Background and aimsThe risk of gastric cancer (GC) following Helicobacter pylori (HP) eradication has gained increasing attention. Map-like redness (MLR) is an easily recognizable and highly specific endoscopic feature observed after eradication. We aimed to quantify the association between MLR and the risk of GC and high-risk precancerous lesions.MethodsWe conducted a systematic search in PubMed, Embase, the Cochrane Library, CNKI, Wanfang, CBM, and VIP databases up to April 23, 2025. The primary outcome was GC, and secondary outcomes were high-risk precancerous lesions defined as the Operative Link on Gastritis Assessment (OLGA) stage > II, Gastric Intestinal Metaplasia Assessment (OLGIM) stage > II, and Kimura–Takemoto (K-T) classification > C2.Results14 studies were included (10 for GC, 2 for OLGA, 3 for OLGIM, and 3 for K–T classification). A significant association was observed between MLR and GC (ORs 4.38; 95% CI 3.45–5.57; I2 = 0%). MLR was also strongly associated with high-risk precancerous lesions: OLGA stage > II (ORs 10.45; 95% CI 5.98–18.25; I2 = 9.6%), OLGIM stage > II (ORs 10.78; 95% CI 2.02–57.60; I2 = 94.0%), and K-T classification > C2 (ORs 4.65; 95% CI 2.62–8.25; I2 = 19.3%). Subgroup analyses by region, study design, time direction, and H. pylori eradication status yielded consistent results (ORs range: 3.77-5.55), and leave-one-out sensitivity analyses showed stable estimates (ORs range: 4.15-4.69), confirming the robustness of the findings.ConclusionMLR is highly associated with an increased risk of GC and high-risk precancerous lesions.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251048039, identifier CRD420251048039.

Autoimmune gastritis (AIG) is an autoimmune disease characterized primarily by the destruction of gastric parietal cell structure and atrophy of the gastric fundic and body mucosa. The global prevalence of AIG is approximately 3.85%. Its main complications include pernicious anemia, gastric neuroendocrine tumors, and gastric cancer, which pose significant health risks. Currently, targeted treatment options for AIG are lacking worldwide. Animal models of AIG are crucial for investigating its pathogenesis and for developing drug therapies. However, reproducible methods for establishing AIG animal models remain scarce. This article provides a systematic review of internationally employed methods for modeling AIG in animals. These methods are categorized and discussed based on the modeling approaches and mechanisms, including neonatal thymectomy, genetically modified animals such as TxA23 and Ctox mice, inducer-based methods such as H⁺/K⁺-ATPase immunization, viral infection, and combined modeling strategies. In addition, the types of modeling agents and the time required for model establishment are also examined. This review highlights existing challenges, such as the lack of uniform modeling standards and evaluation criteria, and aims to provide a foundation for further exploration of AIG.

ObjectiveTo identify and synthesize randomized controlled trials (RCTs) of oral traditional Chinese medicine (TCM) for postherpetic neuralgia (PHN), map the volume, methodological quality, and evidence distribution, identify evidence gaps, and inform future research.MethodsWe systematically searched PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Database, the Chinese Clinical Trial Registry (ChiCTR), and China Biomedical Literature Database (CBM). RCTs published from database inception to 1 August 2025 were included. The evidence was summarized using evidence maps and narrative synthesis. Risk of bias in the included RCTs was assessed using the Cochrane Risk of Bias tool (RoB 1.0).ResultsA total of 357 RCTs were included, most were small studies with sample sizes ranging from 50 to 100 participants. Most studies reported diagnostic criteria and inclusion/exclusion criteria, however, limited attention was paid to TCM syndrome differentiation and its standardization. The main outcomes were pain degree, clinical effective rate, adverse reactions, sleep quality, negative emotions, and quality of life, however, outcomes such as recurrence and TCM syndrome scores were infrequently reported. Overall methodological quality was low, as assessed using the RoB 1.0.ConclusionAlthough many included studies reported favourable findings, the formulas and preparations differed substantially in composition, and high-quality evidence remains limited. Future trials should better incorporate key features of TCM (e.g., syndrome differentiation), use standardized and clinically meaningful outcome measures, and strengthen trial design and reporting to reduce risk of bias and improve the credibility of evidence.Systematic Review RegistrationURL: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251110786, identifier CRD420251110786.

INTRODUCTION:A central controversy in autoimmune gastritis (AIG) concerns the true incidence of gastric cancer (GC) and gastric neuroendocrine tumors (gNETs). Reported risks vary widely, potentially influenced by Helicobacter pylori (HP) status, AIG subtypes, and age-factors not addressed in prior meta-analyses. This study aimed to determine the pooled incidence of GC and gNETs in AIG and to conduct a comprehensive stratified evaluation. METHODS:We searched PubMed, Embase, and Cochrane Library through May 2025 for observational studies reporting incident GC or gNETs in AIG. Subgroup analyses, sensitivity analyses, and meta-regression were conducted. RESULTS:Twenty-three studies were included: 19 hospital-based cohorts (n = 4309) and 4 registries (n = 36,015). The pooled incidence of GC was 0.12/100 person-years (PY; 95% CI, 0.06-0.17; I2 = 45.7%) and of gNETs 1.09/100 PY (95% CI, 0.61-1.58; I2 = 81.3%). By subtype, GC incidence was 0.29/100 PY in pernicious anemia (PA), 0.12 in histopathology-defined AIG, and 0.09 in parietal cell antibody (PCA)-positive patients; gNETs were highest in the hypergastrinemia subgroup (1.74/100 PY). By HP status, GC incidence was 0.12/100 PY in HP-naïve and 0.07 in HP-exposed patients. Age-stratified analyses showed a consistent upward trend in patients ≥ 60 years for both GC (0.27 vs. 0.10/100 PY) and gNETs (1.48 vs. 0.87/100 PY). CONCLUSION:This study underscores the neoplastic risk associated with AIG. GC incidence is highest in PA and lower in PCA-positive patients, likely reflecting different AIG stages. HP-naïve status does not confer protection, and long-term GC risk persists. Age is a key modifier, providing a useful reference for risk stratification and individualized surveillance. TRIAL REGISTRATION:PROSPERO database (CRD420251047873).

Objective: Olfactory dysfunction (OD) defined as a disease of smell disorders. Studies have suggested that traditional Chinese medicine (TCM) is effective for OD. A bibliometric analysis on TCM for OD was conducted to identify trends and potential hot topics. Methods: 11 databases were searched from their inception to Sep 4, 2024 for all types of clinical studies on TCM for OD. Data were extracted and analyzed using Excel 2016 and R Studio data collected included study characteristics, type of diseases, treatments, comparisons, outcomes, effictiveness, and adverse events. The quality of all randomized controlled trials (RCTs) was evaluated using the “Revised Cochrane risk-of-bias tool”. Results: Of 412 studies published from 1963 to 2024, there were 10 systematic reviews, 255 RCTs, 16 non-RCTs, 80 case reports, 47 case series, 3 cohort studies, 1 case controlled study. OD can be caused by a variety of diseases. The most common disease was chronic rhinosinusitis. And the most common OD was hyposmia. The top three common TCM treatment modalities were TCM decoction, acupuncture, and Chinese patent medicine. The most common used herb and acupoint were “Xin Yi (Magnolia Flower)” and “Yingxiang (LI 20)”. Most RCTs reported positive effects of TCM for OD. No severe adverse events related to TCM were reported. The quality of overall RCTs was low. Conclusions: At present, the research hotspots of TCM for OD mainly focus on OD caused by upper respiratory tract infection, TCM decoction internal use and acupuncture in therapy.

Background ChatGPT is a large language model designed to generate responses based on a contextual understanding of user queries and requests. This study utilised the entrance examination for the Master of Clinical Medicine in Traditional Chinese Medicine to assesses the reliability and practicality of ChatGPT within the domain of medical education. Methods We selected 330 single and multiple-choice questions from the 2021 and 2022 Chinese Master of Clinical Medicine comprehensive examinations, which did not include any images or tables. To ensure the test’s accuracy and authenticity, we preserved the original format of the query and alternative test texts, without any modifications or explanations. Results Both ChatGPT3.5 and GPT-4 attained average scores surpassing the admission threshold. Noteworthy is that ChatGPT achieved the highest score in the Medical Humanities section, boasting a correct rate of 93.75%. However, it is worth noting that ChatGPT3.5 exhibited the lowest accuracy percentage of 37.5% in the Pathology division, while GPT-4 also displayed a relatively lower correctness percentage of 60.23% in the Biochemistry section. An analysis of sub-questions revealed that ChatGPT demonstrates superior performance in handling single-choice questions but performs poorly in multiple-choice questions. Conclusion ChatGPT exhibits a degree of medical knowledge and the capacity to aid in diagnosing and treating diseases. Nevertheless, enhancements are warranted to address its accuracy and reliability limitations. Imperatively, rigorous evaluation and oversight must accompany its utilization, accompanied by proactive measures to surmount prevailing constraints.

Background: Post-viral olfactory dysfunction (PVOD) is the common symptoms of long COVID, lacking of effective treatments. Traditional Chinese medicine (TCM) is claimed to be effective in treating olfactory dysfunction, but the evidence has not yet been critically appraised. We conducted a systematic review to evaluate the effectiveness and safety of TCM for PVOD. Methods: We searched eight databases to identified clinical controlled studies about TCM for PVOD. The Cochrane risk of bias tools and GRADE were used to evaluate the quality of evidence. Risk ratio (RR), mean differences (MD), and 95 % confidence interval (CI), were used for effect estimation and RevMan 5.4.1 was used for data analysis. Results: Six randomized controlled trials (RCTs) (545 participants), two non-randomized controlled trials (non-RCTs) (112 participants), and one retrospective cohort study (30 participants) were included. The overall quality of included studies was low. Acupuncture (n = 8) and acupoint injection (n = 3) were the mainly used TCM therapies. Five RCTs showed a better effect in TCM group. Four trials used acupuncture, and three trials used acupoint injection. The results of two non-RCTs and one cohort study were not statistically significant. Two trials reported mild to moderate adverse events (pain and brief syncope caused by acupuncture or acupoint injection). Conclusions: Limited evidence focus on acupuncture and acupoint injection for PVOD and suggests that acupuncture and acupoint injection may be effective in improving PVOD. More well-designed trials should focus on acupuncture to confirm the benefit. Protocol registration: The protocol of this review was registered at PROSPERO: CRD42022366776.

Background:The burden of inflammatory bowel disease (IBD) among children and adolescents is rising globally, with substantial variation in levels and trends of disease in different countries and regions, while data on the burden and trends were sparse in children and adolescents. We aimed to assess the trends and geographical differences in children and adolescents aged zero to 19 in 204 countries and territories over the past 30 years.Methods:Data on IBD among children and adolescents was collected from the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. We used the GBD data and methodologies to describe the change in the burden of IBD among children and adolescents involving prevalence, incidence, disability-adjusted life years (DALYs), and mortality.Results:Globally, the IBD prevalence cases increased between 1990 and 2019. Annual percentage changes (AAPC) = 0.15; 95% confidence interval (CI) = 0.11-0.19, and incidence cases of IBD increased from 20 897.4 (95% CI = 17 008.6-25 520.2 in 1990 to 25 658.6 (95% CI = 21 268.5-31 075.6) in 2019, representing a 22.78% increase, DALYs cases decreased between 1990 and 2019 (AAPC = -3.02; 95% CI = -3.15 to -2.89), and mortality cases of IBD decreased from 2756.5 (95% CI = 1162.6-4484.9) in 1990 to 1208.0 (95% CI = 802.4-1651.4) in 2019, representing a 56.17% decrease. Decomposition analysis showed that IBD prevalence and incidence increased significantly, and a trend exhibited a decrease in underlying age and population-adjusted IBD DALYs and mortality rates. Correlation analysis showed that countries with high health care quality and access (HAQ) had relatively higher IBD age-standardised prevalence rate (ASPR) and age-standardised incidence rate (ASIR), but lower age-standardised DALYs rate (ASDR) and age-standardised mortality rate (ASMR).Conclusions:Global prevalence and incidence rate of IBD among children and adolescents have been increasing from 1990 to 2019, while the DALYs and mortality have been decreasing. Rising prevalence and rising incidence in areas with historically low rates will have crucial health and economic implications.

目的 了解中医医史文献学的研究现状及趋势.方法 利用VOSviewer、Citespace等文献计量可视化软件,对知网、万方数据库所收载的中医医史文献学硕博论文的年载量、高校发文量、导师指导模式、研究生教育经历分析、高被引文章、高频关键词、关键词突变、具体研究方向进行可视化分析.结果 近二十年,本学科经历上升期、爆发期、波折期.各高校师资力量有一定差距,跨校合作培养较弱,疾病史是本学科的研究重点,研究方法在延续传统文献的基础上,未来将更多地向智能化、数字化方向倾斜.结论 本学科研究目前有饱和趋势,应加强本学科的培养力度,进行跨高校、高校-医院培养,增强本学科的外延性、深度性,以适应当今中医临床的发展.

目的 探讨参白颗粒调控磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)/哺乳动物雷帕霉素靶蛋白(mTOR)通路干预胃癌前病变(GPL)患者胃黏膜上皮细胞自噬与凋亡的机制.方法 根据相关标准,纳入病理诊断为GP L且中医证型符合肝胃郁热、胃络瘀血证的患者30例,给予参白颗粒连续干预12周后,再次复查胃镜,取病理组织,采用HE染色法观察参白颗粒干预前后胃黏膜组织病理变化;多色免疫荧光法测定胃黏膜组织PI3K、B淋巴细胞瘤/白血病-2(Bcl-2)、表皮生长因子受体(ERBB4)、磷酸酶张力蛋白同源物(PTEN),P53、Akt蛋白的表达;免疫组织化学染色测定Beclin-1、微管相关蛋白轻链3-Ⅱ(LC3-Ⅱ)、P62、mTOR的表达.结果 参白颗粒治疗后与治疗前比较,胃黏膜的异型增生细胞数量、分布范围及分布密度均有明显减少,固有层厚度增加,腺腔结构趋于正常;治疗后萎缩、肠化、异型增生病理表现积分均下降,其中萎缩、异型增生下降差异具有统计学意义(P<0.05).凋亡相关蛋白的表达水平有不同程度的下调,其中PI3K、Akt、Bcl-2蛋白表达水平下调差异具有统计学意义(P<0.05).自噬相关蛋白中Beclin-1、LC3-Ⅱ蛋白表达水平有不同程度的上调,其中Beclin-1蛋白表达水平上调差异具有统计学意义(P<0.05);mTOR、P62蛋白水平有不同程度的下调,其中mTOR蛋白表达水平下调差异具有统计学意义(P<0.05).结论 参白颗粒对GPL的胃黏膜损伤具有保护作用,可能与其通过PI3K/Akt/mTOR通路调控细胞自噬及细胞凋亡作用有关.

OBJECTIVES:This systematic review assessed whether Tuina (therapeutic massage) is more effective and safer than no treatment or routine medical treatment for irritable bowel syndrome (IBS).METHODS:Eleven databases were searched for randomized controlled trials of IBS diagnosed based on Manning or Rome criteria. Tuina with or without routine treatments (RTs) was tested against RTs. The Cochrane risk of bias was evaluated for each trial. RevMan 5.3 was used to conduct a meta-analysis.RESULTS:A total of 8 trials (5 IBS-diarrhea and 3 IBS-constipation) with 545 participants using 8 different manipulations were included. All trials were published in Chinese. For overall symptom improving rate (> 30 % improvement in overall symptom scores), it had not been shown that Tuina was significantly better than RTs (RR 1.23, 95 % CI 0.94-1.60, 197 participants, 3 studies, I2 = 65 %) for IBS-diarrhea, and Tuina combined with RTs showed more benefit than RTs alone (RR 1.29, 95 % CI 1.08-1.54, 115 participants, 3 studies) for IBS-diarrhea. All trials did not report adverse effect in relation to Tuina. Risk of bias was generally unclear across all domains.CONCLUSIONS:Tuina combined with RTs may be superior to RTs for improving overall symptom of IBS-diarrhea. Due to the existing methodological issues and the heterogeneity of Tuina manipulation, current findings need to be confirmed in large scale, multicenter, and robust randomized trials (especially on outcome assessing blinding and allocation concealment).

目的:通过对比分析《传染性非典型肺炎(SARS)诊疗方案(2004版)》与《新型冠状病毒感染肺炎诊疗方案(试行第七版)》中中药复方用药规律与特点,为新型冠状病毒肺炎(COVID-19)及类似感染性肺炎临床诊治提供参考.方法:人工统计两版诊疗方案中的中药复方用药、性味归经、药物功效频次数据,并使用Microsoft Excel软件将统计结果合并制图,进行对比与归纳分析.结果:本研究共纳入非典型肺炎(SARS)治疗复方28个,涉及中药133味;COVID-19治疗复方22个,涉及中药103味.治疗SARS以黄芩、甘草、金银花使用频次最高;治疗COVID-19以甘草、广藿香、麻黄使用频次最高.两版治疗方案中药物的性味归经与功效归类的统计结果呈现出较高的契合度,后者采用药物四气以寒、温为主,五味以辛、苦、甘频次最高,归经归肺、脾、胃经.不同之处主要表现在SARS治疗方案中更重视从心、肝二经论治的思路以及对活血化瘀药的灵活使用.结论:针对2种疾病同为“热、毒、湿”的病机,治疗方案均采取以清热解毒、宣肺解表、芳香化湿为主的用药思路.此外,SARS的用药思路对COVID-19后续诊疗值得参考借鉴.