Functional dyspepsia （FD） is a prioritized disease category where traditional Chinese medicine （TCM） demonstrates distinct therapeutic advantages. The current western medicine treatment for FD is mainly based on proton pump inhibitors and prokinetic agents， with digestive enzymes， probiotics and antidepressants serving as adjuvant medication， yet such therapies still have certain limitations. TCM treatment for FD includes oral administration of Chinese herbal formulas and Chinese patent medicines， as well as external TCM therapies such as acupuncture and moxibustion， acupoint application， hot medicinal compress therapy， rubbing with ointment， medicinal iontophoresis， auricular acupoint therapy and tui na （Chinese medical massage）. The combined treatment of FD with integrated TCM and western medicine can significantly improve clinical effectiveness and reduce adverse reactions. The common mechanisms underlying the therapeutic effects of both TCM and western medicine revolve around the core pathological processes of FD， mainly focusing on restoring gastrointestinal motility， regulating the levels of brain-gut peptides， modulating intestinal microecology， and ameliorating inflammatory status. The differential mechanisms lie in the precise targeting feature of western medicine versus the holistic-regulating and multi-target characteristics of TCM， and the two approaches exert a synergistic effect to enhance efficacy. This paper proposes to leverage the advantages of TCM in holistic regulation and the strengths of western medicine in targeted treatment， so as to provide personalized and comprehensive treatment regimens for FD patients.

Clinical trials represent a pivotal stage in the development of pharmaceutical drugs. Nevertheless， given the unique characteristics of traditional Chinese medicine （TCM） and the diagnostic and treatment principle of syndrome differentiation and treatment in TCM， the clinical evaluation techniques and methods that can comprehensively reflect the characteristics of TCM and are tailored to its specificities are still in need of refinement and innovation. This paper systematically summarizes the key techniques and methods for designing and evaluating the clinical research on the treatment of the spleen and stomach diseases with TCM from three aspects including clinical research design， evaluation， and platform construction， compares domestic and international research landscapes， and proposes for future directions. It is suggested that a multidimensional evaluation system integrating modern medicine and TCM theory should be established， and further innovation is needed in TCM research design and methodologies， leveraging intelligent devices and technologies powered by next-generation information technology to transform clinical data into high-quality TCM evidence. Moreover， standardized and shared platforms for TCM clinical data should be accelerated， so as to provide references for the design， implementation， and evaluation of future clinical research on the treatment of the spleen and stomach diseases with TCM.

ObjectiveTo investigate the material basis and mechanism of action of Tuoli Xiaodu San in treating ulcerative colitis （UC） by integrating transcriptomics， network pharmacology， and experimental validation. MethodsNetwork pharmacology was initially employed to screen the active components and potential mechanisms of Tuoli Xiaodu San for treating UC. A UC mouse model was established by dextran sulfate sodium （DSS） induction. The mice were divided into the following groups： normal， model， high-dose （11.3 g·kg^-1） Tuoli Xiaodu San， low-dose （5.7 g·kg^-1） Tuoli Xiaodu San， and positive control （mesalazine， 0.4 g·kg^-1）. Intragastric administration commenced on day 1 of modeling and continued for 7 consecutive days. The disease activity index （DAI） was assessed daily. Hematoxylin-eosin （HE） staining was used to observe colonic pathological changes. Serum levels of tumor necrosis factor-alpha （TNF-α）， interleukin-1 beta （IL-1β） and interleukin-6 （IL-6） were measured by enzyme-linked immunosorbent assay （ELISA）. Transcriptome sequencing was performed on mouse colonic tissues， and the results were integrated with network pharmacology findings for in-depth analysis of Tuoli Xiaodu San's potential mechanisms in treating UC. Finally， the expression of key genes and proteins in the identified signaling pathways were detected using Western blot and Real-time polymerase chain reaction （Real-time PCR）. ResultsThe combined analysis of network pharmacology and transcriptomics results showed that the multi-pathway network with phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway as its core was the key mechanism of Tuoli Xiaodu San in the treatment of UC. Tuoli Xiaodu San administration significantly ameliorated weight loss， diarrhea， and bloody stools in UC mice， reduced the DAI scores （P<0.05， P<0.01）， lowered the colonic histopathological scores （P<0.01）， alleviated colon shortening （P<0.01）， and downregulated serum levels of TNF-α， IL-1β， and IL-6 （P<0.05， P<0.01）. Molecular biology experiments confirmed that Tuoli Xiaodu San significantly inhibited the mRNA and protein expression， as well as the phosphorylation levels， of PI3K， Akt， and p65 in colonic tissues （P<0.05， P<0.01）. ConclusionTuoli Xiaodu San can regulate the multi-pathway network with PI3K/Akt as its core through multi-component synergy， thereby reducing colonic inflammatory damage and exerting a therapeutic effect on UC.

Objective To investigate the expression characteristics of poly(rC)-binding protein 1(PCBP1)in gastric cancer tissues and their clinical significances by bioinformatics analysis combined with experimental verification,and to identify its relationship with STIP1 homology and U-Box containing protein 1(STUB1).Specifically,this study aims to verify the expression patterns of PCBP1 and STUB1 in gastric cancer and determine their relationships with clinicopathological features by immunohistochemistry to provide a theoretical framework as well as potential intervention strategies for gastric cancer.Methods Data of PCBP1 expression in gastric cancer and adjacent tissues were obtained from TIMER 2.0 online analysis website.KEGG pathway enrichment analysis was performed using gastric cancer data(STAD)in the TCGA(the Cancer Genome Atlas)database,and its potential mechanism was determined.The main regulatory factor STUB1 was found in the fer-roptosis regulatory pathway.Subsequently,PCBP1 and STUB1 expressions in 33 cases of gastric cancer tissues and corresponding adjacent tissues were detected by immunohistochemistry.The collected cases were grouped according to different degrees of differentiation,age,gender,tumor size,depth of tumor invasion,TNM stage and pathological morphology.The positive expression rates of PCBP1 and STUB1 were observed.The correlation between the two proteins and the correlation between clinical and pathological features were analyzed by c2 test.Finally,the relationship between PCBP1 and STUB1 and malignancy of gastric cancer was further explored.Results Immunohistochemical results showed that the positive expression rate of PCBP1 in cancer tissues was 69.7%,which was significantly higher than that in adjacent tissues(48.5%).The positive expression rate of STUB1 in cancer tissues was 39.4%,which was lower than that in adjacent tissues(54.5%),statistically significant difference(P<0.05).The positive expression rate of PCBP1 was correlated with tumor differentiation,lymph node metastasis and Lauren classification(P<0.05),but not with patient's age,gender,depth of inva-sion,clinical stage,nerve infiltration,and intravascular tumor thrombus(P>0.05).The positive expression rate of STUB1 was correlated with tumor differentiation,depth of invasion,lymph node metastasis and Lauren classification(P<0.05).The Spearman correlation coefficient between PCBP1(cancer)and STUB1(cancer)was-0.413,with P=0.017(P<0.05),indicating that there was a significant negative correlation between them.Conclusion PCBP1 participates in the malignant progression of gastric cancer by regulating the main regulator STUB1 in the ferroptosis pathway.Theoretically,it provides a new insight into molecular mechanism as well as a potential therapeutic strategy for treating gastric cancer.

Objective:To compare the efficacies of endovascular therapy (EVT) and standard medical therapy in acute ischemic stroke (AIS) patients aged ≥85 years, and analyze the independent influencing factors for poor prognosis of AIS patients after EVT.Methods:Sixty-nine AIS patients aged ≥85 years admitted to Department of Neurology, Xi'an Third Hospital from January 2018 to April 2024, including 40 accepted EVT and 28 accepted standard medicinal therapy, were enrolled. Modified Rankin scale (mRS) was used to evaluate the prognosis of the patients 90 days after onset. General data, prognosis and complications between the EVT group and standard medical therapy group were compared. General data, treatment processes and complications between patients with good prognosis and poor prognosis in the EVT group were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for poor prognosis in AIS patients after EVT.Results:Compared with the standard medical therapy, the EVT group had significantly lower NIHSS score at discharge, greater improvement in NIHSS score (NIHSS score at admission-NIHSS score at discharge), lower mRS score 90 days after onset, higher good prognosis rate, lower mortality rate within 90 days of onset, and longer hospital stay ( P<0.05). In the EVT group, 11 patients (27.5%) had good prognosis and 29 patients (72.5%) had poor prognosis 90 days after onset. Compared with the good prognosis group, the poor prognosis group had significantly higher blood glucose level and lower Alberta Stroke Program Early CT Score (ASPECT) on admission ( P<0.05). Multivariate Logistic regression analysis showed that blood glucose on admission ( OR=2.363, 95% CI: 1.134-4.928, P=0.022) and ASPECT score on admission ( OR=0.273, 95% CI: 0.088-0.854, P=0.026) were independent influencing factors for poor prognosis in AIS patients after EVT. Conclusion:AIS patients aged ≥85 years received EVT have better prognosis compared with those accepted standard medical therapy; these patients with high glucose level and low ASPECT score on admission have poor prognosis.

OBJECTIVE To provide a reference for individualized treatment and pharmaceutical care for patients with breast cancer complicated with chronic kidney disease （CKD）. METHODS Clinical pharmacists participated in the anti-tumor treatment and pharmaceutical care for a breast cancer patient with CKD. Clinical pharmacists reviewed guidelines and literature to assist the clinical physician in formulating the initial neoadjuvant treatment plan （docetaxel+trastuzumab+paltuzumab） and provided monitoring recommendations for potential adverse drug reactions， such as vomiting， myelosuppression， renal impairment， cardiotoxicity. In response to the patient’s acute kidney injury after treatment， clinical pharmacists assisted the physician in analyzing the cause of the adverse reaction through causality assessment. Taking into account the patient’s preferences， docetaxel was substituted with paclitaxel （which did not require dose adjustment based on renal function）. The clinical pharmacists collaborated with the physician to establish a postoperative targeted therapy regimen （trastuzumab+pertuzumab）. Taking into account the patient’s positive estrogen receptor status， the clinical pharmacists recommended to initiate regular anastrozole administration after the completion of radiotherapy and undergo periodic bone density assessments. RESULTS The clinical physician accepted the suggestions from the clinical pharmacists. The patient successfully completed preoperative neoadjuvant chemotherapy and postoperative targeted therapy， and was discharged with medication （anastrozole）. During the treatment process， the patient did not experience adverse reactions such as myelosuppression， cardiotoxicity， or the occurrence of osteoporosis. CONCLUSIONS Clinical pharmacists analyzed and adjusted the preoperative and postoperative antitumor treatment plans based on the patient’s renal function. They promptly assessed the correlation between antitumor drugs and acute kidney injury， and actively implemented comprehensive pharmaceutical care to ensure medication safety for breast cancer patients with CKD.

Objective:To observe the current status of the use of personal protective equipment (PPE) by the dust working population, and to analyze the factors affecting its use, so as to provide a reference basis for proposing scientific intervention methods.Methods:From October to December 2023, random sampling method was used to conduct a self-designed Questionnaire on the Use of Personal Protective Equipment by the Dust Working Population. A total of 1216 dust workers were randomly selected from each city in Guangdong Province, and their mask wearing status was evaluated. The Wilcoxon rank sum test was used for comparison between measurement data sets, and the Chi-square test or Fisher exact probability method was used for counting data. A binary logistic regression model was used to analyze the factors affecting the use of PPE in dust workers.Results:The correct rate of wearing PPE in dust working group was 66.12% (804/1216). In univariate analysis, there were statistical significances in different knowledge score, wearing PPE to reduce exposure to dust particles, wearing occupational health protective equipment such as masks was uncomfortable, wearing occupational health protective equipment such as masks reduced work efficiency, attending pre-employment occupational health examination, attending occupational health examination on a regular basis, receiving occupational health training during work in the enterprise, being urged or reminded by workmates, supervisors, or family members to use PPE, the correct use of PPE when workers or shift leaders were exposed to dust particles, second-hand smoke inhalation, smoking, and alcohol consumption ( P<0.05). Multiple logistic regression results showed that gender ( OR=2.00, 95% CI: 1.48-2.72), knowledge score ( OR=1.18, 95% CI: 1.11-1.26), neutral attitude towards the discomfort of wearing occupational health protective equipment such as masks during work ( OR=1.64, 95% CI: 1.18-2.27), and participation in pre-job occupational health examination ( OR=0.23, 95% CI: 0.10-0.54) were the main influencing factors on the use of PPE to be worn correctly ( P<0.05) . Conclusion:The rate of correct wearing of PPE for dust working population still needs to be improved. Factors such as gender, knowledge score, neutral attitude towards the discomfort of wearing masks during work, and participation in pre-job occupational health examination may be the influencing factors on the use of PPE for dust working population.

Objective:To analyze the correct use of personal protective equipment (PPE) among noise-exposed workers and its influencing factors, providing reference information for noise intervention efforts.Methods:In September 2023, a stratified sampling method was employed. Based on the 2022 gross domestic product (GDP) rankings of cities in Guangdong Province, 21 prefecture-level cities were divided into economically developed and less developed groups. Two cities were randomly selected from each group, and 16 to 17 enterprises were randomly chosen from each city as study sites. Twenty workers were included from each enterprise as study subjects. A total of 1200 questionnaires were distributed and collected, and 1099 were valid, with an effective recovery rate of 91.6%. The correctness of hearing protector usage was evaluated according to the GB/T 23466-2009 "Guidelines for the Selection of Hearing Protectors", and the personal attenuation rating values of the workers' hearing protectors were measured. A self-designed Questionnaire on the Use of Hearing Protectors by Noise-Exposed Workers was used to investigate PPE-related usage. Multivariate logistic regression analysis was conducted to identify factors influencing the correct use of PPE.Results:A total of 429 (39.0%) noise-exposed workers were able to use PPE correctly during work. Multivariate logistic regression analysis showed that age, working hours, gender, occupational noise protection knowledge score, whether PPE was checked after use, and the frequency of peer supervision on PPE usage were significant factors influencing the effective use of PPE ( P<0.05) . Conclusion:The correct use of PPE by noise-exposed workers still needs to be improved. The level of occupational health education in enterprises should be enhanced to promote the correct use of PPE by noise-exposed workers.

Benzylisoquinoline alkaloids (BIAs) are a structurally diverse group of plant metabolites renowned for their pharmacological properties. However, sustainable sources for these compounds remain limited. Consequently, researchers are focusing on elucidating BIA biosynthetic pathways and genes to explore alternative sources using synthetic biology approaches. CYP80B, a family of cytochrome P450 (CYP450) enzymes, plays a crucial role in BIA biosynthesis. Previously reported CYP80Bs are known to catalyze the 3'-hydroxylation of (S)-N-methylcoclaurine, with the N-methyl group essential for catalytic activity. In this study, we successfully cloned a full-length CYP80B gene (StCYP80B) from Stephania tetrandra (S. tetrandra) and identified its function using a yeast heterologous expression system. Both in vivo yeast feeding and in vitro enzyme analysis demonstrated that StCYP80B could catalyze N-methylcoclaurine and coclaurine into their respective 3'-hydroxylated products. Notably, StCYP80B exhibited an expanded substrate selectivity compared to previously reported wild-type CYP80Bs, as it did not require an N-methyl group for hydroxylase activity. Furthermore, StCYP80B displayed a clear preference for the (S)-configuration. Co-expression of StCYP80B with the CYP450 reductases (CPRs, StCPR1, and StCPR2), also cloned from S. tetrandra, significantly enhanced the catalytic activity towards (S)-coclaurine. Site-directed mutagenesis of StCYP80B revealed that the residue H205 is crucial for coclaurine catalysis. Additionally, StCYP80B exhibited tissue-specific expression in plants. This study provides new genetic resources for the biosynthesis of BIAs and further elucidates their synthetic pathway in natural plant systems.
Cytochrome P-450 Enzyme System/chemistry* ; Benzylisoquinolines/chemistry* ; Hydroxylation ; Plant Proteins/chemistry* ; Alkaloids/metabolism* ; Stephania tetrandra/genetics*

Objective To explore the predictive value of serum homocysteine(Hcy)and stromal cell-derived factor(SDF)-1 levels in patients with acute ischemic stroke(AIS)for early neurological deterioration(EDN)after thrombolysis.Methods From April 2023 to July 2024,134 AIS patients treated in Jiaxing Second Hospital were selected as subjects.According to the National Institutes of Health stroke scale(NIHSS)evaluation 24 hours after thrombolysis,they were divided into EDN group(n=45)and non EDN group(n=89).Enzyme-linked immunosorbent assay(ELISA)method was applied to detect serum Hcy and SDF-1 levels.Pearson method was applied to analyze correlation.Logistic regression was applied to analyze and test the influencing factors.The receiver operating characteristic curve was applied to analyze the predictive value of indicators for EDN.Results The serum Hcy,SDF-1 levels,admission to puncture time,and baseline NIHSS score in EDN group were higher than those in non EDN group(P＜0.05).The levels of serum Hcy and SDF-1 in AIS patients were positively correlated with admission to puncture time and baseline NIHSS score(P＜0.05).Hcy and SDF-1 were independent influencing factors for EDN in AIS patients after thrombolysis(P＜0.05).The area under the curve of Hcy and SDF-1 combination for predicting EDN was 0.963,with sensitivities of 88.98％,and specificities of 94.43％,respectively.The prediction critical values of Hcy and SDF-1 were 25.31μmol/L and 159.10μg/L.Conclusion Serum Hcy and SDF-1 levels increase in AIS patients with EDN after thrombolysis.The combination of the two has important clinical predictive value for EDN.