Based on the "regulating the pivot and unblocking the stomach" theory， this article proposes that the core pathogenesis of bile reflux gastritis （BRG） is disharmony of the three pivots and imbalance between the gallbladder and the stomach. Specifically， the pivot of zang-fu （脏腑） organs （spleen and stomach） exhibits abnormal ascending and descending functions， while the pivot of opening and closing （shaoyang） shows impaired flow， and the pivot of mind （heart and brain） has disordered regulation. These three pivots interact， ultimately leading to bile reflux attacking the stomach， injuring the gastric mucosa， and causing symptoms such as epigastric distension， pain， acid regurgitation， and heartburn. Clinically， the treatment principle is unblocking and regulating the three pivots， harmonizing the gallbladder and descending stomach qi， which closely follows the different pathomechanisms of three-pivot dysregulation， applying treatment according to syndrome differentiation. The regulation of the pivot of zang-fu organs focuses on fortifying the spleen and harmonzing stomach， raising the clear and directing the turbid downward. The regulation of the opening-and-closing pivot emphasizes harmonizing shaoyang， promoting gallbladder function and bowel movement. The regulation of the mind pivot centers on calming the heart and the mind， and harmonizing the stomach to ensure smooth qi flow. "Unblocking and regulating three pivots" method aims to restore the physiological functions of the gallbladder and stomach， providing a conceptual framework for the clinical management of BRG.

Objective To analyze the characteristics of colorectal adenoma onset,traditional Chinese medicine(TCM)syndromes,and factors influencing advanced colorectal adenoma.Methods A cross-sectional study was conducted to retrospectively analyze the data of 480 patients with colorectal adenoma admitted to the Department of Gastroenterology of Wangjing Hospital,China Academy of Chinese Medical Sciences,between January 2024 and January 2025 who met the inclusion and exclusion criteria.The hospital case system was used to collect demographic information,basic medical history,general conditions associated with colorectal adenoma,and records of TCM syndrome types,which were compiled into a clinical information Excel spreadsheet.Descriptive statistics were calculated to determine the distribution of demographic information,basic medical history,and TCM syndrome types.The chi-square test or Monte Carlo simulation method was used to analyze the differences in the number,size,pathological type and location of colorectal adenomas,as well as the distribution of TCM syndrome types.Univariate chi-square test was used to analyze the related factors of patients with advanced colorectal adenoma,and the statistically significant variables were included in the multivariate logistic regression analysis to analyze the influencing factors of advanced colorectal adenoma.Results Among the 480 patients with colorectal adenoma,296 were male with an onset age of(60.51±11.17)years,and 184 were female with age of(61.65±11.87)years.There were 233 patients(46.46％)aged 45 to 64.There were 269 cases(56.04％)of overweight individuals.Adenomas smaller than 1 cm accounted for 73.33％(352/480).Among the number of adenomas,single adenomas accounted for 66.46％(319/480).Among the pathological types,tubular adenoma accounted for 86.67％(416/480).The left colon accounted for 80.0％(384/480)of the affected sites.The main clinical manifestations included abdominal distension(20.63％,99/480),abdominal pain(16.25％,78/480),diarrhea(9.79％,47/480),among others.The main syndrome types in traditional Chinese medicine are damp-heat syndrome of the large intestine(25.83％,124/480)and spleen deficiency with excessive dampness syndrome(22.94％,110/480).There was a statistically significant difference in the distribution of TCM syndrome types among patients of different age groups(P=0.010).Multitype adenoma(OR=4.504,95％CI:2.819～7.198,P<0.001)and the right colon site(OR=2.166,95％CI:1.146～4.092,P<0.05)are independent risk factors for advanced colorectal adenoma.Conclusion Colorectal adenomas are more common in men and tend to occur in middle-aged people.Adenomas under 1 cm are the most common.Single adenomas and tubular adenomas are more common.The left half of the colon is a common site of occurrence.Common clinical symptoms include abdominal distension,abdominal pain,diarrhea,etc.Damp-heat syndrome of the large intestine is the most common type of syndrome in traditional Chinese medicine.The number of multiple adenomas and the location of the right colon are independent risk factors for advanced colorectal adenomas.

Ulcerative colitis （UC）， a chronic， non-specific inflammatory bowel disease with typical symptoms such as abdominal pain， diarrhea， and bloody stools， demonstrates a high relapse rate and difficulty in curing. Sishenwan， first recorded in Internal Medicine Abstract （Nei Ke Zhai Yao）， are a classic prescription for treating diarrhea caused by deficiency of the spleen and kidney Yang. The core therapeutic principle of Sishenwan is warming and tonifying the spleen and kidney， and astringing the intestine and stopping diarrhea. In recent years， Sishenwan have demonstrated distinct advantages in the clinical treatment of UC. The pathogenesis of UC involves multiple factors， including immune dysregulation and gut microbiota imbalance. Although Western medicine is effective in the short term， its side effects， high relapse rate， and resistance associated with long-term use pose substantial challenges. Sishenwan have shown excellent clinical outcomes in the treatment of UC due to deficiency of the spleen and kidney Yang. Modern clinical studies indicate that Sishenwan， used alone or in combination with Western medicine or other Chinese medicine compound prescriptions， significantly improve the clinical efficacy in treating UC due to deficiency of the spleen and kidney Yang. Sishenwan effectively alleviate core symptoms such as mucus， pus， and blood in stools， and persistent abdominal pain， reduce Mayo scores and the relapse rate， and improve patients' quality of life. Research on the material basis reveals that Sishenwan contain multiple active ingredients such as psoralen， isopsoralen， and evodiamine. Mechanism studies indicate that Sishenwan inhibit the inflammatory cascade reactions by regulating the signal network through multiple targets. Sishenwan regulate cellular immunity and restore intestinal immune homeostasis. At the microecological level， Sishenwan promote the intestinal barrier repair through the "microbiota-metabolism-immunity" axis. The current research still needs to be deepened in aspects such as the mining of specific biomarkers for syndromes and the exploration of the collaborative mechanism of traditional Chinese and Western medicine. In the future， a full-chain system covering syndrome differentiation， targeting， and monitoring needs to be constructed for promoting the paradigm transformation of Sishenwan into precision drugs. This review systematically explains the treatment mechanism of Sishenwan regarding the combination of disease and syndrome and its multi-target regulatory characteristics， providing a theoretical basis and transformation direction for the treatment of UC with integrated traditional Chinese and Western medicine.

Ulcerative colitis （UC）， a chronic， non-specific inflammatory bowel disease with typical symptoms such as abdominal pain， diarrhea， and bloody stools， demonstrates a high relapse rate and difficulty in curing. Sishenwan， first recorded in Internal Medicine Abstract （Nei Ke Zhai Yao）， are a classic prescription for treating diarrhea caused by deficiency of the spleen and kidney Yang. The core therapeutic principle of Sishenwan is warming and tonifying the spleen and kidney， and astringing the intestine and stopping diarrhea. In recent years， Sishenwan have demonstrated distinct advantages in the clinical treatment of UC. The pathogenesis of UC involves multiple factors， including immune dysregulation and gut microbiota imbalance. Although Western medicine is effective in the short term， its side effects， high relapse rate， and resistance associated with long-term use pose substantial challenges. Sishenwan have shown excellent clinical outcomes in the treatment of UC due to deficiency of the spleen and kidney Yang. Modern clinical studies indicate that Sishenwan， used alone or in combination with Western medicine or other Chinese medicine compound prescriptions， significantly improve the clinical efficacy in treating UC due to deficiency of the spleen and kidney Yang. Sishenwan effectively alleviate core symptoms such as mucus， pus， and blood in stools， and persistent abdominal pain， reduce Mayo scores and the relapse rate， and improve patients' quality of life. Research on the material basis reveals that Sishenwan contain multiple active ingredients such as psoralen， isopsoralen， and evodiamine. Mechanism studies indicate that Sishenwan inhibit the inflammatory cascade reactions by regulating the signal network through multiple targets. Sishenwan regulate cellular immunity and restore intestinal immune homeostasis. At the microecological level， Sishenwan promote the intestinal barrier repair through the "microbiota-metabolism-immunity" axis. The current research still needs to be deepened in aspects such as the mining of specific biomarkers for syndromes and the exploration of the collaborative mechanism of traditional Chinese and Western medicine. In the future， a full-chain system covering syndrome differentiation， targeting， and monitoring needs to be constructed for promoting the paradigm transformation of Sishenwan into precision drugs. This review systematically explains the treatment mechanism of Sishenwan regarding the combination of disease and syndrome and its multi-target regulatory characteristics， providing a theoretical basis and transformation direction for the treatment of UC with integrated traditional Chinese and Western medicine.

Objective To analyze the characteristics of colorectal adenoma onset,traditional Chinese medicine(TCM)syndromes,and factors influencing advanced colorectal adenoma.Methods A cross-sectional study was conducted to retrospectively analyze the data of 480 patients with colorectal adenoma admitted to the Department of Gastroenterology of Wangjing Hospital,China Academy of Chinese Medical Sciences,between January 2024 and January 2025 who met the inclusion and exclusion criteria.The hospital case system was used to collect demographic information,basic medical history,general conditions associated with colorectal adenoma,and records of TCM syndrome types,which were compiled into a clinical information Excel spreadsheet.Descriptive statistics were calculated to determine the distribution of demographic information,basic medical history,and TCM syndrome types.The chi-square test or Monte Carlo simulation method was used to analyze the differences in the number,size,pathological type and location of colorectal adenomas,as well as the distribution of TCM syndrome types.Univariate chi-square test was used to analyze the related factors of patients with advanced colorectal adenoma,and the statistically significant variables were included in the multivariate logistic regression analysis to analyze the influencing factors of advanced colorectal adenoma.Results Among the 480 patients with colorectal adenoma,296 were male with an onset age of(60.51±11.17)years,and 184 were female with age of(61.65±11.87)years.There were 233 patients(46.46％)aged 45 to 64.There were 269 cases(56.04％)of overweight individuals.Adenomas smaller than 1 cm accounted for 73.33％(352/480).Among the number of adenomas,single adenomas accounted for 66.46％(319/480).Among the pathological types,tubular adenoma accounted for 86.67％(416/480).The left colon accounted for 80.0％(384/480)of the affected sites.The main clinical manifestations included abdominal distension(20.63％,99/480),abdominal pain(16.25％,78/480),diarrhea(9.79％,47/480),among others.The main syndrome types in traditional Chinese medicine are damp-heat syndrome of the large intestine(25.83％,124/480)and spleen deficiency with excessive dampness syndrome(22.94％,110/480).There was a statistically significant difference in the distribution of TCM syndrome types among patients of different age groups(P=0.010).Multitype adenoma(OR=4.504,95％CI:2.819～7.198,P<0.001)and the right colon site(OR=2.166,95％CI:1.146～4.092,P<0.05)are independent risk factors for advanced colorectal adenoma.Conclusion Colorectal adenomas are more common in men and tend to occur in middle-aged people.Adenomas under 1 cm are the most common.Single adenomas and tubular adenomas are more common.The left half of the colon is a common site of occurrence.Common clinical symptoms include abdominal distension,abdominal pain,diarrhea,etc.Damp-heat syndrome of the large intestine is the most common type of syndrome in traditional Chinese medicine.The number of multiple adenomas and the location of the right colon are independent risk factors for advanced colorectal adenomas.

Myelodysplastic syndrome (MDS) is considered as a preleukemic course, characteristic of hypercellular marrow and pancytopenia. Many studies have demonstrated that defects occur in the heamtopoietic cells from patients with MDS. Recently, many abnormal changes in apoptosis, proliferation, ability of hematopoietic support, cytokine secretion, clonal origin of stromal cells and angiogenesis have also been revealed in the bone marrow microenvironment of MDS patients.