RMS ratios and MEP amplitudes of the three groups significantly increased compared with those before treatment,the RMS ratios and MEP amplitudes of the combined group were significantly higher than those of the control group and the virtual reality group,and the virtual reality group had higher values than the control group,with significant between-group differences(P＜0.05);the CL of the three groups significantly shortened compared with that before treatment,the CL of the combined group was significantly shorter than that of the control group and the virtual reality group,and the CL of the virtual reality group was significantly shorter than that of the control group(P＜0.05).Conclusion The rTMS assisted virtu-al reality interactive robot training can effectively improve upper limb function in stroke patients.

Stroke often causes severe motor, sensory, and daily living function impairments, especially the recovery of distal limb extensor motor function is the most difficult. With the widespread application of Contralateral Control Functional Electrical Stimulation (CCFES) in stroke rehabilitation and continuous improvement of integrated wearable devices in recent years, it has been found that CCFES and combination therapy have good therapeutic effects in improving wrist extension and ankle dorsiflexion function in stroke patients. CCFES can improve both distal and proximal upper limb function, when applied to lower limbs, attention should be paid to the reverse coordination mechanism. Early intervention, sufficient treatment courses, and multiple combination CCFES treatment plans can accelerate the improvement of stroke patients' function.

Objective:To explore the association between thyroid function and chronic kidney disease (CKD) in adults.Methods:A cross-sectional study was conducted in adults who received health checkup in the First Affiliated Hospital of Shandong First Medical University from January to December in 2021. Clinical data were collected, including age, gender, height, weight, blood pressure, etc. And blood glucose, blood lipid, blood creatinine, blood uric acid, routine urine function, thyroid function (free triiodine, free thyroxine, thyroid stimulating hormone) were measured. Multivariate logistic regression model was used to investigate the correlation between thyroid function indicators and the onset of CKD; and receiver operator characteristic (ROC) curve was used to explore the ability of thyroid function indicators in evaluating CKD.Results:In the study, 46 342 adults with an average age of (47.6±14.3) years were enrolled, of which 56.2% were males. The prevalence of DeGFR (eGFR<60 ml·min -1·(1.73 m 2) -1), proteinuria and CKD was 1.15%, 0.53% and 1.58%, respectively. The TSH subgroup analysis showed that the prevalence of DeGFR, albuminuria and CKD in the hypothyroidism group was significantly increased to 1.07%, 2.36% and 3.20%, respectively (all P<0.05). After adjusting for confounding factors, multivariate logistic regression analysis showed that FT3 was negatively associated with CKD ( OR=0.63, 95% CI: 0.54-0.74), however FT4 ( OR=1.05, 95% CI: 1.03-1.07) and TSH ( OR=1.03, 95% CI: 1.01-1.04) were positively correlated with CKD. Similar results were obtained in the subgroup without hypertension and diabetes ( P<0.05). The ROC analysis indicated that FT3 had a better capability for evaluating CKD than FT4 and TSH, with an area under the curve of 0.63, a cut-off value of 4.18 pmol/L, and a sensitivity and specificity of 57.5% and 62.6%, respectively. Conclusions:Thyroid function status is closely associated with the onset of CKD in the adult population receiving health check-up. FT3 is a risk factor for the onset of CKD.