Objective: To observe the multimodal regulatory effects of transcutaneous electrical acupoint stimulation (TEAS) combined with Traditional Chinese Medicine (TCM) five-tone music therapy (FTT) on cerebral oxygenation and digital tongue-pulse parameters in college students with subthreshold depression (SD) of the liver stagnation and spleen deficiency type. Methods: Ninety eligible college students with SD were randomized into control, TEAS, and TEAS+FTT group (n = 30 each). The control group received general mental health education. The latter two groups received TEAS, with the TEAS+FTT group additionally listening to TCM liver-soothing and spleen-fortifying music (30 minutes/session, twice weekly for 4 weeks). Outcome measures included Hamilton Depression Rating Scale-17 (HAMD-17) scores, TCM syndrome scores, prefrontal Oxy-Hb levels, and digitalized tongue and pulse parameters. Results: No baseline differences existed (P>0.05). After treatment, compared with the control group, the TEAS+FTT group showed greater pre-post difference in HAMD-17 and TCM syndrome scores (P<0.05), and significant increases in the left prefrontal Oxy-Hb slope (S17-D13, S20-D13 channels), tongue coating RGB values, left-hand H1 and right-hand Ass pulse wave value (P<0.05). Compared with the TEAS group, the TEAS+FTT group exhibited lower TCM syndrome scores (P<0.05) and significantly higher left prefrontal Oxy-Hb slope (S17-D13, S20-D13), tongue coating R-value, and right-hand Ass pulse wave value (P<0.05). Conclusion: TEAS plus five-tone music therapy more effectively improves cerebral oxygenation, enhance visceral functional status, and alleviate depressive symptoms in college students with SD of the liver stagnation and spleen deficiency type compared to TEAS alone.

Pediatric influenza is a major public health concern. While Chinese patent medicines play a significant role in its treatment, information regarding drug recommendations in existing clinical guidelines is often fragmented, and the logic of syndrome differentiation-based medication is complex, limiting the efficiency of clinical decision-making. The objective of this study is to construct a structured Knowledge Graph for the treatment of pediatric influenza with Chinese patent medicines by integrating multiple authoritative guidelines and consensuses, and to develop an intelligent Question-Answering System based on this graph to provide precise clinical decision support. Using three guidelines and consensuses—including the Clinical Practice Guidelines for the Treatment of Pediatric Influenza with Chinese Patent Medicines (2024)—as core data sources, we manually and systematically extracted and standardized 11 types of entities, including influenza diagnosis, symptoms, Traditional Chinese Medicine (TCM) syndromes, therapeutic drugs, usage methods, and evidence levels. A domain ontology was constructed to define multidimensional semantic relationships between entities, and the Neo4j graph database was utilized for knowledge storage and visualization. The constructed Knowledge Graph consists of 433 nodes and 604 relationships, integrating 22 recommended Chinese patent medicines, 21 symptoms, and 6 types of TCM syndromes. The graph visualizes the dynamic decision-making path of "symptom-syndrome-drug" and embeds GRADE evidence levels and recommendation strengths. It supports intelligent symptom-based queries and provides comprehensive decision support, including drug recommendations, specific usage and dosage, combination medication suggestions, and risk warnings for contraindications. This study successfully constructed a structured Knowledge Graph for the treatment of pediatric influenza with Chinese patent medicines, effectively addressing the fragmentation of knowledge in traditional guidelines. This graph assists physicians, particularly those in primary care and Western medicine practitioners, in rapidly understanding the logic of syndrome differentiation and making standardized medication decisions, thereby reducing the barrier to diagnosis and treatment of pediatric influenza. This study provides a feasible paradigm for the digital transformation of TCM guideline knowledge and the development of clinical intelligent auxiliary tools.

Experimental evidence suggests that alkaloids have anti-influenza and anti-inflammatory effects. However, the risk of translating existing evidence into clinical practice is relatively high. We conducted a systematic review and meta-analysis of animal studies to evaluate the therapeutic effects of alkaloids in treating influenza, providing valuable references for future studies. Seven electronic databases were searched until October 2024 for relevant studies. The Review Manager 5.2 software was utilized to perform the meta-analysis. Our study was registered within the International Prospective Register of Systematic Reviews (PROSPERO) as number CRD42024607535. Alkaloids are significantly correlated with viral titers, pulmonary inflammation scores, survival rates, lung indices, and body weight. However, alkaloid therapy is not effective in reducing the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). In addition, the therapeutic effects of alkaloids may be related to the inhibition of the Toll-like receptor 4 or 7/Nuclear factor (NF)-κB signaling pathway, NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome pathway, and the Antiviral innate immune response receptor RIG-I (RIG-I) pathway. Alkaloids are potential candidates for the prevention and treatment of influenza. However, extensive preclinical studies and clinical studies are needed to confirm the anti-influenza and anti-inflammatory properties of alkaloids.

Background:Post-COVID-19 condition presents complex symptomatology involving multifaceted interactions, which has resulted in a current lack of comprehensive understanding of its disease trajectory. This knowledge gap significantly compromises the efficiency of symptom management and adversely affects patients' quality of life. Objective:This study aims to comprehensively characterize the temporal evolution of post-COVID-19 condition by identifying core symptom clusters and clinical phenotypes, thereby enhancing understanding of the disease trajectory. Methods:The PubMed, Web of Science, and Embase databases were searched from December 1, 2019, to March 1, 2024. Observational studies related to the prevalence of symptoms in post-COVID-19 condition had been included. We conducted a meta-analysis to synthesize symptom prevalence across different follow-up intervals following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used a network to explore interrelationships and co-occurrence patterns among symptoms, enabling the identification of core symptoms and changes over time. Clustering analysis was used to classify included studies into distinct clinical subtypes. Results:This study analyzed 155 sets of macrolevel data from 108 clinical studies, encompassing 63,771 patients. Fatigue was the most prevalent symptom across all 4 follow-up points (52%, 48%, 46%, and 54%). Dyspnea peaked at the third and sixth follow-ups (36% and 31%) and then declined steadily (28% and 22%). Subgroup analysis revealed that Africa reported the fewest symptoms overall, yet showed high early incidences of fatigue (68%, 95% CI 50%-85%) and dyspnea (56%, 95% CI 15%-98%). The Americas placed greater emphasis on symptom evolution within the first postinfection year, with notably higher prevalence of anxiety (60%, 95% CI 54%-66%) and depression (36%, 95% CI 16%-55%). Asia and Europe documented the most comprehensive symptom profiles, with Asia reporting lower early dyspnea rates (29%, 95% CI 18%-40%) and Europe exhibiting more complex multisystem involvement during long-term follow-up. Network analysis showed that core post-COVID-19 symptoms evolved from early respiratory-neurological manifestations to chronic multisystem symptoms dominated by dizziness. Clustering analysis further indicated a progressive convergence of 2 initially distinct post-COVID-19 subtypes, with the acute inflammatory type becoming less prominent and gradually transitioning into a more chronic, persistent pattern. Conclusions:This study provides a comprehensive characterization of the dynamic evolution of post-COVID-19 condition symptoms and clinical subtypes, highlighting their multisystem involvement. The results reveal a progressive decline in respiratory symptoms over time, while neurological manifestations emerge as the most persistent and systemically impactful core symptoms. Our findings emphasize the need for region-specific surveillance and early warning systems informed by symptom progression patterns. By continuously monitoring the trajectories of symptom clusters, this approach offers valuable insights for identifying early warning signals and targeted intervention points in the management of postinfectious sequelae arising from future large-scale epidemics.

BACKGROUND:Insomnia is a prevalent and distressing issue for individuals with cancer, negatively impacting their overall well-being. While cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia in the general population, its effects on cancer populations warrant rigorous, ongoing evaluation. Previous meta-analyses assessing CBT-I against specific comparators in people with cancer have often exhibited methodological limitations. Furthermore, with a recent increase in randomised controlled trials (RCTs) in this field, an updated and comprehensive synthesis is necessary. OBJECTIVES:To assess the effects of cognitive behavioural therapy for insomnia (CBT-I) in people with cancer. SEARCH METHODS:In April 2025, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and clinical trials registries. We also checked reference lists. We applied no language, publication date, or study setting restrictions. SELECTION CRITERIA:We included all RCTs that compared the effects of CBT-I with other treatments in individuals diagnosed with both insomnia and cancer. We placed no restrictions on the specific characteristics of the CBT-I interventions or the comparator groups. We excluded quasi-randomised and cross-over trials. DATA COLLECTION AND ANALYSIS:We used random-effects meta-analysis for our primary analyses. Our critical outcomes were: insomnia severity (Insomnia Severity Index (ISI), range 0 to 28), sleep quality (Pittsburgh Sleep Quality Index (PSQI), range 0 to 21), and serious adverse events (SAEs). Important outcomes were sleep diary-derived parameters: sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE). We also analysed objective sleep parameters for the comparisons presented in the summary of findings (SoF) tables. We used the Cochrane risk of bias 2 (RoB 2) tool to assess risk of bias and the GRADE approach to assess evidence certainty. We interpreted findings for continuous outcomes against minimally important differences (MIDs). MAIN RESULTS:We included 21 RCTs (2431 randomised participants, predominantly female adults). Participants had received treatment for a range of cancer types, with breast cancer being the most frequently studied, and most were cancer survivors undergoing or following cancer treatment. CBT-I was typically delivered via therapist-led sessions or digital programs (four to 12 weeks). We identified five comparisons and summarised the findings for the two primary comparisons, with outcomes assessed at the conclusion of CBT-I treatment. The risk of bias was often high. Overall, CBT-I may offer small subjective improvements in insomnia for cancer survivors, and the evidence certainty was mostly low to very low. Benefits on objective measures are less clear. CBT-I versus inactive control Compared to inactive control post-intervention, CBT-I may slightly reduce ISI scores (mean difference (MD) -5.86 points, 95% confidence interval (CI) -7.22 to -4.51; 14 studies, 1371 participants; very low-certainty evidence) and PSQI scores (MD -3.60 points, 95% CI -4.95 to -2.24; 3 studies, 473 participants; low-certainty evidence). CBT-I may result in little to no difference in the occurrence of SAEs (risk ratio (RR) 1.05, 95% CI 0.07 to 16.77; 4 studies, 765 participants; very low-certainty evidence). Regarding sleep diary outcomes, CBT-I probably reduces SOL (MD -13.35 min, 95% CI -17.18 to -9.51; 9 studies, 760 participants; moderate-certainty evidence), may reduce WASO (MD -15.39 min, 95% CI -25.23 to -5.56; 9 studies, 784 participants; very low-certainty evidence), and may improve SE very slightly (MD 7.84%, 95% CI 3.62 to 12.06; 9 studies, 725 participants; very low-certainty evidence). CBT-I may result in little to no difference in TST (MD 6.43 min, 95% CI -8.30 to 21.16; 10 studies, 899 participants; very low-certainty evidence). Regarding objective sleep outcomes, CBT-I may result in little to no difference in SOL (MD -4.54 min, 95% CI -9.91 to 0.84; 2 studies, 129 participants), WASO (MD -5.08 min, 95% CI -10.62 to 0.46; 3 studies, 242 participants), TST (MD -11.01 min, 95% CI -29.35 to 7.33; 4 studies, 521 participants), and SE (MD 1.35%, 95% CI 0.08 to 2.63; 5 studies, 571 participants). CBT-I versus aerobic activities Compared to aerobic activities post-intervention, CBT-I may reduce ISI scores (MD -3.53 points, 95% CI -4.43 to -2.62; 2 studies, 406 participants; low-certainty evidence) and PSQI scores (MD -1.67 points, 95% CI -2.63 to -0.72; 3 studies, 496 participants; low-certainty evidence). CBT-I may result in little to no difference in the occurrence of SAEs (RR 0.35, 95% CI 0.04 to 3.36; 2 studies, 579 participants; very low-certainty evidence). Regarding sleep diary outcomes, CBT-I may result in little to no difference in SOL (MD -6.15 min, 95% CI -13.07 to 0.78; 2 studies, 131 participants; low-certainty evidence), WASO (MD -6.35 min, 95% CI -15.30 to 2.61; 2 studies, 131 participants; low-certainty evidence), and TST (MD 0.40 min, 95% CI -21.10 to 21.90; 2 studies, 131 participants; very low-certainty evidence). However, CBT-I may slightly increase SE (MD 4.24%, 95% CI 0.45 to 8.02; 2 studies, 131 participants; low-certainty evidence). Regarding objective sleep outcomes, CBT-I may result in little to no difference in SOL (MD 6.07 min, 95% CI -1.47 to 13.62; 2 studies, 131 participants), WASO (MD 6.16 min, 95% CI -3.80 to 16.11; 2 studies, 131 participants), and SE (MD -0.90%, 95% CI -2.84 to 1.04; 3 studies, 416 participants), and may lead to shorter TST (MD -13.02 min, 95% CI -25.00 to -1.04; 3 studies, 416 participants). AUTHORS' CONCLUSIONS:This Cochrane review found very low-certainty to moderate-certainty evidence suggesting that CBT-I may offer small to very small improvements in patient-reported insomnia severity, sleep quality, and most subjective sleep diary parameters when compared with inactive controls. Against aerobic activities, low-certainty evidence indicates that CBT-I may also improve insomnia severity and sleep quality. The incidence of SAEs appeared similar between CBT-I and comparator groups, and the certainty of this evidence is very low. The decision to use CBT-I to treat insomnia in people with cancer might depend on the treatment's availability and cost, as well as clinicians' and patients' preferences. Future research requires long-term, larger, and more rigorously designed studies that are inclusive and diverse.

RATIONALE:Insomnia is a common issue affecting people with cancer. Although acupuncture is widely used as a treatment option for insomnia, its effects on cancer patients require a rigorous and up-to-date evaluation. OBJECTIVES:To evaluate the benefits and harms of acupuncture for insomnia in people with cancer. SEARCH METHODS:We searched CENTRAL, MEDLINE, Embase, PsycINFO, and five other databases or trial registries in January 2024. ELIGIBILITY CRITERIA:We included randomised controlled trials (RCTs) with a minimum duration of four weeks that evaluated acupuncture (defined as needle insertion at specific acupoints) for treating insomnia in patients with cancer. OUTCOMES:Our outcomes were insomnia severity measured by the Insomnia Severity Index (ISI), sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI), adverse events, and sleep diary outcomes including sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE). RISK OF BIAS:We assessed the risk of bias using the RoB 2 tool. SYNTHESIS METHODS:We performed random-effects meta-analysis to calculate risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CIs). We assessed the certainty of evidence with GRADE and interpreted findings for continuous outcomes against minimally important differences (MIDs). INCLUDED STUDIES:We included five studies with 402 participants. The participants were predominantly females with breast cancer, and most were people following primary cancer treatment. SYNTHESIS OF RESULTS:We identified three comparisons with outcomes assessed at the end of the interventions. We rated the certainty of the evidence as very low-to-moderate, mainly due to risk of bias and the imprecision of effect estimates from the small studies. Acupuncture versus sham acupuncture We are very uncertain about all results due to very low-certainty evidence. Compared to sham acupuncture, acupuncture may have little to no effect on post-intervention ISI scores (MD -3.17, 95% CI -10.39 to 4.05; MID -4.7 points; 2 studies, 152 participants; very low-certainty evidence) and PSQI scores (MD -1.16, 95% CI -3.53 to 1.22; MID -3 points; 2 studies, 152 participants; very low-certainty evidence). Acupuncture may increase the risk of adverse events (RR 2.60, 95% CI 0.98 to 6.90; 1 study, 138 participants; very low-certainty evidence), but this result is very uncertain. Regarding sleep diary outcomes, acupuncture compared with sham acupuncture may improve post-intervention SOL (MD -10.02 min, 95% CI -19.09 to -0.94; MID 20 minutes; 2 studies, 152 participants; very low-certainty evidence) and SE (MD 4.90%, 95% CI 1.98 to 7.82; MID 10%; 2 studies, 152 participants; very low-certainty evidence) very slightly. It may have a large effect on TST (MD 45.94 min, 95% CI -0.93 to 92.80; MID 15 minutes; 2 studies; 152 participants; very low-certainty evidence), but this result is very uncertain. Data on WASO were unavailable. No outcome both exceeded its MID and was statistically significant. Acupuncture versus inactive control We are very uncertain about all results due to very low-certainty evidence. Compared to an inactive control, acupuncture may reduce post-intervention ISI scores (MD -3.88, 95% CI -7.25 to -0.52; MID -4.7 points; 2 studies, 46 participants; very low-certainty evidence) and PSQI scores (-2.20, 95% CI -3.35 to -1.04; MID -3 points; 3 studies, 98 participants; very low-certainty evidence) slightly, but may increase the risk of adverse events (RR 15.49, 95% CI 2.12 to 113.10; 2 studies, 76 participants; very low-certainty evidence). With respect to sleep diary outcomes, acupuncture may slightly improve post-intervention SOL (MD -15.61 min, 95% CI -29.23 to -1.99; MID 20 minutes; 2 studies, 46 participants; very low-certainty evidence), TST (MD 34.61 min, 95% CI 12.54 to 56.69; MID 15 minutes; 2 studies, 46 participants; very low-certainty evidence) and SE slightly (MD 5.65, 95% CI 0.99 to 10.32; MID 10%; 2 studies, 46 participants; very low-certainty evidence). However, it may result in little to no difference in post-intervention WASO (MD 5.70 min, 95% CI -17.25 to 28.65; 1 study, 30 participants; very low-certainty evidence). Only the TST improvement surpassed the MID. Acupuncture versus cognitive behavioural therapy for insomnia (CBT-I) Compared to CBT-I, acupuncture probably results in slightly higher (worse) post-intervention ISI scores (MD 2.60, 95% CI 1.13 to 4.07; 1 study, 160 participants; moderate-certainty evidence) and PSQI scores (MD 1.51, 95% CI 0.51 to 2.51; 1 study, 160 participants; moderate-certainty evidence). However, it may have little to no effect on adverse events (RR 1.68, 95% CI 0.59 to 4.79; 1 study; 160 participants; low-certainty evidence). Regarding sleep diary outcomes, acupuncture compared with CBT-I probably slightly worsens post-intervention SOL (MD 16.33 min, 95% CI 8.22 to 24.44; MID 10 minutes; 1 study, 160 participants; moderate-certainty evidence) and SE (MD -5.00%, 95% CI -8.48 to -1.52; MID 5%; 1 study, 160 participants; moderate-certainty evidence) but probably increases TST (MD 26.80 min, 95% CI 3.87 to 49.73; MID 15 minutes; 1 study, 160 participants; moderate-certainty evidence). It probably has little to no effect on WASO (MD 8.94 min, 95% CI -1.47 to 19.35; MID 15 minutes; 1 study, 160 participants; moderate-certainty evidence). The effects on SOL, TST, and SE reached the MIDs. AUTHORS' CONCLUSIONS:Based on very low-certainty evidence, acupuncture may have little to no effect on insomnia severity or sleep quality compared to sham acupuncture, though it may offer slight improvements in some sleep diary metrics. In contrast, when compared to an inactive control, acupuncture may alleviate insomnia severity and improve sleep quality and most sleep diary metrics, but adverse events should be taken into consideration. These findings are derived primarily from studies of female adults with breast cancer. Based on low- to moderate-certainty evidence, when compared with CBT-I, acupuncture is likely less effective at reducing insomnia severity, improving sleep quality, SOL and SE. Conversely, acupuncture probably improves TST. Larger, methodologically robust, long-term trials that include diverse cancer populations are required to provide definitive conclusions. FUNDING:This work was funded by the Postdoctor Research Fund of West China Hospital, Sichuan University (2025HXBH063) and the Fundamental Research Fund of China Academy of Chinese Medical Sciences (No. ZZ17-XRZ-113). REGISTRATION:Protocol available via doi.org/10.1002/14651858.CD015177.

ObjectiveTo evaluate the effectiveness and safety of Chinese medicine (CM) in the treatment of coronavirus disease 2019 (COVID-19) in China. MethodsA multi-center retrospective cohort study was carried out, with cumulative CM treatment period of >= 3 days during hospitalization as exposure. Data came from consecutive inpatients from December 19, 2019 to May 16, 2020 in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting (IPTW), and the Cox proportional hazards regression model was used for statistical analysis. ResultsA total of 2,272 COVID-19 patients were included. There were 1,684 patients in the CM group and 588 patients in the control group. Compared with the control group, the hazard ratio (HR) for the deterioration rate in the CM group was 0.52 [95% confidence interval (CI): 0.41 to 0.64, P<0.001]. The results were consistent across patients of varying severity at admission, and the robustness of the results were confirmed by 3 sensitivity analyses. In addition, the HR for all-cause mortality in the CM group was 0.29 (95% CI: 0.19 to 0.44, P<0.001). Regarding of safety, the proportion of patients with abnormal liver function or renal function in the CM group was smaller. ConclusionThis real-world study indicates that the combination of a full-course CM therapy on the basic conventional treatment, may safely reduce the deterioration rate and all-cause mortality of COVID-19 patients. This result can provide the new evidence to support the current treatment of COVID-19. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific CM interventions. (Registration No. ChiCTR2200062917)

This study aims to systematically review the efficacy and safety of Shufeng Jiedu Capsules in the treatment of influenza. The randomized controlled trial(RCT) of Shufeng Jiedu Capsules alone or in combination with conventional western medicine for treating influenza were retrieved from PubMed, EMbase, Cochrane Library, Web of Science, SinoMed, CNKI, VIP, Wanfang, and ClinicalTrails.gov. The data analysis was performed in RevMan 5.4.1. The Cochrane risk of bias assessment tool was used to evaluate the quality of the involved RCT, and GRADEpro GDT to assess the quality of the evidence. A total of 11 RCTs involving 1 836 patients were included in this study. Compared with conventional western medicine, Shufeng Jiedu Capsules/Shufeng Jiedu Capsules + conventional western medicine improved the response rate(RR=1.09, 95%CI[1.03, 1.15], P=0.002), shortened the time to relief of cough, and increased the 3-day sore throat relief rate, whereas there was no significant difference in the time to fever abatement, the time to relief of sore throat, 3-day cough relief rate, or 3-day runny nose relief rate. Subgroup-analysis showed that Shufeng Jiedu Capsules + conventional western medicine improved the response rate(RR=1.11, 95%CI[1.08, 1.15], P&lt;0.000 01), shortened the time to relief of cough, and increased the 3-day relief rate of symptoms(cough, sore throat, and runny nose) compared with conventional western medicine alone, while there was no significant difference in the time to fever abatement or the time to relief of sore throat. Shufeng Jiedu Capsules alone could not improve the response rate(RR=0.97, 95%CI[0.93, 1.02], P=0.19). In addition, Shufeng Jiedu Capsules/Shufeng Jiedu Capsules + conventional western medicine vs conventional western medicine were no significant difference in adverse reactions(RR=0.98, 95%CI[0.57, 1.69], P=0.95). The available evidence suggests that Shufeng Jiedu Capsules is effective and safe in the treatment of influenza, and the combination of Shufeng Jiedu Capsules with conventional western medicine can accelerate the relief of symptoms. However, since the number and quality of the included studies were low, the above findings remained to be further verified by multicenter RCT with large sample sizes.

Objective To explore the hotspots and frontiers of artificial intelligence（AI） technology in the field of TCM; To provide further ideas for related researches. Methods Literature about the application of AI in TCM basic research and clinical practice was retrieved from CNKI, Wanfang Data, CBM and VIP from the establishment to May 17, 2022. The publication time, author, author unit, journal, keywords and other information were collected, and the author unit, journal and keywords were under preprocessed. VOSviewer 1.6.18 software was used to build a keyword visualization network and perform cluster analysis on the included keywords. Keyword time overlay network was constructed based on the average year of keyword appearance. Results A total of 1 852 articles were finally included. The included articles were published in 409 journals, and the top four journals by the number of published papers were China Journal of Traditional Chinese Medicine and Pharmacy, Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology, Chinese Journal of Information on Traditional Chinese Medicine, and Traditional Chinese Medicine Journal; a total of 2 590 authors of the 272 units from Beijing University of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences and Chengdu University of Traditional Chinese Medicine, have not yet formed a mature regional cooperation network and team; the included articles covered 3 361 keywords, with a total of 8 074 occurrences, focusing on data mining, tongue diagnosis, and expert system, forming three hot research areas. Knowledge graph, convolutional neural network, attention mechanism have become the research frontier in the past five years. Conclusion The application research of AI in the field of TCM has fluctuated over time, and a relatively stable regional cooperation team has not yet formed; how to fully combine modern technology with traditional thinking of TCM diagnosis and treatment to better describe the thinking of TCM and give a standardized expression is an important direction and focus of AI application research in the field of TCM.

Objective To systematically evaluate the efficacy and safety of anlotinib in the treatment of extensive-stage small cell lung cancer (ES-SCLC) by meta-analysis. Methods PubMed, Embase, Cochrane Library, CNKI, Wanfang Data, VIP Database, China Biology Medicine disc were searched for the full literature on studies of anlotinib for the treatment of ES-SCLC published from database establishment to November 2022. Other 2 investigators were responsible for screening the literature and extracting data independently according to the inclusion and exclusion criteria. Revman 5.4 software was used for meta-analysis of the data. Results A total of 6 RCTs were included for analysis studies, with a total of 302 patients. Meta analysis suggested that anlotinib significantly prolonged progression free survival of ES-SCLC (HR=0.12, 95%CI: 0.07 to 0.21, P<0.01) , improved objective response rate (RR=1.48, 95%CI: 1.15 to 1.91, P<0.01) , improved KPS score (MD=9.18, 95%CI: 4.35 to 14.02, P<0.01) , and decreased neuron-specific enolase (NSE) value (MD=-8.20, 95%CI: -9.15 to -7.25, P<0.01) . Compared to control group, the anlotinib group was associated with a higher risk of adverse events (RR=1.11, 95%CI: 0.91 to 1.35, P=0.31) , but without significant difference, while the incidence of hypertension (RR=6.63, 95%CI: 2.44 to 16.44, P<0.01) and rash (RR=3.55, 95%CI: 1.43 to 8.78, P<0.01) increased in anlotinib group. There was no significant difference in the remaining adverse effects, such as fatigue (RR=1.06, 95%CI: 0.74 to 1.52, P=0.74) , diarrhea (RR=2.28, 95%CI: 0.56 to 9.24, P=0.25) , and proteinuria (RR=1.75, 95%CI: 0.53 to 5.73, P=0.36) . Conclusion Anlotinib can raise long-term survival and short-term outcomes, improve quality of life, and reduce NSE values in ES-SCLC patients compared with placebo or blank controls, but it has a higher risk of developing hypertension and rash. The risk of remaining adverse effects such as fatigue, diarrhea, and proteinuria occurred are similar between placebo/blank controls and anlotimib treatment. The patients have a good medication tolerance.

Under the current public health condition in China, the people’s health needs for the service capacity of TCM are growing. However, there are still some problems with the comprehensive medical service level of TCM,such as the secondary treatment means of TCM in the hospital system, the shortage of high-quality TCM talents, the insufficient proportion of grass-roots TCM diagnosis and treatment, low accessibility to quality service of TCM,difficult to sinking into the community, and the undeveloped doctor-patient co-construction evaluation system. Based on these problems, this article sorted out and summarized the diagnosis and treatment mode of TCM since ancient times. Proceeding from the characteristics of TCM diagnosis and treatment and people’s health needs, three thoughts were proposed, i.e. building a family TCM model, promoting the construction of classic TCM wards, and establishing an evaluation method based on antificial intelligence big data, in order to continuously improve the clinical practice of TCM, and promote the development of TCM in inheritance and development through diagnosis and treatment model of hierarchical diagnosis and treatment with big data analysis.

随着真实世界研究方法学的进步和人工智能技术的成熟,以中医诊疗数据为基础,开展"定量"研究指导临床实践的方法正在逐步形成,但在研究总体设计、临床转化等方面仍需进一步完善.提出基于中医临床诊疗数据的真实世界及人工智能研究的总体设计思路及应用方法,包括5个步骤:建设高质量大样本的具有中医特色的研究型数据库、核心处方的挖掘及分类、队列研究评价核心处方疗效、病例对照研究明确优势人群、建立预测模型实现精准医疗.此外,研究人员还需要建立标准化的中医变量采集和数据处理体系,优化混杂因素的确定及测量方法,进一步完善及推广方法学,加强跨学科人才的培养.真实世界研究与人工智能研究的研究基础相似,临床应用互补,未来将是二者的融合.

目的 系统评价滋肾育胎丸联合西药治疗复发性流产的临床疗效和安全性.方法 检索Medline、Cochrane Library、Embase、CNKI、VIP、CBM、万方数据库,筛选自建库至2022年1月12日公开发表的与滋肾育胎丸联合西药治疗复发性流产的疗效和安全性相关的随机对照试验(RCT).根据Cochrane手册评价文献质量,应用RevMan5.4软件进行Meta分析,用倒漏斗图评估发表偏倚,并对结局指标进行GRADE分级.结果 本研究共纳入9篇随机对照试验,共计837例患者.Meta分析显示,与单独使用西药相比,联合滋肾育胎丸可提高临床分娩率(RR=1.41,95％CI[1.26,1.57],I2=0％)、保胎成功率(RR=1.33,95％CI[1.20,1.48],I2=0％)及降低孕期阴道流血率(RR=0.33,95％CI[0.22,0.50],I2=0％),纳入研究未提示明显药物不良反应.GRADE证据评价结果显示,临床分娩率为中级证据质量,保胎成功率为低级证据质量,阴道流血发生率为非常低级证据质量.结论 该研究发现,滋肾育胎丸联合西药在提高复发性流产临床分娩率、保胎成功率和降低孕期阴道流血发生率方面具有显著疗效,无明显副作用,临床值得推广运用.但该结论仍需更多高质量临床试验予以证实.

Abstract Background Thrombosis is a serious condition in children and neonates. However, the risk factors for thrombosis have not been conclusively determined. This study aimed to identify the risk factors for thrombosis in children and neonates in Intensive Care Unit (ICU) through a meta-analysis to better guide clinical treatment. Methods A systematic search of electronic databases (PubMed, Embase, Cochrane Library, WOS, CNKI, Wanfang, VIP) was conducted to retrieve studies from creation on 23 May 2022. Data on the year of publication, study design, country of origin, number of patients/controls, ethnicity, and type of thrombus were extracted. The publication bias and heterogeneity between studies were assessed, and pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed or random effects models. Results A total of 18 studies met the inclusion criteria. The incidence of thrombosis in children was 2% per year (95% CI 1%-2%, P < 0.01). Infection and sepsis (OR = 1.95, P < 0.01), CVC (OR = 3.66, [95%CL 1.78–7.51], P < 0.01), mechanical ventilation (OR = 2.1, [95%CL1.47–3.01], P < 0.01), surgery (OR = 2.25, [95%CL1.2–4.22], P < 0.01), respiratory distress (OR = 1.39, [95%CL0.42–4.63], P < 0.01), ethnicities (OR = 0.88, [95%CL 0.79–0.98], P = 0.78), gestational age (OR = 1.5, [95%CL1.34–1.68], P = 0.65)were identified as risk factors for thrombosis. Conclusions This meta-analysis suggests that CVC, Surgery, mechanical ventilation, Infection/sepsis, gestational age, Respiratory distress, and different ethnicities are risk factors for thrombosis in children and neonates in ICU. These findings may help clinicians to identify high-risk patients and develop appropriate prevention strategies. Trial registration PROSPERO (CRD 42022333449).

目的 系统评价中药灌肠治疗脓毒症急性肾损伤的疗效及安全性.方法 检索中国知网(CNKI)、万方数据库(Wanfang)、中文科技期刊数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Embase与Cochrane Library数据库,纳入中药灌肠治疗脓毒症急性肾损伤的随机对照试验(RCT),使用Cochrane风险偏倚评估工具进行文献质量评价,使用RevMan 5.4.1软件进行数据分析.结果 纳入10篇RCT,共724例患者.Meta分析结果显示,与对照组相比,试验组血肌酐水平降低[MD=-14.38,95％CI(-18.28,-10.47),P＜0.01],临床有效率提高[RR=1.20,95％CI(1.11,1.31),P＜0.01],APACHE Ⅱ 评分[MD=-3.37,95％CI(-3.68,-3.07),P＜0.01]、尿素氮水平[MD=-1.66,95％CI(-2.37,-0.95),P＜0.01]、超敏C反应蛋白水平[MD=-1.84,95％CI(-2.09,-1.59),P＜0.01]、白细胞介素-6水平[SMD=-1.45,95％CI(-1.73,-1.17),P＜0.01]、肿瘤坏死因子-α水平[SMD=-1.43,95％CI(-1.70,-1.16),P＜0.01]均降低.只有1篇文献报道了安全性结局指标,试验组与对照组治疗前后谷草转氨酶、谷丙转氨酶无统计学差异.结论 现有证据表明,中药灌肠治疗脓毒症急性肾损伤具有良好临床疗效且基本安全;但本研究纳入文献数量少、质量低,上述结论仍然需要多中心、大样本的RCT研究进一步验证.

真实世界研究可利用临床实际产生的数据,通过科学合理的研究设计及严谨的数据治理工作,形成真实世界证据,与随机对照试验形成互补的关系.数据治理包括数据链接、数据提取、数据核查、数据清理4个步骤.其中,数据链接的核心在于患者识别码的治理,应确定唯一、无重复的患者ID序列,并进行"纵向锁定";数据提取的核心是同质化操作,可通过背靠背、培训、预提取、格式限定等方法,减少不同操作人员间的差异;数据核查的难点在于选择恰当的核查范围,可采用抽样核查和全面核查相结合的方式,在保证有效核查的前提下减少核查工作量;数据清理的重点在于对核查出的重复数据、矛盾数据、极端值和缺失值等各种问题数据制定恰当的清理规则.本文以"中西医结合治疗新型冠状病毒感染研究型数据库"为例,对研究中数据治理的方法进行介绍,以供研究人员参考.

In observational studies, herbal prescriptions are usually studied in the form of "similar prescriptions". At present, the classification of prescriptions is mainly based on clinical experience judgment, but there are some problems in manual judgment, such as lack of unified criteria, labor consumption, and difficulty in verification. In the construction of a database of integrated traditional Chinese and western medicine for the treatment of coronavirus disease 2019(COVID-19), our research group tried to classify real-world herbal prescriptions using a similarity matching algorithm. The main steps include 78 target prescriptions are determined in advance; four levels of importance labeling shall be carried out for the drugs of each target prescription; the combination, format conversion, and standardization of drug names of the prescriptions to be identified in the herbal medicine database; calculate the similarity between the prescriptions to be identified and each target prescription one by one; prescription discrimination is performed based on the preset criteria; remove the name of the prescriptions with "large prescriptions cover the small". Through the similarity matching algorithm, 87.49% of the real prescriptions in the herbal medicine database of this study can be identified, which preliminarily proves that this method can complete the classification of herbal prescriptions. However, this method does not consider the influence of herbal dosage on the results, and there is no recognized standard for the weight of drug importance and criteria, so there are some limitations, which need to be further explored and improved in future research.

Objective To compare the efficacy of different TCM injections combined with conventional therapy in the treatment of septic myocardial injury by network meta-analysis. Methods RCTs of TCM injection for the treatment of septic myocardial injury were retrieved from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase,and Cochrane Library database from the establishment of the databases until August 15, 2022. The articles were screened according to inclusion and exclusion criteria. Cochrane bias risk assessment tool was used to evaluate the quality of literature and Stata1 6.0 was used to analyze the data. Results Totally 49 articles were finally included,involving 3 903 patients, and including 7 kinds of TCM injections. The results of network Meta-analysis showed that:in terms of improving myocardial injury, the left ventricular ejection fraction of Shenmai Injection, Huangqi Injection, and Shenfu Injection combined with conventional treatment was significantly higher than that of conventional treatment. Shenfu Injection combined with conventional treatment has the best effect on reducing the levels of myocardial enzymes NT-Pro BNP, BNP and cTn Ⅰ; in terms of survival rate, Xuebijing Injection, Shenfu Injection and Danshen Ligustrazine injection combined with conventional treatment had the best effect. The 28-day survival rate was significantly higher than the conventional treatment. Conclusion Shenfu Injection, Huangqi Injection, Shenmai Injection, Xuebijing Injection, and Danshen Ligustrazine Injection have myocardial protective effects on patients with septic myocardial injury. Among them, Shenfu Injection combined with conventional treatment is most likely to be the optimal treatment. This conclusion needs to be further verified by more large-scale RCT studies.

Objective: To compare the effects of electroacupuncture（EA） and moxibustion at Zusanli（ST 36） on the lung phenotype of rat offspring exposed to nicotine during the perinatal period.Methods: Pregnant Sprague-Dawley rats were randomly divided into 4 groups: the control group（saline only）, the model group（nicotine only）, the EA group（nicotine + EA at ST 36 acupoints bilaterally）, and the moxibustion group（nicotine + moxibustion at ST 36 acupoints bilaterally）. n = 6 rats per group. On postnatal day 21, the body weight, lung weight, and pulmonary function were determined and lung morphometry was performed. Peroxisome proliferator-activated receptor gamma and β-catenin levels in the lung tissue of offspring were also determined.Results: Perinatal nicotine exposure（PNE） results in decreased body and lung weights of offspring rats,abnormal lung tissue morphology, and significantly altered pulmonary function, showing an increase in total airway resistance and a decrease in tidal volume, minute ventilation, total airway compliance, and peak expiratory flow. Bilateral EA at ST 36 acupoints could block all of these perinatal nicotine-induced effects. Although moxibustion also had protective effects in nicotine-induced offspring lungs, some of these effects did not reach statistical significance, e.g., protection against the upregulation of β-catenin,the downregulation of PPARγ signaling, and the increase in peak expiratory flow.Conclusion: Maternal EA at ST 36 blocked the PNE-induced changes in key developmental signaling pathways, prevented the PNE-induced changes in lung morphology, and protected pulmonary function.Moxibustion at ST 36 showed similar but weaker protective effects against the PNE-induced changes in the exposed offspring. It is important to note that the mechanism underlying the protective effects of moxibustion at ST 36 may be different from those of EA at ST 36, and further research is needed to understand these differences.

Mining data from traditional Chinese medicine(TCM) prescriptions is one of the important methods for inheriting the experience of famous doctors and developing new drugs. However, current research work has problems such as to be optimized research plans and non-standard statistics. The main problems and corresponding solutions summarized by the research mainly include four aspects.(1)The research plan design needs to consider the efficacy and quality of individual cases.(2)The significance of the difference in confidence order of association rules needs to be further considered, and the lift should not be ignored.(3)The clustering analysis steps are complex. The selection of clustering variables should comprehensively consider factors such as the frequency of TCM, network topology parameters, and practical application significance. The selection of distance calculation and clustering methods should be improved based on the characteristics of TCM clinical data. Jaccard distance and its improvement plan should be given attention in the future. A single, unexplained clustering result should not be presented, but the final clustering plan should be selected based on a comprehensive consideration of TCM clinical characteristics and objective evaluation indicators for clustering.(4)When calculating correlation coefficients, algorithms that are only suitable for continuous variables should not be applied to binary variables. This article explained the connotations of the above problems based on the characteristics of TCM clinical research and statistical principles and proposed corresponding suggestions to provide important references for future data mining research work.