Objective To investigate the clinical value of an 18F-FDG PET/CT radiomics model in differentiating benign from malignant solitary pulmonary nodules with negative tumor markers and positive FDG uptake. MethodsThe data of 130 patients with such pulmonary nodules admitted to Baoding No. 1 Central Hospital from January 2019 to December 2024 were collected. The patients were randomly divided into a training set (n = 91) and an internal test set (n = 39) at a ratio of 7:3. Eligible independent cases were additionally collected from the Cancer Imaging Archive (TCIA) public database as an external validation set (n = 45). PET and CT radiomics features were extracted using LIFEx software. Core features were selected through intraclass correlation coefficient (ICC) stability assessment, Spearman correlation analysis, and least absolute shrinkage and selection operator (LASSO) regression. Logistic regression (LR), random forest (RF), and support vector machine (SVM) models were constructed separately. Receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were used to evaluate and compare the performance of the models. ResultsA total of 8 key radiomics features were ultimately selected, including 4 PET features and 4 CT features. In the internal test set, the LR model showed the best performance, with an area under the curve (AUC) of 0.819 (95% CI: 0.738-0.892), a sensitivity of 0.792, and a specificity of 0.800. In the external validation set, the LR model also maintained the best discriminative performance, with an AUC of 0.801 (95% CI: 0.713-0.905), which was significantly higher than those of the RF model (AUC = 0.721, P = 0.041) and the SVM model (AUC = 0.717, P = 0.028). DCA demonstrated that the LR model yielded greater clinical net benefit in both the internal test set and the external validation set. ConclusionsFor difficult-to-differentiate solitary pulmonary nodules with negative tumor markers and high FDG uptake, PET/CT radiomics models, particularly the LR model, have good discriminative performance and generalizability and can provide an objective quantitative reference for preoperative decision-making.
ObjectiveThis study aimed to evaluate the predictive value of the triglyceride-glucose (TyG) index for coronary in-stent restenosis (ISR) and develop a machine learning model integrating TyG with multidimensional clinical features. MethodsTwo hundred and seventy patients who underwent coronary stent implantation in Department of Cardiovascular Medicine, Longyan First Affiliated Hospital of Fujian Medical University from January 2021 to December 2024 were enrolled. They were categorized into the ISR (n = 62) and non-ISR (n = 208) groups based on follow-up angiography. The TyG index was calculated. Risk factors for ISR were identified using univariate and multivariate Logistic regression, and the predictive performance of TyG was assessed using ROC curves. Five machine learning algorithms [Logistic regression(LR), random Forest(RF）,extreme gradient boosting(XGBoost）,light gradient boosting machine(LightGBM), support vector machine(SVM）]were trained and validated using 5-fold cross-validation. Model interpretability was achieved via SHAP analysis. ResultsThe ISR incidence was 23.0% (62/270). Patients with ISR exhibited a significantly higher TyG index compared to controls (9.17±0.42 vs. 8.82±0.45, P ＜ 0.001). Multivariable analysis identified the TyG index as an independent predictor of ISR (OR = 5.641, 95% CI: 2.428 ～ 13.108, P ＜ 0.001). The TyG index yielded an AUC of 0.708 (cutoff: 9.111; sensitivity: 62.9%; specificity: 73.1%). Among the machine learning models, LR demonstrated superior performance (AUC = 0.841±0.041), with SHAP analysis highlighting the TyG index as a critical predictive variable. ConclusionsThe TyG index serves as an independent risk factor and predictor for ISR following coronary stenting. Integrating TyG into machine learning models based on multidimensional clinical data significantly improves ISR prediction accuracy.
Chronic non-healing wounds,such as diabetic foot ulcers,venous ulcers,and burn wounds,represent a persistent clinical challenge due to delayed repair and high risk of complications.Studies have shown the role of macrophages in regulating lymphatic vessel formation and function through phenotypic transitions,forming what is referred to as the"macrophage-lymphatic axis".This axis relies on IL-4/STAT6-VEGF-C/VEGFR-3-PI3K/Akt signaling,and coordinates lymphatic endothelial cell proliferation,migration,and lumen formation via paracrine signals,exosomes,and direct cell interactions.Despite differences in etiology,these chronic wounds share common features,including insufficient macrophage reparative polarization,impaired lymphangiogenesis,and compromised lymphatic drainage.Targeted Western medicine therapies,bioactive components of traditional Chinese medicine(TCM),and integrated TCM-Western medicine interventions can break the cycle of persistent inflammation and stalled repair by modulating multiple steps in these processes.This review summarizes current understanding of the macrophage-lymphatic axis in chronic wound repair,its dysregulation,and potential interventions.
Prostate cancer ranks second in the incidence rate of male malignant tumors and is a major disease that seriously threatens the health of men. There are difficulties in early diagnosis, treatment resistance, and a high risk of metastasis. Nanomaterials have excellent surface modification ability, excellent biocompatibility, and unique physical and chemical properties, showing great potential in the development of tumor biomarkers, precise targeted delivery, and multimodal imaging-guided therapy. This article systematically reviews the cutting-edge progress of nanomaterials in the field of prostate cancer treatment, deeply analyzes the current research status, and explores the challenges faced in the clinical translation process. Firstly, the mechanism of nanotechnology in medical diagnosis and treatment was introduced. Then, the applications of nanomaterials in new biomarker research, multimodal imaging, etc. were summarized, with a focus on the research and potential advantages of nanomaterials in chemotherapy, immunotherapy, multimodal diagnosis and treatment integration, new treatment methods (sonodynamics/photothermal), and radiotherapy sensitization. This provides a new perspective and solution for clinical challenges such as early screening, precise treatment, efficacy evaluation, and long-term monitoring of prostate cancer.
Female reproductive system-related diseases, such as intrauterine adhesions, thin endometrium, and premature ovarian insufficiency, have emerged as major clinical problems affecting women’s reproductive health. However, conventional treatments are limited by suboptimal efficacy and pronounced adverse effects. Advances in regenerative medicine have introduced novel therapeutic strategies for these conditions. Platelet-rich plasma (PRP), as an autologous biological agent, has demonstrated promising prospects in the treatment of reproductive disorders due to its favorable tissue-repair potential and bio-safety. Recent studies indicate that exosomes are key active components mediating the biological effects of PRP, and they have attracted increasing attention because of their high stability, strong targeting capacity, and low immunogenicity. This review summarizes the biological characteristics of PRP and platelet-derived exosomes, as well as their clinical applications in female reproductive system disorders, with the aim of providing a reference for both clinical practice and scientific research.
Compared with conventional clinical testing techniques,electrochemical detection of tumor markers offers distinct advantages in accuracy,rapid response,and real-time monitoring,providing early warning for related diseases.The performance of electrochemical immunosensors is governed by multiple factors,among which the selection of nanomaterials is particularly critical.This review focuses on carcinoembryonic antigen(CEA)as the target analyte and addresses the general principles of electrochemical immunosensor design and fabrication.Based on a bibliometric visualization analysis,research hotspots and evolutionary trends are revealed,and electrochemical detection principles of linear sweep voltammetry,cyclic voltammetry,and square wave voltammetry are described.Three representative nanomaterials—noble metals,transition metal compounds,and carbon-based materials—are systematically analyzed in terms of their structure-activity relationships and applications in immunosensor design.The results indicate that multi-component composites,leveraging synergistic effects among constituents,can effectively integrate conductivity and catalytic activity,representing a key route to overcome the sensitivity bottleneck.Furthermore,the combination of screen-printed electrodes with microfluidic technology facilitates the gradual standardization of sensor fabrication,serving as a pivotal approach to bridge the gap between laboratory research and clinical translation.This technical pathway,characterized by batch electrode fabrication and automated micro-sample processing,can reduce detection costs and operational errors,and is expected to provide useful insights for developing highly sensitive and low-cost point-of-care CEA detection devices.
Rheumatoid arthritis (RA) is a chronic autoimmune disease pathologically characterized by symmetrical synovitis of small joints, and its pathogenesis has not yet been fully elucidated. Recent studies have found that interleukin-22 (IL-22) plays dual roles at different stages of RA and under different cytokine microenvironments, mainly exerting pro-inflammatory and bone destruction-promoting effects, or protective effects under specific conditions. This article systematically reviews the mechanisms of IL-22 in the course of RA, summarizes recent findings on its activation of downstream signaling networks affecting fibroblast-like synoviocytes (FLS) and osteoclasts (OC), and analyzes the molecular basis and clinical translational potential of IL-22 as a key regulator of inflammation and bone destruction, thereby providing a theoretical basis for novel targeted therapies for RA. IL-22 is an inflammatory cytokine that activates the Janus kinase (JAK) /signal transducer and activator of transcription (STAT), mitogen-activated protein kinase (MAPK), nuclear factor (NF)-κB, and phosphatidylinositol 3-kinase (PI3K) / protein kinase B (AKT) / mammalian target of rapamycin (mTOR) signaling pathways by binding to the IL-22 receptor. It plays dual pro-inflammatory and anti-inflammatory roles in cell proliferation, apoptosis and immune responses. By regulating the generation, differentiation and immune responses of FLS and OC, IL-22 participates in the occurrence and development of RA, leading to synovial inflammation, pannus formation and bone destruction in the joints of patients with RA.
Sensorineural hearing loss(SNHL)represents a major global public health issue,profoundly affecting patients'physical and psychological well-being as well as their quality of life.Therapeutic options for SNHL remain limited due to irreversible damage to cochlear hair cells,degeneration of spiral ganglion neurons,and the restrictive nature of the blood-labyrinth barrier(BLB).The rapid advancement of nanotechnology in biomedical fields,characterized by its tunable particle size,active targeting capability,and multifunctionality,has demonstrated promising potential to overcome the BLB and achieve precise diagnosis and targeted therapy of inner ear disorders.As a result,nanotechnology has emerged as a research hotspot in the field of hearing loss treatment,offering a novel strategy for precision medicine.This review systematically summarizes the core applications and recent progress of nanotechnology in the treatment of SNHL,including three major directions:nanocarrier-mediated drug delivery,protection and regeneration of cochlear hair cells,and bionic nano-based auditory devices.Additionally,current challenges and future development trends of these technologies are discussed.This review aims to provide a theoretical basis for the application of nanotechnology in the diagnosis and treatment of SNHL and to offer insights for its clinical translation.
Objective To investigate the correlation between brain structural-functional network characteristics and executive function impairment in patients with cerebral small vessel disease(CSVD)from a multimodal magnetic resonance imaging(MRI)perspective.Methods Thirty patients with CSVD treated in the Department of Neurology of the First Affiliated Hospital of Guangxi University of Chinese Medicine from June 2024 to December 2025 and 30 healthy controls(HC)were selected as the study participants.General clinical data of two groups were collected,and cognitive scales and multimodal MRI were used for assessment.The cognitive scales included the Mini-Mental State Examination(MMSE),Stroop Color-Word Interference Test B/C(Stroop B/C)and Vascular Dementia Assessment Scale-cognitive Subscale(VADAS-cog).The salience,frontoparietal and dorsal attention networks were selected as regions of interest(ROI),and functional connectivity(FC)values were extracted.The potential mediating role of FC between white matter hyperintensity(WMH)burden and executive function impairment was analyzed.Comparisons between the 2 groups were performed using the independent-samples t test,Mann-Whitney U test or χ2 test.Partial correlation analysis was used to assess the correlations between FC and cognitive assessment scores.The mediating effect was tested using the Bootstrap method.Results Compared with the HC group,the CSVD group showed reduced FC in the right superior temporal gyrus(t=3.874,P＜0.001),left opercular cortex(t=4.820,P＜0.001),right angular gyrus(t=5.829,P＜0.001),right middle frontal gyrus(t=3.087,P=0.004),left superior lateral occipital cortex(t=5.494,P＜0.001),right precentral gyrus(t=6.511,P＜0.001),right superior lateral occipital cortex(t=2.755,P=0.008)and right posterior supramarginal gyrus(t=2.720,P=0.010).Correlation analysis showed that the FC value of the right middle frontal gyrus in patients with CSVD was positively correlated with Stroop B(r=0.759,P＜0.001),Stroop C(r=0.745,P＜0.001),and VADAS-cog scores(r=0.529,P=0.005).Mediation analysis showed that the right middle frontal gyrus mediated the effects of WMH burden on VADAS-cog[indirect effect=-0.017 9,95%CI(-0.043 3,-0.000 2)],Stroop B[indirect effect=-0.020 8,95%CI(-0.042 0,-0.002 5)],and Stroop C[indirect effect=-0.045 8,95%CI(-0.090 1,-0.006 5)].Conclusions Patients with CSVD exhibit abnormal FC in executive control networks centered on the frontoparietal network,and the right middle frontal gyrus is a key mediating node linking white matter structural damage to executive dysfunction.
Sarcopenia is highly prevalent among patients undergoing maintenance hemodialysis (MHD) and represents an important clinical problem affecting functional status, quality of life, and long-term prognosis. Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and function. In MHD patients, it is often driven by the combined effects of multiple factors such as chronic inflammation, malnutrition, metabolic disorders, endocrine abnormalities, and dialysis-related stress. Its pathogenesis is complex, its progression is relatively rapid, and its clinical impact is substantial. Given the high prevalence of sarcopenia and its adverse clinical outcomes in the MHD population, a systematic understanding of its pathogenesis, clinical outcomes, and intervention strategies is of great significance for the early identification of high-risk patients in clinical practice. This article reviews the definition, epidemiological characteristics, pathogenesis, clinical outcomes, and intervention and management strategies of sarcopenia in MHD patients, with the aim of deepening the understanding of its clinical significance in this population and providing a reference for clinical prevention and treatment as well as future research.
ObjectiveTo investigate the mechanism by which Scutellaria barbata D. Don regulates ferroptosis in hepatocellular carcinoma (HCC) cells. MethodsNetwork pharmacology was used to screen the intersecting targets of Scutellaria barbata D. Don, HCC, and ferroptosis regulation. Molecular docking was then performed to validate the binding between the main active components of Scutellaria barbata D. Don and the screened key targets. Huh7 cells were cultured in vitro, and the cell counting kit-8 (CCK-8) assay was used to detect cell proliferation after treatment with Scutellaria barbata D. Don at different concentrations (0, 3.15, 6.3, 12.5, 25, and 50 mg/mL) for 24 h, so as to determine the optimal drug concentration. Huh7 cells were divided into a control group and a Scutellaria barbata D. Don group (20 mg/mL). Lactate dehydrogenase (LDH) release, Fe2+ content, reactive oxygen species (ROS) levels, and mitochondrial membrane potential were measured. Quantitative polymerase chain reaction (qPCR) and Western blot were used to detect the mRNA and protein expression levels of ferroptosis-related indicators, including glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), iron-responsive element-binding protein 2 (IREB2), and long-chain acyl-CoA synthetase 4 (ACSL4), as well as key targets, including mitogen-activated protein kinase 14 (MAPK14), tumor protein p53 (TP53), hypoxia-inducible factor-1α, NF-κB subunit (p65) gene (RELA), and MAPK1. A Huh7 subcutaneous xenograft model was established in male BALB/c nude mice, which were randomly divided into a control group and a Scutellaria barbata D. Don group. The control group was given normal saline by gavage, while the Scutellaria barbata D. Don group was given Scutellaria barbata D. Don granules at 140 mg/kg by gavage. Tumor volume and weight were monitored regularly. After tissue collection, hematoxylin-eosin (HE) staining was performed to evaluate pathological changes in tumor tissues. ResultsNetwork pharmacology identified the top five active components of Scutellaria barbata D. Don as quercetin, luteolin, wogonin, baicalein, and eriodictyol. These components showed strong binding affinities with the core targets MAPK14, TP53, HIF-1α, RELA, and MAPK1. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that Scutellaria barbata D. Don-induced ferroptosis in HCC cells was associated with the HIF-1 signaling pathway, cancer-related signaling pathways, and the IL-17 signaling pathway. In vitro experiments confirmed that Scutellaria barbata D. Don inhibited Huh7 cell proliferation in a concentration-dependent manner. Compared with the control group, the Scutellaria barbata D. Don group showed increased intracellular ROS and Fe2+ levels and decreased mitochondrial membrane potential. Among ferroptosis-related indicators, the mRNA and protein expression levels of GPX4 and SLC7A11 were downregulated, while those of IREB2 and ACSL4 were upregulated. The mRNA and protein expression levels of the network pharmacology-screened targets MAPK1, TP53, MAPK14, and HIF-1α were increased, whereas RELA expression was decreased. In vivo experiments showed that tumor volume and weight in mice in the Scutellaria barbata D. Don group were lower than those in the control group. Tumor tissue cells were arranged irregularly, with obvious necrotic foci observed. ConclusionScutellaria barbata D. Don can effectively inhibit the malignant progression of HCC both in vivo and in vitro, and its mechanism may be associated with the induction of ferroptosis in HCC cells.
The incidence of hyperlipidemia has continued to rise and shows a trend toward younger onset, making it an important issue in the prevention and treatment of metabolic diseases. In recent years, increasing attention has been paid to studies on traditional Chinese medicine intervention for hyperlipidemia through regulation of gut microbiota. Existing studies have shown that traditional Chinese medicine can improve dyslipidemia in hyperlipidemia, and its mechanisms may be associated with regulating the structure of gut microbiota, promoting the production of short-chain fatty acids, influencing bile acid metabolism, improving intestinal barrier function, and alleviating inflammatory responses. Overall, traditional Chinese medicine may exert its intervention effects by regulating the “gut microbiota-metabolite-host response” axis. This article reviews the research progress in the improvement of hyperlipidemia by traditional Chinese medicine through regulation of gut microbiota and its metabolites. This research direction has good application prospects and may provide a reference for subsequent studies on mechanisms of action and exploration of clinical translation.
Objective To investigate the effects of Sijunzi Mixture on immune function in children and adolescents with acute lymphoblastic leukemia(ALL)during maintenance therapy,and to evaluate its role as an adjunctive treatment in stabilizing humoral immune parameters.Methods A total of 50 patients aged 1-18 years with ALL who had entered the maintenance therapy phase and were admitted to the Department of Pediatric Hematology,Guangdong Provincial People's Hospital,from January 2023 to June 2025 were enrolled.They were divided into two groups using a random number table method.The control group(n=25)received standard maintenance chemotherapy,while the medication group(n=25)received oral Sijunzi Mixture in addition to standard maintenance chemotherapy for approximately three months.Routine blood parameters,including white blood cell count,neutrophil count,hemoglobin level,and platelet count,as well as immunoglobulins(IgG,IgA,and IgM),serum free light chains(κ and λ),and complement levels were measured and compared between the two groups one day before the start of maintenance therapy(baseline)and after 12 weeks of maintenance therapy.The change values(Δ values)of humoral immune parameters from baseline to week 12 of maintenance therapy were also compared.Treatment interruption,defined as suspension of chemotherapy,was recorded as an exploratory clinical endpoint.Results There were no statistically significant differences between the two groups in gender,age,or risk stratification(all P＞0.05).After the intervention,there were no statistically significant differences between the two groups in routine blood parameters,IgA,IgM,serum free light chains,or complement levels(all P＞0.05).The IgG level in the medication group was higher than that in the control group(P=0.036),and the magnitudes of decline in key humoral immune parameters[ΔIgG(P=0.001),ΔIgA(P=0.005),ΔIgM(P=0.022),Δκ light chain(P＜0.001),and Δλ light chain(P=0.001)]were all smaller than those in the control group.Effect size analysis showed that the r values for ΔIgG,ΔIgA,Δκ light chain,and Δλ light chain ranged from 0.45 to 0.63,indicating medium to large effects,while the d value for ΔIgM was 0.67,indicating a medium effect.The incidence of chemotherapy interruption was lower in the medication group than in the control group(16.0%vs 48.0%,P=0.032).No obvious adverse reactions were observed in either group.Conclusions The addition of Sijunzi Mixture to standard maintenance chemotherapy can slow the rate of decline in humoral immune parameters and reduce the incidence of chemotherapy interruption in children and adolescents with ALL during maintenance therapy.
Traditional Chinese medicine (TCM) is a vast and profound system of knowledge, and beginners often find it difficult to approach. Modern TCM education frequently begins with abstract theories such as yin-yang, the five phases, zang-fu organs, and meridians. Although this helps construct a systematic framework of knowledge, it can also make TCM appear daunting to newcomers. TCM did not originate from abstract concepts imposed upon life and disease; rather, it gradually developed through long-term observation of nature, the human body, and patterns of disease, forming a mode of thinking that proceeds from observing images and phenomena to grasping underlying principles. Based on this understanding, this article summarizes the first lesson about “learning TCM with ease” delivered by Academician Tong Xiaolin at the “TCM training course for Western medicine practitioners” at the Third Affiliated Hospital of Sun Yat-sen University. It proposes a TCM learning pathway that moves “from observation to abstraction, and from thinking to practice”. This pathway takes “image-based thinking” as the key entry point, enabling learners to understand TCM principles through the observation of natural laws; deepens the holistic view of life through the concept of “unity of form and spirit”; bridges TCM pattern differentiation with modern medical indicators through the “state-target differentiation and treatment” approach; enhances clinical efficacy by mastering the essence of “dose-effect relationships in formulas and medicinals”; and integrates the wisdom of “medicine and food sharing the same origin” into everyday life.
Objective To analyze the injury of sepsis to myocardial tissue and myocardial mitochondria in rats,and to investigate the effects of alprostadil combined with Xuebijing on myocardial injury and mitochondrial structure in septic rats.Methods Ninety SPF healthy adult male SD rats were randomly divided into the sham operation group(Sham group),sepsis group(CLP group),alprostadil group(Alp group),Xuebijing group(XBJ group),and alprostadil combined with Xuebijing group(Alp+XBJ group),with 18 rats in each group.Except for the Sham group,in which only laparotomy and cecal mobilization were performed,sepsis models were established in the other four groups by cecal ligation and puncture.At 3 h after model establishment,rats in the treatment groups were given intraperitoneal injections of alprostadil(10 μg/kg),Xuebijing(10 mL/kg),or alprostadil combined with Xuebijing,respectively,while rats in the sepsis group were given an equal volume of normal saline by intraperitoneal injection.Ten rats from each group were selected to observe 7-day survival,and the remaining rats were euthanized 24 h after surgery.Serum levels of creatine kinase-MB(CK-MB)and cardiac troponin Ⅰ(cTnⅠ)were measured.Histopathological changes in myocardial tissue and mitochondrial ultrastructural changes were observed by HE staining and transmission electron microscopy,respectively.The mitochondrial cross-sectional area and volume density were further quantitatively analyzed using images obtained under transmission electron microscopy.Results There was a statistically significant difference in the 7-day survival rate among the groups(log-rank:χ2=33.587,P＜0.001).The 7-day survival rate in the CLP group was lower than that in the Alp+XBJ group(P=0.003).No statistically significant differences in 7-day survival were observed among the XBJ,Alp,and Alp+XBJ groups(P=0.464,0.330,and 0.074,respectively).Compared with the Sham group,the sepsis group showed increased serum CK-MB and cTnⅠ levels(both P＜0.001),disordered myocardial tissue structure,and inflammatory cell infiltration.Under electron microscopy,mitochondrial swelling,cristae disruption,and vacuolar degeneration were observed,with increases in mitochondrial cross-sectional area and volume density(both P＜0.001).Under the sepsis model,two-way analysis of variance showed that an interaction effect was also observed between alprostadil and Xuebijing in reducing CK-MB and cTnⅠ levels(F=10.98,P=0.003;F=9.63,P=0.004),the estimated marginal means plot showed that the combination therapy had a synergistic effect.In terms of ultrastructure,both drugs improved mitochondrial cross-sectional area and volume density(both P＜0.001),and the combination therapy showed superior improvement in mitochondrial cross-sectional area compared to each monotherapy group(both P＜0.05).Conclusions Sepsis can lead to myocardial injury and mitochondrial structural damage in rats.The combined application of alprostadil and Xuebijing can enhance the cardioprotective effect and shows synergistic effects on some mitochondrial structural indicators.
Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes, affecting approximately half of patients during their disease course. The resulting limb numbness, paresthesia, and pain not only deteriorate the quality of life but also increase the risks of foot ulcers and amputation. Western medicine primarily focuses on glycemic control, anti-oxidative stress, and neurotrophic therapies; while having specific targets, these approaches struggle to reverse established nerve damage, and the adverse effects of long-term medication cannot be ignored. Traditional Chinese medicine (TCM) has accumulated substantial clinical experience in alleviating symptoms and promoting nerve repair. However, the overall efficacy of integrated Chinese and Western medicine requires a systematic review of existing evidence.This article systematically reviewed the pathogenesis and therapeutic evidence of DPN in both Western medicine and TCM, and constructed a clinically applicable integrative strategy framework to provide a reference for clinical decision-making. From a pathophysiological perspective, Western medicine considers DPN a complex outcome of metabolic disorders, oxidative stress, microangiopathy, neuroinflammation, and neurotrophic factor deficiency, making it difficult for monotherapy to cover all pathological pathways. TCM categorizes DPN as “Xiaoke Bi syndrome”, with its core pathogenesis centered on “deficiency, stasis, and phlegm”. The collateral vessel pathology in TCM is highly isomorphic with microangiopathy in Western medicine. According to the 2016 TCM clinical practice guidelines, DPN is classified into six syndromes. Regarding therapeutic evidence, the core herbs for internal application include Astragali Radix (Huangqi), Angelicae Sinensis Radix (Danggui), Spatholobi Caulis (Jixueteng), and Cinnamomi Ramulus (Guizhi); acupuncture primarily targets ST36 (Zusanli), SP6 (Sanyinjiao), and LI4 (Hegu). Current research has established various synergistic models, including Western medicine combined with Chinese herbs, acupuncture, or triple therapy.The integrative treatment of DPN relies on the theoretical foundation of “isomorphic pathogenesis”, adopting a collaborative principle where Western medicine manages glycemic control and acute conditions, while TCM alleviates symptoms, promotes nerve repair, and mitigates Western drug toxicities. Based on this, different synergistic combinations are selected according to the disease stage and TCM syndromes. This “stepped synergistic” strategy offers an actionable approach for the standardized integrative treatment of DPN.
ObjectiveTo investigate the effects of electroacupuncture (EA) at Baihui (GV20) and Hegu (LI4) on postoperative cognitive dysfunction (POCD) in aged rats, and to clarify whether these effects are exerted through regulation of the NOD-like receptor pyrin domain-containing protein 3 (NLRP3)/cysteine-aspartic protease-1 (Caspase-1) signaling pathway. MethodsForty 20-month-old SD rats, equivalent to approximately 60 years of age in humans, were divided by the random number table method into the control group (C group), electroacupuncture group (E group), surgery group (S group), and electroacupuncture plus surgery group (ES group), with 10 rats in each group. A POCD model in aged rats was established by splenectomy combined with exploratory laparotomy. Rats in the E and ES groups received electroacupuncture intervention at Baihui (GV20) and Hegu (LI4), using a 2 Hz/15 Hz disperse-dense wave, 1 mA current, 30 min per session, once daily for 5 consecutive days. Cognitive function was evaluated using the Morris water maze, Y-maze, and novel object recognition tests. Pathological changes in the hippocampus were observed by hematoxylin-eosin (HE) staining, Nissl staining, and dUTP nick-end labeling (TUNEL) staining. Immunofluorescence was used to detect the expression of NLRP3 in hippocampal tissue. Western blotting was used to detect changes in the expression of NLRP3 inflammasome-related proteins, including NLRP3, Caspase-1, and apoptosis-associated speck-like protein (ASC), the inflammatory factors IL-1β and IL-18, and the anti-apoptotic protein B-cell lymphoma/leukemia-2 (Bcl-2). Real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) was used to detect the mRNA expression levels of IL-1β and IL-18 in the hippocampus. ResultsThe interaction effect between surgery and electroacupuncture was significant. Further simple effect analysis showed that, in the absence of electroacupuncture, compared with the C group, rats in the S group had a prolonged escape latency [(27.00±4.21) s vs. (47.68±9.00) s], reduced number of platform crossings [(6.20±1.64) times vs. (0.80±0.84) times], reduced spontaneous alternation rate [(66.10±9.94)% vs. (41.43±7.34)%], and reduced novel object recognition index [(72.31±6.25)% vs. (46.36±8.68)%]. Hippocampal neuronal structural damage was observed, the number of neurons in the hippocampal CA1 region decreased [(61.67±17.39) cells/high-power field vs. (20.67±4.51) cells/high-power field], the apoptosis index increased (4.65±1.09 vs. 49.38±6.85), and the integrated fluorescence intensity of NLRP3 in hippocampal tissue increased (0.25±0.05 vs. 0.59±0.03). The expression levels of NLRP3 (0.80±0.05 vs. 1.12±0.04), Caspase-1 (0.59±0.03 vs. 1.23±0.03), ASC (0.67±0.02 vs. 1.24±0.02), IL-1β (0.68±0.04 vs. 1.12±0.08), and IL-18 (0.41±0.04 vs. 1.15±0.07) were all increased, while Bcl-2 expression decreased (0.88±0.10 vs. 0.27±0.03) (all P ＜ 0.05). Under surgical conditions, compared with the S group, rats in the ES group showed improved cognitive function, reduced hippocampal neuronal structural damage, increased number of neurons in the hippocampal CA1 region [(20.67±4.51) cells/high-power field vs. (56.00±6.08) cells/high-power field], decreased apoptosis index (49.38±6.85 vs. 10.87±1.18), and reduced integrated fluorescence intensity of NLRP3 in hippocampal tissue (0.59±0.03 vs. 0.32±0.05). The expression levels of NLRP3 (1.12±0.04 vs. 0.84±0.03), Caspase-1 (1.23±0.03 vs. 0.69±0.02), ASC (1.24±0.02 vs. 1.04±0.04), IL-1β (1.12±0.08 vs. 0.81±0.02), and IL-18 (1.15±0.07 vs. 0.78±0.05) were all decreased, while Bcl-2 expression increased (0.27±0.03 vs. 0.84±0.03) (all P ＜ 0.05). ConclusionsElectroacupuncture at Baihui and Hegu can improve cognitive function in aged rats with POCD. Its effects are associated with inhibition of the NLRP3/Caspase-1 signaling pathway and attenuation of hippocampal neuroinflammatory responses and neuronal apoptosis.
Existing studies on chronic obstructive pulmonary disease (COPD) have mostly focused on airway lesions, with insufficient attention paid to the critical role of alveolar structural damage. Alveolar loss-type COPD, characterized primarily by emphysema, is the core structural basis for lung function decline and worsening clinical outcomes. This article systematically reviews the pathological network mediating alveolar loss through multiple mechanisms, including protease-antiprotease imbalance, persistent activation of oxidative stress, chronic inflammatory responses and differences in inflammatory endotypes, autoimmune abnormalities, and impaired repair function of alveolar epithelial and mesenchymal cells. It focuses on analyzing the synergistic effects of targeted Western medical therapies and traditional Chinese medicine treatment based on syndrome differentiation in regulating the inflammatory microenvironment and improving repair capacity, explores the value of non-pharmacological interventions in comprehensive management, and clarifies the multiple mechanism-mediated regulatory network of alveolar loss and the potential of integrated traditional Chinese and Western medicine interventions. From an integrated perspective of structural damage, inflammatory milieu, and repair imbalance, this article provides a theoretical basis and practical reference for precision classification, diagnosis, and treatment of alveolar loss-type COPD and combined Chinese and Western medicine interventions.
Cardiovascular disease (CVD) is the leading cause of death in China. Integrated traditional Chinese and Western Medicine (ITCWM) has unique advantages in the prevention and treatment of CVD. However, the lack of objective quantitative standards of traditional Chinese Medicine (TCM) and the challenges in the integration of heterogeneous data of TCM and western medicine restrict its standardized development. Artificial Intelligence (AI) relies on multimodal fusion, machine learning and other technologies to provide a critical path to break the above bottlenecks. We systematically sort out the adaptation logic of AI core technology and ITCWM, review the application status and research progress in this field across five dimensions of CVD risk warning, diagnosis, treatment, prognostic management, and clinical decision support, and analyze the challenges such as insufficient data standardization, poor interpretation of algorithms, and lagging clinical translation. Therefore, we propose an implementation approach centered on standardized database construction, interpretable AI research and development, and real-world clinical verification. The aim of this study is to promote the deep integration of AI with the ITCWM, build an intelligent diagnosis and treatment system of CVD with Chinese characteristics, and provide a reference for research and transformation in this field.
The perioperative period refers to the interval from the decision to undergo surgical treatment through the operation itself to the stage of basic recovery. Patient-centered, multidisciplinary collaborative enhanced recovery after surgery (ERAS) has become a major trend in modern clinical medicine. The integrative application of traditional Chinese and Western medicine is grounded in modern surgery and anesthesiology, while incorporating the holistic perspective and syndrome differentiation principles of traditional Chinese medicine, thereby exerting synergistic and complementary effects at different stages of the perioperative period. In recent years, research on the integrative application of traditional Chinese and Western medicine in the perioperative period has increased, demonstrating potential benefits in the preoperative, intraoperative, and postoperative stages. Accordingly, the present review reviewed and synthesized relevant domestic and international studies on integrative perioperative management, summarizes the principal application approaches, and analyzes the advantages and challenges of current research, with the aim of providing references for the standardized perioperative application of integrated traditional Chinese and Western medicine.
