Objective To observe the effect of electroacupuncture (EA) at u201CJiajiu201D (EX-B2) on asthma symptoms, airway inflammation and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling in rats with allergic asthma (AA), so as to explore its mechanisms underlying improvement of AA. Methods Forty male SD rats were randomly divided into blank control, AA model, EA and medication groups, with 10 rats in each group. The AA model was established by intraperitoneal injection of 1 mL 1% ovalbumin (OVA, grade V) suspension on the 1st day and 7th day and inhalation of 1% aerosol OVA (on the 15th day) for 30 min, once daily for 2 weeks. Rats of the EA group received EA stimulation (2 Hz/15 Hz, 1-2 mA) of bilateral EX-B2 for 20 min, once daily for 2 weeks. Rats of the medication group received intraperitoneal injection of dexamethasone solution (0.5 mg/kg), once daily for 2 weeks. The nasal scratching or tickling (0-3 points) and asthma (0-9 points) behavior were graded, and their summation (behavior score) was used for assessing the severity of asthma. Histopathological changes of the lung tissue were assessed by giving pathological score after H. E. staining. The contents of IL-4, IL-5, IL-13 in the bronchoalveolar lavage fluid (BALF) and lgE in the serum were detected by ELISA. The immunoactivity of Beclin1 and microtubule-associated protein 1A/1B light chain 3B (LC3B) in the lung tissue was detected by immunohistochemistry. The ratio of expression levels of p-PI3K/PI3K, p-AKT/AKT, p-mTOR/mTOR proteins in the lung tissue were detected by Western blot. Results Compared with the blank control group, the model group showed an increase in the behavior score (shortness of breath, wheezing and irritability, etc), pathological scores of the lung tissue, contents of IL-4, IL-5 and IL-13 in the BALF and IgE in the serum, the immunoactivity of Beclin1 and LC3B in the lung tissue (Pu0026lt;0.01), and a decrease in the body weight, and the ratio of expression levels of p-PI3K/PI3K, p-AKT/AKT and p-mTOR/mTOR proteins in the lung tissue (Pu0026lt;0.01). In comparison with the model group, the behavior score, pathological score, the contents of IL-4, IL-5, IL-13 and IgE, and the immunoactivity of Beclin1 and LC3B were significantly decreased (Pu0026lt;0.05, Pu0026lt;0.01), while the ratio of expression levels of p-PI3K/PI3K, p-AKT/AKT and p-mTOR/mTOR proteins were considerably increased (Pu0026lt;0.05, Pu0026lt;0.01) in both EA and medication groups. The body weight of rats was increased (Pu0026lt;0.05) in the EA group compared to the model group. No significant differences were found between the EA and medication groups of all the indexes mentioned above. Conclusion EA of EX-B2 can improve the symptoms of asthma in rats with AA, which may be associated with its functions in inhibiting the autophagy level of airway epithelial cells in the lung tissue and reducing airway inflammation by regulating PI3K/AKT/mTOR signaling pathway.

Objective To observe the effect of electroacupuncture(EA)at"Jiaji"(EX-B2)on asthma symptoms,airway inflammation and phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)signaling in rats with allergic asthma(AA),so as to explore its mechanisms underlying improvement of AA.Methods Forty male SD rats were randomly divided into blank control,AA model,EA and medication groups,with 10 rats in each group.The AA model was established by intraperitoneal injection of 1 mL 1%ovalbumin(OVA,grade V)suspension on the 1st day and 7th day and inhalation of 1%aerosol OVA(on the 15th day)for 30 min,once daily for 2 weeks.Rats of the EA group received EA stimulation(2 Hz/15 Hz,1-2 mA)of bilateral EX-B2 for 20 min,once daily for 2 weeks.Rats of the medication group received intraperitoneal injection of dexamethasone solution(0.5 mg/kg),once daily for 2 weeks.The nasal scratching or tickling(0-3 points)and asthma(0-9 points)behavior were graded,and their summation(behavior score)was used for assessing the severity of asthma.Histopathological changes of the lung tissue were assessed by giving pathological score after H.E.staining.The contents of IL-4,IL-5,IL-13 in the bronchoalveolar lavage fluid(BALF)and lgE in the serum were detected by ELISA.The immunoactivity of Beclin1 and microtubule-associated protein 1A/1B light chain 3B(LC3B)in the lung tissue was detected by immunohistochemistry.The ratio of expression levels of p-PI3K/PI3K,p-AKT/AKT,p-mTOR/mTOR proteins in the lung tissue were detected by Western blot.Results Compared with the blank control group,the model group showed an increase in the behavior score(shortness of breath,wheezing and irritability,etc),pathological scores of the lung tissue,contents of IL-4,IL-5 and IL-13 in the BALF and IgE in the serum,the immunoactivity of Beclin1 and LC3B in the lung tissue(P<0.01),and a decrease in the body weight,and the ratio of expression levels of p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR proteins in the lung tissue(P<0.01).In comparison with the model group,the behavior score,pathological score,the contents of IL-4,IL-5,IL-13 and IgE,and the immunoactivity of Beclin1 and LC3B were significantly decreased(P<0.05,P<0.01),while the ratio of expression levels of p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR proteins were considerably increased(P<0.05,P<0.01)in both EA and medication groups.The body weight of rats was increased(P<0.05)in the EA group compared to the model group.No significant differences were found between the EA and medication groups of all the indexes mentioned above.Conclusion EA of EX-B2 can improve the symptoms of asthma in rats with AA,which may be associated with its functions in inhibiting the autophagy level of airway epithelial cells in the lung tissue and reducing airway inflammation by regulating PI3K/AKT/mTOR signaling pathway.

This study aims to evaluate risk factors for readmission within 6 months after acute exacerbation of chronic obstructive pulmonary disease (COPD) and to develop a multifactorial predictive model. A total of 151 patients with acute exacerbation of COPD, admitted to our hospital from October 2021 to December 2023, were included in this retrospective analysis. Data on baseline characteristics, medical history, lung function, lifestyle, comorbidities, inflammatory markers, and treatment adherence were obtained from electronic medical records to identify risk factors associated with readmission. Univariate and multivariate logistic regression analyses were used to identify independent risk factors, construct a predictive model, and assess its predictive efficacy using the receiver operating characteristic (ROC) curve. Patients in the readmission group were older (69.8 +/- 9.5 years vs 65.2 +/- 8.4 years, P =.048), had a higher proportion of males (76.4% vs 59.5%, P =.032), higher body mass index (25.3 +/- 3.8 kg/m(2) vs 23.1 +/- 3.2 kg/m(2), P =.018), more frequent exacerbations (3.2 +/- 1.0 episodes vs 1.5 +/- 0.8 episodes, P =.009), longer disease duration (12.1 +/- 7.3 years vs 8.4 +/- 5.7 years, P =.043), and higher GOLD classification (70% in stages III-IV vs 50%, P =.043) and BODE index (5.1 +/- 1.4 vs 3.8 +/- 1.2, P =.022). Additionally, they had a higher prevalence of cardiovascular comorbidities (55.6% vs 31.6%, P =.015), lower FEV1 levels (45.3 +/- 10.1% vs 52.7 +/- 8.5%, P =.033), higher levels of C-reactive protein (CRP) (15.2 +/- 6.5 mg/L vs 10.4 +/- 4.9 mg/L, P =.005), fractional exhaled nitric oxide (FeNO) (32.5 +/- 10.4 ppb vs 26.7 +/- 8.9 ppb, P =.03), and end-tidal carbon dioxide partial pressure (PetCO(2)) (40.1 +/- 6.3 mm Hg vs 36.2 +/- 5.7 mm Hg, P =.028), all of which were significant independent risk factors for readmission. The area under the ROC curve for the multivariate regression model was 0.801, indicating good predictive efficacy. This study evaluates multiple factors affecting readmission risk after acute exacerbation of COPD, highlighting the importance of early identification of high-risk patients and constructing an effective predictive model. Further large-sample, multi-center studies are needed to validate these findings and explore personalized interventions to reduce readmission rates and improve the quality of life for COPD patients.

This case report presents a 67-year-old male diagnosed with stage IV lung adenocarcinoma harboring rare EGFR exon 18/20 mutations (Gly719Cys/Ser768Ile) and a concurrent TP53 mutation, complicated by nephrotic syndrome. The scarcity of approved EGFR-TKIs targeting rare EGFR mutations in NSCLC, coupled with nephrotic syndrome-induced renal impairment, hypoalbuminemia, and massive pleural effusion refractory to conventional management, prompted the development of a personalized multimodal approach.A multimodal therapeutic regimen incorporating albumin-bound paclitaxel, intrathoracic perfusion of Endostar (recombinant human endostatin), and traditional Chinese medicine (TCM) was implemented, achieving effective disease control. Notably, the treatment resulted in significant tumor shrinkage (reduction rate: 48.1% by RECIST 1.1), complete resolution of malignant pleural effusion, and marked improvement in nephrotic syndrome parameters. The synergistic effects of targeted chemotherapy, anti-angiogenic therapy, and TCM-based symptom modulation highlight the potential of integrative approaches in managing advanced malignancies with complex molecular profiles and multisystem complications.

BACKGROUND:cGAS-STING-induced cellular senescence is a key driver of age-related chronic obstructive pulmonary disease (COPD). Bu-fei decoction (BFD) is a traditional Chinese medicine formula with significant clinical efficacy for COPD. However, the specific mechanism by which BFD modulates the cGAS-STING pathway to impact age-related COPD remains unclear. PURPOSE:To evaluate the therapeutic efficacy of BFD in age-related COPD and elucidate the underlying mechanisms. STUDY DESIGN AND METHODS:Flow cytometry and RT-qPCR were conducted to assess the phenotypes and transcriptional profiles of peripheral CD4+ naïve T cells from aged COPD patients and healthy controls. Young and aged COPD mouse models were established using cigarette smoke extract and lipopolysaccharide to investigate age-dependent mechanisms and BFD-related effects. C1qbp-knockdown Jurkat T cells were used to validate BFD's mechanisms in vitro. Network pharmacology and molecular docking predicted BFD-derived bioactive compounds targeting the cGAS-STING pathway. RESULTS:C1qbp downregulation in CD4+ Tnaive cells of aged COPD patients and mice significantly correlated with activated cGAS-STING signaling and elevated senescence markers. C1qbp knockdown in Jurkat T cells recapitulated these findings, triggering spontaneous cGAS-STING activation and senescence-related gene upregulation. BFD exhibited multi-therapeutic effects in aged COPD mice, improving lung function, reducing pulmonary inflammation, and restoring CD4+ Tnaive populations while suppressing cGAS-STING signaling and cellular senescence. The therapeutic benefits were substantially diminished when C1qbp was silenced. Twelve potential cGAS-STING-targeting bioactive compounds were predicted from BFD, mainly including formononetin, β-sitosterol, quercetin, etc. CONCLUSION: BFD mitigates CD4+ Tnaive cell senescence and attenuates age-related COPD, primarily by inhibiting the cGAS-STING pathway in a C1qbp-dependent manner.

Traditional Chinese Medicine (TCM) boasts a long history and a unique diagnostic and therapeutic paradigm. Integrating TCM with Western medicine and modern medical devices has yielded numerous successful cases in recent years. TCM treatment has developed a special knowledge framework focusing on precise differentiation based on multidimensional information such as the patient's diseases, symptoms, and syndromes. This offers significant opportunities for AI research in similar patient scenarios within TCM contexts. However, traditional medicine's reliance on the physiological sensory judgment of human physicians to gather clinical information might lead to non-standardized descriptions and disturbances in patient assessments. Additionally, how to integrate TCM's fine-grained differentiation knowledge to design a patient similarity measure remains an open question. To address this, we first constructed a real-world dataset of TCM gastrointestinal malignancies (TCMGI) based on real cases in the Guang'anmen Hospital, China Academy of Chinese Medical Sciences. It contains 406 types of multidimensional information from 719 patients, organized in a graph structure. Second, we develop a novel deep learning framework, Robust Traditional Chinese Medicine Graph Networks (RTGN), which employs a Siamese network architecture with self-attention and self-supervision strategies to enhance robustness in patient retrieval. Lastly, we design a patient similarity metric integrating TCM and Western medicine approaches, demonstrating superior performance in depicting fine-grained patient similarities. Experimental results show our method outperforms existing best practices in patient retrieval accuracy. Moreover, the proposed similarity metric exhibits excellent performance in clustering tasks at various granularity levels, possibly supporting precision TCM patient retrieval and downstream tasks, such as prescription generation.

Objective:To observe the effects of acupuncture on podocyte autophagy and long non-coding RNA SOX2 overlapping transcript (LncRNA SOX2OT)/mammalian target of rapamycin C1 (mTORC1)/Unc-51-like kinase 1 (ULK1) pathway in rats with diabetic kidney disease (DKD), and to explore the mechanism by which acupuncture reduces urinary protein. Methods:A total of 40 SPF-grade male Sprague-Dawley rats were randomly divided into a control group (n=10) and a modeling group (n=30). The DKD model was established by feeding a high-fat, high-sugar diet combined with intraperitoneal injection of streptozotocin (STZ) in the modeling group. Twenty rats with successful DKD model were randomly divided into a model group (n=10) and an acupuncture group (n=10). The acupuncture group received "spleen and stomach-regulating" acupuncture at bilateral "Zusanli" (ST36), "Fenglong" (ST40), "Yinlingquan" (SP9), and "Zhongwan" (CV12), 30 min per session, once daily, five times per week, for four weeks. The general condition, fasting blood glucose (FBG), 2-hour postprandial glucose (2hPG), serum creatinine (SCr), blood urea nitrogen (BUN), 24-hour urinary protein quantification, and urine albumin-to-creatinine ratio (UACR) were compared before and after the intervention. After intervention, urinary podocyte injury marker SPON2 was measured by ELISA. Podocyte autophagosomes and glomerular basement membrane ultrastructure in renal tissue were observed via transmission electron microscopy. Podocyte apoptosis was assessed by TUNEL staining. The protein expression of microtubule-associated protein 1 light chain 3Ⅱ (LC3-Ⅱ), mTORC1, ULK1, Beclin-1, and p62 in renal tissue was detected by Western blot. LncRNA SOX2OT expression in renal tissue was measured by real-time PCR. Results:After the intervention, compared with the control group, the model group exhibited increased food and water intake, increased urine output, weight loss, and loose stools; compared with the model group, the food and water intake, urine volume, and loose stools were improved in the acupuncture group. Compared with the control group, FBG, 2hPG, SCr, BUN, 24-hour urinary protein quantification, UACR, and urinary SPON2 were all higher in the model group (P<0.01); compared with the model group, the FBG, 2hPG, SCr, BUN, 24-hour urinary protein quantification, UACR, and urinary SPON2 were all lower in the acupuncture group (P<0.01). Compared with the control group, the model group showed reduced podocyte autophagosomes and thickened glomerular basement membrane; compared with the model group, the acupuncture group had increased podocyte autophagosomes and less thickened basement membrane. Compared with the control group, the podocyte apoptosis index (AI) was higher in the model group (P<0.01); compared with the model group, the AI was lower in the acupuncture group (P<0.01). Compared with the control group, the expression of ULK1, Beclin-1, and LC3-Ⅱ proteins was lower, and the expression of mTORC1 and p62 proteins was higher in the model group (P<0.01). Compared with the model group, the expression of ULK1, Beclin-1, and LC3-Ⅱ proteins was higher, and the expression of mTORC1 and p62 proteins was lower in the acupuncture group (P<0.01). Compared with the control group, the LncRNA SOX2OT expression was lower in the model group (P<0.01). Compared with the model group, LncRNA SOX2OT expression was higher in the acupuncture group (P<0.01). Conclusion:The "spleen and stomach-regulating" acupuncture method could improve renal function in DKD rats, reduce blood glucose and urinary protein excretion, alleviate podocyte injury, and enhance podocyte autophagy. The mechanism may be related to modulation of the renal LncRNA SOX2OT/mTORC1/ULK1 pathway.

Background: The incidence and mortality of lung cancer is the highest among malignant tumors worldwide, and it seriously threatens human life and health. Surgery is the primary radical treatment for lung cancer. However, patients often experience discomfort, changes in social roles, economic pressures, and other postsurgical challenges. These factors frequently cause various psychological disorders such as anxiety and depression, significantly diminishing the quality of life and elevating the risks of recurrence, metastasis, and mortality. Therefore, effective strategies for mental function rehabilitation should be urgently developed. Traditional Chinese medicine can significantly improve psychological function and physical symptoms after lung cancer surgery, and prolong patient survival. However, its effectiveness for mental function rehabilitation after lung cancer surgery remains unclear. This study aimed to investigate the effects of Chinese medicine on mental function recovery after lung cancer surgery through a systematic review and meta-analysis. Methods: This study will systematically search the following databases: PubMed, Cochrane Library, EMBASE, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang database, VIP database, and Chinese BioMedical Literature database. Search for studies published from the inception of each database until April 22, 2024. This study will be limited to clinical randomized controlled trials (RCTs). The primary outcome will be depression or anxiety, as indicated by the scale score. Data analysis will be performed using RevMan 5. The Cochrane Risk of Bias Assessment Tool will be used to evaluate the quality of included studies. Finally, the quality of the evidence will be classified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) System. Results: This meta-analysis aims to offer comprehensive evidence of the effectiveness of traditional Chinese medicine in mental function rehabilitation after lung cancer surgery. The study will assess the quality of the reports and conduct a subgroup analysis based on various postoperative stages, intervention measures, intervention duration, and sex to gather more evidence to fill the gap in psychological function rehabilitation after lung cancer surgery. These data can be used to guide clinical practice and inform future studies. More importantly, the results of this study will provide evidence to support the development of expert consensus and clinical guidelines in the field of mental function rehabilitation after lung cancer surgery.

e20577 Background: Chemotherapies combined with immune checkpoint inhibitors (ICIs) and/or bevacizumab (named IC, BC and IBC respectively) are the preferred first-line options for PD-L1 negative and oncogenic driver wild-type metastatic lung adenocarcinoma. However, the optimal strategy is still undetermined. Methods: This retrospective real-world study enrolled PD-L1 negative metastatic lung adenocarcinoma patients from four cancer centers between January 1, 2018 and June 30, 2022. All the patients received IC, BC, or IBC as the first-line therapies. The efficacy and safety were evaluated. Results: A total of 205 patients were included, with 60, 83, and 62 patients in IC, BC, and IBC groups, respectively. Patients receiving IBC obtained the highest objective response rate (ORR) (43.5%) and disease control rate (DCR) (100%) relative to those receiving IC (40.4%, 84.2%) or BC (40.5%, 96.2%). Compared with the IC (6.74m) or BC (8.28m) group, IBC group improved significantly median progression-free survival (mPFS) (9.53m, P = 0.005). However, the difference in overall survival (OS) were not observed among the three groups. When analyzed based on different clinical and molecular information, we found that male gender, ever smoking, wild-type genes, and adrenal metastasis predicts superior PFS benefit when treated with IBC. In patients with liver metastasis, IBC or BC treatment achieved better PFS compared with IC. No additional adverse reactions were observed in IBC group compared with other two groups. Conclusions: Combined IBC treatment achieved superior DCR and PFS compared with IC or BC treatment in patients with PD-L1 negative metastatic lung adenocarcinoma, while did not increase the adverse events.

e24054 Background: Cancerous pain (CP) is a troublesome symptom which can not be adequately controlled. It is reported by several clinical studies that Huachansu can help to relieve CP. However, its mechanism is unclear. In this study, we try to use network pharmacology to explore the underlying mechanism of Huachansu capsule (a capsule form of Huachansu) in the treatment of CP. Methods: Firstly, we collected Huachansu capsule’s active compounds from the literature. And then DrugBank and SwissTargetPrediction were used to obtain the drug targets. Genecards, OMIM, Drugbank, CTD, TTD and DisGeNET were used to gather CP-related genes. Cytoscape 3.7.2 was applied to construct the PPI network. The candidate genes were screened according to betweenness centrality (BC), closeness centrality (CC), degree centrality (DC) and local average connectivity (LAC). A PPI enrichment analysis was performed by MCODE. GO and KEGG analysis were carried out by Metascape. Results: In this study, we collected 11 active compounds and 235 CP-related targets of Huachansu capsule. Go analysis showed that the main related-biological functions included immune response, cytokine-mediated signaling, hypoxia. The main related-KEGG pathways included MAPK, AMPK, mTOR, erbB, Chemokine, TNF, HIF-1, toll-like receptor, PI3K-Akt, cAMP and NF-Kappa B signaling pathway. Conclusions: This study provides a systematic view of the polypharmacological characteristics of Huachansu capsule for pain treatment. Nevertheless, it still need to be verified by in vitro or in vivo studies.

Cancer and cardiovascular diseases are major contributors to global morbidity and mortality, and their seemingly separate pathologies are intricately intertwined. In the context of cancer, the cardiovascular disease encompasses not only the side effects arising from anti-tumor treatments but also the metabolic shifts induced by oncological conditions. A growing body of research indicates that lipid metabolic reprogramming serves as a distinctive hallmark of tumors. Furthermore, anomalies in lipid metabolism play a significant role in the development of cardiovascular disease. This study delves into the cardiac implications of lipid metabolic reprogramming within the cancer context, closely examining abnormalities in lipid metabolism present in tumors, cardiac tissue, and immune cells within the microenvironment. Additionally, we examined risk factors such as obesity and anti-tumor therapy. Despite progress, a gap remains in the availability of drugs targeting lipid metabolism modulation for treating tumors and mitigating cardiac risk, with limited advancement seen in prior studies. Here, we present a review of previous research on natural drugs that exhibit both shared and distinct therapeutic effects on tumors and cardiac health by modulating lipid metabolism. Our aim is to provide insights for potential drug development.

ETHNOPHARMACOLOGICAL RELEVANCE:Kanglaite injection (KLTi), a Chinese herbal medicine, is used as an adjuvant treatment for non-small-cell lung cancer (NSCLC).AIMS OF THE STUDY:To provide an evidence-based endorsement for the clinical application and selection of KLTi by evaluating the reporting quality, methodological quality, risk of bias, and evidence quality of systemic reviews (SRs).MATERIALS AND METHODS:SRs of KLTi adjuvant therapy of NSCLC were searched by using 12 databases, consulting experts, and retrieving relevant conference papers until 2022.03.24. The treatment group received KLTi in combination with other therapies, regardless of dosage, duration, or the therapy combined. Network meta-analyses and SRs using repeated data were excluded. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines 2009, A MeaSurement Tool to Assess systematic Reviews, Risk of Bias in Systematic Review, and the Grading of Recommendations Assessment, Development and Evaluation were used to assess the quality of reports, methodological quality, risk of bias, and level of evidence; R was used for visual analysis of the relevant contents.RESULTS:Twenty SRs (13 Chinese and 7 English articles), all authored by Chinese authors as the first author, were included. The reporting information of most included studies was relatively complete (21-27 points), accounting for three-fourths of the total literature. The quality of the methods used in all studies was critically low. The risk of bias was mostly high. Results of the evidence summary showed that among the "moderate" evidence, KLTi combined with chemotherapy had benefits of 9.7-16.4% for objective response rate (ORR) (11 SRs), 8.1-14% for disease control rate (four SRs), and 20.1-28.6% for quality of life (12 SRs) compared with those of chemotherapy alone. The incidence of gastrointestinal symptoms (five SRs) was reduced by 11.5%-23.2%, while that of leukopenia (four SRs) improved by 19.5-29.2%. Combined radiotherapy and targeted therapy had benefits of 25.9% and 16.8%, respectively, in ORR and 31.3% and 22.8%, respectively, in quality of life (the quality of evidence was "low"). The results depicted that treatment with two courses of KLTi produce the best results.CONCLUSION:Our results suggest that KLTi, whether combined with chemotherapy, radiotherapy, or targeted therapy, has an effect on ORR and quality of life and induces adverse reactions, such as leukopenia, nausea, and vomiting. It may improve patient survival; however, the impact of its low-grade quality on the immune function remains undetermined. Owing to the low reporting quality and methodological quality and high risk of bias of the SRs and the included studies, clinical application of KLTi remains unelucidated; higher-quality SRs and randomized controlled trials are necessary in the future.

"虚—寒—毒—闭—衰"五期演变理论体系已明确诠释"寒"在肿瘤论治中的重要地位.本文以内寒为基、外寒为因、气机为引,从内外寒合阐述致瘤病理机制,提出寒聚不散、阳虚阴凝是肿瘤全程发展关键,即阳虚寒凝变毒而促进展、毒窜寒聚挟风而致复发转移,强调寒毒对肿瘤病机演化与预后转归的核心价值.治当温散,以调阳散寒,还应根据邪寒分源论治,内寒者当温补,脾肾共养改善免疫微环境;外寒者当辛温,散而通肺增强抗肿瘤活性.本文从"寒"论治肿瘤,冀以丰富中医肿瘤病机学说,为构建现代肿瘤中医理论与诊疗体系奠定基础.

恶性淋巴瘤发病机制复杂,是临床防治中的难题.本文基于"阳虚痰凝"理论,依据三焦与淋巴组织在位置及生理功能上的相关性,以阳虚导致三焦疏泄失常,凝痰成核为主要病机,提出防治恶性淋巴瘤应重视机体阴阳的动态变化情况,在疾病初起之时以温阳化气行水为主,进展期重视祛瘀排毒消积,后期则主扶阳益阴培本,进而达到恢复三焦正常疏泄功能、化痰消瘤的最终目的,为探求更高效安全的中西医结合治疗方案提供新的思路.

Radiation enteritis is a common intestinal complication arising from abdominal and pelvic malignancies after radiation therapy, which is currently poorly treated by western medicine and greatly affects the quality of life of patients.In this paper, based on the theory of “Zangfu extraordinary connection”,from the perspective of yin and yang properties, generation-inhibition of five elements, and meridian circulation, and in accordance with the western medicine “liver-intestine axis” theory, we clarify the pathological mechanism basis that liver and large intestine are connected with each other in terms of qi and blood, disease transmission and mutual treatment.Moreover, according to the symptoms of radiation enteritis in different periods, we summarized the pathological characteristics of acute radiation enteritis with damp-heat, chronic radiation enteritis with blood deficiency and loss of qi harmony throughout.Therefore, we propose that the treatment should be combined with the patient’s symptoms, the application of liver regulating methods such as clearing heat and dampness, benefiting yin and nourishing blood, regulating qi and relieving depression.If the liver has not been affected, it should be settled first.Since it has been affected, then it should restore its function of lifting and draining, moistening and retaining, thus helping the intestinal bowels to restore its function of purging and excreting, promoting the healing of the disease, in order to supplement and enlighten the subsequent Chinese medicine treatment of radiation enteritis.

在全面推进思想政治教育和实施教育数字化战略行动的背景下,高校课程的建设面临新的挑战与机遇.中医内科学见习课程是一门重要的桥梁课程.在突发公共卫生事件情况下,教研室利用互联网优势,采用"空中课堂"混合式教学法,将"以学生为本"和"以临床能力为导向"的教学理念渗透其中,将"医者仁心"等思政教育贯穿其中,通过调研数据反馈发现该模式有一定成效,保证了教学效果与教学质量,并对日后见习课程的改革进行了思考.

乳腺癌相关淋巴水肿(breast cancer related lymphedema,BCRL)是乳腺癌患者最常见的并发症之一,严重影响患者生活质量,可归属于中医"水肿"范畴.《素问·生气通天论篇》认为"因于气,为肿",水肿的发生与人体之气相关.故本文以此立论,结合乳腺癌患者素体肝郁,经手术、放化疗等现代医学治疗后正气受损,阳气不足,肿块虽除,气滞、瘀毒等有形实邪仍残存体内,阻碍阳气布运流行的特点,探讨从气致肿的机理,并以调和阳气为原则,提出益气温阳健脾、理气疏肝、祛邪化瘀以利水等治法,以期更好的指导临床用药.

Objective: To analyze the characters of registered trials on acupuncture-related therapies for treating cancer based on clinicaltrials.gov in the past twenty years, thus to provide reference for the following researches. Methods: Clinicaltrials.gov database was electronically searched to collect acupuncture-related clinical trials registered from inception of the database to 1st September, 2020. Two reviewers independently screened items, extracted data, and descriptive analysis was performed for the included trials. Results: The results showed that there were 215 registered clinical trials on acupuncture related therapy for treating cancer, finally 179 trials were included. The trials were mainly randomized controlled trials, which accounted for 92.18%（165/179）. These researches were initiated mainly in North America, East Asia and Europe. The number of studies was generally on the rise. The registered trials mainly focused on breast cancer, head and neck cancer, colorectal cancer, and the symptoms involved were cancer pain, chemotherapy-induced peripheral neuropathy, as well as chemotherapy-induced nausea and vomiting, fatigue and insomnia. The most commonly used intervention in the included studies was acupuncture, which accounted for 74.86%（134/179）, followed by electro-acupuncture at 10.06%（18/179）. Other interventions include moxibustion, thumbtack needling and laser acupuncture. The therapy used in the control group was mainly sham acupuncture, which accounted for 34.63%（62/179）, followed by blank control at 22.90%（41/179） and standard treatment at 12.29%（22/179）. The frequency of interventions was from one to three times per week. The average duration of included interventions was from one month to five months. Sample size varied among studies. Conclusion: At present, there are relatively few registered studies on acupuncture-related therapies for treating cancer initiated by China. We should pay attention to clinical trial registration, and explore the potentials of acupuncture therapy to generate high-quality evidence and provide patients with more choices.

肿瘤相关性失眠(CRI)是在肿瘤发生发展及抗肿瘤过程中常见症状之一,但常常被肿瘤患者及医生所忽视,逐渐成为慢性失眠,严重影响患者生存质量,影响抗肿瘤治疗效果.根据失眠与"躁狂越"相似的特征表现,基于《黄帝内经》"诸躁狂越,皆属于火",探讨从火认识CRI:生理之火维系、保证睡眠发生及正常运行,而基于肿瘤病机及抗肿瘤不良反应而产生的病理之火扰乱心神,导致失眠发生.从恶性肿瘤分期不同,探讨CRI以实火及虚火为不同病因,分别采取升降气机以助清透实火、滋阴潜阳以助虚火下潜对CRI进行辨证论治.