Functional dyspepsia （FD） is a prioritized disease category where traditional Chinese medicine （TCM） demonstrates distinct therapeutic advantages. The current western medicine treatment for FD is mainly based on proton pump inhibitors and prokinetic agents， with digestive enzymes， probiotics and antidepressants serving as adjuvant medication， yet such therapies still have certain limitations. TCM treatment for FD includes oral administration of Chinese herbal formulas and Chinese patent medicines， as well as external TCM therapies such as acupuncture and moxibustion， acupoint application， hot medicinal compress therapy， rubbing with ointment， medicinal iontophoresis， auricular acupoint therapy and tui na （Chinese medical massage）. The combined treatment of FD with integrated TCM and western medicine can significantly improve clinical effectiveness and reduce adverse reactions. The common mechanisms underlying the therapeutic effects of both TCM and western medicine revolve around the core pathological processes of FD， mainly focusing on restoring gastrointestinal motility， regulating the levels of brain-gut peptides， modulating intestinal microecology， and ameliorating inflammatory status. The differential mechanisms lie in the precise targeting feature of western medicine versus the holistic-regulating and multi-target characteristics of TCM， and the two approaches exert a synergistic effect to enhance efficacy. This paper proposes to leverage the advantages of TCM in holistic regulation and the strengths of western medicine in targeted treatment， so as to provide personalized and comprehensive treatment regimens for FD patients.

Objective:To establish a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products,screen critical quality markers,and provide methodological support for their intelligent quality control.Methods:Ultra-performance liquid chromatography coupled with quadrupole-orbitrap mass spectrometry(UPLC-Q-Orbitrap-MS)was employed to quantitatively analyze 34 bioactive components(e.g.,tanshinone Ⅱ A and alvianol-ic acid B)in 20 batches of fermentation products.The key markers were screened through hierarchical cluster anal-ysis and partial least squares discriminant analysis,and an intelligent discriminant model was constructed with sup-port vector machine machine learning algorithm to digitally analyze the characteristics of quality differences between batches.Results:Thirty-four common peaks were calibrated across all batches.Combined with partial least squares analysis,six key difference markers were further screened,including terpenoids such as isotanshinone Ⅱ A and tan-shinone Ⅱ A and phenolic acids such as salvianolic acid G.The support vector machine model can achieve 100％accuracy of origin discrimination by optimizing parameters jointly with genetic algorithm and grid search.Conclusion:This study developed a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products through a three-step analytical strategy("chemical feature exploration-marker screening-model valida-tion"),providing a transferable technical pathway for the intelligent transformation of traditional Chinese medicine quality control.

Objective:To establish a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products,screen critical quality markers,and provide methodological support for their intelligent quality control.Methods:Ultra-performance liquid chromatography coupled with quadrupole-orbitrap mass spectrometry(UPLC-Q-Orbitrap-MS)was employed to quantitatively analyze 34 bioactive components(e.g.,tanshinone Ⅱ A and alvianol-ic acid B)in 20 batches of fermentation products.The key markers were screened through hierarchical cluster anal-ysis and partial least squares discriminant analysis,and an intelligent discriminant model was constructed with sup-port vector machine machine learning algorithm to digitally analyze the characteristics of quality differences between batches.Results:Thirty-four common peaks were calibrated across all batches.Combined with partial least squares analysis,six key difference markers were further screened,including terpenoids such as isotanshinone Ⅱ A and tan-shinone Ⅱ A and phenolic acids such as salvianolic acid G.The support vector machine model can achieve 100％accuracy of origin discrimination by optimizing parameters jointly with genetic algorithm and grid search.Conclusion:This study developed a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products through a three-step analytical strategy("chemical feature exploration-marker screening-model valida-tion"),providing a transferable technical pathway for the intelligent transformation of traditional Chinese medicine quality control.

ObjectiveTo investigate the effect of mucin 1 (MUC1) on the proliferation and apoptosis of nasopharyngeal carcinoma (NPC) and its regulatory mechanism. MethodsThe 60 NPC and paired para-cancer normal tissues were collected from October 2020 to July 2021 in Quanzhou First Hospital. The expression of MUC1 was measured by real-time quantitative PCR (qPCR) in the patients with PNC. The 5-8F and HNE1 cells were transfected with siRNA control (si-control) or siRNA targeting MUC1 (si-MUC1). Cell proliferation was analyzed by cell counting kit-8 and colony formation assay, and apoptosis was analyzed by flow cytometry analysis in the 5-8F and HNE1 cells. The qPCR and ELISA were executed to analyze the levels of TNF-α and IL-6. Western blot was performed to measure the expression of MUC1, NF-кB and apoptosis-related proteins (Bax and Bcl-2). ResultsThe expression of MUC1 was up-regulated in the NPC tissues, and NPC patients with the high MUC1 expression were inclined to EBV infection, growth and metastasis of NPC. Loss of MUC1 restrained malignant features, including the proliferation and apoptosis, downregulated the expression of p-IкB、p-P65 and Bcl-2 and upregulated the expression of Bax in the NPC cells. ConclusionDownregulation of MUC1 restrained biological characteristics of malignancy, including cell proliferation and apoptosis, by inactivating NF-κB signaling pathway in NPC.

Objective To evaluate the bioequivalence of the test preparation and reference preparation of azithromycin capsules in healthy Chinese subjects.Methods A total of 48 subjects were enrolled in this study using a randomized,open,two-sequence,cross design.Each subject received a single oral dose of azithromycin capsules test drug(T)or reference drug(R)for 250 mg.The concentrations of azithromycin in plasma were determined by Liquid Chromatograph Mass Spectrometer,and the pharmacokinetic parameters were calculated by WinNonlin 8.1 software to evaluate the bioequivalence.Results The main pharmacokinetic parameters of azithromycin after a single fasting dose of the test drug and the reference drug were as follows:the Cmax were respectively(319.89±127.35)and(330.41±122.11)ng·mL-1;AUC0-192h were respectively(2 423.04±587.15)and(2 489.97±685.73)ng·h·mL-1;AUC0-∞ were respectively(2 753.40±644.96)and(2 851.71±784.05)ng·h·mL-;tmax were respectively(2.60±1.11)and(2.62±1.13)h;t1/2 were respectively(76.76±15.14)and(79.83±17.14)h.The 90％confidence intervals for the geometric mean ratios of Cmax,AUC0-192h and AUC0-∞ of T and R were 87.52％-107.18％,91.46％-105.80％and 91.17％-105.06％,respectively.Conclusion The test preparation of azithromycin capsule was bioequivalent to the reference preparation under fasting condition.

Objective To investigate the causal relationship between obstructive sleep apnea(OSA)and hypertension using bidirectional Mendelian randomization(MR).Methods Genetic data for OSA were obtained from the Genome-wide association study(GWAS)of FinnGen Biobank,including 16 761 cases and 201 194 controls,from which 5 single-nucleotide polymorphisms(SNPs)were screened as instrumental variables(IVs)for OSA.Genetic data for hypertension were obtained from GWAS of UK Biobank,including 124 227 cases and 337 653 controls from which 214 SNPs were selected as IVs for hypertension.Multiple MR methods,mainly Inverse variance weighted(IVW),were used for analysis.Sensitivity analysis of MR results was performed using MR-Egger regression et al,and IVs were evaluated using F values.Results OSA was associated with an increased risk of hypertension(OR=1.053,95%CI 1.019-1.089,P<0.01),and hypertension was significantly associated with the risk of developing OSA(OR=1.812,95%CI 1.354-2.425,P<0.001).Heterogeneity was observed in both two-way outcomes(OSA→ hypertension,P<0.001;hypertension→ OSA,P<0.001),but no evidence of horizontal pleiotropy was detected(OSA→ hypertension,P=0.666;hypertension→ OSA,P=0.556).The IVs selected in this study were strong instrumental variables for both OSA and hypertension(OSA-IVs F=14.695;hypertension-IVs F=39.624).Conclusions Our findings indicate a bidirectional causal relationship between OSA and hypertension,with a particularly significant effect of hypertension on the development of OSA.

Objective To select,evaluate and integrate the optimal evidence for collection of faecal specimen and management of patients with inflammatory bowel disease(IBD),therefore to provide evidence-based strategies for specimen collection.Methods According to the model of"6S"evidence,systematic search was performed on UpToDate,JBI evidence-based healthcare database,BMJ Best Practice,National Guideline Clearinghouse(NGC),Registered Nurses'Association of Ontario(RNAO),Scottish Intercollegiate Guidelines Network,(SIGN),American Society for Microbiology(ASM),Web of Science,Cochrane Library,PubMed,Embase,CNKI,Wanfang Data,Chinese Biomedical Literature Database and the associations related to IBD,DXY,Medlive in order to acquire information in relation to the collection of faecal specimens and management of patients with IBD.Data were searched from the inception of databases to June10th 2023.Quality evaluation and evidence extraction of the literatures were performed by two researchers to ensure that the literatures were met with the quality standards.Results A total of nine articles were included and they were 1 clinical decision,3 clinical guidelines,3 expert consensus,1 systematic review and 1 evidence summary.Finally,27 pieces of evidence were summarised from five aspects including preparation before sampling,sampling time,sampling method,preservation and transportation,and health education.Conclusions This study summarises the best evidences in faecal collection from IBD patients,which can provide evidence-based strategies for standardised collection of clinical faecal specimens.Medical staff can apply the evidences according to clinical conditions hence to improve the accuracy in monitoring and diagnosis of IBD.

Psoriasis is a refractory disease mainly co-acted by immune,genetic and environment.Tumor necrosis factor α (TNF-α)-related biologics have brought the landmark advances in the treatment of psoriasis;however,the anti-TNF-α therapy has the adverse response,its limitation may be related to the different bio-logical functions exerted by activation of TNF-α different receptors.Tumor necrosis factor receptor 2 (TNFR2) is one of the key receptors for TNF-α,and after binding to TNF-α,it can activate multiple signaling pathways such as NF-κB,PI3K/Akt,MAPK,STAT3,etc.,which are involved in the regulation of inflamma-tion,epidermal homeostasis,cellular apoptosis,cellular proliferation,cellular autophagy and other biological processes.It is suggested that TNFR2 is closely related to the occurrence and development of psoriasis.Previ-ous studies have often overlooked the role of TNFR2 in anti-TNF-α therapies;therefore,this article reviews the structure and signaling pathways of TNFR2,research advances in the disease,and its relationship with psoriasis to provide new references for exploring the pathogenesis and treatment of psoriasis.

Objective:To explore the changes in early postpartum pelvic floor muscle strength following the implementation of the new labor process.Methods:This retrospective cohort study selected 1 834 primiparous women with singleton, full-term pregnancies who delivered at Peking University First Hospital from February 2011 to March 2016 and had a pelvic floor re-examination 6-8 weeks postpartum. Out of these, 738 cases who followed the old labor process before 2014 were categorized as the old process group, and 1 096 cases who followed the new labor process after 2014 were categorized as the new process group. Basic data, childbirth information, and postpartum pelvic floor muscle strength of the two groups were compared. Data were statistically analyzed using t-test, Chi-square test, Mann-Whitney U test, Wilcoxon rank-sum test, and ordered multicategory logistic regression to assess the impact of the new and old labor process and other factors on pelvic floor muscle strength. Results:The total duration of labor, as well as the duration of the first, second, and third stages of labor, were longer in the new process group than in the old process group [549.0 min (360.0-768.0 min) vs. 482.5 min (328.0-635.0 min), 465.0 min (297.5-672.5 min) vs. 420.0 min (285.0-555.0 min), 42.0 min (24.0-74.0 min) vs. 27.0 min (18.0-45.0 min), with Z-value of－5.72,－3.95, and－9.28, all P<0.05). The rates of vaginal delivery and labor analgesia were higher in the new process group [72.1% (790/1 096) vs. 67.2% (496/738), χ2=7.41; 67.4% (739/1 096) vs. 53.4% (394/738), χ2=36.82; both P<0.05]. There were no statistically significant differences in the comparison of Class Ⅰ and Class Ⅱ muscle strength grades between the two groups (all P>0.05). Conclusion:There was no significant decline in early postpartum pelvic floor muscle strength following the implementation of the new labor process standards.

This study investigated the mechanism by which kaempferol(KAE) affected intervertebral disc degeneration(IDD) through the p38 mitogen-activated protein kinase(p38 MAPK) signaling pathway. Rats were randomly divided into five groups: control group, model group, low-dose KAE group, medium-dose KAE group, and high-dose KAE group. An IDD model was established by needle puncture of the caudal intervertebral discs. Four weeks post-surgery, the rats were administered KAE via gavage for 8 consecutive weeks. Magnetic resonance imaging(MRI) was performed, and samples were collected. In vitro, an inflammation model of nucleus pulposus cells(NPCs) induced by tumor necrosis factor-alpha(TNF-α) was constructed. Anisomycin was used to activate the p38 MAPK signaling pathway. NPCs were divided into blank, model, KAE, agonist, and KAE + agonist groups. After 1 day of treatment, cell proliferation activity was assessed using the CCK-8. Protein expression levels were determined by Western blot, and mRNA expression was measured by real-time quantitative polymerase chain reaction. Cell apoptosis was detected by TUNEL staining, and immunofluorescence staining was used to detect type Ⅱ collagen and matrix metalloproteinase 3(MMP3). In vivo results indicated significant improvement in the degree of IDD in the treatment groups compared to the model group, with the medium-dose group showing more pronounced therapeutic effects than the low-and high-dose groups. In vitro results demonstrated that KAE treatment significantly enhanced NPC proliferation activity, down-regulated the expression levels of Bcl-2-associated X protein(Bax), interleukin-6(IL-6), interleukin-17A(IL-17A), MMP3, and a disintegrin and metalloproteinase with thrombospondin motifs 5, and inhibited the phosphorylation of p38 MAPK pathway-related proteins. Activation of the p38 MAPK signaling pathway by anisomycin reduced the therapeutic effects of KAE. The study concluded that KAE could improve the proliferation activity of degenerated NPCs, reduce inflammation levels, and slow the progression of IDD in rats, and the mechanism was likely related to the regulation of the p38 MAPK signaling pathway.
Animals ; p38 Mitogen-Activated Protein Kinases/genetics* ; Kaempferols/pharmacology* ; Intervertebral Disc Degeneration/genetics* ; Rats ; Rats, Sprague-Dawley ; Male ; Apoptosis/drug effects* ; Cell Proliferation/drug effects* ; Nucleus Pulposus/drug effects* ; Signal Transduction/drug effects* ; Humans ; MAP Kinase Signaling System/drug effects*