Patients with inflammatory bowel disease (IBD) require long-term pharmacotherapy. Due to the wide variety of clinically available drugs, medication safety has become increasingly concerning. As an indispensable component of pharmaceutical formulations, drug excipients may induce various adverse reactions, including rash, allergic responses, and gastrointestinal discomfort, and may even lead to severe organic injury. However, they are often overlooked in clinical practice. Therefore, identifying and managing excipient-related adverse reactions is crucial for ensuring medication safety. To address this issue, this article systematically reviews common excipients in IBD therapeutics, the underlying mechanisms of excipient-induced adverse reactions, and corresponding management strategies, aiming to enhance clinicians' awareness of excipient-related issues, improve their ability to recognize and manage such reactions, and ultimately ensure patient safety.

ObjectiveTo explore the mechanism by which Buyang Huanwutang regulates the glutathione peroxidase 4 （GPX4）-acyl-CoA synthetase long-chain family member 4 （ACSL4） axis to inhibit ferroptosis and promote neurological functional recovery after spinal cord injury （SCI）. MethodsNinety rats were randomly divided into five groups： sham operation group， model group， low-dose Buyang Huanwutang group （12.5 g·kg^-1）， high-dose Buyang Huanwutang group （25 g·kg^-1）， and Buyang Huanwutang + inhibitor group （25 g·kg^-1 + 5 g·kg^-1 RSL3）. The SCI model was established by using the allen method. Tissue was collected on the 7th and 28th days after operation. Motor function was assessed by using the Basso-Beattie-Bresnahan （BBB） scale. Hematoxylin-eosin （HE）， Nissl， and Luxol fast blue （LFB） staining were performed to observe spinal cord histopathology. Transmission electron microscopy was used to examine mitochondrial ultrastructure. Immunofluorescence staining was used to detect the number of NeuN-positive cells and the fluorescence intensity of myelin basic protein （MBP）， GPX4， and ACSL4. Real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） was used to analyze the mRNA expression of GPX4 and ACSL4. Enzyme linked immunosorbent assay （ELISA） was performed to measure the levels of reactive oxygen species （ROS）， malondialdehyde （MDA）， glutathione （GSH）， and superoxide dismutase （SOD）. Colorimetric assays were used to determine the iron content in spinal cord tissue. ResultsCompared to the sham operation group， the model group exhibited significantly reduced BBB scores （P<0.01）， severe pathological damage in spinal cord tissue， and marked mitochondrial ultrastructural disruption. In addition， the model group showed a decrease in the number of NeuN-positive cells （P<0.01）， reduced fluorescence intensity of MBP and GPX4 （P<0.01）， lower levels of GSH and SOD （P<0.01）， and downregulated mRNA expression of GPX4 （P<0.01）. Moreover， compared to the sham operation group， the model group had elevated levels of ROS， MDA， and tissue iron content （P<0.01）， along with increased fluorescence intensity and mRNA expression of ACSL4 （P<0.01）. Compared with the model group and Buyang Huanwutang + inhibitor group， the Buyang Huanwutang group showed significantly improved BBB scores （P<0.05， P<0.01） and exhibited less severe spinal cord tissue damage， reduced edema and inflammatory cell infiltration， increased neuronal survival， and more intact myelin structures. Additionally， mitochondrial ultrastructure was significantly improved in the Buyang Huanwutang group. Compared to the model group and Buyang Huanwutang + inhibitor group， the Buyang Huanwutang group significantly increased the number of NeuN-positive cells and the fluorescence intensity of MBP （P<0.05， P<0.01）. Furthermore， Buyang Huanwutang significantly increased the fluorescence intensity and mRNA expression of GPX4 （P<0.01） and decreased the fluorescence intensity and mRNA expression of ACSL4 （P<0.01） compared to the model group and Buyang Huanwutang + inhibitor group. Finally， the Buyang Huanwutang group significantly decreased ROS， MDA， and tissue iron content （P<0.01） and significantly increased GSH and SOD levels （P<0.01） compared to the model group and Buyang Huanwutang + inhibitor group. ConclusionBuyang Huanwutang inhibits ferroptosis through the GPX4/ACSL4 axis， reduces secondary neuronal and myelin injury and oxidative stress， and ultimately promotes the recovery of neurological function.

ObjectiveTo evaluate the clinical efficacy of different acupuncture-related therapies in treating postoperative pain in patients with osteoporotic vertebral compression fractures (OVCFs) after percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) using a network meta-analysis.MethodsA systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database (SinoMed) from their inception to January 15, 2025. Outcome measures included the Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI) score, and overall efficacy rate. Literature screening, data extraction, and risk-of-bias assessment were independently performed by two researchers. Data analysis was conducted using Stata 17.0 software.ResultsA total of 35 randomized controlled trials involving 2860 patients were included. The data analysis revealed that, in terms of improving VAS and ODI scores, the top three effective therapies were Fu's subcutaneous needling, wrist-ankle acupuncture, and acupotomy. For the overall efficacy rates in pain treatment, the top three therapies were wrist-ankle acupuncture, warm acupuncture and moxibustion, and Fu's subcutaneous needling. Based on the combined results across the three outcome measures, Fu's subcutaneous needling was found to be the most effective in relieving pain and improving lumbar function.ConclusionFu's subcutaneous needling, wrist-ankle acupuncture, warm acupuncture and moxibustion, and acupotomy were all effective in treating postoperative pain post-PKP/PVP and improving lumbar function. However, further high-quality, large-sample studies are required to confirm these findings.

Objective To investigate the effects of Zhuang medicinal thread moxibustion on apoptosis of interstitial cells of Cajal(ICC)in gastric smooth muscle of diabetic gastroparesis(DGP)rats via regulation of the p38MAPK signaling pathway.Methods Totally 60 rats were randomly divided into a blank group(10 rats)and a modeling group(50 rats).DGP models were established in the modeling group via intraperitoneal injection of streptozotocin.50 successfully modeled rats were further randomized into model group,Western medication group,prevention+treatment group,prevention group and treatment group,with 10 rats in each group.The Western medication group was administered mosapride citrate by gavage for 3 weeks starting at week 10;the prevention+treatment group underwent Zhuang medicinal thread moxibustion("Zhongwan",bilateral"Neiguan"and"Zusanli")intervention for 6 weeks starting at week 7;the prevention group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 7;and the treatment group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 10,3 cones per point,once a day;the blank group and model group received handling only.The random blood glucose and body mass of rats were detected,and the gastric emptying rate and intestinal propulsion rate were calculated.HE staining was used to observe the morphology of gastric smooth muscle tissue,TUNEL staining was used to detect the apoptosis of gastric smooth muscle tissue,ELISA was used to detect the contents of Caspase-3,TNF-α,IL-1β and IL-6 in gastric smooth muscle tissue,immunohistochemistry was used to detect the positive expressions of Cx43 and c-kit in gastric smooth muscle tissue,Western blot was used to detect the expressions of p38MAPK,p-p38MAPK,BAX and Bcl-2 protein in gastric smooth muscle tissue.Results Compared with the blank group,the random blood glucose significantly increased in the model group(P<0.01),and the body mass,gastric emptying rate and small intestinal propulsion rate significantly decreased(P<0.01),the blood vessels of gastric tissue were not clear,the surface was not smooth,the mucosal folds were less,the arrangement of gastric smooth muscle cells was disordered,the nuclear membrane was not clear,and there were vacuole like changes between cells,the apoptosis rate significantly increased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the protein expressions of p38MAPK,p-p38MAPK and BAX in gastric smooth muscle tissue significantly increased(P<0.01),and the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio significantly decreased(P<0.01).Compared with the model group,the random blood glucose of rats in each intervention group decreased,and the body mass,gastric emptying rate and intestinal propulsion rate increased(P<0.01),the blood vessels of gastric tissue were clear,the inner surface of stomach was smooth,the mucosal folds were not rich,no ulcer was found,the shape of gastric smooth muscle cells was complete,the nuclear membrane was clear,and the arrangement of muscle cells was regular,the apoptosis rate significantly decreased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the expressions of p38MAPK,p-p38MAPK,BAX protein in gastric smooth muscle tissue decreased(P<0.05,P<0.01),the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio increased(P<0.05,P<0.01).The overall effect of the prevention+treatment group was better than that of the Western medication group,prevention group and treatment group(P<0.05,P<0.01).Conclusion Zhuang medicinal thread moxibustion may reduce gastric inflammation and ICC apoptosis in DGP rats by inhibiting p38MAPK signaling pathway,so as to improve DGP gastric motility disorder,and the effect of early intervention is more significant.

Objective To summarise the best evidence of tracheal intubation and extubation in patients with non-ventilated neurocritical care so as to provide a reference and guidance for clinical work.Methods The"6S"evidence-based pyramid model was employed to search multiple databases and sources,including UpToDate,BMJ Best Practice(BMJ),National Institute for Health and Care Excellence(NICE),National Guideline Clearinghouse(NGC),Guidelines International Network(GIN),Scottish Intercollegiate Guidelines Network(SIGN),Canadian Medical Association:Clinical Practice Guideline(CMA Infobase),New Zealand Guidelines Group(NZGG),European Association of Neurosurgical Societies(EANS),American Association of Neurological Surgeons(AANS),Cochrane Library,Joanna Briggs Institute(JBI),Campbell,PubMed,Embase,CINAHL,ProQuest,Elsevier,EBSCO,Web of Science,CNKI,Wanfang Data,VIP,SinoMed and Yimaitong,from inception of the databases to 31st March,2024 for literature on tracheal extubation of the patients in non-ventilated neurocritical care.The retrieved literature included clinical decisions,guidelines,systematic reviews,evidence summaries,expert consensuses,and randomised controlled trials.Two researchers who were trained in evidence-based nursing comprehensively screened the quality of the included literature and extracted the evidences.Results A total of 15 articles were included consisting of 2 clinical decisions,5 guidelines,4 systematic reviews,2 evidence summaries and 2 expert consensuses.They were synthesised into 23 evidence-based recommendations across 4 themes:pre-extubation assessment,pre-extubation preparation,extubation procedure and post-extubation care.Conclusion The best evidence on endotracheal intubation and extubation in patients with non-ventilated neurocritical care summarised in this study provides an evidence-based reference for clinical practice.

Objective To compare the dosimetric disparities among static intensity-modulated radiotherapy(IMRT),volumetric modulated arc therapy(VMAT),and tomotherapy(TOMO)techniques in cervical cancer radiotherapy for providing data support for clinical decision-making scheme of radiotherapy.Methods The clinical data of 19 cervical cancer patients,treated at the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from February to May in 2024,were analyzed.Three plans were devised for each case using IMRT,VMAT,and TOMO techniques,followed by dosimetric evaluation in terms of various metrics such as dose volume parameters of the target areas as well as organs-at-risk(OAR),conformity index(CI),homogeneity index(HI),and delivery time.Results All 3 plans met the clinical prescription requirements for the target areas.Compared with static IMRT and VMAT,TOMO had significantly lower Dmean and Dmaxof PCTV and PGTVnd.For OAR,TOMO demonstrated significant advantages over IMRT and VMAT in the Dmean of the bladder,the Dmean,Dmax,V30,V40of the rectum,the Dmean,Dmax,V20,V30of left and right femoral heads,and the Dmean,V20,V50of the pelvis(P<0.05).In addition,the TOMO group showed significantly higher CI for both PCTV and PGTVnd as compared with IMRT and VMAT groups,and lower PGTVnd HI than IMRT group(all P<0.05).Although there was trivial difference among 3 groups in term of PCTV HI,TOMO group performed slightly better than the other two groups.Notably,VMAT technique had the shortest treatment time.Conclusion In various treatment modalities for cervical cancer,TOMO is superior to IMRT and VMAT in terms of target dose coverage,OAR dose distribution,CI,and HI.However,VMAT has the highest efficiency.

Objective To summarise the best evidence of tracheal intubation and extubation in patients with non-ventilated neurocritical care so as to provide a reference and guidance for clinical work.Methods The"6S"evidence-based pyramid model was employed to search multiple databases and sources,including UpToDate,BMJ Best Practice(BMJ),National Institute for Health and Care Excellence(NICE),National Guideline Clearinghouse(NGC),Guidelines International Network(GIN),Scottish Intercollegiate Guidelines Network(SIGN),Canadian Medical Association:Clinical Practice Guideline(CMA Infobase),New Zealand Guidelines Group(NZGG),European Association of Neurosurgical Societies(EANS),American Association of Neurological Surgeons(AANS),Cochrane Library,Joanna Briggs Institute(JBI),Campbell,PubMed,Embase,CINAHL,ProQuest,Elsevier,EBSCO,Web of Science,CNKI,Wanfang Data,VIP,SinoMed and Yimaitong,from inception of the databases to 31st March,2024 for literature on tracheal extubation of the patients in non-ventilated neurocritical care.The retrieved literature included clinical decisions,guidelines,systematic reviews,evidence summaries,expert consensuses,and randomised controlled trials.Two researchers who were trained in evidence-based nursing comprehensively screened the quality of the included literature and extracted the evidences.Results A total of 15 articles were included consisting of 2 clinical decisions,5 guidelines,4 systematic reviews,2 evidence summaries and 2 expert consensuses.They were synthesised into 23 evidence-based recommendations across 4 themes:pre-extubation assessment,pre-extubation preparation,extubation procedure and post-extubation care.Conclusion The best evidence on endotracheal intubation and extubation in patients with non-ventilated neurocritical care summarised in this study provides an evidence-based reference for clinical practice.

Objective To compare the dosimetric disparities among static intensity-modulated radiotherapy(IMRT),volumetric modulated arc therapy(VMAT),and tomotherapy(TOMO)techniques in cervical cancer radiotherapy for providing data support for clinical decision-making scheme of radiotherapy.Methods The clinical data of 19 cervical cancer patients,treated at the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from February to May in 2024,were analyzed.Three plans were devised for each case using IMRT,VMAT,and TOMO techniques,followed by dosimetric evaluation in terms of various metrics such as dose volume parameters of the target areas as well as organs-at-risk(OAR),conformity index(CI),homogeneity index(HI),and delivery time.Results All 3 plans met the clinical prescription requirements for the target areas.Compared with static IMRT and VMAT,TOMO had significantly lower Dmean and Dmaxof PCTV and PGTVnd.For OAR,TOMO demonstrated significant advantages over IMRT and VMAT in the Dmean of the bladder,the Dmean,Dmax,V30,V40of the rectum,the Dmean,Dmax,V20,V30of left and right femoral heads,and the Dmean,V20,V50of the pelvis(P<0.05).In addition,the TOMO group showed significantly higher CI for both PCTV and PGTVnd as compared with IMRT and VMAT groups,and lower PGTVnd HI than IMRT group(all P<0.05).Although there was trivial difference among 3 groups in term of PCTV HI,TOMO group performed slightly better than the other two groups.Notably,VMAT technique had the shortest treatment time.Conclusion In various treatment modalities for cervical cancer,TOMO is superior to IMRT and VMAT in terms of target dose coverage,OAR dose distribution,CI,and HI.However,VMAT has the highest efficiency.

Objective To investigate the effects of Zhuang medicinal thread moxibustion on apoptosis of interstitial cells of Cajal(ICC)in gastric smooth muscle of diabetic gastroparesis(DGP)rats via regulation of the p38MAPK signaling pathway.Methods Totally 60 rats were randomly divided into a blank group(10 rats)and a modeling group(50 rats).DGP models were established in the modeling group via intraperitoneal injection of streptozotocin.50 successfully modeled rats were further randomized into model group,Western medication group,prevention+treatment group,prevention group and treatment group,with 10 rats in each group.The Western medication group was administered mosapride citrate by gavage for 3 weeks starting at week 10;the prevention+treatment group underwent Zhuang medicinal thread moxibustion("Zhongwan",bilateral"Neiguan"and"Zusanli")intervention for 6 weeks starting at week 7;the prevention group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 7;and the treatment group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 10,3 cones per point,once a day;the blank group and model group received handling only.The random blood glucose and body mass of rats were detected,and the gastric emptying rate and intestinal propulsion rate were calculated.HE staining was used to observe the morphology of gastric smooth muscle tissue,TUNEL staining was used to detect the apoptosis of gastric smooth muscle tissue,ELISA was used to detect the contents of Caspase-3,TNF-α,IL-1β and IL-6 in gastric smooth muscle tissue,immunohistochemistry was used to detect the positive expressions of Cx43 and c-kit in gastric smooth muscle tissue,Western blot was used to detect the expressions of p38MAPK,p-p38MAPK,BAX and Bcl-2 protein in gastric smooth muscle tissue.Results Compared with the blank group,the random blood glucose significantly increased in the model group(P<0.01),and the body mass,gastric emptying rate and small intestinal propulsion rate significantly decreased(P<0.01),the blood vessels of gastric tissue were not clear,the surface was not smooth,the mucosal folds were less,the arrangement of gastric smooth muscle cells was disordered,the nuclear membrane was not clear,and there were vacuole like changes between cells,the apoptosis rate significantly increased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the protein expressions of p38MAPK,p-p38MAPK and BAX in gastric smooth muscle tissue significantly increased(P<0.01),and the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio significantly decreased(P<0.01).Compared with the model group,the random blood glucose of rats in each intervention group decreased,and the body mass,gastric emptying rate and intestinal propulsion rate increased(P<0.01),the blood vessels of gastric tissue were clear,the inner surface of stomach was smooth,the mucosal folds were not rich,no ulcer was found,the shape of gastric smooth muscle cells was complete,the nuclear membrane was clear,and the arrangement of muscle cells was regular,the apoptosis rate significantly decreased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the expressions of p38MAPK,p-p38MAPK,BAX protein in gastric smooth muscle tissue decreased(P<0.05,P<0.01),the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio increased(P<0.05,P<0.01).The overall effect of the prevention+treatment group was better than that of the Western medication group,prevention group and treatment group(P<0.05,P<0.01).Conclusion Zhuang medicinal thread moxibustion may reduce gastric inflammation and ICC apoptosis in DGP rats by inhibiting p38MAPK signaling pathway,so as to improve DGP gastric motility disorder,and the effect of early intervention is more significant.

Atherosclerosis(AS)is a common cardiovascular disease,and its treatment and prevention have been the focus of medical research.AS an emerging technology,nanotechnology has unique advantages and plays an important role in the prevention,diagnosis and treatment of AS.This paper reviews the latest research on the application of nanotechnology in AS diseases,systematically discusses the role of nanotechnology in the diag-nosis and treatment of AS,and comprehensively analyzes the effects of nano-drug carriers based on different sur-face trimmers,loading diagnostic and therapeutic drugs so as to monitordisease progression of AS and its targeted treatment.The aim is to provide new thought for the clinical treatment of AS.