IntroductionHepatocellular carcinoma (HCC) is a leading cause of cancer death globally. Transarterial chemoembolization (TACE) is key for unresectable HCC, but patient outcomes vary, necessitating reliable prognostic markers. Although preoperative serum prealbumin (PAB) reflects nutrition and liver function and shows prognostic potential in single-center studies, high-level evidence is lacking. This meta-analysis aimed to systematically confirm the prognostic value of baseline serum PAB in HCC patients undergoing TACE.Materials and methodsRelevant publications up to February 3, 2026, were retrieved from PubMed, The Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM databases. Fixed-effect or random-effects models were used to calculate the pooled hazard ratio (HR) for overall survival (OS) and odds ratio (OR) for clinicopathological characteristics associated with serum PAB. Sensitivity and subgroup analyses investigated heterogeneity and assessed result stability. Publication bias analysis was conducted to evaluate the reliability of the meta-analysis findings.ResultsEight datasets from five studies were analyzed. Lower baseline PAB was significantly associated with poorer OS (pooled HR for high vs. low PAB = 0.64, 95% CI: 0.59–0.70, P<0.0001; random-effects model, I2 = 0%). Higher PAB correlated with favorable features: earlier BCLC stage (OR = 2.23), better Child-Pugh class (OR = 5.36), absence of vascular invasion (OR = 0.44) or extrahepatic metastasis (OR = 0.22), smaller tumor size (OR = 0.51), single tumor (OR = 1.39), and lower AFP (OR = 0.56) (all P<0.05 except single tumor P = 0.020 and AFP P = 0.006). No significant association was found between prealbumin level and hepatitis B virus (HBV) infection status (P = 0.630). Subgroup and sensitivity analyses supported these findings, with no significant publication bias.ConclusionThe analysis of 2,996 patients confirms that lower baseline serum PAB is significantly associated with poorer OS and unfavorable clinicopathological features in HCC patients receiving TACE. Further prospective and multi-center studies are needed to validate its clinical utility.

ObjectivesTo evaluate the efficacy and safety of Yiqi Huatan Sanjie (YQHTSJ) Formula in patients with pulmonary nodules and the traditional Chinese medicine pattern of Lung-Spleen Qi deficiency with phlegm-stasis accumulation.MethodsIn this prospective two-center cohort study, 170 patients were enrolled, including 50 in the treatment group and 120 controls. The treatment group received YQHTSJ Formula for 3 months, whereas controls underwent watchful waiting. The primary outcome was change in mean nodule diameter on computed tomography. Secondary outcomes included exploratory artificial intelligence-assisted volumetry, traditional Chinese medicine symptom scores, anxiety and depression scores, and safety. Propensity score matching was performed using 1:1 nearest-neighbor matching with a caliper of 0.2.ResultsOf 170 enrolled patients, 140 completed follow-up. Propensity score matching generated 37 matched pairs, with all standardized mean differences below 0.1. In the matched cohort, the diameter-based response rate was higher with YQHTSJ Formula than with watchful waiting (43.2% vs 0.0%; exact McNemar test, P< 0.001), with 16 discordant pairs favoring treatment and none favoring control. The paired mean difference in diameter change was −2.95 mm favoring treatment (95% CI, −4.62 to −1.29; paired t-test, P = 0.001). Anxiety and traditional Chinese medicine symptom scores improved after treatment (both P < 0.05). Among 14 treated patients with evaluable paired thin-slice DICOM data, the exploratory volumetric response rate was 50.0%. No serious adverse events occurred.ConclusionsYQHTSJ Formula was associated with short-term pulmonary nodule regression or stabilization and was generally well tolerated. Larger randomized multicenter trials are needed.

IntroductionDEP domain containing 1 (DEPDC1) has been well-known as a significant contributor to tumorigenesis and cancer progression. However, its potential oncogenic mechanism in liposarcoma is still unclear.MethodsIn this study, the expression and clinical relevance of DEPDC1 in sarcoma was assessed by employing data from The Cancer Genome Atlas (TCGA) data and conducting Kaplan-Meier online analyses, respectively. Furthermore, the impact of DEPDC1 on cellular functions of liposarcoma cell lines and its underlying mechanisms were studied using the in vitro assays.ResultsHere, our findings revealed that the expression levels of DEPDC1 and KIF20A were elevated in liposarcoma compared to the paired adjacent adipose tissues, with their expression positively correlating with the malignancy of liposarcoma. Moreover, patients with high DEPDC1 or KIF20A mRNA levels experienced shorter survival times. In vitro assays showed that DEPDC1 overexpression enhanced cell proliferation, migration, and invasion in 93T449 cells, whilst an opposite effect was observed in SW872 cells with DEPDC1 knockdown. Furthermore, potential interacting proteins of DEPDC1 were predicted by STRING, and the DEPDC1-KIF20A interaction was confirmed by co-immunoprecipitation in liposarcoma cells. The deletion of KIF20A partially mitigated the promoting effect of DEPDC1 on the malignant phenotype of liposarcoma cells and the activation of PI3K/AKT/mTOR signaling pathway.ConclusionsIn conclusion, this study suggested that DEPDC1 might interact with KIF20A to promote the occurrence and progression of liposarcoma by activating PI3K/AKT/mTOR signaling pathway.

The causal relationship between plasma methyltransferase protein concentrations and the onset of digestive system cancers remains unclear. This study employed a Mendelian randomization (MR) analysis to explore potential causal relationships. A bidirectional two-sample MR analysis was conducted to systematically investigate causal associations. Data from the FinnGen Biobank and the European Bioinformatics Institute (EBI) were used for verification. This analysis focused on 14 types of methyltransferases and 5 types of digestive system cancers. The analysis identified specific methyltransferases associated with increased risks for certain digestive system malignancies. Notably, dual verification confirmed that HEMK2 is associated with an increased risk of colorectal cancer [Odds Ratio (OR) = 1.28; 95

RESEARCH QUESTION:What is the effect and underlying molecular mechanism of plasminogen activator inhibitor 1 (PAI-1) on the progress of endometrial fibrosis in intrauterine adhesions (IUA)? DESIGN:The expression of PAI-1 was investigated in endometrial tissues from 20 healthy women and 31 individuals with IUA. Quantitative real-time PCR, haematoxylin and eosin staining and immunofluorescence staining were applied to examine the endometrial morphology as well as the expression of mRNA and proteins. An in-vitro model of endometrial fibrosis was constructed by inducing primary human endometrial stromal cells to differentiate into myofibroblasts using transforming growth factor β1 (TGF-β1). The study also examined the alterations in the FAK/Src/ERK and AKT signalling pathways in primary hESC following the knockdown of PAI-1, both before and after TGF-β1 treatment. RESULTS:There was a dramatically higher expression of PAI-1 mRNA in adhesive endometrial tissues than in normal endometrium from IUA patients (P = 0.0439). A significant difference in PAI-1 concentration was also observed between normal endometrium from healthy women and fibrotic tissues from IUA patients (P = 0.0087). Furthermore, PAI-1 expression was up-regulated following treatment with TGF-β1 in vitro. Moreover, the silencing of PAI-1 inhibited the expression of fibrosis markers (FN1, COL1A1 and α-SMA), revealing that PAI-1 deletion exerted an anti-fibrotic effect. PAI-1 down-regulation also suppressed the activation of the FAK/Src/ERK and AKT signalling pathways as well as the proliferation and migration of TGF-β1-treated primary hESC. CONCLUSIONS:PAI-1 acts as a regulator of endometrial fibrosis progression via modulation of the FAK/Src/ERK and AKT signalling pathways, offering new insights into the clinical treatment of IUA.

Objective:We undertook a knowledge map-based visual analysis of the literature concerning the use of Traditional Chinese Medicine (TCM) for treating lung cancer. By examining publications over the past three decades, we aimed to elucidate the current status of research, identify key areas of focus, and anticipate future trends in this field, thereby providing valuable insights for future scientific and clinical investigations.Materials and Methods:Using CiteSpace and VOSviewer software, a scientometric and visual analysis was conducted on literature from the Web of Science Core Collection Database spanning 1994-2023, focusing on TCM in the context of lung cancer treatment.Results:In total, 857 publications were included. The volume of publications from 1994 to 2023 followed an exponential function y = 0.8837e0.2335x, with an average annual publication rate of 28.6 articles, indicating a growing interest in this field. China emerged as the most prolific contributor, accounting for approximately 92.88% of the total literature. Shanghai University of TCM was the leading institution, contributing approximately 8.63% of the total publications, with Ling Xu being the most prolific author, representing approximately 1.98%. There are notable collaborative relationships among different countries, institutions, and authors that need to be maintained and nurtured. The journal with the highest publication volume was Evidence-based Complementary and Alternative Medicine, which accounted for approximately 6.18% of the total literature. The most cited journal was The Journal of Ethnopharmacology, whereas the CA-A Cancer Journal for Clinicians had the most significant impact in 2023 (Impact Factor 254.700). The most cited publication was "Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries," and the paper with the highest centrality was "Pilot study of huachansu in patients with hepatocellular carcinoma, nonsmall-cell lung cancer, or pancreatic cancer." Key research hotspots mainly focus on the quality of life for lung cancer patients treated with TCM, NSCLC, apoptosis, metastasis, and exploration of the anti-cancer mechanisms of TCM. Research has mainly focused on exploring the potential mechanisms of TCM in the treatment of lung cancer through approaches such as network pharmacology and molecular docking.Conclusions:This study provides an in-depth and comprehensive perspective on the use of TCM for the treatment of lung cancer. We identified the current status, research hotspots, and emerging trends in this field, thereby offering invaluable information to researchers.

BackgroundThe advanced lung cancer inflammation index (ALI) is a composite index that combines inflammation and nutritional status, and non-alcoholic fatty liver disease (NAFLD) is associated with inflammation, nutritional status, and obesity. This study aimed to investigate the possible relationship between ALI and NAFLD.MethodsWe extracted cohort datasets from the 2017–2020 National Health and Nutrition Examination Survey (NHANES) for the study. Weighted analyses and multivariate linear regression models were applied to assess the association between ALI and NAFLD. Fitted curves and threshold effects analyses were used to characterize nonlinear relationships.ResultsA total of 6,595 adults aged 18–80 years were included in this study. In multivariate linear regression analysis, there was a significant positive association between ALI and NAFLD [OR: 1.02, 95% CI (1.01, 1.02)]. In subgroup analyses, this positive association was maintained in females [OR: 1.02, 95% CI (1.01, 1.02)] and not in males. In addition, we found that the association between ALI and NAFLD was nonlinear, with an L-shaped relationship and an inflection point of 32.47. ALI showed a U-shaped association with NAFLD in the male population, with an inflection point of 40.65, and an L-shaped association in the female population, with an inflection point of 30.61.ConclusionOur study suggests that there is a significant positive association between high ALI levels and NAFLD prevalence in the US adult population. However, more clinical cohort studies are needed to confirm this finding.

STUDY QUESTION Does the expression of proliferating cell nuclear antigen (PCNA) in the endometrium regulate endometrial receptivity in patients with recurrent implantation failure (RIF)?SUMMARY ANSWER A high abundance of PCNA attenuates endometrial adhesive capacity and decidualization in patients with RIF.WHAT IS KNOWN ALREADY Aberrant expression of PCNA has been discovered in multiple infertility-related disorders. However, the expression pattern and role of PCNA in the establishment of endometrial receptivity and endometrial decidualization in patients with RIF remain unclear.STUDY DESIGN, SIZE, DURATION We analysed the expression of PCNA in mid-secretory endometrial tissues from 24 patients with RIF and 24 healthy women. Additionally, PCNA expression levels were measured in proliferative and mid-secretory phase endometrial tissue samples from women with regular menstrual cycles and in decidual tissue samples taken from ten women during normal early pregnancy (n = 10 per phase for each group). The function and regulatory mechanisms of PCNA in endometrial adhesive capacity and endometrial decidualization were investigated using BeWo spheroids, Ishikawa cells, and human endometrial stromal cells (HESCs).PARTICIPANTS/MATERIALS, SETTING, METHODS The expression of PCNA in mid-secretory endometrial tissues of patients with RIF and women with normal endometrium and in endometrial tissue at different stages of the menstrual cycle and in decidualized tissues was analysed by RT-qPCR, western blot, and immunohistochemistry staining (IHC). Furthermore, the number of BeWo spheroids directly attached to the Ishikawa cell monolayers, and the potential molecular mechanisms involved, were compared between cells overexpressing PCNA and a control group. Additionally, the effect and regulatory mechanisms of PCNA on the decidualization of HESCs in vitro were investigated.MAIN RESULTS AND THE ROLE OF CHANCE Our findings indicated that the abundance of PCNA was dramatically greater in mid-secretory endometrial tissues from patients with RIF than in those from women with healthy endometrium. The expression of PCNA increased in the proliferative phase of the menstrual cycle but decreased gradually in the mid-secretory phase and in decidual tissues. Interestingly, PCNA was expressed in both human endometrial epithelial cells (HEECs) and HESCs. In Ishikawa cells, PCNA overexpression dramatically reduced the endometrial adhesive capacity by inhibiting the expression of adhesion molecules (E-cadherin and integrin beta 3) and activating the FAK/paxillin signalling pathway. Furthermore, in HESCs, PCNA overexpression attenuated endometrial decidualization by activating the AKT/beta-catenin signalling pathway and increasing tight junctions between cells by upregulating ZO-1 and occludin expression. In addition, PCNA-ELAVL1 interactions were confirmed by coimmunoprecipitation in decidualized HESCs.LARGE SCALE DATA N/A.LIMITATIONS, REASONS FOR CAUTION The functional analysis of PCNA was limited by the number of human endometrial tissues. A larger sample size is required to further explore the potential roles of PCNA during embryo implantation. Moreover, the present results should be taken with caution, as only a few of the embryos that were transferred in RIF patients population underwent preimplantation genetic testing for embryonic chromosome aneuploidies (PGT-A), despite embryo ploidy testing being significant in the diagnosis of unexplained RIF. WIDER IMPLICATIONS OF THESE FINDINGS High PCNA expression attenuates endometrial adhesive capacity and decidualization in patients with RIF. These findings provide new insights into the potential mechanisms underlying the occurrence of implantation failure.STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Natural Science Foundation of China (82101698), Shandong Provincial Natural Science Foundation (ZR2021MH012), and the Science and Technology Plan of Yantai (2023YD021 and 2022YD031). The authors have no conflicts of interest to disclose.TRIAL REGISTRATION NUMBER N/A.

To investigate whether Buthus martensii karsch (Scorpiones), Scolopendra subspinipes mutilans L. Koch (Scolopendra) and Gekko gecko Linnaeus (Gekko) could ameliorate the hypoxic tumor microenvironment and inhibit lung cancer growth and metastasis by regulating phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin/hypoxia-inducible factor-1α (PI3K/AKT/mTOR/HIF-1α) signaling pathway. Male C57BL/6J mice were inoculated with luciferase labeled LL/2-luc-M38 cell suspension to develop lung cancer models, with rapamycin and cyclophosphamide as positive controls. Carboxy methyl cellulose solutions of Scorpiones, Scolopendra and Gekko were administered intragastrically as 0.33, 0.33, and 0.83 g/kg, respectively once daily for 21 days. Fluorescent expression were detected every 7 days after inoculation, and tumor growth curves were plotted. Immunohistochemistry was performed to determine CD31 and HIF-1α expressions in tumor tissue and microvessel density (MVD) was analyzed. Western blot was performed to detect the expression of PI3K/AKT/mTOR/HIF-1α signaling pathway-related proteins. Enzyme-linked immunosorbent assay was performed to detect serum basic fibroblast growth factor (bFGF), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in mice. Scorpiones, Scolopendra and Gekko prolonged the survival time and inhibited lung cancer metastasis and expression of HIF-1α (all P<0.01). Moreover, Scorpiones, Scolopendra and Gekko inhibited the phosphorylation of AKT and ribosomal protein S6 kinase (p70S6K) (P<0.05 or P<0.01). In addition, they also decreased the expression of CD31, MVD, bFGF, TGF-β1 and VEGF compared with the model group (P<0.05 or P<0.01). Scorpiones, Scolopendra and Gekko all showed beneficial effects on lung cancer by ameliorating the hypoxic tumor microenvironment via PI3K/AKT/mTOR/HIF-1α signaling pathway.

本文通过对近年来西医一线、中西结合一线治疗广泛期小细胞肺癌的临床研究进行归纳总结,发现相对于单纯西医一线治疗,围绕辨证论治为特点的中医药联合治疗展现出了增效减毒、延长生存期、改善中医证候、提高免疫等治疗优势,提示中医药不应只作为西医治疗失败的备用选择,应尽早介入并全程参与,形成与现代医学模式互补的中医联合治疗模式,实现效益最大化.

目的 基于数据挖掘探讨燕京肿瘤医家秦厚生治疗头颈部恶性肿瘤用药规律.方法 自首都医科大学附属北京中医医院病案室名老中医案卷中,筛选秦厚生治疗头颈部恶性肿瘤诊疗医案,采集医案的西医诊断及治疗、中医症状、组方用药信息等建立数据库,并进行描述统计分析、关联规则分析和聚类分析.结果 共纳入有效数据170条,接受手术治疗者约54.7％,放疗者约28.5％;带瘤者约78.2％;高频症状为头颈部疼痛(75)、肿物(28)、身痛(27)、憋闷(13)、乏力(11);涉及药物共154味,药物频次居前3位的是功劳叶(85)、黄岑(74)、板蓝根(74);药物类别居于前3位的是清热药(41.9％)、补虚药(12.1％)、解表药(7.1％);药性以寒为主,药味以甘居多,药物归经主入肺经.对高频药物进行关联规则分析和聚类分析.结论 对于头颈部恶性肿瘤,秦厚生教授在治疗原则上以清热解毒为主,配以养阴生津,辅以引经药助药上达于头面;在用药方面,喜用既能清热解毒,又可养阴生津的功劳叶,药组如白薇+茵陈+生牡蛎等.

目的:基于数据挖掘方法,对王笑民教授治疗非小细胞肺癌用药规律进行探究.方法:收集王笑民教授中医药治疗非小细胞肺癌病历资料并建立数据库,采用Excel、SPSS Statistics 25.0、SPSS Modeler18.0 统计软件进行频数、聚类及关联规则分析等,对用药规律进行总结.结果:本研究纳入病例168 例,男82 例,女86 例,年龄33～83 岁,症状以咳嗽、咳痰、眠差等常见,中医辨证以瘀毒、相火妄动、脾虚等多见.纳入中药处方424 首,涉及药物181 味,高频中药29 味,归经以肺、肝、脾为多,药性以寒、微寒、温为主,药味以甘、苦、辛多见.聚类分析得到5 个药组.关联规则分析得到28 条,白花蛇舌草-龙葵-白英-半枝莲-车前子,柴胡-法半夏-白芍,生黄芪-防风-炒白术常联合使用.症-证-药关联分析得出非小细胞肺癌患者以瘀毒证最为常见,常用半枝莲、白花蛇舌草、白英、龙葵、车前子.结论:王笑民教授治疗非小细胞肺癌,重在从肺、肝、脾论治,以清肺解毒、活血通滞、疏肝醒脾为治,明确邪正辨证关系及疾病发展的不同阶段,选择合适用药.

Objective The aim of this study is to evaluate the efficacy and safety of traditional Chinese medicine (TCM) for postviral olfactory dysfunction (PVOD). Methods PubMed, EMBASE, Cochrane Central Register of Controlled Trials, China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Chinese Biomedical and Medical (CBM) Database, and Wanfang Database were electronically searched from their inception to July 25, 2022. Two authors independently performed study selection, data extraction, and quality assessment to ensure systematic quality evaluation. Randomized controlled trials (RCTs) comparing TCM with olfactory training and/or drug therapy (OTDT) were included. The outcomes were the effective rate, QOD-P, TDI score, UPSIT score, and adverse effects. Cochrane RoB was the guideline used to evaluate the methodological quality of the included trials. RevMan 5.3 software was used for statistical analysis. Results A total of 6 RCTs involving 467 patients with PVOD were selected. Compared with OTDT, TCM plus OTDT decreased QOD-P (MD = −1.73, 95% CI (−2.40, −1.06), P < 0.0001) but did not increase the effective rate (T&T) (RR = 1.28, 95% CI (0.86, 1.90), P=0.22, I2 = 61%). Compared with no treatment, TCM seemed to increase the treatment success rate (UPSIT) (RR = 3.17, 95% CI (1.78, 5.65), P < 0.0001, I2 = 0%), but there was no statistically significant difference in improving the UPSIT score (MD = 3.44, 95% CI (−1.36, 8.24), P=0.16). Compared with drug therapy, TCM plus drug therapy appeared to increase the effective rate (ΔVAS) (RR = 2.36, 95% CI (1.41, 3.94), I2 = 0%), but there was no statistically significant difference in improving the TDI score (MD = 2.10, 95% CI (−1.99, 6.19), P=0.31). No significant differences in adverse reactions were reported between TCM and OTDT. Conclusion TCM may be an effective treatment for PVOD. With a lack of high-quality RCTs, further large-scale and high-quality RCTs are still warranted.

OBJECTIVE:To evaluate the efficacy and safety of acupuncture and moxibustion therapy (AMT) for cancer-related psychological symptoms (CRPS) of insomnia, depression and anxiety.METHODS:Seven databases were searched for randomized controlled trials (RCT) comparing AMT to routine care or conventional drug for alleviating CRPS of insomnia, depression, and anxiety before April 2020. Two independent reviewers performed the data extraction and assessed the risk of bias.RESULTS:A total of 30 RCTs involving 2483 cancer patients were enrolled. The pooled analysis indicated that the treatment group was significantly better than the control group in improving the depression effective rate [= 1.29, 95% (1.12, 1.49), 0.0004], the quality of life (QOL) [1.11, 95% (0.80, 1.42), 0.000 01], and reducing Self-rating Anxiety Scale (SAS) [﹣7.75, 95% (﹣10.44, ﹣5.05), 0.000 01]. But there was no statistically significant difference between two groups in improving the insomnia effective rate [= 1.18, 95% (0.93, 1.51), 0.18]. The subgroup analysis showed the effectiveness of different intervention on CRPS. Compared with routine care, AMT helps relieve CRPS better evaluated by Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD), and Self-rating Depression Scale (SDS), and depression effective rate. Compared with conventional drug, AMT performs better evaluated by SDS, depression effective rate and QOL. Moreover, the conventional drug showed higher treatment efficacy on improving insomnia effective rate compared with AMT. Compared to conventional drug, AMT plus conventional drug resulted in a significant reduction on CRPS such as PSQI, HAMD, SDS, and SAS, and also had a meaningful improvement on insomnia effective rate, depression effective rate and QOL. Fewer published reports were found on the adverse events of AMT than the conventional drug.CONCLUSION:The results suggested that AMT might be effective in improving CPRI; however, a definite conclusion could not be drawn because the quality of trials are low. Further large-scale and high-quality RCTs to verify the efficacy and safety of AMT on CRPS are still warranted.

紫龙金片是国内外较早完成细胞分子学基础研究和临床研究的天然抗癌药物,且临床实践证实紫龙金片对众多癌肿具有良好的抗癌作用.但后期紫龙金片基础研究数量减少,研究深度不足,临床研究评价内容及方式不尽相同.基于此,本文通过对近年来紫龙金片基础研究及临床研究相关文献进行分析和归纳总结,从体内外抗癌机制、临床联合多种治疗、甚至单药维持治疗等方面进行详尽综述,旨在更好地探究紫龙金片抗癌机理、探讨紫龙金片抗癌效能,为进一步探索紫龙金片抗肿瘤机制提供研究思路,为进一步临床研究及应用紫龙金片提供参考依据,以期促进紫龙金片的规范化、个体化应用,提高临床用药精准性.

Abstract Background Patients with breast cancer have a high incidence of insomnia, which is often accompanied by anxiety, depression, and fatigue. Acupuncture is considered useful for insomnia and emotional disorders and is becoming increasingly acceptable for patients with cancer. However, few studies have been conducted on acupuncture for patients with breast cancer who are suffering from insomnia. This study aims to describe a protocol for an 8-week acupuncture intervention to explore the efficacy and safety of acupuncture therapy using the “regulating spirit and soothing liver” method for treating insomnia patients with breast cancer. Methods This study is a single-center, single-blind, randomised, controlled trial. We aim to recruit 70 females, aged 18-60 years, who will be randomly allocated to the intervention (acupuncture) or control (sham acupuncture) groups. The intervention will include an 8-week acupuncture therapy followed by a 3-month follow-up period. The primary outcome is the Pittsburgh Sleep Scale(PSQI) measured every two weeks. Secondary outcomes are the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ9), and Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) to assess emotional health and quality of life. We will also record the drug name and quantity given to treat severe insomnia. We also will measure serum 5-hydroxytryptamine(5-HT) concentrations at baseline and again at 4 and 8 weeks. Adverse events will be recorded in detail throughout the trial. Intention-to -treat analyses will be conducted, and the data will be assessed using a global statistical test. Ethical approval for this trial was granted by the Institutional Ethics Committee of the Beijing Hospital of Traditional Chinese Medicine, Capital Medical University(2022BL02-059-02). Written informed consent was obtained from enrolled patients and will last throughout the trial. The trial results will be disseminated through peer-reviewed publications and conferences. Discussion Patients with breast cancer are more likely to experience insomnia, and it may influence the curative effect of their treatments. Undoubtedly, more attention is needed regarding insomnia in these patients; however, there is no established principle or guideline for patients with breast cancer who take multiple different medicines. Therefore, acupuncture may be useful as a less harmful intervention. Trial registration number ISRCTN12913513, 7 March,2023

乳腺癌相关淋巴水肿(BCRL)是一种慢性进行性疾病.中医从"病""症"角度探讨BCRL病机,主要集中在虚、痰、瘀、毒4个方面,且相互交叉、互为因果、互相联系.临床进行针对性治疗时需病症结合、辨证论治.中医药干预方式包括中药内服、中药外用、针灸拔罐、推拿导引等,防治手段呈现多环节、多途径的优势,但存在着辨证标准不统一,临床辨证施治可重复率低,缺乏长期疗效的大规模、多中心研究,以及疗效评价在标准化、客观化、规范化方面尚显不足等问题.

Pulmonary rehabilitation (PR) has a curative effect in patients undergoing pneumonectomy for lung cancer. Nevertheless, the contribution of PR to the clinical status of patients with chronic obstructive pulmonary disease (COPD) undergoing lung resection has not been adequately elucidated. The aim of this systematic review of randomized and nonrandomized controlled trials was to appraise the impact of PR compared to conventional treatment based on postoperative clinical status in patients with lung cancer and COPD. Literature in English from PubMed, Cochrane Library, Science Citation Index, and Embase databases and in Chinese from the Chinese National Knowledge Infrastructure and the WANFANG Database was retrieved from inception to November 2021, employing the keywords “Pulmonary Neoplasms,” “Chronic Obstructive Pulmonary Diseases,” “Physical Therapy Modalities,” and “pulmonary rehabilitation.” Only studies that reported PR results were included. This review was registered in the International Prospective Register of Systematic Reviews (number: CRD42021224343). A total of nine controlled trials with 651 patients were included. Postoperative pulmonary complications (PPCs) were the primary outcome measure. PR decreased the risk of complications after surgery compared to regular treatment (odds ratio (OR) 0.21, 95% confidence interval (CI) 0.12–0.37, P<0.01). PR reduced the risk of pneumonia after surgery compared to regular treatment (OR 0.36, 95% CI 0.15–0.86, P=0.02). There was a significant difference in the postoperative length of stay (mean difference −2.13 days, 95% CI −2.65 to −1.61 days, P<0.05). PR was an effective intervention that decreased PPCs in patients suffering from lung cancer and COPD. However, due to the limitations of the available data, the results should be interpreted with caution.

Background: Insufficient endometrial receptivity contributes to repeated implantation failure (RIF), which is associated with aberrant proliferation and decidualization of human endometrial stromal cells. Methods: In this study, we retrieved the expression profiles from GEO databases and filtered the differentially expressed genes between RIF and the fertile control group. Ultimately, RPA2 was confirmed as target gene. RPA2 expression in endometrial tissues of RIF patients, the control group and different phases was detected by RT-qPCR, immunohistochemistry and western blotting. The role of RPA2 in endometrial decidualization was performed by in vitro decidualization inducing by 8-Br-cAMP and MPA. Results: RPA2 was significantly upregulated in the mid-secretory endometrium of patients with RIF. As a proliferation-related gene, RPA2 was obviously higher expressed in the proliferative phase than in the mid-secretory and decidualized tissues. Moreover, the downregulation of RPA2 was discovered during decidualization of HESC which revealed that the proliferation ability decreased with the decidualization of the endometrium. Conclusions: Our finding indicated that upregulation of RPA2 disrupted the homeostasis between proliferation and decidualization of HESC and further reduced endometrial receptivity of RIF women.

本文主要从"火"的不同角度辨析肿瘤相关性失眠的病机和证治.肿瘤相关性失眠病机复杂,其基本病机源于"火邪"内扰心神,阴阳不交.本文基于中医肿瘤病机特点以及肿瘤失眠患者临床表现,提出肿瘤患者失眠之火源自"郁火""阴火"和"相火",并从这三个"火"的角度出发阐述肿瘤失眠的相关病机:肝气不舒,郁而化火之"郁火"上扰清窍而不寐;脾胃受损,元气亏虚之"阴火"扰乱神明而不眠;肾阳亏虚,命门火衰之"相火"扰乱心神而难安.同时,在临证中可以用柴胡加龙骨牡蛎汤合升降散来疏肝解郁散郁火,补脾胃泻阴火升阳汤来补脾升阳泻阴火,潜阳封髓丹合引火汤来温肾潜阳移相火,以求达到调节阴阳,安神定志之效.