Objective On the basis of the theory of the tumor metastatic state, this work aims to explore the metastasis trajectories and peripheral immune response patterns in patients with non-small cell lung cancer (NSCLC) receiving vital qi-strengthening and toxin-eliminating therapy (Fuzheng Juandu) and reveal the value of peripheral immunity in assessing vital qi deficiency during metastasis. Methods A retrospective study design was adopted. Patients with NSCLC admitted from January 1, 2018, to October 31, 2025 were enrolled. Data on metastasis status and peripheral immune indices were collected at the follow-up time points of one, two, three, and five years. Group-based trajectory modeling was used to fit metastasis trajectories, and the independent predictors of trajectory grouping were analyzed through multifactor and multiclassification logistic regression. Results A total of 184 patients with NSCLC were included, and three different groups of metastasis trajectories were identified, namely, the low-risk stable (46.74%, n=86), low-risk rising (13.59%, n=25), and high-risk stable (39.67%, n=73) groups. Univariate analysis revealed substantial differences in peripheral immune indices among the three trajectory groups. Multivariate analysis showed that TNM stage, absolute neutrophil count, lymphocyte count, absolute monocyte count, platelet volume, SAA:CRP ratio, and NLR were independent predictors of the low-risk rising group, whereas TNM stage, absolute monocyte count, basophil count, SII, and NLR were independent predictors of the high-risk stable group. Conclusion Under Fuzheng Juandu therapy, patients with NSCLC exhibit three distinct metastasis trajectories, each corresponding to a specific peripheral immune response pattern. Elucidating these peripheral immune response patterns may facilitate the objective quantification of the degree of vital qi deficiency, prediction of future metastasis risk, and providing an important reference for the individualized clinical implementation of Fuzheng Juandu therapy.

Objective:To investigate the association between peripheral immune function status and lung cancer metastasis,and to identify peripheral blood immune biomarkers for'Deficiency of Vital Qi'assessment in lung cancer metastasis.Methods:A retrospective analysis was conducted on peripheral blood immune markers collected before treatment from lung cancer patients admitted into Shanghai Municipal Hospital of Traditional Chinese Medicine,affiliated to Shanghai University of Traditional Chinese Medicine,between March 2023 and April 2025.Patients were categorized into the non-metastatic and the metastatic groups based on the presence of distant metastasis,and the differences in the expressions of immune cells and cytokines between groups were compared.Peripheral blood immune markers with P<0.05 in univariate analysis were incorporated into a multivariate binary logistic regression model to identify independent predictors of lung cancer metastasis.Results:A total of 193 lung cancer patients were included(101 in the non-metastatic group and 92 in the metastatic group).There were no statistically significant differences between the two groups in terms of gender,age,smoking history,drinking history,or pathological type(all P>0.05).Univariate analysis revealed significant differences in multiple immune markers between the non-metastatic and metastatic groups(all P<0.05),including:lymphocyte count,CD3+,CD4+,and CD8+T,CD19+B cells,absolute counts of CD3-CD16+CD56+NK cells,percentages of Treg cells,CD8+CD28+Treg cells,G-MDSC,and CD3-CD16+CD56+dim NK cells,and levels of cytokine IL-1β,IL-6,and IL-10.Binary logistic regression analysis of differential indicators suggested that the percentage of Treg cells and CD8+CD28+Treg cells in peripheral blood were independent predictors of distant metastasis in lung cancer(OR=1.193,95%CI[1.047,1.36],P<0.01;OR=0.978,95%CI[0.957,0.999],P<0.05).Conclusion:Peripheral blood immune dysfunction is the biological basis for'qi deficiency'in lung cancer metastasis.This study quantitatively demonstrates the correlation between peripheral immune function status and lung cancer metastasis,providing empirical evidence for the theories of'qi deficiency and hidden toxicity'and'metastatic state of tumors'.

Objective To systematically evaluate the efficacy of different analgesic methods in re-lieving the pain in hip and femoral shaft fractures patients during spinal anesthesia position by using network meta-analysis.Methods The articals of randomized controlled trials(RCTs)that analgesia was performed in patients with hip and femoral shaft fractures during the spinal anesthesia position placement were retrieved from the following database from the establishment of the database to August 2022,PubMed,the Cochrane Library,Web of Science,EMbase,China Biology Medicine(CBM),CNKI,VIP,and Wanfang databases.Literature screening,data extraction and bias risk assessment were conducted by two researchers separately.Stata 17.0 and RevMan 5.3 software were used for statistical analysis.Results A total of 28 RCTs with 1 773 patients were included.The surface under the cumulative ranking(SUCRA)curve showed that and PENG block(94.4%)had the best effect on reducing the VAS pain score of placement position,followed by FIBcombinedwith IVA(83.8%)and FIB(71.1%),and PENG block(98.2%)had the best effect on reducing VAS pain score during spinal anesthesia,followed by FIB(71.1%)and FNB(55.6%),and PENG block(84.1%)had the best effect on shortening the time of spinal anesthesia operation,followed by FNB(70.7%)and FIB(68.5%),and PENG block(99.1%)had the best effect on improving the quality of positioning,followed by FIB(73.1%)and FNB(52.9%).Conclusion Nerve blocks or the combina-tion with IVA can reduce pain scores during position placement and spinal anesthesia,shorten anesthesia operation time,and improve quality of position placement in patients with hip and femoral shaft fractures.PENG block has the best analgesic effect in patients with hip or femoral shaft fractures during positioning and spinal anesthesia.

Objective To systematically evaluate the efficacy and safety of electroacupuncture(EA)in the treatment of postoperative nausea and vomiting(PONV)after gynecological surgery.Methods PubMed,Cochrane Library,Web of Science,Embase,China national knowledge infrastructure(CNKI),Wanfang database,and China biomedical literature database(CBM)were systematically searched.The re-trieval period was from the establishment of the database to December 2022.Relevant randomized controlled trials on EA for the treatment of PONV in gynecological surgery were collected.RevMan 5.3 software was used for meta-analysis.Results Fourteen randomized controlled trials were accommodated,including 958 patients,477 patients in the EA group and 481 patients in the control group.Compared with the control group,the incidence of PONV was significantly lower in group EA at 0-48 hours postoperatively(RR=0.55,95％CI 0.47 to 0.65,P＜0.001),and the PONV scores were significantly lower in the postopera-tive period within 48 hours in group EA(MD=-0.40 scores,95％CI-0.65 to-0.16 scores,P=0.004),the incidence of postoperative remedial antiemetic were significantly lower(RR=0.28,95％CI 0.16 to 0.51,P＜0.001).Conclusion EA can reduce the incidence of PONV and the incidence of re-medial antiemetic after gynecologic surgery.

Objective To systematically evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)in the treatment of postoperative nausea and vomiting(PONV)after laparoscopic non-gastrointestinal surgery.Methods Databases such as PubMed,Cochrane library,Web of Science,Embase,CNKI,Wanfang,and Chinese biomedical database(CBM)were searched to find and screen ran-domized controlled trials(RCTs)of TEAS in the prevention and treatment of PONV after laparoscopic non-gastrointestinal surgery.The retrieval time was from the establishment of the database to July 2023.Meta-a-nalysis was performed using RevMan 5.3 software.Results Twenty-two RCTs involving 3 538 patients were included,including 1 799 in the TEAS group and 1 739 in the control group.The results of meta-analysis showed that the total incidence of PONV in the TEAS group was significantly lower than that in the control group 0-24 hours after operation(RR=0.54,95％CI 0.44-0.68,P＜0.001),and the incidence of postoperative remedial antiemetic was significantly reduced(RR=0.54,95％CI 0.38-0.77,P＜0.001).There was no significant difference in the incidence of postoperative acupoint stimulation-related adverse reactions between the two groups(RR=0.62,95％CI 0.15-2.51,P=0.500).Conclusion TEAS has good clinical efficacy and safety in the treatment of PONV after laparoscopic non-gastrointestinal surgery.

To investigate the detection threshold of Treponema pallidum specific antibody method by chemiluminescent immunoassay (CLIA) in Siemens ADVIA Centaur XP for Syphilis serological test, and compare with the results derived from CMIA, TP-WB and TPPA method. The result can serve as reference for the application of CLIA. In total 30 887 samples screened by Treponema pallidum specific antibody method were collected by Abbott architect i2000 CMIA from July 2018 to July 2019 in Yanda Hospital of Hebei Province. We selected 153 patients with the ratio of sample absorbance to critical value (S/CO) of 1-9 by CMIA screening of Treponema pallidum specific antibody as the research objects. The reverse sequence of syphilis serological detection was adopted, and TP-WB and TPPA were used as the confirmation methods respectively. MedCalc software was used to analyze the results of ROC curve, and the cut-off value was obtained. Chi square test was used to test the difference significance of counting data. The detection results of Treponema pallidum specific antibody in the same batch of serum samples were unequal by different methods. There was no significant difference between CLIA method and TPPA method, but significant difference between CLIA method with TP-WB method and CMIA method was found. TPPA test results and TP-WB test results were taken as gold standards, ROC curve analysis showed that the best diagnostic cutoff value of CLIA method was 4.01 and 16.06, respectively, and the area under the curve was 0.961 and 0.838. The suggested cutoff value of CLIA method is quite different when using different syphilis serological test methods as the gold standard, Therefore, when the S/CO value determined by CLIA is between 1.00 to 16.06, TP-WB method should be recommended as the first choice in laboratory serological test for recheck and confirmation to avoid clinical misdiagnosis.

Objective:o prepare Danshensu liposomes and investigate drug release characteristics in vitro. Methods: Danshensu liposomes were prepared by a reverse-phase evaporation method. The encapsulation efficiency was used as the index, an orthogonal test was adopted to investigate the effect of concentration of soybean lecithin, ratio of lipid-Danshensu and pH value of solution on the preparation procedure of Danshensu liposomes. The particle size of the liposomes was also investigated by a transmission electron micro-scope ( TEM) . The concentration of Danshensu was determined by HPLC, and the difference of release characteristics in Danshensu li-posomes and Danshensu solution was measured by a dialysis method. Results:The optimum preparation technology was as follows:the concentration of soybean lecithin was 40 mg·ml-1 ,the ratio of drug-lipid was 1: 10,and the pH value of solution was 6. 6. The mor-phology of the prepared liposomes showed spheric structure with uniform diameter, and the average particle size was ( 174 ± 36 ) nm and the encapsulation efficiency was 38. 9%. The linear range of Danshensu was 2. 0-20. 0 mg·L-1(r=0. 9984). The drug release of liposomes in vitro was slower than that of free Danshensu solution in 24 h. Conclusion:Danshensu liposomes with fine morphology have sustained release property.

OBJECTIVETo evaluate the efficacy and safety of autologous cytokine-induced killer (CIK) cell t combined with XELOX regimen in treatment of senile advanced gastric cancer.

METHODSForty-six cases of senile advanced gastric cancer patients with a mean age of 70 years were prospectively divided into two groups according to individual acceptance of CIK cells: 25 patients receiving autologous CIK cell treatment combined with XELOX regimen (trial group) and 21 patients receiving simple chemotherapy (control group). Patients in CIK group were matched to those in control group by sex, ages, KPS ranking scores, histological type, pathological grade, and clinical stage. Immune reaction, adverse reaction, time to progression (TTP) and overall survival (OS) were evaluated.

RESULTSHost immune function was increased (P<0.05) and the adverse reaction was decreased in patients of trial group as compared to control group. There were no significant differences in response rate (RR)(33.3% vs. 23.1%, P>0.05), disease control rate (DCR)(86.7% vs. 80.8%, P>0.05) between the two groups. TTP (4.8 months vs. 3.1 months, P<0.05) and OS (7.1 months vs. 5.9 months, P<0.05) in trial group were significantly improved as compared to control group.

CONCLUSIONAutologous CIK cells combined with XELOX regimen can increase immune function, improve clinical efficacy, decrease adverse reaction and prolong OS for senile patients with advanced gastric cancers.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytokine-Induced Killer Cells ; immunology ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Humans ; Immunotherapy, Adoptive ; Prospective Studies ; Stomach Neoplasms ; immunology ; therapy

To explore the diagnostic value of 75 commonly used clinical laboratory markers for differentiation of traditional Chinese medicine syndromes such as liver and gallbladder damp-heat and liver depression and spleen deficiency in patients with chronic hepatitis B.