[Purpose]To evaluate the liver and kidney safety of traditional Chinese medicine(TCM)compounds in the treatment of gastric cancer.[Methods]The clinical data of gastric cancer patients who attended in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2012 to February 2022 were collected.The results of liver and renal func-tion tests were rated according to National Cancer Institute-Common Terminology Criteria for Ad-verse Events(NCI-CTCAE)V5.0.The patients were divided into 4 groups:TCM group,TCM+chemotherapy/targeted/antivascular therapy group,TCM+TCM preparation group and TCM+chemotherapy/targeted/antivascular therapy+TCM preparation group,and the effects of TCM on liver and renal functions were analyzed.[Results]A total of 7 943 patients were included in the analysis,of which 2 941 cases receiving TCM ≥12 months,1 468 months ≥36 months,and 687 months≥60 months.The highest incidence rate of liver function abnormality was 13.71％,the highest in-cidence rate of grade 3/4 abnormality was 2.58％;the highest incidence of creatinine abnormality was 2.32％,the highest incidence rate of grade 3/4 abnormality was 0.37％in patients with differ-ent duration of taking TCM.Most of liver and renal function abnormalities occurred in the early stage of drug taking.The incidence of liver and renal function abnormalities in the TCM group was lower than that of the other three groups.The incidence of grade 3/4 abnormality for direct biliru-bin(DBIL)in the TCM group was 0.14％,for aspartate transaminase(AST)was 0.11％,for alka-line phosphatase(ALP)was 0.16％,for alanine aminotransferase(ALT)was 0.06％and for total bilirubin(TBIL)was 0.07％,and there was no grade 3/4 creatinine abnormality observed.The ab-normal liver and renal function indexes were not increased with the increase of the length of herbal medicine taking.[Conclusion]The study shows that long term taking TCM drugs and stan-dardized prescriptions for gastric cancer patients are safe.

BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

The paper reviews the evolution of the theory related to meridians and zangfu organs during the Warring States, Qin and Han dynasties, so as to reveal the rules and value of its development. By analyzing historical documents, especially Zubi Shiyimai Jiujing (Moxibustion Classics of Eleven Meridians of Legs and Arms), Yinyang Shiyimai Jiujing (Moxibustion Classic on Eleven Yin and Yang Meridians), Laoguanshan bamboo medical slips of Han Dynasty and lacquer figure of meridian points, the evolutionary stages, i.e. the germination, development, and maturity of meridian-zangfu theory, are explored. In the time of the Warring States, Qin and Han dynasties, the meridian-zangfu related theory was developed from the germination to the maturity. In the classics of the early time, Zubi Shiyimai Jiujing and Yinyang Shiyimai Jiujing demonstrated the preliminary relationship between meridians and zangfu organs, focusing on the physiological connection and pathogenesis of three yin meridians of foot and zangfu organs. In the literature of Laoguanshan bamboo medical slips of Han Dynasty and lacquer figure of meridian points, the physiological connection between the yin meridians of hand and foot, and five zang organs, as well as the related diseases were further clarified; additionally, the meridian-zangfu theory had been developed in the field of diagnosis and treatment. In the era of Chapter of Meridians in Lingshu (Miraculous Pivot), there were up to 31 descriptions relevant with the connection of meridian distribution and zangfu physiological functions. It marks the construction of the "circular" flow of meridians and the interior-exterior communication of zang and fu organs; and enriches the knowledge in diseases, diagnosis and treatment with meridians and zangfu organs involved. The review on the evolution of the meridian-zangfu theory is conductive to supplementing and improving the development history of this theory of early time, and further recognizing its development rules and value. The maturity of this theoretical system not only links the meridians with the five zang and six fu organs, but also provides an important theoretical basis for the diagnosis and treatment of traditional Chinese medicine.
Meridians ; Humans ; History, Ancient ; China ; History, Medieval ; History, 19th Century ; History, 20th Century ; History, 18th Century ; History, 17th Century ; History, 16th Century ; Medicine, Chinese Traditional/history*

Kinesin superfamily proteins(KIFs)are motor proteins that travel along microtubules and facilitate the transport of small biological molecules within cells.Various kinesin proteins are present in the dorsal root ganglion and spinal dorsal horn,where they modulate the excitability and sensitivity of sensory neurons,contributing to the occurrence and maintenance of pathological pain.Therefore,they represent potential therapeutic targets for the treatment of pathologi-cal pain.This review provides a comprehensive overview of the recent advancements in understanding the peripheral and central mechanisms of kinesins in the context of pathological pain,offering valuable insights for the potential development of analgesic medications targeting kinesin.

Kinesin superfamily proteins(KIFs)are motor proteins that travel along microtubules and facilitate the transport of small biological molecules within cells.Various kinesin proteins are present in the dorsal root ganglion and spinal dorsal horn,where they modulate the excitability and sensitivity of sensory neurons,contributing to the occurrence and maintenance of pathological pain.Therefore,they represent potential therapeutic targets for the treatment of pathologi-cal pain.This review provides a comprehensive overview of the recent advancements in understanding the peripheral and central mechanisms of kinesins in the context of pathological pain,offering valuable insights for the potential development of analgesic medications targeting kinesin.

[Purpose]To evaluate the liver and kidney safety of traditional Chinese medicine(TCM)compounds in the treatment of gastric cancer.[Methods]The clinical data of gastric cancer patients who attended in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2012 to February 2022 were collected.The results of liver and renal func-tion tests were rated according to National Cancer Institute-Common Terminology Criteria for Ad-verse Events(NCI-CTCAE)V5.0.The patients were divided into 4 groups:TCM group,TCM+chemotherapy/targeted/antivascular therapy group,TCM+TCM preparation group and TCM+chemotherapy/targeted/antivascular therapy+TCM preparation group,and the effects of TCM on liver and renal functions were analyzed.[Results]A total of 7 943 patients were included in the analysis,of which 2 941 cases receiving TCM ≥12 months,1 468 months ≥36 months,and 687 months≥60 months.The highest incidence rate of liver function abnormality was 13.71％,the highest in-cidence rate of grade 3/4 abnormality was 2.58％;the highest incidence of creatinine abnormality was 2.32％,the highest incidence rate of grade 3/4 abnormality was 0.37％in patients with differ-ent duration of taking TCM.Most of liver and renal function abnormalities occurred in the early stage of drug taking.The incidence of liver and renal function abnormalities in the TCM group was lower than that of the other three groups.The incidence of grade 3/4 abnormality for direct biliru-bin(DBIL)in the TCM group was 0.14％,for aspartate transaminase(AST)was 0.11％,for alka-line phosphatase(ALP)was 0.16％,for alanine aminotransferase(ALT)was 0.06％and for total bilirubin(TBIL)was 0.07％,and there was no grade 3/4 creatinine abnormality observed.The ab-normal liver and renal function indexes were not increased with the increase of the length of herbal medicine taking.[Conclusion]The study shows that long term taking TCM drugs and stan-dardized prescriptions for gastric cancer patients are safe.

Objective:To analyze the effects of vitamin D supplementation therapy on the levels of serum total immunoglobulin E (IgE) and specific IgE (sIgE), as well as T lymphocyte subsets in children with atopic dermatitis (AD).Methods:A retrospective study was conducted. A total of 103 children with AD who visited the Dermatology Department of Xi'an Children's Hospital from January 2023 to December 2024 were selected as the research subjects. They were divided into an observation group 52 cases and a control group 51 cases according to the treatment methods. Children in both the control group and the observation group received treatment with levocetirizine oral solution, and the observation group additionally received oral treatment with vitamin D drops. The general clinical data and clinical efficacy were compared between the two groups of children. The characteristics and differences of serum IgE (total IgE, sIgE of inhaled allergens, sIgE of ingested allergens) and T lymphocyte subsets [regulatory T lymphocyte (Treg cell), helper T lymphocyte 17 (Th17 cell), Th17 cell/Treg cell] before and after treatment were evaluated. The Pearson correlation coefficient was used to test the correlations among the observed indicators.Results:After treatment, the total effective rate in the observation group was higher than that in the control group: 92.3% (48/52) vs. 78.4% (40/51), with a statistically significant difference ( P<0.05). After treatment, the levels of serum total IgE, sIgE of inhaled allergens and sIgE of ingested allergens in the observation group were lower than those in the control group: (174.93 ± 18.78) kU/L vs. (194.04 ± 19.87) kU/L, (93.07 ± 17.52) kU/L vs. (101.38 ± 19.80) kU/L, (74.21 ± 16.11) kU/L vs. (86.20 ± 14.72) kU/L, with statistically significant differences ( P<0.05). After treatment, the Treg cell in the observation group was higher than that in the control group: (5.46 ± 0.41)% vs. (4.42 ± 0.24)%, while the Th17 cell and Th17 cell/Treg cell were both lower than those in the control group: (1.78 ± 0.30)% vs. (2.26 ± 0.25)%, 0.33 ± 0.06 vs. 0.51 ± 0.06, and the differences were statistically significant ( P< 0.05). Among all the enrolled children, after treatment, the total IgE ( r = - 0.48, P<0.001), sIgE of inhaled allergens ( r = -0.24, P = 0.016) and sIgE of ingested allergens ( r = - 0.32, P = 0.001) were negatively correlated with the Treg cell. The total IgE ( r = 0.38 and 0.50, P<0.001) and sIgE of ingested allergens ( r = 0.24 and 0.32, P = 0.013 and 0.001) were positively correlated with the Th17 cell and the Th17 cell/Treg cell. Conclusions:Vitamin D supplementation therapy can effectively reduce total IgE and sIgE levels in children with AD. Concurrently, it can ameliorate the Th17 cell/Treg cell imbalance, ultimately leading to improved treatment outcomes and prognosis for these children.

Objective:To analyze the effects of vitamin D supplementation therapy on the levels of serum total immunoglobulin E (IgE) and specific IgE (sIgE), as well as T lymphocyte subsets in children with atopic dermatitis (AD).Methods:A retrospective study was conducted. A total of 103 children with AD who visited the Dermatology Department of Xi'an Children's Hospital from January 2023 to December 2024 were selected as the research subjects. They were divided into an observation group 52 cases and a control group 51 cases according to the treatment methods. Children in both the control group and the observation group received treatment with levocetirizine oral solution, and the observation group additionally received oral treatment with vitamin D drops. The general clinical data and clinical efficacy were compared between the two groups of children. The characteristics and differences of serum IgE (total IgE, sIgE of inhaled allergens, sIgE of ingested allergens) and T lymphocyte subsets [regulatory T lymphocyte (Treg cell), helper T lymphocyte 17 (Th17 cell), Th17 cell/Treg cell] before and after treatment were evaluated. The Pearson correlation coefficient was used to test the correlations among the observed indicators.Results:After treatment, the total effective rate in the observation group was higher than that in the control group: 92.3% (48/52) vs. 78.4% (40/51), with a statistically significant difference ( P<0.05). After treatment, the levels of serum total IgE, sIgE of inhaled allergens and sIgE of ingested allergens in the observation group were lower than those in the control group: (174.93 ± 18.78) kU/L vs. (194.04 ± 19.87) kU/L, (93.07 ± 17.52) kU/L vs. (101.38 ± 19.80) kU/L, (74.21 ± 16.11) kU/L vs. (86.20 ± 14.72) kU/L, with statistically significant differences ( P<0.05). After treatment, the Treg cell in the observation group was higher than that in the control group: (5.46 ± 0.41)% vs. (4.42 ± 0.24)%, while the Th17 cell and Th17 cell/Treg cell were both lower than those in the control group: (1.78 ± 0.30)% vs. (2.26 ± 0.25)%, 0.33 ± 0.06 vs. 0.51 ± 0.06, and the differences were statistically significant ( P< 0.05). Among all the enrolled children, after treatment, the total IgE ( r = - 0.48, P<0.001), sIgE of inhaled allergens ( r = -0.24, P = 0.016) and sIgE of ingested allergens ( r = - 0.32, P = 0.001) were negatively correlated with the Treg cell. The total IgE ( r = 0.38 and 0.50, P<0.001) and sIgE of ingested allergens ( r = 0.24 and 0.32, P = 0.013 and 0.001) were positively correlated with the Th17 cell and the Th17 cell/Treg cell. Conclusions:Vitamin D supplementation therapy can effectively reduce total IgE and sIgE levels in children with AD. Concurrently, it can ameliorate the Th17 cell/Treg cell imbalance, ultimately leading to improved treatment outcomes and prognosis for these children.

Objective:To establish an ICP-MS method for the determination of 10 elemental impurities in meglu-mine(APIs).Methods:The samples were processed by closed high-pressure microwave digestion,and the con-tents of the Class 1 elemental impurities arsenic(As),cadmium(Cd),mercury(Hg)and lead(Pb),the Class 2 A elemental impurities cobalt(Co),nickel(Ni)and vanadium(V),and the Class 3 elemental impurities lithium(Li),antimony(Sb)and copper(Cu)were detected by ICP-MS with total quantification.Results:The linear correlation coefficients(r)of each elemental impurity were greater than 0.997.The recoveries of the spiked samples ranged from 93.6％to 116.8％with RSD values of the recoveries lower than 7.4％.RSD values of the precision were lower than 5.4％.The content of nickel in 11 batches of the samples was lower than the permissible daily exposure(PDE)of the impurities of the elements of category 2A in the elemental guideline of ICH Q3D(R2)for oral use but higher than that of PDE of the impurities of category 2A for injection.Conclusion:The method is sensitive and precise enough to accurately determine the levels of Class 1,2A and 3 elemental impurities in meglumine.Nine batches of meglumine were found to have a high risk of nickel residue.

Objective To construct a scientific and practical management model of the hospice and pal-liative care outpatient clinic and provide a reference for the operation and development of the outpatient clin-ic.Methods The basic framework of the whole process management model of hospice and palliative care outpa-tient clinic was determined preliminarily by literature analysis,qualitative interviews and experts group meet-ings.Two rounds of consultation were conducted among 18 experts in hospice and palliative care and medical-nursing combined outpatient service by the Delphi method.Results The questionnaire response rates of the two rounds of expert consultation were both 100%and the authority coefficients of the two rounds of expert consultation were 0.88 and 0.91,respectively.Finally,the whole process management model of hospice and palliative care out-patient clinic was constructed,which was composed of three first-level indicators including staff composition,work structure and effect evaluation,5 second-level indicators and 62 third-level indicators.Conclusion The construc-ted whole process management model is scientific,innovative and continuous,which can provide a reference for the operation and development of the hospice and palliative care outpatient clinic.