In recent years， traditional Chinese medicine （TCM） has achieved significant progress in the treatment of inflammatory bowel disease （IBD）. A comprehensive literature search was conducted covering the period from January 1， 2010， to December 30， 2024， across Chinese databases including China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP China Science and Technology Journal Database， and the Chinese Biomedical Literature Service System， as well as international databases such as PubMed， Web of Science， and Embase. The clinical applications and mechanistic studies of TCM in IBD were systematically reviewed. The current status of TCM research on the etiology and pathogenesis of IBD， innovative clinical practices， and multimodal therapeutic approaches， including Chinese herbal formulas， single herbs or active compounds， acupuncture， herbal retention enema， and acupoint application， were summarized， together with their synergistic effects when combined with western medical treatments. The development and application of Chinese patent medicines for IBD are undergoing a profound transition from efficacy validation to mechanistic exploration. Mechanistic studies on the effects of TCM in IBD mainly focus on regulating gut microbiota homeostasis， repairing the intestinal mucosal barrier， and modulating intestinal immune balance. Furthermore， future research directions for TCM-based IBD management are proposed， including the establishment of TCM diagnostic and treatment models， expanding integrated applications of external and internal TCM therapies， innovating personalized treatment strategies， and advancing drug development. These efforts aim to provide insights for the standardized and precision-oriented development of TCM in the diagnosis and treatment of IBD.

OBJECTIVE To evaluate the anticoagulant efficacy and safety of nafamostat mesylate （NM） in the treatment of uremic patients at high risk of bleeding undergoing continuous veno-venous hemofiltration （CVVH） with different methods （pre- dilution and post-dilution）. METHODS A total of 130 uremic patients at high risk of bleeding who underwent CVVH treatment in the nephrology department of Chongqing University Three Gorges Hospital from July 2023 to September 2024 were selected. They were divided into pre-dilution group and post-dilution group according to the random number table method， with 65 cases in each group. Both groups of patients received CVVH treatment under NM anticoagulation. The pre-dilution group adopted the pre-dilution replacement method， while the post-dilution group adopted the post-dilution replacement method. The coagulation， pressure， and usage duration of the filter and dialysis circuit venous reservoirs were compared between the two groups. The changes in prothrombin time （PT）， prothrombin time-international normalized ratio （PT-INR）， activated partial thromboplastin time （APTT）， and fibrinogen （FIB） in the peripheral venous blood before the heparin pump and after the filter at 1， 4 and 7 h of CVVH treatment， as well as 20 min after the end of treatment， were compared between the two groups. The single-compartment urea clearance rate （spKt/V）， β2-microglobulin （β2-MG） clearance rate and the incidence of adverse reactions were duni2007@foxmail.com compared between the two groups. RESULTS Both the pre-dilution and post-dilution groups had 60 patients who completed the study. The incidence of grade Ⅱ-Ⅲ coagulation of the filter and venous reservoirs， as well as the number of patients with transmembrane and venous pressure alarm intervention in the post- dilution group were significantly higher or more than those in the pre-dilution group （P＜0.05）， while usage time of the filter and the pipeline in the post-dilution group was significantly shorter than that in the pre-dilution group （P＜0.05）. The APTT values before the heparin pump as well as PT and APTT values after the filter at 1 h， 4 h， and 7 h of CVVH treatment in the post-dilution group were significantly higher than those in the pre-dilution group （P＜0.001）. There were no significant differences in PT， PT- INR， APTT and FIB between the two groups of patients 20 min after the end of treatment （P＞0.05）. The spKt/v and β2-MG clearance rates in the post-dilution group were significantly higher than those in the pre-dilution group （P＜0.001）. There was no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS When NM is used as an anticoagulant in the CVVH treatment of uremic patients at high risk of bleeding， compared with the pre-dilution treatment method， the post-dilution treatment method has a higher incidence of filter and dialysis tubing venous reservoir， a shorter usage time of the filter and pipeline， and a greater impact on extracorporeal coagulation， but has a higher solute clearance rate. Clinically， different dilution methods can be selected according to the different treatment needs of patients.

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Personalized drug response prediction from molecular data is an important challenge in precision medicine for treating cancer. Computational methods have been widely explored and have become increasingly accurate in recent years. However, the clinical application of prediction methods is still in its infancy due to large discrepancies between preclinial models and patients. We present a novel disentangled synthesis transfer network (DiSyn) for drug response prediction specifically designed for transfer learning from preclinical models to clinical patients. DiSyn uses a domain separation network (DSN) to disentangle drug response related features, employs data synthesis technology to increase the sample size and iteratively trains for better feature disentanglement. DiSyn is pretrained on large-scale unlabeled cancer samples and validated by three datasets, The Cancer Genome Atlas (TCGA), Investigation of Serial Studies to Predict Your Therapeutic Response With Imaging And moLecular Analysis 2 (I-SPY2) and Novartis Institutes for Biomedical Research Patient-Derived Xenograft Encyclopedia (NIBR PDXE), achieving competitive performance with the state-of-the-art methods on cancer patients and mice. Furthermore, the application of DiSyn to thousands of breast cancer patients show the heterogeneity in drug responses and demonstrate its potential value in biomarker discovery and drug combination prediction.

Alzheimer's disease (AD) is regarded as a neurodegenerative disease, and it has been proposed that AD may be a systemic disease. Studies have reported associations between non-neurological diseases and AD. The correlations between AD pathology and systemic (non-neurological) pathological changes are intricate, and the mechanisms underlying these correlations and their causality are unclear. In this article, we review the association between AD and disorders of other systems. In addition, we summarize the possible mechanisms associated with AD and disorders of other systems, mainly from the perspective of AD pathology. Regarding the relationship between AD and systemic pathological changes, we aim to provide a new outlook on the early warning signs and treatment of AD, such as establishing a diagnostic and screening system based on more accessible peripheral samples.
Alzheimer Disease/therapy* ; Humans ; Brain/pathology*

Objective To explore the value of shear wave elastography(SWE)combined with cervical length(CL)measurement in predicting spontaneous preterm birth(SPB)at 20 to 27 weeks of gestation.Methods A total of 161 pregnant women with antenatal care and examination in the hospi-tal from January 2020 to June 2022 were selected as research objects.All pregnant women underwent CL measurement and SWE detection by ultrasound during 20 to 27 weeks of gestation to obtain CL and SWE parameters.The occurrence of SPB was followed up,and the correlations of CL and SWE param-eters with the occurrence of SPB were analyzed.Results Among the 161 pregnant women,34 pa-tients experienced SPB.There were significant differences in the external os strain(EOS),elastic contrast index(ECI),internal os strain(IOS),and hardness ratio(HR)of SWE parameters between pregnant women with and without preterm birth(P＜0.05).Similarly,there was a significant differ-ence in CL between the two groups(P＜0.05).Spearman correlation analysis showed that ECI,IOS and EOS were positively correlated with the occurrence of preterm birth(P＜0.05),while HR and CL were negatively correlated with the occurrence of preterm birth(P＜0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)for CL in predicting preterm birth was 0.800,with a cut-off value of 2.710 cm.Among the SWE parameters,the AUCs for ECI,HR,IOS and EOS in predicting preterm birth were 0.651,0.642,0.705 and 0.653 respectively,with cut-off values of 5.140,53.650％,0.320 and 0.330 respectively.The ROC curve showed that the AUC for predicting preterm birth by SWE parameters combined with CL was 0.813,which was significantly higher than the AUC for prediction by the combination of the four SWE parameters(P＜0.05).The sensitivity and specificity at the maximum Youden index were 0.794 and 0.732 respectively.Conclusion CL,as well as ECI,HR,IOS and EOS among SWE parameters,have certain value in predicting SPB in pregnant women at 20 to 27 weeks of gestation,especially when the five indicators are combined for prediction.The critical values for prediction are 2.710 cm,5.140,53.650％,0.320 and 0.330 respectively.

Objective To analyze the incidence,colonization pathways,and predictive factors of bacterial colonization of epidural analgesia catheters in patients with chronic pain.Methods A total of 150 patients with chronic pain who underwent continuous epidural catheterization(catheter in-dwelling time of 7 to 10 days)were selected as study subjects.Samples from three sites were collect-ed for bacterial culture.Clinical data of the patients were collected,and the positive rate of bacterial culture,characteristics of bacterial species distribution,and bacterial colonization pathways were ana-lyzed.The efficacy of predictive factors was assessed using the receiver operating characteristic(ROC)curve.Results The positive rates of bacterial culture in samples from the skin swabbing fluid around the puncture site,the subcutaneous segment of the catheter,and the catheter tip were 22.0％,7.3％,and 8.7％,respectively.Staphylococcus epidermidis was the predominant colonizing bacterial species.Spearman correlation coefficient analysis showed a significant correlation between the results of bacterial culture from the skin around the puncture site and catheter tip colonization(r=0.47,P＜0.01).ROC curve analysis revealed that the area under the curve of bacterial culture results from the skin around the puncture site in predicting catheter tip bacterial colonization was 0.843,with a sensitivity of 84.9％and a specificity of 84.6％.Conclusion Bacterial migra-tion along the catheter is the main pathway for catheter tip bacterial colonization,and the results of bacterial culture from the skin around the puncture site are an effective predictive factor for the risk of bacterial colonization.

Objective: To analyze the results of colorectal cancer screening among residents in Baoshan District, Shanghai Municipality from 2013 to 2021, so as to provide the basis for promoting colorectal cancer screening and prevention. Methods: Permanent residents aged 50 to 74 years in Baoshan District from 2013 to 2021 were selected as the screening population. The initial screening was conducted using a risk assessment form and fecal occult blood test. Positive results on either the risk assessment form or fecal occult blood test were considered positive for the initial screening. Participants with positive initial screening results were invited to undergo colonoscopy. The positive rate of the initial screening, colonoscopy compliance rate, and colonoscopy results were analyzed. Results: A total of 264 907 individuals underwent the initial colorectal cancer screening in Baoshan District from 2013 to 2021, with 65 333 individuals (24.66%) testing positive. Among them, the positive rate of the risk assessment form was 12.16%, and the positive rate of fecal occult blood test was 14.64%. A total of 14 473 individuals completed colonoscopy, with a compliance rate of 22.15%. A total of 1 284 precancerous lesions were detected, with a detection rate of 8.87%, and 386 cases of colorectal cancer were identified, with a detection rate of 2.67%. The positive rate of the initial screening, colonoscopy compliance rate, precancerous lesion detection rate, and colorectal cancer detection rate were higher in males than in females (25.55% vs. 24.06%, 23.12% vs. 21.45%, 11.60% vs. 6.74%, 3.62% vs. 1.93%, all P<0.05). With increasing age, the positive rate of the initial screening increased, the colonoscopy compliance rate decreased, the precancerous lesion detection rate and colorectal cancer detection rate increased (all P<0.05). From 2013 to 2021, the positive rate of the initial screening among residents showed a downward trend, while the colonoscopy compliance rate showed an upward trend (both P<0.05). Conclusions The detection rate of precancerous lesions in colorectal cancer was 8.87%, and the detection rate of colorectal cancer was 2.67% in Baoshan District from 2013 to 2021. Male and older individuals were the key populations for screening, and the colonoscopy compliance among residents needs to be improved.

Objective To investigate the clinical efficacy of Wuhu Decoction plus Tingli Dazao Xiefei Decoction combined with Budesonide atomization for the treatment of pediatric bronchopneumonia with phlegm-heat obstructing the lung syndrome,and to observe its effect on inflammatory response.Methods Seventy children with bronchopneumonia of phlegm-heat obstructing the lung type were randomly divided into an observation group and a control group,with 35 cases in each group.The children in the control group were treated with atomized inhalation of Budesonide suspension,and the children in the observation group were treated with Wuhu Decoction plus Tingli Dazao Xiefei Decoction orally on the basis of treatment for the control group.Both groups were treated for a period of 7 days.The changes in the traditional Chinese medicine(TCM)syndrome scores and the serum levels of inflammatory factors of interleukin 6(IL-6),procalcitonin(PCT),and hypersensitive C-reactive protein(hs-CRP)in the two groups were observed before and after the treatment.Moreover,the clinical efficacy,time for the relief of symptoms and signs,and the incidence of adverse reactions in the two groups were compared.Results(1)After 7 days of treatment,the total effective rate of the observation group was 91.43%(32/35),and that of the control group was 71.43%(25/35).The intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores of the children in both groups were significantly lower than those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the time for the relief of symptoms and signs such as wheezing,cough,lung rales,constipation and fever in the observation group was significantly shortened compared with that in the control group(P＜0.01).(4)After treatment,the serum IL-6,PCT and hs-CRP levels in both groups were significantly lower than those before treatment(P＜0.05),and the reduction in the observation group was significantly superior to that in the control group(P＜0.01).(5)The incidence of adverse reactions in the observation group was 5.71%(2/35)and that in the control group was 8.57%(3/35),while the difference was not statistically significant between the two groups(P＞0.05).Conclusion Wuhu Decoction plus Tingli Dazao Xiefei Decoction combined with Budesonide atomization exert certain effect for the treatment of pediatric bronchopneumonia with phlegm-heat obstructing the lung syndrome,which can effectively relieve the clinical symptoms and alleviate the inflammatory response of the children.

Objective To investigate the microstructural changes of temporal lobe epilepsy(TLE)in patients with sleep disorders based on diffusion kurtosis imaging(DKI).Methods This research prospectively included 38 TLE patients(case group)and 20 healthy controls(HC)(HC group).Participants used sleep questionnaires to evaluate their sleep status.All TLE patients were divided into groups with and without sleep disorders according to the diagnostic criteria and scale scores of sleep disorders.The mean kurtosis(MK),mean diffusivity(MD),and fractional anisotropy(FA)of the relevant region of interest(ROI)were measured by DKI sequence.The differences of sleep quality scores and DKI parameters between groups were further compared via independent samples t-test and one-way analysis of variance.Results The Epworth sleepiness scale(ESS),Athens insomnia scale(AIS),and Pittsburgh sleep qual-ity index(PSQI)scores of TLE patients with sleep disorders were significantly higher than those of HC group(P＜0.05).The FA and MK values in TLE patients were significantly lower than those in HC group,while the MD value of TLE patients were substan-tially higher than that of HC group(P＜0.05).The values of MK and FA in left TLE patients with sleep disorders were significantly lower than those of without sleep disorders(P＜0.05),while there was no significant difference in MD value between the two groups(P＞0.05).MK value of right TLE patients with sleep disor-ders was significantly lower than that of without sleep disorders(P＜0.05),however,there were no significant differences in MD and FA values between the two groups(P＞0.05).Conclusion Quantitative DKI analysis revealed differences in DKI parameters in TLE patients combined with sleep disorders,inferring a specific white matter fiber damage in this group and providing imaging data to support the personalized treatment and prognostic assessment of these patients.