Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective The objective of this study was to explore the effect of knocking down CXCL8 on the efficacy of pacli-taxel chemotherapy in cervical squamous cell carcinoma and to investigate its potential mechanism of action.Methods The Hela cell model was used to specifically inhibit CXCL8 gene expression through lentivirus-mediated RNA interference(RNAi)technology.The optimal transfection conditions were HitransG P and a multiplicity of infection(MOI)of 100.The CCK-8 assay was used to screen the optimal intervention concentration of puromycin as 1.5μg/mL.The LV-CXCL8-RNAi(3 targets)and negative control lentivirus were transfected into cells under optimal transfection conditions and set up a blank control group.The qRT-PCR assay was used to select the sh-CXCL8-13 group lentivirus as the intervention sequence and virus for subsequent experiments.The experiments were divided into the blank control group,negative control group,sh-CXCL8 group,paclitaxel group,and sh-CXCL8+paclitaxel group.The prolifer-ative activity and invasive ability of cervical cancer cells were assessed by CCK-8 and cell invasion assays.The expression of CXCL8,Bcl2,Bax,and β-actin were detected by qRT-PCR and Western blot.Results Compared with the other four groups,the proliferative and invasive ability of Hela cells was significantly reduced in the sh-CXCL8+paclitaxel group,and the difference was statistically sig-nificant(P<0.01).The qRT-PCR results showed that the expression of CXCL8,Bcl2,PIK3CB,and Akt1 genes was significantly re-duced,and the expression of Bax gene was significantly increased in the sh-CXCL8+paclitaxel group.The difference between the groups was statistically significant(P<0.001).The results of Western blot showed that the expression of CXCL8,PIK3CB,and p-Akt1 proteins was reduced in the sh-CXCL8+paclitaxel group(P<0.05).Conclusion Knocking down CXCL8 can reduce the prolif-erative and invasive capacity of Hela cells,possibly by affecting the PI3K/Akt pathway to affect the drug sensitivity of Hela cells to paclitaxel.

OBJECTIVE: To evaluate the anti-hepatocellular carcinoma (HCC) activity of total alkaloids from Gelsemium elegans Benth. (TAG) in vivo and in vitro and to elucidate their potential mechanisms of action through transcriptomic analysis. METHODS: TAG extraction was conducted, and the primary components were quantified using high-performance liquid chromatography (HPLC). The effects of TAG (100, 150, and 200 µg/mL) on various tumor cells, including SMMC-7721, HepG2, H22, CAL27, MCF7, HT29, and HCT116, were assessed. Effects of TAG on HCC proliferation and apoptosis were detected by colony formation assays and cell stainings. Caspase-3, Bcl-2, and Bax protein levels were detected by Western blotting. In vivo, a tumor xenograft model was developed using H22 cells. Totally 40 Kunming mice were randomly assigned to model, cyclophosphamide (20 mg/kg), TAG low-dose (TAG-L, 0.5 mg/kg), and TAG high-dose (TAG-H, 1 mg/kg) groups, with 10 mice in each group. Tumor volume, body weight, and tumor weight were recorded and compared during 14-day treatment. Immune organ index were calculated. Tissue changes were oberseved by hematoxylin and eosin staining and immunohistochemistry. Additionally, transcriptomic and metabolomic analyses, as well as quatitative real-time polymerase chain reaction (RT-qPCR), were performed to detect mRNA and metabolite expressions. RESULTS: HPLC successfully identified the components of TAG extraction. Live cell imaging and analysis, along with cell viability assays, demonstrated that TAG inhibited the proliferation of SMMC-7721, HepG2, H22, CAL27, MCF7, HT29, and HCT116 cells. Colony formation assays, Hoechst 33258 staining, Rhodamine 123 staining, and Western blotting revealed that TAG not only inhibited HCC proliferation but also promoted apoptosis (P<0.05). In vivo experiments showed that TAG inhibited the growth of solid tumors in HCC in mice (P<0.05). Transcriptomic analysis and RT-qPCR indicated that the inhibition of HCC by TAG was associated with the regulation of the key gene CXCL13. CONCLUSION TAG inhibits HCC both in vivo and in vitro, with its inhibitory effect linked to the regulation of the key gene CXCL13.
Animals ; Apoptosis/drug effects* ; Liver Neoplasms/genetics* ; Carcinoma, Hepatocellular/genetics* ; Humans ; Alkaloids/therapeutic use* ; Gelsemium/chemistry* ; Cell Line, Tumor ; Cell Proliferation/drug effects* ; Mice ; Xenograft Model Antitumor Assays

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

OBJECTIVES: To investigate the dynamic changes in serum microRNA-15b (miR-15b) and vascular endothelial growth factor (VEGF) in preterm infants with mild or moderate-to-severe bronchopulmonary dysplasia (BPD), as well as their value in assessing short-term neurodevelopment. METHODS: A retrospective analysis was conducted on the medical data of 156 preterm infants with BPD who were admitted to the neonatal intensive care unit from January 2020 to February 2023. According to the severity of BPD, they were divided into a mild group (n=88) and a moderate-to-severe group (n=68). Serum levels of miR-15b and VEGF were measured on postnatal days 1, 7, 14, and 28. Repeated measures analysis of variance was used to assess the dynamic changes in serum levels of miR-15b and VEGF. The mediating effect of VEGF between miR-15b and short-term neurological development was tested and analyzed using the stepwise regression method and the Bootstrap method. Logistic regression analysis was used to identify factors influencing adverse neurodevelopmental outcomes. RESULTS: In the mild group, there was a significant reduction in the serum level of miR-15b and a significant increase in VEGF over time (P<0.05), while in the moderate-to-severe group, there was a significant increase in miR-15b and a significant reduction in VEGF over time (P<0.05). Serum miR-15b and VEGF levels were important factors influencing neurodevelopmental outcomes, showing independent correlations (P<0.001). The mediating effect analysis indicated that miR-15b indirectly affected short-term neurodevelopment by inhibiting VEGF expression [indirect effect: -0.705 (95%CI: -1.178 to -0.372)], with the indirect effect accounting for 54.36% of the total effect. CONCLUSIONS There are different changing trends in serum levels of miR-15b and VEGF in preterm infants with mild and moderate-to-severe BPD. miR-15b primarily influences neurodevelopment through VEGF.
Humans ; Bronchopulmonary Dysplasia/physiopathology* ; MicroRNAs/blood* ; Vascular Endothelial Growth Factor A/blood* ; Infant, Newborn ; Infant, Premature/blood* ; Female ; Male ; Retrospective Studies ; Child Development ; Nervous System/growth & development*

Objective To assess the expression of CXCL8 in cervical cancer and its association with clinicopathological features and therapeutic efficacy of patients.Methods Bioinformatic analysis was performed using The Cancer Genome Atlas and Genotype-Tissue Expression databases to compare CXCL8 expression between cervical cancer and normal tissues.R software(version 4.4.0)was used for data analysis,with the timeROC package applied to construct time-dependent receiver operating characteristic(ROC)curves for evalua-ting the prognostic predictive efficacy of CXCL8.The survival package with the survfit function was used to compare survival differences between CXCL8 high-and low-expression groups.Clinical data and tissue specimens were collected from 94 patients with cervical squa-mous cell cancer treated at The First Affiliated Hospital of Xinjiang Medical University between January 2017 and December 2021.Immu-nohistochemical staining was used to detect CXCL8 expression levels and analyze its correlation with clinicopathological characteristics,therapeutic efficacy,and prognosis.Results Bioinformatic analysis showed that CXCL8 was highly expressed in cervical cancer tissues than in normal tissues(P＜0.05).Time-dependent ROC curves and survival analyses showed that patients with high CXCL8 expression had significantly shorter overall survival than those with low CXCL8 expression(P＜0.001).Immunohistochemical results showed that CXCL8 expression in cervical cancer tissues was significantly higher than that in adjacent tissues(P＜0.000 1).Clinical correlation analy-sis revealed that CXCL8 expression levels were associated with treatment regimen(P＜0.001)and short-term therapeutic efficacy(P=0.017).Compared to the low-expression group,the high-expression group showed a significantly lower therapeutic efficacy and shorter overall survival(P＜0.05).Conclusion CXCL8 is highly expressed in cervical cancer tissues,and patients with high CXCL8 expression have poor prognosis.Thus,CXCL8 may be an effective target for assessing the prognosis and clinical treatment of cervical cancer.

Objective To assess the expression of CXCL8 in cervical cancer and its association with clinicopathological features and therapeutic efficacy of patients.Methods Bioinformatic analysis was performed using The Cancer Genome Atlas and Genotype-Tissue Expression databases to compare CXCL8 expression between cervical cancer and normal tissues.R software(version 4.4.0)was used for data analysis,with the timeROC package applied to construct time-dependent receiver operating characteristic(ROC)curves for evalua-ting the prognostic predictive efficacy of CXCL8.The survival package with the survfit function was used to compare survival differences between CXCL8 high-and low-expression groups.Clinical data and tissue specimens were collected from 94 patients with cervical squa-mous cell cancer treated at The First Affiliated Hospital of Xinjiang Medical University between January 2017 and December 2021.Immu-nohistochemical staining was used to detect CXCL8 expression levels and analyze its correlation with clinicopathological characteristics,therapeutic efficacy,and prognosis.Results Bioinformatic analysis showed that CXCL8 was highly expressed in cervical cancer tissues than in normal tissues(P＜0.05).Time-dependent ROC curves and survival analyses showed that patients with high CXCL8 expression had significantly shorter overall survival than those with low CXCL8 expression(P＜0.001).Immunohistochemical results showed that CXCL8 expression in cervical cancer tissues was significantly higher than that in adjacent tissues(P＜0.000 1).Clinical correlation analy-sis revealed that CXCL8 expression levels were associated with treatment regimen(P＜0.001)and short-term therapeutic efficacy(P=0.017).Compared to the low-expression group,the high-expression group showed a significantly lower therapeutic efficacy and shorter overall survival(P＜0.05).Conclusion CXCL8 is highly expressed in cervical cancer tissues,and patients with high CXCL8 expression have poor prognosis.Thus,CXCL8 may be an effective target for assessing the prognosis and clinical treatment of cervical cancer.

Objective The objective of this study was to explore the effect of knocking down CXCL8 on the efficacy of pacli-taxel chemotherapy in cervical squamous cell carcinoma and to investigate its potential mechanism of action.Methods The Hela cell model was used to specifically inhibit CXCL8 gene expression through lentivirus-mediated RNA interference(RNAi)technology.The optimal transfection conditions were HitransG P and a multiplicity of infection(MOI)of 100.The CCK-8 assay was used to screen the optimal intervention concentration of puromycin as 1.5μg/mL.The LV-CXCL8-RNAi(3 targets)and negative control lentivirus were transfected into cells under optimal transfection conditions and set up a blank control group.The qRT-PCR assay was used to select the sh-CXCL8-13 group lentivirus as the intervention sequence and virus for subsequent experiments.The experiments were divided into the blank control group,negative control group,sh-CXCL8 group,paclitaxel group,and sh-CXCL8+paclitaxel group.The prolifer-ative activity and invasive ability of cervical cancer cells were assessed by CCK-8 and cell invasion assays.The expression of CXCL8,Bcl2,Bax,and β-actin were detected by qRT-PCR and Western blot.Results Compared with the other four groups,the proliferative and invasive ability of Hela cells was significantly reduced in the sh-CXCL8+paclitaxel group,and the difference was statistically sig-nificant(P<0.01).The qRT-PCR results showed that the expression of CXCL8,Bcl2,PIK3CB,and Akt1 genes was significantly re-duced,and the expression of Bax gene was significantly increased in the sh-CXCL8+paclitaxel group.The difference between the groups was statistically significant(P<0.001).The results of Western blot showed that the expression of CXCL8,PIK3CB,and p-Akt1 proteins was reduced in the sh-CXCL8+paclitaxel group(P<0.05).Conclusion Knocking down CXCL8 can reduce the prolif-erative and invasive capacity of Hela cells,possibly by affecting the PI3K/Akt pathway to affect the drug sensitivity of Hela cells to paclitaxel.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

OBJECTIVE To optimize the simmering technology of Rheum palmatum from Menghe Medical School and compare the difference of chemical components before and after processing.METHODS Using appearance score,the contents of gallic acid,5-hydroxymethylfurfural (5-HMF),sennoside A+sennoside B,combined anthraquinone and free anthraquinone as indexes,analytic hierarchy process (AHP)-entropy weight method was used to calculate the comprehensive score of evaluation indicators;the orthogonal experiment was designed to optimize the processing technology of simmering R.palmatum with fire temperature,simmering time,paper layer number and paper wrapping time as factors;validation test was conducted.The changes in the contents of five anthraquinones (aloe-emodin,rhein,emodin,chrysophanol,physcion),five anthraquinone glycosides (barbaloin,rheinoside,rhubarb glycoside,emodin glycoside,and emodin methyl ether glycoside),two sennosides (sennoside A,sennoside B),gallic acid and 5-HMF were compared between simmered R.palmatum prepared by optimized technology and R.palmatum.RESULTS The optimal processing conditions of R.palmatum was as follows:each 80 g R.palmatum was wrapped with a layer of wet paper for 0.5 h,simmered on high heat for 20 min and then simmered at 140 ℃,the total simmering time was 2.5 h.The average comprehensive score of 3 validation tests was 94.10 (RSD<1.0％).After simmering,the contents of five anthraquinones and two sennosides were decreased significantly,while those of 5 free anthraquinones and gallic acid were increased to different extents;a new component 5-HMF was formed.CONCLUSIONS This study successfully optimizes the simmering technology of R.palmatum.There is a significant difference in the chemical components before and after processing,which can explain that simmering technology slows down the relase of R.palmatum and beneficiate it.