Objective To investigate the expression levels and clinical significance of B7 homolog 3(B7-H3),peroxiredoxin 1(PRDX1),and thioredoxin(TRX)in the serum and tissues of patients with ulcerative colitis(UC)and UC-associated colorectal cancer(UC-CRC).Methods A total of 108 patients with UC who underwent examination in our hospital between January 2019 and December 2023 were enrolled in the UC group.Additionally,108 patients with UC-CRC who were examined in our hospital were included in the UC-CRC group.Furthermore,108 individuals without any abnormalities detected during colonoscopy were recruited as the control group.The serum levels of B7-H3,PRDX1,and TRX were quantified using enzyme-linked immunosorbent assay(ELISA).The expression of B7-H3,PRDX1,and TRX in tissues from UC-CRC and UC patients was assessed by immunohis-tochemistry.The diagnostic performance of serum B7-H3,PRDX1,and TRX levels for UC-CRC was evaluated by constructing receiver operating characteristic(ROC)curves.Results Compared with the control group,the serum expression levels of B7-H3,PRDX1,and TRX in both the UC group and the UC-CRC group were significantly elevated in sequence(P<0.05).In comparison to the resting UC group,the serum expression levels of B7-H3,PRDX1,and TRX in the episodic UC group also increased significantly(P<0.05).Furthermore,compared with UC patients,the positive expression rates of B7-H3,PRDX1,and TRX in the tissues of UC-CRC patients were markedly higher(P<0.05).The combination of serum B7-H3,PRDX1,and TRX demonstrated the highest AUC for diagnosing UC-CRC patients,outperforming the individual diagnostic performance of each biomarker(Z combination-B7-H3=2.829,P=0.005,Z combination-PRDX1=2.544,P=0.011,Z combination-TRX=3.673,P<0.001).Conclusion B7-H3,PRDX1,and TRX are significantly overexpressed in both the serum and tissues of UC-CRC patients,and their combined evaluation holds potential as a diagnostic tool for detecting the development of UC-CRC.

Acupuncture is an ancient treatment method used in traditional Chinese medicine and has been popularized worldwide. Over the past decade, there has been an increase in the amount of acupuncture research, mostly comprised of randomized controlled trials (RCTs) that aimed to answer the question on the efficacy of acupuncture. However, poor methodology and low replicability in these acupuncture RCTs have resulted in uncertainty about the efficacy of acupuncture. In this review, current advancements and challenges in acupuncture RCTs, regarding the methodological aspects of randomization, blinding, sham acupuncture and quality of reporting, were discussed. While there have been advancements in various aspects, current acupuncture RCTs still face pressing issues such as inadequate randomization and blinding, unviable sham acupuncture controls, and poor reporting quality. Given these limitations, this review seeks to identify the methodological problems that are responsible for these problems and to suggest solutions that could help to overcome them so as to improve the quality of future studies evaluating the efficacy of acupuncture. Please cite this article as: Seetoh WS, Lim RQR, Xu RB, Sun MX, Zhang P, Wang MN. Advancements and challenges of acupuncture randomized controlled trials. J Integr Med. 2025; 23(4): 333-343.
Acupuncture Therapy ; Humans ; Randomized Controlled Trials as Topic/methods* ; Research Design

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective:To explore the incidence status,influencing factors and short-term prognosis characteristics of early onset coronary heart disease in women in Wansheng District of Chongqing,and to provide scientific basis for formulating regional prevention and treatment strategies.Methods:This study was a single-center retrospective study,100 coronary heart disease in women from January 2022 to December 2023 at Chongqing Wansheng Economic and Technological Development Zone People's Hospital were prospective selected,and they were divided into early onset group of 40 cases(≤ 65 years old)and late onset group of 60 cases(＞65 years old)based on their age of onset.Another 60 healthy women who underwent physical examinations during the same period to exclude coronary heart disease were selected as the control group.Univariate factor and multiple factor logistic regression analysis were used to identify independent risk factors for early onset coronary heart disease in women.Draw receiver operating characteristic(ROC)curve for the subjects,the efficacy of risk factors in predicting early onset coronary heart disease based on the area under the curve(AUC)of ROC curve were evaluated.Patients were followed up for 1 year to observe the occurrence of major adverse cardiovascular events(MACE).Result:Among 100 fcoronary heart disease in women,the early onset group accounted for 40.00％(40/100).Univariate analysis showed that age,hyperlipidemia history,smoking history,hypertension history,family history,diabetes history,total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)were related to the early onset coronary heart disease.Multivariate analysis showed that,hyperlipidemia history(OR=4.124,95％CI:2.343-7.217),smoking history(OR=3.564),hypertension(OR=3.253),family history(OR=2.981),diabetes history(OR=2.873)were independent risk factors.ROC curve analysis results showed that joint evaluation had the best predictive value,with AUC of 0.829,which was higher than the AUC of individual evaluation for each factor.The incidence of MACE in the early onset group(45.00％)was significantly higher than that in the late onset group(P＜0.05).Conclusion:Early onset coronary heart disease in women in Wansheng District of Chongqing is related to the hyperlipidemia history,smoking,hypertension history,family history and diabetes history.The incidence of MACE in early-onset patients followed up for 1 year is higher than that in late-onset patients.

Objective:To explore the effects of early vitamin D supplementation on the immune function of premature infants.Methods:A total of 150 premature infants admitted to Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to March 2023 were enrolled perspectively, they were divided into the intervention group (75 cases) and the control group (75 cases) by the random number table method. The control group received formula milk intervention, and the intervention group received early vitamin D supplementation treatment on the basis of the control group. The course of treatment was 14 d. The levels of serum 25-hydroxyvitamin D [25- (OH) D], immunoglobulin (Ig), T cell subsets, complement C3, C4, and serum interleukin (IL)-1β and IL-10 were compared between the two groups before and after intervention.Results:The level of serum 25- (OH) D in the intervention group at 14 d after intervention was higher than that in the control group, the level of IL-1β was lower than that in the control group: (30.13 ± 6.00) nmol/L vs. (26.84 ± 5.79) nmol/L, (0.54 ± 0.20) ng/L vs. (0.65 ± 0.23) ng/L, there were statistical differences ( P<0.05). The levels of CD 3+, CD 4+, complement C3, C4, and IL-10 in the intervention group were higher than those in the control group at 14 d after intervention: 0.692 ± 0.043 vs. 0.632 ± 0.038, 0.400 ± 0.027 vs. 0.369 ± 0.026, (0.98 ± 0.26) g/L vs. (0.84 ± 0.24) g/L, (0.20 ± 0.05) g/L vs. (0.16 ± 0.04) g/L, (13.82 ± 3.64) ng/L vs. (11.36 ± 2.93) ng/L, there were statistical differences ( P<0.05). There were no statistically significant differences in the levels of IgA, IgM and IgG between the two groups before and after intervention ( P>0.05). Conclusions:Early vitamin D supplementation can significantly improve T cell subsets and regulate IL-1β/IL-10 levels in premature infants.

Objective:To investigate the clinical effectiveness of vitamin D combined with conventional anti-infective therapy and formula feeding in the treatment of preterm infants with infectious diseases.Methods:A total of 150 premature infants with infectious diseases treated in Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January to December 2022 were prospectively selected as the study objects, and divided into the control group and the study group according to the admission sequence number, with 75 cases in each group. The control group was treated with routine anti-infection regimen and formula feeding, and the study group was combined with early vitamin D supplementation on the basis of the control group. Both groups were treated continuously for 4 weeks. Serum prealbumin (pre-Alb), 25-hydroxyvitamin D[25-(OH)D], immune indexes and inflammatory response indexes were compared between the two groups before and after treatment, and neonatal complications and adverse reactions were compared between the two groups.Results:After treatment, the levels of serum 25-(OH)D and pre-Alb in the study group were higher than those in the control group: (37.58 ± 4.02) nmol/L vs. (27.20 ± 3.75) nmol/L, (141.27 ± 16.79) mg/L vs. (132.83 ± 16.36) mg/L, there were statistical differences ( P<0.05). After treatment, the levels of serum complement C3, C4, immunoglobulin (Ig) M and IgG in the study group were higher than those in the control group : (0.92 ± 0.15) g/L vs. (0.77 ± 0.19) g/L, (0.18 ± 0.05) g/L vs. (0.15 ± 0.04) g/L, (0.24 ± 0.04) g/L vs. (0.22 ± 0.05) g/L, (8.07 ± 1.05) g/L vs. (7.68 ± 1.13) g/L, there were statistical differences ( P<0.05). After treatment, the serum levels of interleukin-2 (IL) in the study group was higher than that in the control group, while the levels of IL-4, amyloid A (SAA), soluble human tumor necrosis factor receptor 1 (sTNFR-1) and Toll-like receptor 4 (TLR4) in the study group were lower than those in the control group: (4.61 ± 1.14) pg/L vs. (3.81 ± 0.91) pg/L, (20.53 ± 2.61) pg/L vs. (23.97 ± 3.12) pg/L, (5.56 ± 1.78) mg/L vs. (7.24 ± 1.93) mg/L, (4.16 ± 1.27) mg/L vs. (6.08 ± 1.54) mg/L, (75.21 ± 7.39) mg/L vs. (81.42 ± 8.17) mg/L, there were statistical differences ( P<0.05). The incidence rates of neonatal pneumonia, necrotizing enterocolitis (NEC) and metabolic bone disease in the study group were lower than those in the control group: 1.33%(1/75) vs. 10.67%(8/75), 1.33%(1/75) vs. 10.67%(8/75), 0 vs. 9.33%(7/75), there were statistical differences ( P<0.05). Conclusions:Vitamin D supplementation can effectively maintain the nutritional status of premature infants with infectious diseases and improve the immune system function, regulate inflammation and reduce complications.

Objective To investigate the expression levels and clinical significance of B7 homolog 3(B7-H3),peroxiredoxin 1(PRDX1),and thioredoxin(TRX)in the serum and tissues of patients with ulcerative colitis(UC)and UC-associated colorectal cancer(UC-CRC).Methods A total of 108 patients with UC who underwent examination in our hospital between January 2019 and December 2023 were enrolled in the UC group.Additionally,108 patients with UC-CRC who were examined in our hospital were included in the UC-CRC group.Furthermore,108 individuals without any abnormalities detected during colonoscopy were recruited as the control group.The serum levels of B7-H3,PRDX1,and TRX were quantified using enzyme-linked immunosorbent assay(ELISA).The expression of B7-H3,PRDX1,and TRX in tissues from UC-CRC and UC patients was assessed by immunohis-tochemistry.The diagnostic performance of serum B7-H3,PRDX1,and TRX levels for UC-CRC was evaluated by constructing receiver operating characteristic(ROC)curves.Results Compared with the control group,the serum expression levels of B7-H3,PRDX1,and TRX in both the UC group and the UC-CRC group were significantly elevated in sequence(P<0.05).In comparison to the resting UC group,the serum expression levels of B7-H3,PRDX1,and TRX in the episodic UC group also increased significantly(P<0.05).Furthermore,compared with UC patients,the positive expression rates of B7-H3,PRDX1,and TRX in the tissues of UC-CRC patients were markedly higher(P<0.05).The combination of serum B7-H3,PRDX1,and TRX demonstrated the highest AUC for diagnosing UC-CRC patients,outperforming the individual diagnostic performance of each biomarker(Z combination-B7-H3=2.829,P=0.005,Z combination-PRDX1=2.544,P=0.011,Z combination-TRX=3.673,P<0.001).Conclusion B7-H3,PRDX1,and TRX are significantly overexpressed in both the serum and tissues of UC-CRC patients,and their combined evaluation holds potential as a diagnostic tool for detecting the development of UC-CRC.

Objective To explore the application efficacy of refined management on antimicrobial agents in a chest specialty hospital.Methods Multiple measures were implemented through perfecting management systems and processes,as well as conducting knowledge training,such as multi-dimensional specialized prescription reviewing,optimizing information systems,and implementing grid-based management of clinical pharmacist.A refined manage-ment mode for antimicrobial agents in a chest specialty hospital has been established.Antimicrobial management in-dicators for the whole hospital and each clinical specialty in 2023(before management)and 2024(after manage-ment)were analyzed.Results Compared with 2023,antimicrobial use rate among hospitalized patients in 2024 de-creased from 47.48％to 45.92％,and antimicrobial use density(AUD)decreased from 46.28 defined daily doses(DDDs)/(100 person·day)to 39.73 DDDs/(100 person·day).The ratio of antimicrobial cost to total drug cost decreased from 12.71％to 9.51％,and the per capita cost of antimicrobial use decreased from 1 344.18 Yuan to 975.52 Yuan.The use rate of prophylactic antimicrobial agents for class Ⅰ incision surgery increased from 84.48％to 89.52％,and the rationality rate increased from 69.25％to 94.53％.The management indicators of each clinical specialty improved significantly.Conclusion Through adopting a series of refined management measures,antimi-crobial management modes that are suitable for the actual situation of the hospital has been constructed,and obvious efficacy was achieved.Clinical application of antimicrobial agents is more standardized and rational.

Aim To explore the role of zinc transporter 6(SLC30A6)on the proliferation,migration and inva-sion capabilities of hepatocellular carcinoma(HCC)cell line Huh7,and to identify potential traditional Chi-nese medicine(TCM)small-molecule inhibitors targe-ting SLC30A6 from the China Natural Products Data-base(CNPD)using virtual screening techniques.Methods The expression levels,clinical characteris-ticsand prognostic value of SLC30A6 in HCC were pre-dicted based on TCGA and ICGC datasets.SLC30A6 was knocked down in Huh7 cells using lentiviral trans-fection.The effects on cell proliferation,migration,and invasion were assessed using CCK-8,EdU,wound heal-ing,and Transwell assays.The regulation of HCC cancer stem cell markers(CD44,CD133,CD90)by SLC30A6 was also examined.Based on the CNPD,a docking-based virtual screening strategy was employed,including high-throughput virtual screening,standard precision virtual screening,and high-precision virtual screening,to identify the potential drug candidates with high specificity and favorable drug-likeness.Results SLC30A6 expression was upregulated in HCC tissues.Higher SLC30A6 levels were associated with advanced pathological stages,histological grades,alpha-fetopro-tein(AFP)levels,vascular invasion,and poor progno-sis in HCC patients.SLC30A6 knockdown significantly inhibited the proliferation,migration,and invasion of Huh7 cells and reduced the levels of HCC cancer stem cell markers.Virtual screening identified six potential TCM small-molecule inhibitors.Conclusions SLC30A6 can regulate the proliferation,migrationand invasion of HCC cells.SLC30A6 may serve as a poten-tial prognostic biomarker and therapeutic target for HCC.

The renin-angiotensin-aldosterone system (RAAS) is crucial for regulating blood pressure and maintaining fluid balance, while clock genes are essential for sustaining biological rhythms and regulating metabolism. There exists a complex interplay between RAAS and clock genes that may significantly contribute to the development of various cardiovascular and metabolic diseases. Although current literature has identified correlations between these two systems, the specific mechanisms of their interaction remain unclear. Moreover, the interaction patterns under different physiological and pathological conditions need further investigation. This review summarizes the synergistic roles of the RAAS and clock genes in cardiovascular diseases, explores their molecular mechanisms and pathophysiological connections, discusses the application of chronotherapy, and highlights potential future research directions, aiming to provide novel insights for the prevention and treatment of related diseases.
Humans ; Renin-Angiotensin System/genetics* ; Cardiovascular Diseases/genetics* ; CLOCK Proteins/physiology* ; Animals