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Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

Objective:To establish a total normalized productive maintenance(TnPM)model for medical equipment,and to explore its application value in the management of multi-source treatment equipment.Methods:In accordance with the principles of self-management,economic efficiency and dynamic improvement,the TnPM management mode of the medical equipment lifecycle management system was developed.22 multi-source treatment equipment in clinical use in the of department of burn and plastic surgery of The Second Affiliated Hospital of Air Force Medical University were selected and divided into a control group(16 units)and an observation group(18 units,including 12 of control group and 6 newly added units)according to different management modes.The control group implemented the traditional management mode,and the observation group adopted TnPM management mode.The operation quality,comprehensive efficiency and team management capabilities of the two groups were compared.Results:The equipment failure rate of the observation group was(4.82±0.21)%,which was lower than that of traditional group,the self-repair rate,maintenance rate and operating standard rate were(91.63±3.59)%,(96.60±2.47)%and(97.31±1.54)%,respectively,which were higher than those of the control group,the difference was statistically significant(t=2.434,5.246,4.525,5.311,P<0.05).The equipment availability rate,performance index and quality index of the observation group were(90.82±2.78)%,(97.03±2.24)%and(97.85±1.26)%,respectively,which were higher than those of control group,the difference was statistically significant(t=6.231,4.671,5.997,P<0.05).The assessment scores of the personnel involved in the equipment on job responsibilities,basic equipment theory,usage assurance level and management performance of observation group were(93.95±2.81)points,(91.45±2.47)points,(90.75±2.54)points and(93.08±3.34)%,respectively,which higher than those of the control group,the difference was statistically significant(t=2.831,3.979,6.472,4.001,P<0.05).Conclusion:The TnPM management mode can improve the operation quality of equipment in the treatment of clinical patients,reduce the incidence of failure,enhance the comprehensive efficiency of equipment and clinical service level,and promote the construction of a management team.

Objective To observe the value of shear wave elastography(SWE),superb microvascular imaging(SMI)and their combination with conventional ultrasound for diagnosing cervical cancer.Methods Data of 178 patients with cervical lesion confirmed by pathology were retrospectively analyzed.The patients were divided into malignant group(n=32)and benign group(n=146),and those in benign group were further divided into low-grade or high-grade cervical intraepithelial neoplasia subgroups,cervical leiomyosarcoma subgroup,cervical polyps subgroup and cervicitis subgroup.The manifestations of lesion on conventional ultrasound,SWE and SMI were observed,and the mean value of Young's modulus(Emean)and SMI flow index(Ratio)were collected.The optimal cut-off value of SWE Emean and SMI Ratio were obtained with receiver operating characteristic(ROC)curves,and the classification of benign or malignant lesions were predicted.The consistency of predictive results and pathology results were assessed with the Kappa test.The diagnostic efficacies of conventional ultrasound,SWE and SMI alone and their combination were compared.Results The age of patients in malignant group was higher than that in benign group(P＜0.05).SWE Emean and SMI Ratio were both higher in malignant group than those in each benign subgroup(all P＜0.05).Taken 44.35 kPa and 3.95％ as the best cut-off values,the consistency of SWE Emean classification results and pathological results was good(Kappa=0.818),while of SMI Ratio was moderate(Kappa=0.453).The efficacy of conventional ultrasound,SWE and SMI alone for classifying benign and malignant cervical lesions(AUC=0.845,0.914,0.892)were all higher than that of their combination(AUC=0.806,all adjusted P＜0.05).The sensitivity of SWE and SMI for diagnosing cervical cancer was 90.60％ and 93.78％ respectively,with specificity of 95.20％ and 72.60％,respectively.Conclusion SWE hag higher efficacy for diagnosing cervical cancer,while SMI had better sensitivity but lower specificity.Combination of conventional ultrasound,SWE and SWI did not increase the efficacy of ultrasound for diagnosing cervical cancer.

We investigated whether FTY-720 might have an effect on bleomycin-induced pulmonary fibrosis through inhibiting TGF-β1 pathway, and up-regulating autophagy. The pulmonary fibrosis was induced by bleomycin. FTY-720 (1 mg/kg) drug was intraperitoneally injected into mice. Histological changes and inflammatory factors were observed, and EMT and autophagy protein markers were studied by immunohistochemistry and immunofluorescence. The effects of bleomycin on MLE-12 cells were detected by MTT assay and flow cytometry, and the related molecular mechanisms were studied by Western Blot. FTY-720 considerably attenuated bleomycin-induced disorganization of alveolar tissue, extracellular collagen deposition, and α-SMA and E-cadherin levels in mice. The levels of IL-1β, TNF-α, and IL-6 cytokines were attenuated in bronchoalveolar lavage fluid, as well as protein content and leukocyte count. COL1A1 and MMP9 protein expressions in lung tissue were significantly reduced. Additionally, FTY-720 treatment effectively inhibited the expressions of key proteins in TGF-β1/TAK1/P38MAPK pathway and regulated autophagy proteins. Similar results were additionally found in cellular assays with mouse alveolar epithelial cells. Our study provides proof for a new mechanism for FTY-720 to suppress pulmonary fibrosis. FTY-720 is also a target for treating pulmonary fibrosis.

The development of speech is a process by which the neural network structure of brain perceives, decodes, represents, and outputs input signals. At the cortical level, the classic model of speech processing proposed two pathways leading from the auditory system: the ventral stream and the dorsal stream.The ventral stream, which involved structures in the superior and middle portions of the temporal lobe, was involved in processing speech signals for perception and comprehension (speech recognition). The dorsal stream, which involved structures in the posterior frontal lobe and the posterior dorsal-most aspect of the temporal lobe and parietal operculum, had an auditory-motor integration function and was essential for speech production. However, the importance of auditory processing in central auditory nervous system(CANS) from the vestibulocochlear nerve to the auditory cortex for speech development had not been clarified.This review aims to discuss the roles and related mechanisms of the CANS in speech recognition and generation from the perspective of cognitive neuroscience, so as to provide new ideas for clinical monitoring and long-term prediction of auditory processing and speech development, and for diagnosis and treatment of clinical speech-related diseases.

OBJECTIVE: This study investigated the effects of bis (2-butoxyethyl) phthalate (BBOP) on the onset of male puberty by affecting Leydig cell development in rats. METHODS: Thirty 35-day-old male Sprague-Dawley rats were randomly allocated to five groups mg/kg bw per day that were gavaged for 21 days with BBOP at 0, 10, 100, 250, or 500 mg/kg bw per day. The hormone profiles; Leydig cell morphological metrics; mRNA and protein levels; oxidative stress; and AKT, mTOR, ERK1/2, and GSK3β pathways were assessed. RESULTS: BBOP at 250 and/or 500 mg/kg bw per day decreased serum testosterone, luteinizing hormone, and follicle-stimulating hormone levels mg/kg bw per day (P < 0.05). BBOP at 500 mg/kg bw per day decreased Leydig cell number mg/kg bw per day and downregulated Cyp11a1, Insl3, Hsd11b1, and Dhh in the testes, and Lhb and Fshb mRNAs in the pituitary gland (P < 0.05). The malondialdehyde content in the testis significantly increased, while Sod1 and Sod2 mRNAs were markedly down-regulated, by BBOP treatment at 250-500 mg/kg bw per day (P < 0.05). Furthermore, BBOP at 500 mg/kg bw per day decreased AKT1/AKT2, mTOR, and ERK1/2 phosphorylation, and GSK3β and SIRT1 levels mg/kg bw per day (P < 0.05). Finally, BBOP at 100 or 500 μmol/L induced ROS and apoptosis in Leydig cells after 24 h of treatment in vitro (P < 0.05). CONCLUSION: BBOP delays puberty onset by increasing oxidative stress and apoptosis in Leydig cells in rats. UNLABELLED The graphical abstract is available on the website www.besjournal.com.
Rats ; Male ; Animals ; Leydig Cells/metabolism* ; Testosterone ; Glycogen Synthase Kinase 3 beta/pharmacology* ; Rats, Sprague-Dawley ; Sexual Maturation ; Testis ; Oxidative Stress ; TOR Serine-Threonine Kinases/metabolism* ; Apoptosis

The method of scoping review was used to systematically search and sort out the clinical research of oral Chinese patent medicines for ischemic stroke，to understand the scope of relevant research and the distribution of evidence. Three medical catalogs were manually searched to obtain the oral Chinese patent medicines used for ischemic stroke，and 7 databases were retrieved to obtain the clinical research including these oral Chinese patent medicines. Then the clinical evidence results were visualized by description combined with chart analysis. A total of 68 oral Chinese patent medicines were retrieved，and 1 392 articles were included，with 367 published in core journals， involving 35 oral Chinese patent medicines. The research types included randomized controlled trials，cohort studies，case series，case reports，secondary studies，adverse drug reaction reports，pharmacoeconomic evaluations，drug interactions，consensus or guidelines，non-randomized intervention studies and cross-sectional studies，of which randomized controlled trials had the largest number （283， 77.1%），followed by secondary studies and case series （25， 6.7% for each）. Among the 283 randomized controlled trials，there were 159 clinical studies in the acute phase of ischemic stroke，65 in the non-acute phase，and 59 in the unclear phase. Ten intervention control types and 20 outcome index types were summarized. Among them， the composite outcome index and surrogate outcome index were used 217 times （76.7%） and 245 times （86.6%）， respectively，followed by the degree of neurological impairment （three scales）. Future clinical research of oral Chinese patent medicines for ischemic stroke should clarify the stage of the disease，and the research design should specify the advantages of oral Chinese patent medicines intervening in ischemic stroke. Furthermore， publicly-recognized positive controls should be employed，and important clinical outcome indexes should be selected.

Child ; Consensus ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Respiratory System

Objective: To explore the heterogeneity and correlation of clinical phenotypes and genotypes in children with disorders of sex development (DSD). Methods: A retrospective study of 1 235 patients with clinically proposed DSD in 36 pediatric medical institutions across the country from January 2017 to May 2021. After capturing 277 DSD-related candidate genes, second-generation sequencing was performed to analyzed the heterogeneity and correlation combined with clinical phenotypes. Results: Among 1 235 children with clinically proposed DSD, 980 were males and 255 were females of social gender at the time of initial diagnosis with the age ranged from 1 day of age to 17.92 years. A total of 443 children with pathogenic variants were detected through molecular genetic studies, with a positive detection rate of 35.9%. The most common clinical phenotypes were micropenis (455 cases), hypospadias (321 cases), and cryptorchidism (172 cases) and common mutations detected were in SRD5A2 gene (80 cases), AR gene (53 cases) and CYP21A2 gene (44 cases). Among them, the SRD5A2 mutation is the most common in children with simple micropenis and simple hypospadias, while the AMH mutation is the most common in children with simple cryptorchidism. Conclusions: The SRD5A2 mutation is the most common genetic variant in Chinese children with DSD, and micropenis, cryptorchidism, and hypospadias are the most common clinical phenotypes. Molecular diagnosis can provide clues about the biological basis of DSD, and can also guide clinicians to perform specific clinical examinations. Target sequence capture probes and next-generation sequencing technology can provide effective and economical genetic diagnosis for children with DSD.
3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics* ; Child ; China/epidemiology* ; Cryptorchidism/genetics* ; Disorders of Sex Development/genetics* ; Female ; Genital Diseases, Male ; Genotype ; Humans ; Hypospadias/genetics* ; Male ; Membrane Proteins/genetics* ; Penis/abnormalities* ; Phenotype ; Retrospective Studies ; Steroid 21-Hydroxylase/genetics*