Dampness-heat syndrome of the spleen and stomach refers to the evil dampness-heat invading the spleen and stomach,the abnormal rise and fall of the middle jiaoqi machinery,dampness-heat depression and steaming,the physiological dysfunction of the spleen and stomach,with abdominal distention and distention,nausea and lethargy of the limbs,poor loose stool,red tongue and yellow greasy fur,and slippery pulse as the main symptoms of the syndrome,most common in digestive system diseases,among which chronic gastritis is the first.This paper summarized the research results in the past decade and related fields.In the mode of combination of disease and syndrome,based on the principle of corresponding prescription and syndrome,combined with the etiology and pathogenesis evolution of spleen and stomach damp-heat syndrome,the biological connotation of spleen and stomach damp-heat syndrome was explained from various aspects such as inflammation and immune disorders,gastrointestinal motivity disorders,water and humidity loss,endoplasmic reticulum function,and micro-ecological disorders.Enrich the research of the essence of syndrome.

Objective To investigate the regulatory mechanism of the central nervous system in patients with refractory overactive bladder (rOAB) using diffusion tensor imaging (DTI) and graph theory analysis. Methods A total of 43 rOAB patients (rOAB group) and 46 matched healthy controls (HC group) were recruited during May and Nov.2024. All participants were scanned with DTI, and surveyed with the overactive bladder symptom score (OABSS), and overactive bladder questionnaire (OAB-q). Their age, gender, height, weight, and educational years were collected.DTI plus graph theory analysis was employed to explore the alterations in global and local topological properties of the brain structural network in rOAB patients. Brain regions showing significant group differences in structural metrics [specifically, the right paracentral lobule (PCL.R) ]were further used as seed points for functional connectivity (FC) analysis. Correlations between the nodal clustering coefficient (NCp) of the identified region, FC strength, OABSS, and OAB-q score were investigated. Results The OABSS [8 (6,10) vs.0 (0,1) ]and OAB-q [71 (53,80) vs.20 (19,24) ]were higher in the rOAB group than the HC group (P<0.001). Graph theory analysis revealed no statistically significant differences in global network metrics between the two groups (P>0.05). However, the NCp was significantly higher in the PCL.R of rOAB group compared to HC group (P<0.05, FDR-corrected).FC analysis using the PCL.R as a seed region demonstrated significantly reduced FC value in the left cerebellar crus Ⅱ (Cerebelum_Crus2_L) of the rOAB group (P<0.05, FDR-corrected). Partial correlation analysis showed that the NCp of PCL.R was positively correlated with both OABSS (r=0.255, P=0.018) and OAB-q score (r=0.257, P=0.017). Conversely, the FC of Cerebelum_Crus2_L was significantly negatively correlated with OABSS (r=-0.545, P<0.001) and OAB-q score (r=-0.535, P<0.001). Conclusion Patients with rOAB exhibit distinct brain structural network alterations compared to healthy individuals, primarily manifestation in the NCp value of PCL.R increased, and the FC intensity of Cerebelum_Crus2_L is significantly weakened. These alterations in the topological properties of the structural network may be implicated in the pathogenesis of rOAB.

Objective:To explore the clinicopathological characteristics and prognosis of fumarate hydratase-deficient uterine leiomyoma (FH-dUL).Methods:Clinical data and follow-up information for 117 patients with FH-dUL diagnosed through surgical pathology and immunohistochemistry in the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2024, were collected. A control group of 130 patients with common uterine leiomyomas was also included. The differences between the two groups in clinical, imaging, and pathological characteristics were compared. Additionally, recurrence rates, fertility outcomes for FH-dUL patients, and the incidence of renal cancer in FH germline mutation carriers were monitored.Results:(1) Comparison of clinicopathological characteristics: the median age of 117 FH-dUL patients was 35 years, and the median age at first diagnosis of uterine leiomyomas was 29 years, both significantly younger than the control group (41 and 36 years; both P<0.01). The FH-dUL group showed significantly higher incidences of uterine myomectomy, multiple leiomyomas, diffusion restriction on pelvic magnetic resonance imaging diffusion weighted imaging, and typical pathological features (candelabra-like vessels, bizarre nuclei, cytoplasmic eosinophilic globules, perinuclear halo, cellular atypia) and higher ultrasound blood flow score (all P<0.05). Of the 30 FH-dUL patients who underwent genetic testing, 9 had germline mutations, 3 had somatic mutations, and 6 had mutations of unclear origin. Among the 9 FH gene germline mutation patients, 2 had already developed renal cell carcinoma. (2) Recurrence analysis: among the 56 patients who underwent uterine myomectomy, 22 (39.3%, 22/56) experienced recurrence during follow-up, compared to 12 (21.8%, 12/55) of the 55 patients in the control group, the difference between the two groups was statistically significant ( P=0.046). Multivariate binary logistic regression analysis showed that cellular leiomyomas ( OR=9.489, 95% CI: 1.740-51.755; P=0.009) and multiple uterine leiomyomas ( OR=10.709, 95% CI: 1.354-84.683; P=0.025) were significant risk factors for recurrence in FH-dUL. (3) Fertility analysis: among the 66 FH-dUL patients who underwent fertility-preserving surgery, 16 had the intention to have fertility desire, only 2 (2/16) completed their fertility plans during follow-up. Conclusions:Clinicopathological features and imaging features help to differentiate FH-dUL from common type uterine fibroids, but lack specificity, and the diagnosis of FH-dUL is based on immunohistochemistry. The recurrence rate after resection of FH-dUL is high, and cellular and multiple leiomyomas are important predictors of recurrence. It is crucial to perform genetic testing, genetic counseling, drug treatment to prevent recurrence, fertility guidance, and long-term comprehensive management after surgery for FH-dUL management.

Based on commonly used acupoints in the clinical acupuncture treatment of functional dyspepsia （FD）， this study systematically analyzes the therapeutic differences and synergistic effects between local and distal point selection. It also examines the suitability of primary acupoint selection for different FD subtypes， postprandial distress syndrome （PDS） and epigastric pain syndrome （EPS）. The findings suggest that a combination of local and distal acupoints may be more appropriate as primary points for PDS， whereas local acupoints alone may be more suitable for EPS. Additionally， the study explores the impact of various factors， such as stimulation techniques， needling order， intensity or stimulation parameters， and depth， on the efficacy of acupuncture. It concludes that the intrinsic properties of acupoints are the primary determinants of therapeutic direction. Other factors mainly influence the magnitude rather than the direction of the effect. Future research may further investigate how different acupoint combinations， local versus distal， affect the treatment outcomes of FD subtypes， providing new insights for clinical acupuncture prescriptions.

Background The neck, shoulders, and lower back are the primary affected areas of work-related musculoskeletal disorders. In manual tasks, combinations of hand functional height (defined as working height below the waist), awkward postures, and cognitive load are common risk factors. However, there is limited literature documenting how these factors specifically alter biomechanical load on the neck, shoulders, and lower back when working at hand functional height. Objective To explore quantitative differences in biomechanical load on the neck, shoulders, and lower back of workers performing manual tasks at hand functional height under different postures and cognitive load combinations. Methods A 3x2 within-subject design was implemented, with three postures (squat, kneeling, and stoop) and two levels of cognitive load (with cognitive load induced by a 2back task and without cognitive load). Ten male university students were recruited to perform a predetermined assembly task (a sequence of loosening and tightening screws) at hand functional height. Surface electromyography (sEMG) and 3D motion capture system were employed to assess the participants’ trunk biomechanical load in executing the tasks. Additionally, subjective perception, including fatigue, muscle pain, and cognitive load, were evaluated using scales. Results Significant variations in biomechanical load were observed across the three postures (P<0.05). The stoop posture exhibited the lowest muscle activation in most target muscles, except for the sternocleidomastoid, and showed the fastest decline in instantaneous median frequency (IMF) of the erector spinae, with a rate of (-0.050±0.008) Hz per unit time (0.128 s), and the greatest trunk flexion angle (35.14°±4.40°). Performing the task by squatting resulted in the highest muscle activation, especially in the upper trapezius, where maximum voluntary contraction percentage reached 20.07%±1.26%. In addition, the squatting posture also resulted in larger joint angles in the sagittal plane for the neck (−7.03°±2.70°), shoulders (60.20°±7.89°), and lower back (34.42°±4.20°). The kneeling posture showed intermediate muscle activation, the slowest IMF decline for the erector spinae in the lower back (−0.005±0.008) Hz per unit time (0.128s), and the joint angles were closest to neutral. The task performance results were also superior in the kneeling posture. Regarding cognitive load, no significant differences were found for most biomechanical indicators, except for subjective cognitive load scores, neck flexion, and shoulder external rotation angles. Conclusion In assembly tasks performed at hand functional height, kneeling results in moderate biomechanical load on the neck, shoulders, and lower back while also improves task performance compared to squatting and forward bending. Additionally, no significant effects of cognitive load under the 2back condition on biomechanical load are observed.

OBJECTIVE To compare the measures taken by China， the U.S. and Japan to adapt drug instructions to aging， and provide reference for the reform of elderly-friendly drug instructions in China. METHODS The relevant documents published by the official websites of National Medical Products Administration of China， the U.S. FDA， and Pharmaceuticals and Medical Devices Agency of Japan， were consulted. Additionally， relevant literature from comprehensive databases such as CNKI， Wanfang data， and Web of Science， as well as search engines， was reviewed to understand the measures taken by the above countries in elderly-friendly management process of drug instructions. The comparative analysis was conducted for elderly-friendly adaptations of drug instructions in China， the U.S. and Japan， and the suggestions were put forward for the reform of elderly-friendly drug instructions in China. RESULTS & CONCLUSIONS The measures taken by China， the U. S.， and Japan in the process of elderly- friendly management of drug labels had different emphases： China adopted large fonts and simplified drug instructions to alleviate the problem of the elderly being unable to read and understand drug instructions； the U.S. had set up a special section for the elderly in the drug instructions for special populations and issued the principles for writing information on medications for the elderly. The U. S. and Japan had established a classification management system for patient instructions and professional instructions， promoted structured electronic instructions， and built a unified electronic instructions platform. It is recommended that China incorporate elderly-specific medication information into the writing requirements of drug instructions， improve specific measures to encourage the reform of drug instructions suitable for the elderly， improve the accessibility and readability of electronic drug instructions， and build a drug instruction information disclosure platform to better ensure the safety of medication for the elderly.

Objective To systematically sort out the current situation of animal model construction and evaluation of damp-heat syndrome of spleen and stomach under the pattern of combining disease and evidence,references for optimizing the standardized research of this syndrome were provided.Methods The references in the past 20 years from CNKI,Wanfang,VIP,PubMed and other databases were searched to summarize and analyze the modeling ideas,evaluation systems and problems of the animal models of spleen-stomach damp-heat syndrome.Results Most of the existing models used high-fat and high-sugar feeds combined with hot and humid environment exposure,compound pathogenic microbial infection or chemical stimulation to construct the combined disease and evidence model.The model validity was evaluated by macroscopic signs,gastrointestinal function indexes,inflammatory factors,and intestinal bacterial flora,etc.However,there were still problems of insufficient stability of the model,and inconsistencies in the criteria for evaluation of the evidence.Conclusion The combination of disease and evidence model can better simulate the clinical characteristics of spleen and stomach damp-heat syndrome,but it is necessary to strengthen the construction of multimodal evaluation system and molecular mechanism research.The standardization of animal models can be promoted through the integration of multidisciplinary technology,which can provide a more accurate method for the modernization of traditional Chinese medicine research.

Objective:To explore the clinicopathological characteristics and prognosis of fumarate hydratase-deficient uterine leiomyoma (FH-dUL).Methods:Clinical data and follow-up information for 117 patients with FH-dUL diagnosed through surgical pathology and immunohistochemistry in the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2024, were collected. A control group of 130 patients with common uterine leiomyomas was also included. The differences between the two groups in clinical, imaging, and pathological characteristics were compared. Additionally, recurrence rates, fertility outcomes for FH-dUL patients, and the incidence of renal cancer in FH germline mutation carriers were monitored.Results:(1) Comparison of clinicopathological characteristics: the median age of 117 FH-dUL patients was 35 years, and the median age at first diagnosis of uterine leiomyomas was 29 years, both significantly younger than the control group (41 and 36 years; both P<0.01). The FH-dUL group showed significantly higher incidences of uterine myomectomy, multiple leiomyomas, diffusion restriction on pelvic magnetic resonance imaging diffusion weighted imaging, and typical pathological features (candelabra-like vessels, bizarre nuclei, cytoplasmic eosinophilic globules, perinuclear halo, cellular atypia) and higher ultrasound blood flow score (all P<0.05). Of the 30 FH-dUL patients who underwent genetic testing, 9 had germline mutations, 3 had somatic mutations, and 6 had mutations of unclear origin. Among the 9 FH gene germline mutation patients, 2 had already developed renal cell carcinoma. (2) Recurrence analysis: among the 56 patients who underwent uterine myomectomy, 22 (39.3%, 22/56) experienced recurrence during follow-up, compared to 12 (21.8%, 12/55) of the 55 patients in the control group, the difference between the two groups was statistically significant ( P=0.046). Multivariate binary logistic regression analysis showed that cellular leiomyomas ( OR=9.489, 95% CI: 1.740-51.755; P=0.009) and multiple uterine leiomyomas ( OR=10.709, 95% CI: 1.354-84.683; P=0.025) were significant risk factors for recurrence in FH-dUL. (3) Fertility analysis: among the 66 FH-dUL patients who underwent fertility-preserving surgery, 16 had the intention to have fertility desire, only 2 (2/16) completed their fertility plans during follow-up. Conclusions:Clinicopathological features and imaging features help to differentiate FH-dUL from common type uterine fibroids, but lack specificity, and the diagnosis of FH-dUL is based on immunohistochemistry. The recurrence rate after resection of FH-dUL is high, and cellular and multiple leiomyomas are important predictors of recurrence. It is crucial to perform genetic testing, genetic counseling, drug treatment to prevent recurrence, fertility guidance, and long-term comprehensive management after surgery for FH-dUL management.

Objective To systematically sort out the current situation of animal model construction and evaluation of damp-heat syndrome of spleen and stomach under the pattern of combining disease and evidence,references for optimizing the standardized research of this syndrome were provided.Methods The references in the past 20 years from CNKI,Wanfang,VIP,PubMed and other databases were searched to summarize and analyze the modeling ideas,evaluation systems and problems of the animal models of spleen-stomach damp-heat syndrome.Results Most of the existing models used high-fat and high-sugar feeds combined with hot and humid environment exposure,compound pathogenic microbial infection or chemical stimulation to construct the combined disease and evidence model.The model validity was evaluated by macroscopic signs,gastrointestinal function indexes,inflammatory factors,and intestinal bacterial flora,etc.However,there were still problems of insufficient stability of the model,and inconsistencies in the criteria for evaluation of the evidence.Conclusion The combination of disease and evidence model can better simulate the clinical characteristics of spleen and stomach damp-heat syndrome,but it is necessary to strengthen the construction of multimodal evaluation system and molecular mechanism research.The standardization of animal models can be promoted through the integration of multidisciplinary technology,which can provide a more accurate method for the modernization of traditional Chinese medicine research.

Dampness-heat syndrome of the spleen and stomach refers to the evil dampness-heat invading the spleen and stomach,the abnormal rise and fall of the middle jiaoqi machinery,dampness-heat depression and steaming,the physiological dysfunction of the spleen and stomach,with abdominal distention and distention,nausea and lethargy of the limbs,poor loose stool,red tongue and yellow greasy fur,and slippery pulse as the main symptoms of the syndrome,most common in digestive system diseases,among which chronic gastritis is the first.This paper summarized the research results in the past decade and related fields.In the mode of combination of disease and syndrome,based on the principle of corresponding prescription and syndrome,combined with the etiology and pathogenesis evolution of spleen and stomach damp-heat syndrome,the biological connotation of spleen and stomach damp-heat syndrome was explained from various aspects such as inflammation and immune disorders,gastrointestinal motivity disorders,water and humidity loss,endoplasmic reticulum function,and micro-ecological disorders.Enrich the research of the essence of syndrome.