Attention deficit hyperactivity disorder （ADHD） is often accompanied by tic disorder. The core pathogenesis is considered to be ministerial fire scorching yin and internal stirring of deficient wind， which leads to disharmony between the body and spirit， resulting in clinical manifestations. The treatment principles emphasize nourishing yin fluids， calming ministerial fire， and extinguishing endogenous wind （内风）. The method of nourishing yin fluids is applied throughout the entire treatment process， commonly using ingredients such as Shudihuang （Rehmanniae Radix Praeparata）， Shanzhuyu （Corni Fructus）， Gouqizi （Lycii Fructus）， Wuweizi （Schisandrae Chinensis Fructus）， and Tusizi （Cuscutae Semen）. These are combined with approaches to harmonize the zang-fu organs， primarily including extinguishing liver wind， clearing heart fire， nourishing kidney water， and strengthening spleen earth， thereby stabilizing ministerial fire and extinguishing endogenous wind. Additionally， emotional regulation and smoothing emotional constraint are essential to improve clinical symptoms in children with ADHD comorbid with tic disorder.

Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

Lung transplantation is currently the only effective treatment for end-stage lung disease. However, the field of lung transplantation still faces numerous challenges, including donor shortage, primary graft dysfunction, rejection, infection and others. In 2025, scholars worldwide have made remarkable progress in clinical research on lung transplantation. This article systematically reviews the cutting-edge developments in clinical research on lung transplantation in 2025, focusing on the application of novel evaluation tools in donor lung screening, optimization of lung perfusion techniques, exploration of extracorporeal membrane oxygenation and robot-assisted minimally invasive surgery, as well as mechanistic research and intervention strategies for primary graft dysfunction, acute kidney injury and chronic lung allograft dysfunction. Meanwhile, hot topics such as the management of special populations, prevention and control of postoperative infections, and improvement of quality of life are summarized. This review aims to conclude the important annual research findings and provide references for the clinical practice and research development of lung transplantation in China.

ObjectiveTo analyze the influencing factors of hepatic fibrosis in patients with Wilson's disease （WD） and to develop and validate a predictive model for hepatic fibrosis in WD that integrates traditional Chinese medicine （TCM） syndromes and modern biomarkers， thus providing a basis for early identification of high-risk populations and medical intervention. MethodsThe clinical data of 220 WD patients diagnosed in the Department of Encephalopathy， The First Affiliated Hospital of Anhui University of Chinese Medicine between January 2010 and December 2024 were retrospectively collected. Through a random number table， patients were assigned into a training set （154 patients） and a validation set （66 patients） in a 7∶3 ratio. Univariate COX regression， LASSO regression analysis， and multivariate COX regression analysis were performed to identify independent influencing factors for hepatic fibrosis in WD patients， and a clinical prediction model was established based on these factors. The discrimination， calibration， and clinical utility of the model were evaluated based on the area under the receiver operating characteristic curve （AUC）， calibration curves， and decision curve analysis （DCA）， respectively. ResultsA total of 220 patients were included. The syndrome of combined phlegm and stasis， triglycerides （TG）， laminin （LN）， and male gender were identified as independent risk factors for hepatic fibrosis in WD patients， while TCM intervention and high-density lipoprotein cholesterol （HDL-C） were protective factors. The C-index indicated excellent discriminative ability （training set： 3-year AUC=0.908， 5-year AUC=0.869， 7-year AUC=0.829； validation set： 3-year AUC= 0.898， 5-year AUC=0.780， 7-year AUC=0.743）. Calibration curves showed good consistency. DCA demonstrated the clinical net benefit probabilities across different risk thresholds at various time points. ConclusionThe predictive model established in this study has high accuracy and can be conveniently used for the early identification and risk prediction of hepatic fibrosis in patients with WD.

ObjectiveTo systematically compare the effects of diverse electromagnetic stimulation protocols on hand function and activities of daily living (ADL) in stroke patients using network meta-analysis (NMA), and screen the optimal stimulation strategy for post-stroke hand dysfunction rehabilitation. MethodsNMA was performed in accordance with the PRISMA-NMA statement. Databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science and Embase were searched from database inception to April, 2026 for eligible randomized controlled trials (RCTs) comparing different electromagnetic stimulation protocols for post-stroke hand impairment. The Cochrane Risk of Bias tool and PEDro scale were used to assess methodological quality of included studies, while the GRADE system was adopted to grade evidence quality of primary outcomes of Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI). After literature screening, data extraction and bias evaluation, RevMan 5.4 and Stata 17.0 were used for meta-analysis and NMA. ResultsA total of 22 RCT involving 17 electromagnetic stimulation protocols were finally included. The PEDro scores ranged from six to ten. The top five protocols for improving FMA-UE score were repetitive peripheral magnetic stimulation (rPMS) + repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS) + rPMS, iTBS + transcranial direct current stimulation (tDCS), transcutaneous electrical acupoint stimulation (TEAS) and contralaterally controlled functional electrical stimulation (CCFES). tDCS was the most effective on MBI, followed by TEAS and iTBS+rPMS. Evidence quality for FMA-UE and MBI was moderate. Funnel plots suggested low risk of publication bias, and consistency tests verified good coherence between direct and indirect comparisons in network models. ConclusionElectromagnetic stimulation significantly facilitates upper limb and hand functional recovery, and improves ADL in stroke patients. The combined central-peripheral magnetic stimulation protocol may be the most effective on motor rehabilitation, whereas tDCS on ADL.

This study identified blood-entering components of Anshen Dropping Pills and explored their anti-insomnia effects and mechanisms. The main blood-entering components of Anshen Dropping Pills were detected and identified by UPLC-Q-TOF-MS/MS. The rationality of the formula was assessed by using enrichment analysis based on the relationship between drugs and symptoms, and core targets of its active components were selected as the the potential anti-insomnia targets of Anshen Dropping Pills through network pharmacology analysis. Furthermore, protein-protein interaction(PPI) network, Gene Ontology(GO) enrichment analysis, and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis were performed on the core targets. An active component-core target network for Anshen Dropping Pills was constructed. Finally, the effects of low-, medium-, and high-dose groups of Anshen Dropping Pills on sleep episodes, sleep duration, and sleep latency in mice were measured by supraliminal and subliminal pentobarbital sodium experiments. Moreover, total scores of the Pittsburgh sleep quality index(PSQI) scale was used to evaluate the changes before and after the treatment with Anshen Dropping Pills in a clinical study. The enrichment analysis based on the relationship between drugs and symptoms verified the rationality of the Anshen Dropping Pills formula, and nine blood-entering components of Anshen Dropping Pills were identified by UPLC-Q-TOF-MS/MS. The network proximity revealed a significant correlation between eight components and insomnia, including magnoflorine, liquiritin, spinosin, quercitrin, jujuboside A, ginsenoside Rb_3, glycyrrhizic acid, and glycyrrhetinic acid. Network pharmacology analysis indicated that the major anti-insomnia pathways of Anshen Dropping Pills involved substance and energy metabolism, neuroprotection, immune system regulation, and endocrine regulation. Seven core genes related to insomnia were identified: APOE, ALB, BDNF, PPARG, INS, TP53, and TNF. In summary, Anshen Dropping Pills could increase sleep episodes, prolong sleep duration, and reduce sleep latency in mice. Clinical study results demonstrated that Anshen Dropping Pills could decrease total scores of PSQI scale. This study reveals the pharmacodynamic basis and potential multi-component, multi-target, and multi-pathway effects of Anshen Dropping Pills, suggesting that its anti-insomnia mechanisms may be associated with the regulation of insomnia-related signaling pathways. These findings offer a theoretical foundation for the clinical application of Anshen Dropping Pills.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Tandem Mass Spectrometry/methods* ; Sleep Initiation and Maintenance Disorders/metabolism* ; Mice ; Network Pharmacology ; Male ; Chromatography, High Pressure Liquid ; Humans ; Protein Interaction Maps/drug effects* ; Sleep/drug effects* ; Female ; Adult

This study explored the prescription pattern of traditional Chinese medicine(TCM) in the treatment of hypertensive left ventricular hypertrophy(LVH), so as to provide a relevant theoretical basis for the clinical diagnosis and treatment of hypertensive LVH. The study systematically searched the databases of CNKI, Wanfang, VIP, and SinoMed to screen out the qualified literature on TCM treatment of hypertensive LVH and used Microsoft Excel 2021 to establish the relevant prescription database. It also counted the frequency, property, flavor, and meridian affiliation of TCM in the prescriptions and classified their efficacy. The study used Lantern 5.0 and Rstudio software to analyze the hidden structural models and association rules of the high-frequency TCM with a frequency of >3.50% and adopted Origin 2024 software to visualize the data, so as to explore the prescription pattern of TCM in treating hypertensive LVH. The results showed that a total of 128 TCM prescriptions were included, involving 163 TCM with a total frequency of 1 242. The high-frequency TCM included Salviae Miltiorrhizae Radix et Rhizoma, Uncariae Ramulus Cum Uncis, Gastrodiae Rhizoma, Poria, and Chuanxiong Rhizoma, with the main efficacy from blood-activating and stasis-resolving herbs, tonic herbs, and liver-calming and wind-extinguishing herbs. The latent structure analysis(LSA) identified 10 latent variables, 20 latent classes, 7 comprehensive clustering models, and 23 core prescriptions. It was speculated that the common syndromes of hypertensive LVH included blood stasis obstructing the collaterals, ascending hyperactivity of liver Yang, Yin deficiency with Yang hyperactivity, and intermingled phlegm and blood stasis. The association rule analysis yielded 33 strong association rules, with the highest comprehensive association rule being Gastrodiae Rhizoma→Uncariae Ramulus Cum Uncis. Hypertensive LVH is characterized by asthenia in origin and asthenia in superficiality, with Yin deficiency and Qi deficiency as the origin and blood stasis and phlegm as the superficiality. Clinical treatment focuses on activating blood circulation, resolving stasis, tonifying Qi, and nourishing Yin, combined with syndrome-specific therapies such as calming wind and stopping convulsions, clearing heat, eliminating dampness and resolving phlegm, and promoting diuresis and reducing swelling.
Drugs, Chinese Herbal/therapeutic use* ; Data Mining ; Humans ; Hypertension/complications* ; Hypertrophy, Left Ventricular/physiopathology* ; Medicine, Chinese Traditional ; Drug Prescriptions

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

Objective To investigate the expression of methyltransferase like protein 5(METTL5)and Vi-ral like m6A methyltransferase associated(VIRMA)in hepatocellular carcinoma(HCC)and their relationship with clinical prognosis.Methods A total of 89 HCC patients who visited the hospital from March 2018 to March 2021 were enrolled in the study.Immunohistochemistry and fluorescence quantitative PCR were con-ducted to analyze the expression of METTL5,VIRMA protein and mRNA in tissues.Kaplan-Meier curve and COX regression were used to analyze the impact of METTL5 and VIRMA proteins on the prognosis of HCC.Results The METTL5 mRNA(3.23±0.55 vs.0.61±0.20)and VIRMA mRNA(2.97±0.42 vs.0.58±0.17)in HCC cancer tissue were higher than those in adjacent tissues,and the differences were statistically significant(t=42.234,49.762,both P＜0.001).METTL5 and VIRMA proteins were located in the cyto-plasm and cell membrane,with some in the nucleus.The positive rates of METTL5[71.91％(64/89)vs.5.62％(5/89)]and VIRMA[69.66％(62/89)vs.6.74％(6/89)]in HCC cancer tissues were higher than those in adjacent tissues,and the differences were statistically significant(x2=82.385,74.627,P＜0.001,P=0.001).The expression of METTL5 and VIRMA proteins in HCC were related to China Liver Cancer Staging(CNLC)stages,maximum tumor diameter,and vascular invasion,and the positive rates of METTL5 and VIRMA proteins were higher in HCC cancer tissues with CNLC stage Ⅱ-Ⅲ,maximum tumor diameter≥ 5 cm,and vascular invasion(P＜0.05).The 3-year survival rates of METTL5 positive and negative groups were 34.88％(15/43)and 67.39％(31/46),with statistically significant differences(Log-rank x2=7.893,P=0.005).The 3-year survival rates of the VIRMA positive and negative groups were 36.36％(16/44)and 66.67％(30/45),with statistically significant differences(Log-rank x2=9.828,P=0.002).CNLC staging stages Ⅱ-Ⅲ,maximum tumor diameter ≥5 cm,vascular invasion,METTL5 positivity,and VIRMA positivi-ty were risk factors for poor prognosis in HCC patients(P＜0.05).Conclusion The upregulation of MET-TL5 and VIRMA expression in HCC are associated with CNLC stage Ⅱ-Ⅲ,maximum tumor diameter and vascular invasion,and both of them are tumor markers for evaluating the prognosis of HCC.

Objective To investigate the clinical efficacy of Zhikang Capsules plus Compound Huangbai Lotion for retention enema in the treatment of patients with mild to moderate distal ulcerative colitis(UC)of damp-heat in large intestine type,and to observe their effects on the serum levels of pro-inflammatory cytokines of tumor necrosis factor α(TNF-α),interleukin 6(IL-6)and C-reactive protein(CRP).Methods A total of 110 patients with mild to moderate distal UC of damp-heat in large intestine type who were treated in the Outpatient Clinics and Wards of the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from October 2022 to December 2023 were randomly divided into an observation group and a control group according to random number table method,with 55 patients in each group.The control group was given retention enema with 1 g of Xilei Powder and 50 mL of Compound Huangbai Lotion before going to bed every night,while the observation group was given retention enema with 2.4 g of Zhikang Capsules and 50 mL of Compound Huangbai Lotion before going to bed every night The course of treatment for the two groups covered 14 days.The changes in the serum inflammation factors,coagulation function indicators,traditional Chinese medicine(TCM)syndrome scores,and the Inflammatory Bowel Disease Quality of Life Questionnaire(IBDQ)scores in the two groups were observed before and after treatment.After treatment,the clinical efficacy and drug safety in the two groups were evaluated.Results(1)After 14 days of treatment,the total effective rate of the observation group was 90.91％(50/55)and that of the control group was 80.00％(44/55),and the intergroup comparison(tested by rank sum test)showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(P＜0.01).(2)After treatment,the serum levels of inflammation factors of TNF-α,IL-6,and CRP patients in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(3)After treatment,the prothrombin time(PT)and fibrinogen(FIB)of the two groups of patients were improved compared with those before treatment(P＜0.05),while the improvement of thrombin time(TT)and activated partial thromboplastin time(APTT)were not obvious when compared with those before treatment(P＞0.05);the comparison between the two groups showed that the improvement of PT and FIB in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(4)After treatment,the scores of TCM symptoms of diarrhea,mucous-purulent and bloody stool,tenesmus,scorching sensation of the anus in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)After treatment,the scores of IBDQ items of general symptoms,intestinal symptoms,social functioning,emotional role functioning in the two groups were increased compared with those before treatment(P＜0.05),and the increase in the observation group was significantly superior to that in the control group(P＜0.01).(6)During the treatment,no obvious adverse reactions occurred in the two groups,with higher safety.Conclusion Zhikang Capsules plus Compound Huangbai Lotion for retention enema are effective and safe in treating mild to moderate distal UC of damp-heat in large intestine type.The therapy can effectively control the illness of UC,alleviate the clinical symptoms and negative emotions,improve the inflammatory response and coagulation function,and enhance the quality of life of the patients.