IntroductionUlcerative colitis (UC) is being increasingly connected to the pathogen Veillonella parvula (V. parvula). Modified Gegen Qinlian Decoction (MGQD), a traditional Chinese medicine therapy, is used to treat UC. However, the underlying mechanism by which V. parvula exacerbates UC and whether MGQD can alleviate it is unknown.MethodsMGQD therapy was tested on pathogen-free and pseudo-germ-free mice infected with V. parvula. Colitis severity was determined by disease activity index, colon length, and histology. Transmission electron microscopy, Western blot, immunofluorescence, and immunohistochemistry were used to assess the integrity of the intestinal mucosal barrier. In vitro, mouse colonic organoids were utilized to examine the effects of baicalin and puerarin on inflammation-induced downregulation of Muc2 and ZO-1.ResultsMGQD therapy dramatically reduced the severity of colitis in both mouse models. MGQD restored the integrity of the mucus and mechanical barriers. Furthermore, baicalin and puerarin reduced inflammation-induced downregulation of Muc2 and ZO-1 in mouse colonic organoids.DiscussionThese findings demonstrate that MGQD alleviates intestinal barrier dysfunction caused by V. parvula, providing novel mechanistic insight for the management of chronic colitis.

Collagenous gastritis (CG) is a rare chronic inflammatory disorder defined histologically by a subepithelial collagen band exceeding 10 μm, together with a chronic inflammatory infiltrate within the lamina propria. First described in 1989, CG presents with a striking age-stratified dichotomy. The pediatric phenotype is dominated by treatment-refractory iron-deficiency anemia and chronic abdominal pain, with disease usually confined to the stomach. The adult phenotype is dominated by chronic watery diarrhea and frequently coexists with collagenous colitis as part of a broader collagenous gastroenteropathy spectrum. The pathogenesis is widely held to be immune-mediated. Strong associations exist with autoimmune conditions, including celiac disease, common variable immunodeficiency (CVID), and systemic lupus erythematosus (SLE). Recent gene-expression and single-cell studies have identified mixed T-helper 1 (Th1) and T-helper 2 (Th2) cytokine profiles in gastric tissue, together with α4β7-mediated mucosal homing of activated CD4+ T cells, suggesting complex immune dysregulation rather than a primary disorder of collagen biosynthesis. Implicated triggers include certain medications—notably olmesartan—and, more speculatively, infectious agents; a single case report has increased the possibility of Epstein–Barr virus (EBV) reactivation. A single proteomics study has identified reduced epidermal growth factor (EGF) expression as a candidate biomarker, suggesting impaired mucosal repair, although further validation is needed. Diagnosis demands a high index of clinical suspicion and rests on histopathological examination of multi-site gastric biopsies since endoscopic appearances range from normal mucosa to characteristic nodular patterns. Management is empirical and individualized: symptomatic support with proton pump inhibitors (PPIs) and iron supplementation, anti-inflammatory therapy with topically targeted budesonide, dietary intervention in selected patients, and emerging mechanism-targeted approaches including α4β7 blockade. This narrative review synthesizes 101 articles published between 1989 and 31 August 2025, describing approximately 730 histopathologically confirmed CG cases (≈40% pediatric, ≈60% adult; overall female-to-male ratio ≈2.1:1). Replicated findings are distinguished throughout from those based on single reports, with preliminary observations explicitly flagged as hypothesis-generating.

Objectives:To anticipate future trends in science and technology related to traditional Chinese medicine(TCM)and guide cutting-edge research directions,the China Association of Chinese Medicine(CACM)organized experts to deliberate and propose pivotal scientific questions,engineering challenges,and industrial technology issues in the TCM field for 2025.The aim is to address core bottlenecks impeding the high-quality development of TCM through original scientific research,thereby providing strategic technological support for improving the consistency of clinical efficacy,ensuring the sustainable utilization of resources,advancing intelligent industrial upgrading,and enhancing international influence. Methods:In accordance with the targeted commission requirements of the China Association for Science and Technology(CAST)and considering the disciplinary distribution characteristics,the CACM established an expert panel comprising five strategic scientists.Drawing on the major scientific questions selected by CAST and the CACM in previous years,the panel carried out a systematic process of deliberation and discussion,collation and review,evaluation and screening,as well as validation and refinement.Ultimately,two frontier scientific questions,one engineering challenge,and two industrial technology issues were identified and submitted to CAST. Results:This report focuses on key bottlenecks in transforming TCM from empirical inheritance to precision-driven science.It systematically elaborates on five core issues:the two frontier scientific questions aim to uncover the modern scientific underpinnings of classical TCM theories(e.g.,the spleen deficiency theory)and the core efficacy of Daodi Herbs;the engineering challenge is dedicated to constructing intelligent reasoning AI models capable of clarifying the scientific principles underlying TCM-based prevention and treatment of complex diseases(e.g.,gastric cancer);the two industrial technology issues address pressing industrial demands,namely,key technologies for the stable production of"three-excellence"medicinal materials based on molecular pharmacognosy,and the establishment of a quality homogenization technology system for TCM solid preparations based on multimodal data fusion. Conclusions:The five major scientific questions and engineering challenges selected and reported herein systematically target the core bottlenecks and frontier directions in TCM modernization,exhibiting distinct strategic,interdisciplinary,and forward-looking attributes.The development of TCM in the new era must be driven by cutting-edge multidisciplinary technologies to thoroughly elucidate the scientific core of traditional wisdom,thereby achieving comprehensive modernization covering basic research,industrial technology,and clinical application.This will lay a solid foundation for gaining strategic advantages in the global competition of traditional medicine science and technology.

Ménétrier's disease (MD) is a rare, acquired premalignant condition characterized by hypertrophic gastropathy. Its defining features include giant gastric rugal folds, predominantly in the fundus and body of the stomach, foveolar hyperplasia with glandular atrophy and a protein-losing gastropathy leading to hypoalbuminemia and peripheral edema. The pathogenesis is primarily driven by the overactivation of the epidermal growth factor receptor (EGFR) signaling pathway, most commonly due to the overexpression of its ligand, transforming growth factor-alpha (TGF-α). The clinical presentation varies significantly between pediatric and adult populations. In children, the disease is often acute, self-limiting and strongly associated with cytomegalovirus (CMV) infection. In adults, it typically follows a chronic and progressive course, carrying a significant risk for the development of gastric adenocarcinoma. Diagnosis is challenging and relies on a combination of endoscopic visualization, histopathological analysis of deep or full-thickness biopsies and advanced imaging techniques such as endoscopic ultrasound (EUS) to differentiate it from its mimics, which include gastric lymphoma and infiltrative carcinoma. Management strategies have evolved from supportive care, such as high-protein diets and treatment of associated infections like Helicobacter pylori, to targeted molecular therapies. The monoclonal antibody cetuximab, which blocks EGFR, has emerged as a highly effective treatment, capable of inducing clinical and histological remission. Somatostatin analogues like octreotide and lanreotide also offer symptomatic control by inhibiting growth factor signaling. For patients with refractory symptoms, severe complications or malignant transformation, surgical intervention via partial or total gastrectomy remains the definitive treatment. This review provides a detailed examination of the current understanding of the molecular underpinnings, diverse clinical spectrum, diagnostic modalities and therapeutic landscape of MD.

Background Irritable bowel syndrome with diarrhea (IBS-D) is a common functional gastrointestinal disorder. It is often accompanied by anxiety and depression, and severely impacts patients' quality of life. Visceral hypersensitivity is closely associated with the pathogenesis of IBS-D, potentially involving activation of the AhR-Notch1 signaling pathway in mast cells. Chang'an II recipe is a formulation developed by Prof. Tang Xudong based on the classical formula of Tong-Xie-Yao-Fang, which has documented clinical efficacy in the treatment of IBS-D. However, the mechanism underlying the action of the Chang'an II recipe in treating IBS-D is not fully understood. Objective To investigate the ameliorative efficacy of the Chang'an II recipe on rat models of IBS-D, as well as its underlying mechanism in IBS-D rats and the RBL-2H3 rat basophilic leukemia cell line. Methods The IBS-D model rats received high, medium, and low doses of the Chang'an Ⅱ recipe and the AhR inhibitor Kyn by oral gavage for 14 days. The body weight, food intake, fecal water content (FWC), abdominal withdrawal reflex (AWR), and severity of diarrhea symptoms were assessed. Sera and colonic tissues were collected for histopathological analyses, and relevant indices were measured in tissues and RBL-2H3 cells. Results The Chang'an II recipe effectively alleviated weight loss and increased food intake and intestinal absorption in IBS-D rats. It also alleviated diarrhea, decreased visceral hypersensitivity, and reduced intestinal inflammation. The mechanism underlying the reduction in visceral hypersensitivity was associated with AhR upregulation and Notch1 downregulation, reducing activation of p-p38, p-JNK, and p-ERK1/2. This process suppressed mast cell activation and inhibited the production of biologically active substances such as mast cell tryptase, histamine, IL-4, and TNF-α. Conclusion The Chang’an II recipe alleviates IBS-D symptoms by modulating the AhR/Notch1 signaling pathway, suppressing mast cell activation, and downregulating the PAR2/TRPV1 axis in intestinal afferent nerves. These findings provide novel mechanistic insights into its therapeutic effects, highlighting its potential as a targeted treatment for IBS-D.

BACKGROUND: Non-coding RNAs regulate gene expression through various mechanisms, playing key roles in life activities. Intestinal epithelial homeostasis (IEH) is a dynamic equilibrium state formed by the interaction of intestinal mucosal barrier, intestinal environment and other factors. There are many recorded documents demonstrating a close relationship between non-coding RNAs and IEH. Therefore, it is significant to retrospectively explore the current status, hotspots and trends of non-coding RNA (ncRNA) and IEH through a bibliometric perspective. METHODS: We searched the Web of Science (WOS) for studies related to non-coding RNA and intestinal epithelial homeostasis from 1980 to December 2024, then downloaded the data. CiteSpace 6.3.1, VOSviewer 1.6.20, SCImago Graphica and Excel software were used to draw knowledge visualization maps. RESULTS: A total of 667 publications relevant to ncRNA and IEH were included. The publication output and citation counts generally demonstrated an initial increase followed by a subsequent decrease. The publications have received a total of 18,979 citations, with an average of approximately 28 citations per article. China published the most articles, followed by the United States. Keyword analysis indicated that inflammatory bowel disease (IBD), intestinal immunity, and gut microbiota were of high importance. IBD dominates IEH research, yet circRNA is an emerging focus. Exploring ncRNAs in intestinal stem cell and colitis-associated cancer holds great research potential in the future. Multidisciplinary integration is the research trend. CONCLUSIONS: Our findings provide a comprehensive knowledge framework for researchers and clinicians aiming to explore ncRNA-based diagnostic and therapeutic strategies for IEH. Our results highlight the need for translational research to validate ncRNA-based diagnostic and therapeutic strategies for gut barrier disorders.

Background At present, the focus of COVID-19's treatment has shifted from the prevention and treatment of acute viral infection to the treatment and rehabilitation of symptoms in the recovery period of long COVID and the associated diseases. Objective To preliminarily evaluate the clinical efficacy of integrated Chinese and Western medical treatment plans and to describe the characteristics of “long COVID” syndromes. Methods Eligible “long COVID” patients diagnosed between December 2022 and June 2023 at the Third Affiliated Hospital of Zhejiang Chinese Medical University were identified through electronic medical records. Baseline demographic information was collected, and patients were divided into a TCM group and a Western medicine group based on their treatment methods. The primary outcome for efficacy evaluation was TCM syndrome scores and symptom improvement time, with secondary outcomes including symptom improvement rates. Survival curve analysis was used to assess symptom improvement time, and a Cox regression model was employed to identify potential risk factors affecting symptom prognosis. Chi-square tests were used to compare binary data between or among groups. The Jaccard method was applied for systematic clustering of TCM syndromes, and clinical characteristics at the start and end of treatment were reported. Results Analysis showed that younger patients, those with underweight, and those receiving TCM treatment had shorter recovery times (P < 0.0001). Systematic clustering of the main symptom elements (33 elements with a frequency ≥ 5%) identified six core combinations. The main symptoms of long COVID included cough, excessive sputum, nasal congestion, chest tightness, sore throat, and fatigue. Notably, symptoms such as fatigue, shortness of breath, and loss of appetite, classified as deficiency syndromes in TCM, had longer recovery times. Conclusion Elderly, obesity, underlying diseases, and exclusive Western medicine treatment were associated with poorer prognosis. The early recovery period is characterized by a mix of deficiency and excess syndromes, whereas the later period is dominated by deficiency syndromes. TCM treatment can effectively improve clinical symptoms and shorten symptom duration, but further research is needed.

基于“心胃相关”理论，认为脾胃失和、心神失调是慢性萎缩性胃炎（CAG）伴焦虑抑郁发生的重要基础，CAG发展过程还受痰瘀等病理因素的影响。临床治疗以健脾护膜、养心安神为本，并通过化湿消滞，通脉和胃祛邪，可取得满意效果。

Objective To systematically analyze the clinical research evidence on traditional Chinese medicine（TCM） in the prevention and treatment of chronic atrophic gastritis（CAG）, summarize the efficacy, and provide guidance for future research. Methods With the help of the big data platform of evidence-based literature of traditional Chinese medicine which covers multiple dominant digestive diseases of TCM, the clinical researches, systematic reviews, guidelines and consensuses on the prevention and treatment of CAG by TCM published between the year 2000 and 2020 were searched for. The publication time, research type, sample size and intervention duration, the distribution of TCM syndromes and constitution in the observational studies, the category and role of prevention and treatment TCM programs（prevention, treatment, rehabilitation/secondary prevention, uncertainty）, clinical evaluation indicators and other information of the included articles were statistically analyzed, and the distribution of evidence was presented in the form of both graphics and text. Results A total of 796 articles were included, involving 775 clinical studies, 19 systematic reviews and 2 expert consensus. Total number of annual publications was slowly moving upward, with highest volume published in 2015 and 2019, both of which were 51. The clinical researches were mainly interventional studies（714 articles）, including 518 randomized controlled trials and 196 non-randomized controlled trials; besides, there were 61 observational studies. The sample size in 46. 50%（332/714） of the interventional studies was 60～100 cases, and the duration of the intervention in 47. 48%（339/714） of the intervention studies was 3～6 months. The intervention explored in the included studies was mainly Chinese herbal medicine. The focused outcome indicators were the total effective rate, endoscopic appearance, histopathology, TCM syndrome scores, clinical symptom improvement, and Hp negative conversion rate, while less attention was paid to the quality of life and psychological evaluation. The methodological quality of systematic reviews was generally low, with the AMSTAR scale scores mainly at 4 to 8 points, and 16 systematic reviews（84. 21%） concluded that "evidence shows potential efficacy".Conclusion TCM has certain advantages in the treatment of CAG, but most evidence have deficiencies in the rationality of research design, the uniformity of diagnostic criteria, and the scientificity of efficacy evaluation. In the future, it is necessary to strengthen the standardization of clinical diagnosis and treatment, and carry out rigorous large sample size, multi-center, randomized controlled trials to improve the evidence of TCM in the prevention and treatment of CAG.

Background: Ginseng consumption has been associated with various health outcomes. However, there are no review articles summarizing these reports. Methods: PubMed, Embase, the Cochrane Library of Systematic Reviews, Scopus, CNKI and Wanfang databases were searched from inception to 31 July 2022. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) systems were used to assess the methodological quality and quality of evidence in each meta-analysis, and the results were summarized in a narrative form. Results: Nineteen meta-analyses that met the eligibility criteria were identified from among 1,233 papers. The overall methodological quality was relatively poor, with only five studies being low-quality, and 14 critically low-quality. When compared with control treatments (mainly placebo), ginseng was beneficial for improving fatigue and physical function, sexual function, menopausal symptoms, metabolic indicators, inflammatory markers, unstable angina and respiratory diseases. Adverse events included gastrointestinal symptoms and potential bleeding; however, no serious adverse events were reported. Conclusion: This umbrella review suggests that ginseng intake has beneficial therapeutic effects for diverse diseases. However, the methodological quality of studies needs to be improved considerably. In addition, it is imperative to establish the clinical efficacy of ginseng through high-quality randomized controlled trials.

Objective:The mechanism of Indigo Naturalis in the treatment of ulcerative colitis (UC) was predicted by GEO chip combined with network pharmacology, and preliminarily verified by molecular docking. Methods:The main active components and targets of Indigo Naturalis were obtained by searching TCMSP, SymMap database, SwissTargetPrediction and Pharmmapper. The UC disease targets were obtained from DrugBank database, OMIM database, TTD database, Disgenet database and GEO gene chips. Venn diagram was used to show drug-disease common targets. The protein-protein interaction (PPI) network of intersection targets was analyzed by String platform, and Cytoscape 3.8.2 software was used to construct the PPI network of components and disease targets. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed on the core targets. AutoDock Vina 1.2.1 was used for molecular docking, and the results were visualized by Discovery studio Visualizer. Results:A total of 10 active components and 184 compound targets of IN-UC, of which 42 were core targets, were enriched and analyzed by GO and KEGG. The therapeutic effect of Indigo Naturalis on UC may involve activation of various process, such as reactive oxygen species metabolism, heme binding, protein phosphatase binding, secretory granule exocytosis, cytoplasmic vesicles, cell focal adhesion and cell substrate connection, and regulates PI3K/Akt signal pathway, human cytomegalovirus infection signal pathway, EB virus infection signal pathway HF1 signaling pathway and insulin resistance signaling pathway to treat UC. Conlusion:Indigo Naturalis has the characteristics of multi-component, multi target and multi pathway in the treatment of ulcerative colitis. Through PTGS2, CAT and other core targets, it can regulate PI3K/Akt signal pathway, human giant cell signal pathway, HIF-1 signal pathway to play a therapeutic role.

Background:Nigella sativa (N. sativa) consumption has been associated with various health outcomes; however, the results are not completely consistent.Objectives:This overview of systematic reviews and meta-analyses aimed to evaluate the reporting and methodological quality, and to grade the available evidence of associations between N. sativa and health outcomes.Methods:PubMed, Cochrane Library, Embase, and Scopus databases were searched from their inception to September 30, 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 statement, Assessment of Multiple Systematic Reviews (AMSTAR) 2 checklist, and Grades of Recommendations, Assessment, Development and Evaluations (GRADE) systems were used to assess the reporting, methodological, and evidence quality for each meta-analysis, respectively. The results were synthesized in a narrative form.Results:This overview included 20 eligible meta-analyses published in peer-reviewed journals between 2013 and 2021. The overall methodological quality was relatively poor, with only one moderate quality, four low quality, and 15 critically low quality studies. For reporting quality, items two, five, eight, nine, 15, and 24 need to improve. Among the 110 outcome indicators of the quality of evidence, five were graded as moderate, 17 as low, and 88 as very low. Risk of bias, inconsistency, and imprecision were the main downgrading factors.Conclusion:This overview suggests that N. sativa is beneficial for various clinical outcomes. However, there are certain limitations to reporting and methodological quality. The clinical efficacy of N. sativa requires confirmation in high-quality, large-sample, randomized controlled trials.

Chronic gastritis was one of the commonest diseases in digestive system, atrophic gastritis and gastric precancerous conditions and lesions（GPCL） were more and more focused in clinical practice. The development of responding new drug research was slow partly because of the lack of clinical research guidance of new drug of Chinese Medicine. Clinical Research Guidance of New Drug of Chinese Medicine in Chronic Gastritis was published in December 2022 by National Medical Products Administration. Details and interpretations on atrophic gastritis and GPCL in this clinical research guidance were specially described in this article in order to provide references for clinical researches.

Several functional gastrointestinal disorders (FGIDs) have overlapping symptoms, and, consequently, developing treatment strategies based on symptomatology poses a challenge for the clinical management of complex FGIDs. The significant overlap in the symptoms of FGIDs caused by the shared pathophysiological mechanisms is both a challenge and an excellent target for therapeutic development, since treatment strategies focused on shared pathophysiological mechanisms can treat the associated underlying diseases rather than just alleviating the primary symptoms. Owing to its multi-targeted approach, traditional Chinese medicine (TCM) has garnered immense interest worldwide; however, the quality of the data demonstrating its effectiveness is generally weak. Additionally, the causal link between the intrinsic mechanisms of action of TCM and its clinical benefits remains obscure. Systems biology is characterized by holistic and dynamic research, which corresponds to the holistic, multi-targeted, and syndrome-based approach of TCM. Therefore, high-throughput analysis techniques can be employed to describe and comprehend the genesis and progression of diseases, as well as the impacts of TCM on the organism, which may aid in elucidating the pathogenic mechanisms of the diseases as well as the mechanism of action of TCM.

目的 探讨持续性房颤中药用药规律.方法 通过DisGeNET数据库和GeneCards数据库搜索持续性房颤相关靶点,运用Venn图去除重复疾病靶点,之后采用DAVID、KEGG数据库进行基因本体(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路分析.以OB≥30％,DL≥0.18为筛选条件,于TCMSP数据库筛选持续性房颤潜在靶点相关化合物和相关中药,并以此构建靶点-化合物-中药可视化网络.参考中国药典2020版和中药学第九版,收集中药四气五味、归经等相关信息,运用统计方法进行分析,获取持续性房颤的中药用药规律.结果 获得持续性房颤相关基因靶点21个,与此同时,在TCMSP数据库中匹配到相关化合物566个,4613个相关中药,去除重复值,总计中药316味,如甘草、钩藤、延胡索等.其中槲皮素、表没食子儿茶素没食子酸酯、木犀草素、非瑟酮、汉黄芩素、鸢尾酮等预测为主要干预持续性房颤的化合物.中药的四气五味、归经统计结果显示,相关中药性味以苦寒为主,多归肝经.结论 本研究探讨了治疗持续性房颤的相关化合物,分析了中药用药规律,为治疗持续性房颤的临床用药提供参考,对推动新药研发具有一定的价值.

真实世界中医临床科研范式的核心是临床科研一体化.中医临床一体化平台首先被开发出来,不同的平台或侧重科研或侧重辅助医院日常工作,随着时代发展和科技进步,中医临床科研大数据平台的概念被提出.目前,已有关于建设中医临床科研大数据平台的技术方法和架构设计的探讨.现有的平台或构想存在一定不足,基于此我们提出对中医临床科研大数据平台的构想和展望,平台以人工智能为技术支持、真实世界为数据管理方式、单病例随机对照试验为临床研究方法,可处理大量、来源不同的数据,同时可辅助临床决策,这样的平台可兼顾中医药循证医学特点和个体精准施治要求,既满足科研需求又能辅助临床决策.