Gastric ulcer （GU） is a high-incidence digestive system disease characterized pathologically by disruption of gastric mucosal integrity， with clinical features including a prolonged course and periodic recurrence. Modern medicine attributes its pathogenesis to the dynamic imbalance between aggressive and defensive factors，while traditional Chinese medicine （TCM） posits its development as closely linked to spleen deficiency. Current therapies combining acid suppressants and antibiotics face challenges such as high recurrence rates，poor mucosal healing，and adverse drug reactions. Long-term use may induce metabolic disturbances like hypergastrinemia and reduced intestinal microbiota diversity. Therefore，exploring safer and longer-lasting therapeutic strategies has become a critical focus. TCM has extensive clinical experience and unique advantages in GU prevention and treatment. Studies demonstrate that the classic formula Shenling Baizhu San exhibits therapeutic properties of "invigorating spleen and tonifying Qi to restore physiological balance and eliminating dampness and regulating middle energizer to unblock Qi movement"， enabling a holistic approach targeting both symptoms and root causes in GU with spleen deficiency as the core pathology by suppressing aggressive factors and strengthening defensive factors. Experimental research reveals its mechanisms involve enhancing the physicochemical barrier of the mucus layer，repairing epithelial barriers and microcirculation，modulating gastric acid secretion and gastrointestinal motility，and regulating microecological barriers and mucosal immunity. Clinical evidence confirms its synergistic effects in promoting ulcer healing，improving Helicobacter pylori eradication rates，and reducing recurrence risks. This review examined the etiology and pathogenesis of GU and systematically evaluated Shenling Baizhu San from three perspectives-clinical application，pharmacological effects， and experimental research-to provide insights for optimizing integrated traditional Chinese and Western medicine protocols and expanding its clinical applications.

ObjectiveTo investigate the reversal effect of Cordyceps sinensis extract on immunotherapy resistance of non-small cell lung cancer （NSCLC）. MethodsELISA， flow cytometry， and co-culture assays were performed to evaluate the effects of Cordyceps sinensis extract on cytokine secretion， proliferation， and tumor cell killing activity of Jurkat （JKT） cells. Furthermore， the therapeutic effect of Cordyceps sinensis extract on programmed cell death ligand 1 （PD-L1） resistant lung cancer was evaluated through in vivo experiments both alone and in combination with anti-PD-L1 monoclonal antibody. ResultsCordyceps sinensis extract enhanced the secretion of cytokines interferon gamma（IFN-γ）， tumor necrosis factor-alpha（TNF-α） and interleukin-2 （IL-2）in JKT cells， promoted cell proliferation （P=0.006）， and boosted their killing function against tumors （P＜0.001）. Compared with the control group， in vivo study demonstrated that Cordyceps sinensis extract monotherapy effectively inhibited the growth of PD-L1-resistant tumors ［tumor growth inhibition value （TGI）=26.1%， P=0.090］， while its combination with anti-PD-L1 antibody significantly reversed PD-L1 resistance （TGI=50.6%， P＜0.001）. ConclusionThis study provides certain data support for the activation of anti-tumor immunity by Cordyceps sinensis extract， and offers a new treatment strategy for enhancing anti-tumor immunity and reversing immune resistance in lung cancer.

Objective To compare the postoperative enhanced recovery outcomes of lobectomy performed under non-intubated video-assisted thoracic surgery (NIVATS) versus intubated video-assisted thoracic surgery (IVATS). Methods Computerized searches were performed in the following databases: China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Information, China Biomedical Literature Database (CBMdisc), Web of Science, Clinicaltrials.gov, The Cochrane Library, EMbase, and PubMed. We collected randomized controlled trials (RCTs) and observational studies comparing NIVATS and IVATS. The search period extended from the inception of each database to April 1, 2023. Two independent researchers screened the literature and assessed study quality. Results A total of 14 studies were included, comprising 4 RCTs, 7 retrospective cohort studies, and 3 propensity score matching studies, involving 1 840 patients. Meta-analysis results indicated that, compared to IVATS, NIVATS was associated with significantly shorter operative time [MD=–13.39, 95%CI (–20.16, –6.62), P<0.001], shorter length of hospital stay [MD=–0.81, 95%CI (–1.39, –0.22), P=0.005], shorter chest tube duration [MD=–0.73, 95%CI (–1.36, –0.10), P=0.02], shorter postoperative anesthesia recovery time [MD=–20.34, 95%CI (–26.83, –13.84), P<0.001], and shorter time to oral intake after surgery [MD=–5.68, 95%CI (–7.63, –3.73), P<0.001]. Furthermore, NIVATS showed a lower incidence of postoperative airway complications [OR=0.49, 95%CI (0.34, 0.71), P<0.001] and less total chest tube drainage volume [MD=–251.11, 95%CI (–398.25, –103.98), P<0.001], all contributing to significantly accelerated postoperative enhanced recovery for patients. Conclusion NIVATS is a safe and technically feasible anesthesia method in thoracoscopic lobectomy, which can to some extent replace IVATS.

Objective To explore serum periostein,interleukin (IL)-5,IL-8 and IL-13 expression levels in patients with allergic bronchopulmonary aspergillosis (ABPA) and their correlation with lung function. Methods 73 patients with ABPA admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2019 to December 2022 were selected as the case group,and 60 asthma patients during the same period were selected as the control group. ELISA was used to detect serum levels of Periodin,IL-5,IL-8 and IL-13. Pearson analysis was used to investigate the correlation between serum Periodin and lung function indicators. Multivariate Logistic regression analysis was used to investigate the effect of serum period on the occurrence of ABPA in patients with bronchial asthma,and the diagnostic value of serum Periodin for ABPA was evaluated by ROC curves. Results Compared with the control group,the serum levels of Periostin(97.64±28.05 ng/ml vs 57.39±22.78 ng/ml),IL-5(1.62±0.35 ng/L vs 0.59±0.31 ng/L),IL-8(79.22±10.26 ng/L vs 51.04±8.26 ng/L )and IL-13(1.59±0.43 ng/L vs 1.02±0.51 ng/L)in the case group increased(t=6.997～17.776),the total serum IgE,specific IgE positivity rate,eosinophil count and fractional exhaled nitric oxide (FeNO) levels in the case group increased(t=9.341～131.469),the percentage of forced expiratory volume in the first second to the expected value (FEV1％pred),and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) levels decreased(t=2.652,3.126),the differences were statistically significant(all P<0.05),respectively. Serum Periodin in ABPA patients was positively correlated with IL-5,IL-8,IL-13 and FeNO (r=0.539～0.695,all P<0.05),and negatively correlated with FEV1％ pred,FVC％ pred and FEV1/FVC (r=-0.657,-0.506,-0.582,all P<0.05). Compared with serum Periosin>68.35 ng/ml,bronchial asthma patients with serum Periodin 97.83～131.02 ng/ml and>131.02 ng/ml had a higher risk of ABPA,and the differences were statistically significant (all P<0.05),respectively .The area under the curve of combined diagnosis of ABPA with serum Periodin+IL-5+IL-8+IL-13+total IgE+specific IgE+eosinophils was better than that of single periodin and periodin combined with inflammatory factor diagnosis,the difference was statistically significant(Z=3.562,2.931,all P<0.05).Conclusion Serum Periostin is abnormally elevated in ABPA patients,which is closely related to lung function. Early detection can assist in clinical diagnosis of ABPA.

Objective To explore serum periostein,interleukin (IL)-5,IL-8 and IL-13 expression levels in patients with allergic bronchopulmonary aspergillosis (ABPA) and their correlation with lung function. Methods 73 patients with ABPA admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2019 to December 2022 were selected as the case group,and 60 asthma patients during the same period were selected as the control group. ELISA was used to detect serum levels of Periodin,IL-5,IL-8 and IL-13. Pearson analysis was used to investigate the correlation between serum Periodin and lung function indicators. Multivariate Logistic regression analysis was used to investigate the effect of serum period on the occurrence of ABPA in patients with bronchial asthma,and the diagnostic value of serum Periodin for ABPA was evaluated by ROC curves. Results Compared with the control group,the serum levels of Periostin(97.64±28.05 ng/ml vs 57.39±22.78 ng/ml),IL-5(1.62±0.35 ng/L vs 0.59±0.31 ng/L),IL-8(79.22±10.26 ng/L vs 51.04±8.26 ng/L )and IL-13(1.59±0.43 ng/L vs 1.02±0.51 ng/L)in the case group increased(t=6.997～17.776),the total serum IgE,specific IgE positivity rate,eosinophil count and fractional exhaled nitric oxide (FeNO) levels in the case group increased(t=9.341～131.469),the percentage of forced expiratory volume in the first second to the expected value (FEV1％pred),and forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) levels decreased(t=2.652,3.126),the differences were statistically significant(all P<0.05),respectively. Serum Periodin in ABPA patients was positively correlated with IL-5,IL-8,IL-13 and FeNO (r=0.539～0.695,all P<0.05),and negatively correlated with FEV1％ pred,FVC％ pred and FEV1/FVC (r=-0.657,-0.506,-0.582,all P<0.05). Compared with serum Periosin>68.35 ng/ml,bronchial asthma patients with serum Periodin 97.83～131.02 ng/ml and>131.02 ng/ml had a higher risk of ABPA,and the differences were statistically significant (all P<0.05),respectively .The area under the curve of combined diagnosis of ABPA with serum Periodin+IL-5+IL-8+IL-13+total IgE+specific IgE+eosinophils was better than that of single periodin and periodin combined with inflammatory factor diagnosis,the difference was statistically significant(Z=3.562,2.931,all P<0.05).Conclusion Serum Periostin is abnormally elevated in ABPA patients,which is closely related to lung function. Early detection can assist in clinical diagnosis of ABPA.

Fetal structural anomalies and birth defects are primarily caused by genetic variants such as chromosomal number abnormalities, copy number variations (CNV), single nucleotide variants (SNV), and small insertions and deletions (indel). Whole-genome sequencing (WGS) based on next-generation sequencing (NGS) as an emerging technology for genetic disease diagnosis can detect the aforementioned types of variants. In recent years, high-depth WGS (> 30×) for prenatal diagnosis has also become available, and proved to be practical for unraveling the genetic etiology of fetal developmental abnormalities. To fascilitate clinical practice, test development and preliminary implementation of WGS for diagnosing fetal structural anomalies, we have formulated a consensus over the application of WGS in prenatal diagnosis by compiling previously published consensuses, guidelines, and research findings to provide a guidance on data analysis, reporting recommendations, and consultation of prenatal WGS results.

Minimal residual disease (MRD), a crucial biomarker for assessing efficacy and predicting recurrence, refers to residual tumor cells remaining in the body of patients with hematological malignancies who achieved complete remission after treatment. This study aimed to conduct a retrospective analysis of the clinical diagnosis, treatment, and MRD monitoring of a pediatric patient with multiple acute B-lymphocytic leukemia relapses, alongside a review of relevant literature. In this case, Ig rearrangement based on next-generation sequencing (NGS) was more accurate in assessing the MRD level, compared with the traditional method of MRD detection, indicating the risk of earlier relapse and guided interventions in time. Additionally, NGS-MRD detected clonal evolution, providing new ideas to further investigate the intrinsic factors of disease development.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

ObjectiveTo observe the therapeutic effect of Qiwei Baizhusan（QWBZS） on diabetic encephalopathy（DE） rat model， and to explore the possible mechanism of QWBZS in the treatment of DE based on phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt）/glycogen synthase kinase-3β（GSK-3β） signaling pathway. MethodForty-eight SPF male Wistar rats were randomly divided into blank group（8 rats） and high-fat diet group（40 rats）. After 12 weeks of feeding， rats in the high-fat diet group were intraperitoneally injected with 35 mg·kg^-1 of 1% streptozotocin（STZ） for 2 consecutive days to construct a DE model， and rats in the blank group were injected with the same amount of sodium citrate buffer. After successful modeling， according to blood glucose and body weight， model rats were randomly divided into model group， low， medium and high dose groups of QWBZS（3.15， 6.3， 12.6 g·kg^-1）， combined western medicine group（metformin+rosiglitazone， 0.21 g·kg^-1）， with 6 rats in each group. The administration group was given the corresponding dose of drug by gavage， and the blank group and the model group were given an equal volume of 0.9% sodium chloride solution by gavage， 1 time/day for 6 weeks. Morris water maze was used to detect the spatial memory ability of DE rats. Fasting insulin （FINS） level was detected by enzyme-linked immunosorbent assay（ELISA） and insulin resistance index（HOMA-IR） was calculated. Hematoxylin-eosin（HE） staining was used to observe the morphological changes of hippocampus in rats， ELISA was used to detect the indexes of oxidative stress in hippocampal tissues， real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） was used to detect mRNA expression levels of PI3K， Akt， nuclear transcription factor-κB（NF-κB）， tumor necrosis factor-α（TNF-α） and interleukin-1β（IL-1β） in hippocampus， and Western blot was used to detect the protein expression of PI3K， Akt， phosphorylated（p）-Akt， GSK-3β and p-GSK-3β in hippocampus of rats. ResultCompared with the blank group， FINS and HOMA-IR values of the model group were significantly increased（P<0.01）， the path of finding the original position of the platform was significantly increased， and the escape latency was significantly prolonged（P<0.01）， the morphology of neuronal cells in hippocampal tissues was disrupted， the levels of reactive oxygen species（ROS） and malondialdehyde（MDA） in hippocampus of rats were increased， and the activity of superoxide dismutase（SOD） was decreased（P<0.05， P<0.01）， mRNA expression levels of PI3K and Akt were decreased（P<0.01）， mRNA expression levels of NF-κB， TNF-α and IL-1β were increased（P<0.05， P<0.01）， the protein expression levels of PI3K， p-Akt and p-GSK-3β were significantly decreased， and the protein expression of GSK-3β was significantly increased（P<0.01）. Compared with the model group， the FINS and HOMA-IR values of the medium dose group of QWBZS and the combined western medicine group were significantly decreased（P<0.01）， the path of finding the original position of the platform and the escape latency were significantly shortened（P<0.01）， the hippocampal tissue structure of rats was gradually recovered， and the morphological damage of nerve cells was significantly improved， the contents of ROS and MDA in hippocampus of rats decreased and the level of SOD increased（P<0.01）， the mRNA expression levels of PI3K and Akt were increased（P<0.01）， and the mRNA expression levels of NF-κB， TNF-α and IL-1β were decreased （P<0.05， P<0.01）， the protein expression levels of PI3K， p-Akt and p-GSK-3β were significantly increased（P<0.01）， and the expression of GSK-3β was significantly decreased（P<0.01）. ConclusionQWBZS can alleviate insulin resistance in DE rats， it may repair hippocampal neuronal damage and improve learning and cognitive ability of DE rats by activating PI3K/Akt/GSK-3β signaling pathway.

Objective To explore the effect of pristimerin combined with cisplatin on proliferation and apoptosis of nasopharyngeal carcinoma cells.Methods CCK-8 assay was used to examine the survival rate of HNE-1 and CNE-2Z cells following treatment for 24 h with different concentrations of pristimerin,cisplatin or their combination.The changes in colony formation ability,apoptosis,and intracellular reactive oxygen species(ROS)levels of the treated cells were analyzed using colony formation assay and flow cytometry.Western blotting was performed to detect the changes in protein expressions in the cells.The effects of pre-treatment with NAC on proliferation,apoptosis,and PI3K/AKT signaling pathway were observed in pristimerin-and/or cisplatin-treated cells.Results Both pristimerin and cisplatin significantly lowered the survival rate of HNE-1 and CNE-2Z cells(P<0.05).Compared with pristimerin or cisplatin alone,their combination more strongly inhibited survival and colony formation ability of the cells,increased cell apoptosis rate and intracellular ROS levels,upregulated the protein expressions of Bax,cleaved caspase-3,and cleaved PARP,and downregulated the protein expressions of Bcl-2,Mcl-1,PARP and p-PI3K and p-AKT(P<0.05).NAC pretreatment significantly attenuated proliferation inhibition and apoptosis-promoting effects of pristimerin combined with cisplatin,and partially restored the downregulated protein expressions of p-PI3K and p-AKT in HNE-1 and CNE-2Z cells with the combined treatment(P<0.05).Conclusion Pristimerin can enhance cisplatin-induced proliferation inhibition and apoptosis in nasopharyngeal carcinoma cells,the mechanism of which may involve ROS-mediated deactivation of the PI3K/AKT signaling pathway.