BACKGROUND:This study aimed to evaluate the efficacy and safety of Congrong Runtong Oral Liquid (CROL) in treating functional constipation of Yang-deficiency type in adults. OBJECTIVE:To determine the efficacy of Congrong Runtong Oral Liquid (CROL) versus placebo in adults with functional constipation of Yang-deficiency type. METHODS:In this multicenter, double-blind, placebo-controlled randomized clinical trial, 180 participants aged 18-70 years, diagnosed with functional constipation meeting the Rome IV and Yang-deficiency type TCM criteria, were randomized 1:1:1 to receive CROL (3 g or 6g/day) or placebo for 8 weeks. The primary outcome was treatment response (≥ 3 complete spontaneous bowel movements [CSBMs] per week plus increase of ≥ 1 CSBMs per week from baseline for ≥ 4 weeks during the 8-week treatment period). Secondary outcomes included CSBMs, spontaneous bowel movements [SBMs], fecal characteristics, stool passage difficulty, PAC-QOL scores, rescue medication use and adverse events. Outcomes were assessed over 8 weeks. RESULTS:Among participants (mean age 44.5 years; 80% female), the response rate was 60.7% (37/61) with 6g/d CROL, 35.0% (21/60) with 3g/d CROL, and 18.6% (11/59) with placebo (p < 0.0001 for 6g/d vs placebo; p = 0.044 for 3g/d vs placebo). Weekly CSBMs were 2.0 (1.3) (6g/d), 1.5 (1.4) (3g/d), and 1.2 (1.2) (placebo) (p = 0.001 for 6g/d vs placebo). There was no statistically significant difference in weekly SBMs among the three groups, although the 6g/d CROL group showed a numerical trend toward higher SBMs (3.7 [1.9]) compared with the placebo group (3.1 [1.8], p = 0.0735). The rate of treatment-related AEs was 1.6% in the 6g/day group, 0.0% in the 3g/day group, and 3.4% in the placebo group, respectively (p = 0.3241). No severe events were reported. CONCLUSION:CROL was effective and well-tolerated in adult patients with functional constipation of the Yang-deficiency type. REGISTRATION NUMBER:NCT05803161.

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, represents a significant health challenge due to its intricate interplay of genetic, environmental, and immunological factors. While current treatments are effective at managing symptoms, they are not without drawbacks, such as potential side effects, the financial strain on patients, and the risk of complications. Nanotechnology presents an innovative solution to these challenges, offering the potential to improve the bioavailability, stability, and precise delivery of natural compounds with potent anti-inflammatory properties. This review examines the array of nanoparticle (NP) delivery systems that are revolutionizing IBD treatment, including lipid-based NPs, polymeric NPs, metallic NPs, plant-derived exosomes, and mesoporous silica NPs. Furthermore, the review explores the various responsive mechanisms of NPs, including pH-responsive, reactive oxygen species (ROS)-responsive, enzyme-responsive, charge-mediated, ligand-receptor targeted, and multi-responsive systems. The therapeutic potential of nanomedicines derived from natural products is highlighted, with a focus on their roles in immunomodulation, reducing inflammation, repairing the intestinal barrier, and modulating the gut microbiota. Nanotechnology boosts IBD treatment with novel natural NPs. NPs delivery systems offer notable benefits, such as improving drug solubility, increasing the efficiency of absorption, alongside providing a controlled and sustained release of therapeutic agents directly at the inflammation site. Despite the promising capabilities of nanotechnology in IBD treatment, obstacles remain. These include the necessity for comprehensive toxicological assessments, formulating strategies to guarantee the safety and effectiveness of these innovative treatments. Therefore, this review provides a systematic analysis that provides guidance for the research and development of NPs based natural products.

Ulcerative colitis (UC) is a worldwide health issue with limited therapies. Traditional Chinese Medicine (TCM) shows potential, but lacks systematic efficacy evaluation and detailed mechanistic explanations. This study aims to evaluate the efficacy of TCM for active UC and explore its mechanisms. A meta-analysis of RCTs was conducted to assess TCM efficacy in active UC, and treatment efficacy was ranked. Core Chinese herbs were identified via association rule analysis. Network pharmacology and molecular docking predicted active components, targets, and pathways. Efficacy of the key component was validated in active UC mice. 17 studies (1,598 patients) showed TCM significantly improved active UC (SMD -1.73, 95

BackgroundPlatelet activation (PA) acts as a molecular bridge connecting thrombosis and inflammation. This study aimed to identify key PA-related genes (PARGs) in ulcerative colitis (UC), and explore their transcriptional associations with immune–stromal dysregulation.MethodsTranscriptomic data of UC patients were obtained from the GEO database, and PARGs were retrieved from the MSigDB database. Differential expression analysis, WGCNA, LASSO, SVM-RFE, and random forest algorithms were applied to the GSE87466 dataset to identify key genes. Functional enrichment and immune infiltration analyses were performed to characterize their biological features. Additionally, single-cell RNA sequencing (scRNA-seq) analysis of the GSE214695 dataset was conducted to clarify their expression and localization. Findings were validated using independent GEO cohorts (GSE47908, GSE38713, and GSE36807) and qRT-PCR in a dextran sodium sulfate (DSS)-induced colitis mouse model.ResultsWe identified 22 PARGs in UC, which were associated with extracellular matrix (ECM) remodeling, platelet activation, and immune cell recruitment. Machine learning algorithms refined these to three key genes: SPARC, TIMP1, and SERPINA1. ROC analysis demonstrated robust diagnostic performance (AUC > 0.8) across the training and external validation cohorts. Crucially, single-cell analysis revealed that these genes were predominantly expressed in intestinal fibroblasts. Their expression levels strongly correlated with the infiltration of pathogenic immune cells (e.g., M1 macrophages, neutrophils). Additionally, an upstream regulatory network predicted transcription factors such as NFKB1 and SP1 as potential regulators. Finally, qRT-PCR confirmed the significant upregulation of these three genes in the DSS-induced colitis model.ConclusionThis study highlights the role of platelet activation in UC; identifies SPARC, TIMP1, and SERPINA1 as potential biomarkers; and provides important insights for the diagnosis and development of therapies for UC.

BACKGROUND AND AIMS:Irritable bowel syndrome (IBS) is a prevalent disorder of gut-brain interactions, while the pathophysiology is intricate and current treatments mainly focus on improving symptoms. Our study aims to explore potential drug targets for IBS using Mendelian randomization (MR) analysis. METHODS:Firstly, we integrated 1443 plasma and 151 cerebrospinal fluid (CSF) proteins with the largest IBS genome-wide association study (GWAS) dataset for MR analysis, and validated the findings in the FinnGen cohorts. The robustness of the results was then corroborated through reverse causality detection and Bayesian colocalization. Secondly, we performed mediation analysis to explore whether psychiatric disorders mediate the association between IBS and the identified protein. Finally, we performed druggability assessment investigate the potential mechanisms and medicinal value of the target. RESULTS:The MR analysis indicated that LRP8 deficiency in both plasma and CSF was linked to a higher risk of IBS. Sensitivity analyses provided strong support for the finding. Additionally, schizophrenia mediates a small portion of this causal relationship. LRP8 exhibited strong and stable affinity with several small molecular compounds in molecular docking, revealing the potential of LRP8 as the novel drug target for IBS. CONCLUSIONS:The study suggests that LRP8 in both plasma and CSF has a causal relationship with IBS. This relationship provides novel mechanistic insights into the complex pathophysiology of brain-gut interactions in IBS, and LRP8 has the potential to be a drug target.

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.

Identifying associations between microbial taxa and sample features has always been a worthwhile issue in microbiome analysis and various regression-based methods have been proposed. These methods can roughly be divided into two types. One considers sparsity characteristic of the microbiome data in the analysis, and the other considers phylogenetic tree to employ evolutionary information. However, none of these methods apply both sparsity and phylogenetic tree thoroughly in the regression analysis with theoretical guarantees. To fill this gap, a phylogenetic tree-assisted regression model accompanied by a Lasso-type penalty is proposed to detect feature- related microbial compositions. Specifically, based on the rational assumption that the smaller the phylogenetic distance between two microbial species, the closer their coefficients in the regression model, the phylogenetic tree is accommodated into the regression model by constructing a Laplacian-type penalty in the loss function. Both linear regression model for continuous outcome and generalized linear regression model for categorical outcome are analyzed in this framework. Additionally, debiasing algorithms are proposed for the coefficient estimators to give more precise evaluation. Extensive numerical simulations and real data analyses demonstrate the higher efficiency of the proposed method.

BACKGROUND:The interaction between T cell-related vaccines and the dysregulated immune environment in inflammatory bowel disease (IBD) patients remains unclear. AIM:To systematically evaluate the immune response of IBD patients following vaccination with T-cell-related vaccines and analyze the impact of immunosuppressive therapy on vaccine response. METHODS:Multiple databases and preprint platforms were searched, and study quality was assessed using the Newcastle-Ottawa Scale. Data amenable to synthesis were analyzed via Meta-analysis, while non-combinable data were presented as a narrative review. RESULTS:IBD patients showed no significant difference in spike-specific CD4⁺/CD8⁺ T cell frequencies compared to healthy controls.RBD-IgG titers and sVNT inhibition rates were significantly reduced in IBD patients. Both anti-TNF agents and JAK inhibitors profoundly weakened humoral immunity, whereas gut-selective drugs have minimal impact on antibody responses. Notably, long-term immunosuppression is correlated with broad T-cell functional impairment, though prior infection partially compensated for primary response defects. CONCLUSION:Overall, T-cell responses remain relatively stable after T-cell-related vaccination in IBD patients, while humoral immunity is significantly impaired. Clinicians should monitor humoral immune indices in patients on immunosuppressive therapy.

Ethnopharmacological relevance Yinxu Weitong Capsule (YXWTC) is a Chinese patent medicine used to treat chronic gastritis. However, its efficacy and mechanisms of action in treating precancerous lesions of gastric cancer (PLGC) remain unclear. Aim of the study To evaluate the effects of YXWTC on PLGC and explore the underlying mechanisms. Materials and methods YXWTC components were identified using ultra-high-performance liquid chromatography coupled with electrospray ionization quadrupole-exactive orbitrap mass spectrometry. A PLGC animal model was established and the protective effects of YXWTC on the gastric mucosa in PLGC rats were evaluated using hematoxylin and eosin (H&E), Alcian blue-periodic acid-Schiff and Alcian blue-high iron diamine staining, and transmission electron microscopy (TEM). The vital organs of the rats were examined using H&E staining to evaluate biosafety. Network pharmacology identified potential targets and pathways of YXWTC in PLGC treatment, followed by molecular docking validation. Various techniques, including enzyme-linked immunosorbent assay, real-time quantitative reverse transcription PCR, Western blotting, immunohistochemistry, apoptosis detection, and reactive oxygen species fluorescence staining were employed to elucidate the underlying mechanisms. Results In total, 340 YXWTC components were identified. YXWTC effectively improves gastric mucosal pathology in rats with PLGC. Network pharmacology identified 403 targets common to PLGC and YXWTC. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses identified 2,323 biological processes and 206 signaling pathways, respectively. Molecular docking revealed that the primary target proteins and major drug molecules exhibited strong binding affinities. Animal studies demonstrated that YXWTC inhibited the IL-6/STAT3 pathway, promoted mitochondrial apoptosis, and induced ROS release. Conclusions We verified the pharmacodynamic effects of YXWTC in PLGC. In summary, the effects are mediated by inhibition of the IL-6/STAT3 pathway, promotion of mitochondrial apoptosis, and induction of ROS release.

OBJECTIVE:Qishen Huoxue Granule (QHG), a classical Traditional Chinese Medicine prescription, can reduce septic cardiomyopathy in the clinic. However, the mechanism of QHG remains unclear. This study aims to investigate the mechanism and effect of QHG-contained serum (QHG-CS) on sepsis-induced cardiomyopathy (SICM). METHODS:QHG was administered to Wistar rats via gavage to obtain QHG-CS. The chemical constituents of QHG-CS were identified via UPLC-Q-TOF-MS. In vitro, rat cardiomyocytes H9c2 cells isolated from embryonic BD1X rat heart tissue, and septic myocardial injury model was established by inducing H9c2 cells with lipopolysaccharide (LPS). Cell viability was assessed through CCK-8. Protein expression was determined using western blot, and gene expression was measured using real-time quantitative PCR. Cell autophagy was investigated by detecting LC3 expression using flow cytometry and immunofluorescence. In addition, three inhibitors, A779 (MasR), wortmannin (PI3K) and rapamycin (mTOR) were used to focus the potential therapeutic targets. RESULTS:QHG-CS significantly improved the survival of septic cardiomyocytes (p<0.0001). The expression of autophagy-related markers Beclin1, ATG5, and LC3II/I was increased in LPSinduced cardiomyocytes, which could be inhibited by QHG-CS. QHG-CS upregulated the mRNA expression of MasR, PI3K, and AKT, as well as the phosphorylation of PI3K, AKT, and mTOR. Moreover, A779 markedly lowered mRNA levels of MasR, PI3K, and mTOR, while wortmannin decreased mRNA levels of PI3K and mTOR, whereas rapamycin only suppressed mTOR phosphorylation. CONCLUSIONS:By inhibiting excessive autophagy through upregulation of the MasR/PI3K-AKTmTOR pathway, QHG can alleviate sepsis-induced cardiomyocyte damage. This study provides novel perspectives for the management of sepsis-induced cardiac damage.

BACKGROUND AND AIMS:While the association between inflammatory bowel disease (IBD) and autoimmune liver disease (AILD) is well-established, prevalence estimates vary considerably across studies. In this study, a meta-analysis was performed to determine the pooled prevalence and characterize the bidirectional relationship between AILD and IBD. METHODS:A systematic search was conducted in PubMed, Embase, and the Cochrane Library to identify observational studies reporting the prevalence between IBD and AILD. Data were extracted for eligible studies, and pooled prevalence estimates were derived using random effects models. Subgroup analyses were performed based on IBD and AILD subtypes, gender, race, geographical region, extent of IBD, and publication year. RESULTS:Of the 9347 citations, 172 studies involving 1 550 966 participants were included. The pooled prevalence of IBD among AILD patients, based on 65 studies, was 32.05% (95% CI 22.83%-42.94%; I2 = 100%, p < 0.001). Specifically, the prevalence of IBD in patients with primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and primary biliary cirrhosis (PBC) was 62.79% (95% CI 57.74%-67.57%), 3.54% (95% CI 2.08%-5.96%), and 1.99% (95% CI 1.05%-3.74%), respectively. The pooled prevalence of AILD among IBD patients, based on 109 studies, was 2.28% (95% CI 1.88%-2.76%; I2 = 100%, p < 0.001). Prevalence of PSC, AIH, and PBC in IBD patients was 2.24% (95% CI 1.85%-2.70%), 0.59% (95% CI 0.24%-1.47%), and 0.32% (95% CI 0.09%-1.13%), respectively. Subgroup analyses revealed significant variations in prevalence associated with gender, race, IBD extent, geographic region, and publication year. CONCLUSION:This study reveals a significant bidirectional association in the prevalence of AILD and IBD, supporting the gut-liver axis theory. Further research is needed to elucidate causal mechanisms.

Colorectal cancer (CRC) prevention requires early detection and removal of adenomas. We aimed to develop a computational model for real-time detection and classification of colorectal adenoma. Computationally constrained background based on real-time detection, we propose an improved adaptive lightweight ensemble model for real-time detection and classification of adenomas and other polyps. Firstly, we devised an adaptive lightweight network modification and effective training strategy to diminish the computational requirements for real-time detection. Secondly, by integrating the adaptive lightweight YOLOv4 with the single shot multibox detector network, we established the adaptive small object detection ensemble (ASODE) model, which enhances the precision of detecting target polyps without significantly increasing the model's memory footprint. We conducted simulated training using clinical colonoscopy images and videos to validate the method's performance, extracting features from 1148 polyps and employing a confidence threshold of 0.5 to filter out low-confidence sample predictions. Finally, compared to state-of-the-art models, our ASODE model demonstrated superior performance. In the test set, the sensitivity of images and videos reached 87.96% and 92.31%, respectively. Additionally, the ASODE model achieved an accuracy of 92.70% for adenoma detection with a false positive rate of 8.18%. Training results indicate the effectiveness of our method in classifying small polyps. Our model exhibits remarkable performance in real-time detection of colorectal adenomas, serving as a reliable tool for assisting endoscopists.

Ulcerative colitis (UC) is an inflammatory bowel disease that predominantly impacts the colon, typically starting in the rectum. A significant characteristic of UC is its propensity to affect the distal colon, which is particularly beneficial for targeted treatments such as enemas. This localized approach ensures that the medication is delivered directly to the affected areas, resulting in minimal systemic absorption. In this research, we have formulated a novel stimuli-responsive quercetin-loaded guanosine borate supramolecular hydrogel (named GBQ hydrogel), designed to prolong the residence time of the drug and protect the ulcerated intestinal tissues. The GBQ hydrogel has exhibited excellent injectability, self-healing capabilities, and biocompatibility, rendering it an ideal candidate for enema administration. In vitro studies have highlighted its ROS/pH dual-responsive release profile, which mimics the microenvironment of intestinal inflammation. Furthermore, we assessed the efficacy of the GBQ hydrogel on dextran sulfate sodium (DSS)-induced colitis, a common animal model for UC. Our findings indicate that the GBQ hydrogel significantly reduces disease activity, mitigates oxidative stress, restores the intestinal mucosal barrier, and prevents colonic cell apoptosis. Collectively, this study underscores the therapeutic potential of the GBQ hydrogel in managing inflammatory bowel conditions and paves the way for a novel hydrogel enema-based treatment strategy for UC. GBQ hydrogel enema for treating DSS-induced colitis in mice.

Constipation and frailty are associated with intestinal dysbiosis. This study aims to identify intestinal microbial signatures that can differentiate between constipated elders accompanied by frailty and those without frailty. We collected stool samples from 61 participants and conducted 16S rRNA gene sequencing. Constipated patients with frailty (Constipation_F) exhibited reduced gut microbial diversities compared to constipated patients without frailty (Constipation_NF) and healthy individuals (C). From differential genera, random forest models identified 14, 8, and 5 biomarkers for distinguishing Constipation_F from Constipation_NF, Constipation_F from C, and Constipation_NF from C, respectively. Functional analysis revealed that pathways (P381-PWY and PWY-5507) related to vitamin B12 synthesis were reduced in Constipation_F, which aligns with the decreased abundances of vitamin-B12-producing Actinomyces and Akkermansia in this group. Our study unveils substantial differences in gut microbiota between constipated elders with frailty and those without, underscoring the diagnostic and therapeutic potential of genera involved in vitamin B12 synthesis.

Prodrug delivery strategy for its potential to enhance the pharmacokinetic properties of drugs, especial to low oral absorption and bioavailability agents. Here, a berberine metabolite demethyleneberberine was conjugated into carboxymethyl chitosan by borate bond as a pH/ROS dual-responsive trigger. The amphiphilic conjugate readily spontaneously self-assembled into the nanomicelles in aqueous solution as prodrug delivery system for the therapy of inflammatory bowel diseases (IBD). In vivo experiments demonstrated the significant anti-inflammatory effect of CMCS-B-DMB nanomicelles.

Object: The creation of modern TCM is based on ancient literature, and the establishment of the ancient evidence evaluation method is crucial in determining the clinical efficacy of TCM.Methods: In this study, based on the principle of "evidence-based, consensus and experience supplemented",in order to investigate the evidence-based evaluation grade of ulcerative colitis disease in ancient Chinese medical books, two rounds of questionnaires were distributed using the Delphi method, and evidence-based scoring of ancient books was performed based on 28 prescriptions in Expert consensus opinion on the diagnosis and treatment of ulcerative colitis in Chinese medicine (2017) developed by the Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, and the evaluation grade was determined by screening the evidence and measuring the percentage before and afterscreening.Results: By screening the evidence and comparing the percentages before and after filtering, the evaluation grade was calculated. Shenling Baizhu powder (40.9 points), Sijunzi decoction (40.9 points), Taohua decoction (36 points), Baitouweng decoction (36 points), Shaoyao decoction (35.95 points), and Sishen pill were all part of the finished high-grade evidence (35.3 points). Middle-grade evidence consists of the following: Fuzi Lizhong pill (33.9 points), Tongxie Yaofang decoction (33.15 points), Gegen Qinlian decoction (32.5 points), Huangqin decoction (32.5 points), Chishizhi Yuyuliang decoction (32.5 points), Wumei pill (32.5 points), Sini powder (32.5 points), Zhenren Yangzang decoction (30.4 points), Siwu decoction (30.4 points), Moshizi pill (26.9 points), Zhuche pill(26.2 points), Banxia Xiexin decoction(25.5 points), Renshen Baidu san (23.4 points), Huanglian Ejiao decoction(22 points), Buzhong Yiqi decoction(21.95 points), Yizhi Hezhong decoction(21.95 points),Shengyang Yiwei Decoction(21.95 points).Low-rated evidence: Huangqi Jianzhong decoction (19.9 points), Xiaoyao powder (19.9 points), Huanglian Jiedu decoction (17.8 points), Shaofu Zhuyu decoction (15.7 points) and Lianli decoction (15.3 points).Conclusions: This time, most of the conclusions obtained from the evidence-based evaluation of ulcerative colitis diseases in ancient Chinese medical books are in line with the actual clinical diagnosis and treatment, providing a reasonable basis for guiding the clinical use of decoctions, which is of guiding significance for the preparation of International Guidelines. In addition,it was advised to enhance the evidence rating for the Lianli decoction formula because it had a lower rating but a higher evidence re-screening and pre and post-screening % measurement.

Background and objectives: There are concerns about the serological responses to Coronavirus disease 2019 (COVID-19) vaccines in inflammatory bowel disease (IBD) patients, particularly those receiving anti-TNF therapy. This study aimed to systematically evaluate the efficacy of COVID-19 vaccines in IBD patients receiving anti-TNF therapy. Methods: Electronic databases were searched to identify relevant studies. We calculated pooled seroconversion rate after COVID-19 vaccination and subgroup analysis for vaccine types and different treatments were performed. Additionally, we estimated pooled rate of T cell response, neutralization response, and breakthrough infections in this population. Results: 32 studies were included in the meta-analysis. IBD patients receiving anti-TNF therapy had relatively high overall seroconversion rate after complete vaccination, with no statistical difference in antibody responses associated with different drug treatments. The pooled positivity rate of T cell response was 0.85 in IBD patients receiving anti-TNF therapy. Compared with healthy controls, the positivity of neutralization assays was significantly lower in IBD patients receiving anti-TNF therapy. The pooled rate of breakthrough infections in IBD patients receiving anti-TNF therapy was 0.04. Conclusions: COVID-19 vaccines have shown good efficacy in IBD patients receiving anti-TNF therapy. However, IBD patients receiving anti-TNF have a relatively high rate of breakthrough infections and a low level of neutralization response.

慢性腹泻的中医发生发展机制与三焦、玄府功能失常密切相关.《内经》指出,三焦主通行诸气、主运行水液;玄府是津液流通和气机升降之"门户",三焦和玄府在结构和功能上形成一个有机的整体.三焦通路的畅达和玄府开阖有度,在整个人体气液代谢过程中起着主宰作用.从"三焦?玄府?气液"理论出发,可以为慢性腹泻的中医治疗提供新思路.