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 determine the pharmacological impact of hesperidin, the main component of Citri Reticulatae Pericarpium, on depressive behavior and elucidate the mechanism by which hesperidin treats depression, focusing on the gut-brain axis. METHODS: Fifty-four Sprague Dawley male rats were randomly allocated to 6 groups using a random number table, including control, model, hesperidin, probiotics, fluoxetine, and Citri Reticulatae Pericarpium groups. Except for the control group, rats in the remaining 5 groups were challenged with chronic unpredictable mild stress (CUMS) for 21 days and housed in single cages. The sucrose preference test (SPT), immobility time in the forced swim test (FST), and number in the open field test (OFT) were performed to measure the behavioral changes in the rats. Enzyme-linked immunosorbent assay was used to determine the levels of 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) in brain tissue, and the histopathology was performed to evaluate the changes of colon tissue, together with sequencing of the V3-V4 regions of 16S rRNA gene on feces to explore the changes of intestinal flora in the rats. RESULTS: Compared to the control group, the rats in the model group showed notable reductions in body weight, SPF, and number in OFT (P<0.01). Hesperidin was found to ameliorate depression induced by CUMS, as seen by improvements in body weight, SPT, immobility time in FST, and number in OFT (P<0.05 or P<0.01). Regarding neurotransmitters, it was found that at a dose of 50 mg/kg hesperidin treatment upregulated the levels of 5-HT and BDNF in depressed rats (P<0.05). Compared to the control group, the colon tissue of the model group exhibited greater inflammatory cell infiltration, with markedly reduced numbers of goblet cells and crypts and were significantly improved following treatment with hesperidin. Simultaneously, the administration of hesperidin demonstrated a positive impact on the gut microbiome of rats treated with CUMS, such as Shannon index increased and Simpson index decreased (P<0.01), while the abundance of Pseudomonadota and Bacteroidota increased in the hesperidin-treated group (P<0.05). CONCLUSION The mechanism responsible for the beneficial effects of hesperidin on depressive behavior in rats may be related to inhibition of the expressions of BDNF and 5-HT and preservation of the gut microbiota.
Animals ; Hesperidin/therapeutic use* ; Rats, Sprague-Dawley ; Depression/drug therapy* ; Male ; Stress, Psychological/drug therapy* ; Brain/metabolism* ; Brain-Derived Neurotrophic Factor/metabolism* ; Serotonin/metabolism* ; Gastrointestinal Microbiome/drug effects* ; Behavior, Animal/drug effects* ; Rats ; Brain-Gut Axis/drug effects* ; Chronic Disease ; Colon/drug effects*

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Male reproductive disorders have emerged as a global issue.Infertility affects 8％to 12％of couples of childbearing age.The sperm concentration and total sperm count of men have shown a significant downward trend over the past four decades,with a decrease of more than 50％.Male reproductive disorders are related to multiple factors.Circular RNA(circRNA)is a type of non-cod-ing RNA with covalently closed circular structures.It is involved in a variety of biological processes,including gene expression regula-tion,protein function regulation and epigenetic regulation.Studies have shown that there are differences in the expression of circRNA in the testicles and semen between infertile patients and healthy people,suggesting that circRNA is involved in the process of spermato-genesis,and its abnormal expression is associated with male infertility.This review takes the biological functions of circRNA as the starting point and summarizes the research progress of circRNA in male reproductive disorders.CircRNA has the potential to serve as a novel biomarker due to its conservative,special structure and tissue specificity,which provides a new strategy for the clinical diagnosis of male reproductive disorders.

Aim To explore the effect of liraglutide on myocardial injury in diabetic rats by activating Nrf2/HO-1 signaling pathway.Methods Forty rats were divided into thenormal group,model group,metformin group and liraglutide group.After modeling,the nor-mal group and model group did not intervene,the met-formin group was administrated with 250 g·kg-1 met-formin,and the liraglutide group was injected with 0.324 g·kg-1 liraglutide,once a day for a total of one month.Blood sugar and insulin levels were detec-ted by ELISA,and the pathological changes were ob-served by HE staining.The expression of Nrf2,HO-1,NLRP3,IL-1 β and caspase-1 were detected by West-ern blot and fluorescent quantitative PCR,respective-ly.Results Compared with the model group,the fasting glucose,NLRP3,caspase-1,IL-1β of the treatment group were reduced,while insulin,Nrf2,HO-1 levels increased(P＜0.05),of which the effects of liraglutide group was more obvious.Conclu-sions Liraglutide has a protective effect on diabetic myocardium,and its mechanism may be related to the regulation of Nrf2/HO-1 signaling pathway and the im-provement of pyroptosis.

Objective To analyze the methodology and reporting quality of acupuncture related randomized controlled trials(RCTs)in order to provide a basis for improving the design and reporting of acupuncture studies.Methods Literatures on RCTs included in acupuncture were obtained from two systematic reviews of acupuncture studies.Two reviewers were selected independently according to the exclusion criteria,and RoB2.0,CONSORT statement and STRICTA criteria were used to evaluate the methodology and report quality.Results 95 literatures on acupuncture RCTs were included,including 51 in Chinese and 44 in English,involving 38 diseases and 54 outcome indicators.CONSORT declared that there were 8 items with high reporting rate,15 items with low reporting rate and 2 items with medium reporting rate in the evaluation.The STRICTA criteria included 8 items with high reporting rate,4 items with low reporting rate,and 4 items with medium reporting rate.As for RoB2.0 bias risk assessment,11.6%of the literature in the overall bias area that served as a summary was high risk,50.5%was likely risk,and 37.9%was low risk.Conclusion The current published RCTs research methodology and report quality evaluation are not high,the future research should improve the scientific and rigorous program design,to form a transparent and complete research report.

Aim To explore the effect of liraglutide on myocardial injury in diabetic rats by activating Nrf2/HO-1 signaling pathway.Methods Forty rats were divided into thenormal group,model group,metformin group and liraglutide group.After modeling,the nor-mal group and model group did not intervene,the met-formin group was administrated with 250 g·kg-1 met-formin,and the liraglutide group was injected with 0.324 g·kg-1 liraglutide,once a day for a total of one month.Blood sugar and insulin levels were detec-ted by ELISA,and the pathological changes were ob-served by HE staining.The expression of Nrf2,HO-1,NLRP3,IL-1 β and caspase-1 were detected by West-ern blot and fluorescent quantitative PCR,respective-ly.Results Compared with the model group,the fasting glucose,NLRP3,caspase-1,IL-1β of the treatment group were reduced,while insulin,Nrf2,HO-1 levels increased(P＜0.05),of which the effects of liraglutide group was more obvious.Conclu-sions Liraglutide has a protective effect on diabetic myocardium,and its mechanism may be related to the regulation of Nrf2/HO-1 signaling pathway and the im-provement of pyroptosis.

Objective To analyze the methodology and reporting quality of acupuncture related randomized controlled trials(RCTs)in order to provide a basis for improving the design and reporting of acupuncture studies.Methods Literatures on RCTs included in acupuncture were obtained from two systematic reviews of acupuncture studies.Two reviewers were selected independently according to the exclusion criteria,and RoB2.0,CONSORT statement and STRICTA criteria were used to evaluate the methodology and report quality.Results 95 literatures on acupuncture RCTs were included,including 51 in Chinese and 44 in English,involving 38 diseases and 54 outcome indicators.CONSORT declared that there were 8 items with high reporting rate,15 items with low reporting rate and 2 items with medium reporting rate in the evaluation.The STRICTA criteria included 8 items with high reporting rate,4 items with low reporting rate,and 4 items with medium reporting rate.As for RoB2.0 bias risk assessment,11.6%of the literature in the overall bias area that served as a summary was high risk,50.5%was likely risk,and 37.9%was low risk.Conclusion The current published RCTs research methodology and report quality evaluation are not high,the future research should improve the scientific and rigorous program design,to form a transparent and complete research report.

To construct a high-quality Panax ginseng cDNA library, transcription factors binding to the P. ginseng PgD14 gene promoter were screened by yeast one-hybrid, and proteins interacting with the P. ginseng Pgpht2-1 gene-encoded protein were screened by yeast two-hybrid. In this study, root tissues of P. ginseng were used as materials. Gateway technology was used to construct the P. ginseng yeast one-hybrid library, and duplex-specific nuclease(DSN) homogenization technology was used to construct the P. ginseng yeast two-hybrid library. The pAbAi-PgD14-Pro961 vector was used as bait to screen candidate transcription factors that might bind to the PgD14 gene promoter from the yeast one-hybrid library, and the pGBKT7-Pgpht2-1 vector was used as bait to screen candidate proteins that might interact with the Pgpht2-1 gene-encoded protein from the yeast two-hybrid library. The yeast one-hybrid library had a size of 1.20×10~7 CFU, a recombination rate of 100%, and an average inserted fragment length of more than 1 000 bp. The yeast two-hybrid library had a size of 1.832×10~5 CFU, a recombination rate of 100%, and an average inserted fragment length of about 1 000 bp. The recombinant vectors pAbAi-PgD14-Pro961 and pGBKT7-Pgpht2-1 were transformed into Y1HGold and AH109 strains, respectively, and interacting proteins were screened by yeast one-hybrid and yeast two-hybrid. As a result, 54 transcription factors that could bind to the PgD14 gene promoter of P. ginseng and 42 proteins that may interact with the protein encoded by the Pgpht2-1 gene were identified. This study successfully constructed the P. ginseng yeast one-hybrid and yeast two-hybrid cDNA libraries, laying a foundation for subsequent studies on the functions of the P. ginseng PgD14, Pgpht2-1, and other genes.
Panax/metabolism* ; Two-Hybrid System Techniques ; Plant Proteins/metabolism* ; Gene Library ; Plant Roots/chemistry* ; Protein Binding ; Transcription Factors/metabolism* ; Promoter Regions, Genetic

Objective To investigate the correlation between the level of oxidative stress indicators in placental tissues and placental perfusion level in twin-to-twin transfusion syndrome (TTTS). Methods A total of 105 cases of dichorionic monoamniotic monozygotic twin pregnant women were included in the study. They were divided into control group of 90 cases and observation group of 15 cases based on whether TTTS occurred during pregnancy. The levels of oxidative stress indicators[malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX)]in placental tissues below the attachment points of the two umbilical cords in the two groups were detected. The maximum diameters of arterio-arterial (AA) anastomosis, veno-venous (VV) anastomosis, and arterio-venous (AV) anastomosis, as well as the difference ratio of placental tissue areas (PTD), were compared between the two groups. The correlation between the levels of oxidative stress indicators in placental tissues and placental perfusion level was analyzed. Results Compared with placental A and placental B in the control group, the MDA level in the placental tissues of the blood supply end and the blood recipient end in the observation group was increased, while the SOD and GSH-PX levels were decreased, and the maximum diameter of AA anastomosis was reduced, there were statistically significant differences (P < 0.05). In the observation group, the MDA level in the placental tissues of the blood supply end was higher than that of the blood recipient end, the SOD and GSH-PX levels were lower than those of the blood recipient end, and the maximum diameter of AA anastomosis was smaller than that of the blood recipient end, with statistically significant differences (P < 0.05). The maximum diameters of AV anastomosis and PTD in the observation group were larger than those in the control group (P < 0.05). There was no significant difference in the maximum diameter of VV anastomosis between the two groups (P>0.05). Pearson correlation analysis showed that there were no significant correlations of MDA, SOD and GSH-PX levels with the maximum diameter of AA anastomosis and PTD in the placental tissues of the control group (P>0.05).In the placental tissues of the blood supply end and the blood recipient end in the observation group, MDA levels showed a strong negative correlation with the maximum diameter of AA anastomosis and a strong positive correlation with the maximum diameter of AV anastomosis and PTD (P < 0.05). SOD and GSH-PX levels showed strong positive correlations with the maximum diameter of AA anastomosis and strong negative correlations with the maximum diamete of AV anastomosis and PTD (P < 0.05). Conclusion There is a significant imbalance of oxidative stress in placental tissues of TTTS pregnant women, and the decrease in antioxidant activity of placental tissues may be an important cause of placental perfusion injury.