Introduction: : Steroid-induced adverse reactions present significant challenges in the treatment of autoimmune diseases. Chinese herbal medicine, especially yin-nourishing formulations, shows potential for managing these adverse reactions. The objective of this review is to evaluate the effectiveness and safety of various types of Chinese herbal medicine, including herbal formulations, extracts, and single compounds, in preventing and managing the adverse reactions caused by steroids in patients with autoimmune diseases. Methods: : We followed PRISMA guidelines to report this review. Randomized Controlled Trials (RCTs) which investigated the effectiveness and safety of Chinese herbal medicine, in any form and way of administration, on patients with steroid-induced adverse reactions, compared to any type of control, without language restrictions, were identified through electronic database searches. PubMed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database were systematically searched. All databases were screened up to March 2025. Retrieved data were both qualitatively and quantitatively synthesized. Risk of bias was assessed with the Cochrane risk-of-bias tool 2 and the following domains were considered: randomization, deviations from intended interventions, missing outcome data, outcome measurement, and selection of reported results. Each outcome’s quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, considering the risk of bias, inconsistency, indirectness, imprecision, and publication bias. Results: : A total of 18 studies with 1651 participants were included in this meta-analysis, of which 14 studies were rated as high risk of bias and 4 were rated as some concerns. All the evidence generated from this study was moderate or very low based on GRADE system. Compared with standard care alone, adding Chinese herbal medicine during the treatments for autoimmune diseases yielded a significant reduction in the incidence of gastrointestinal disturbance (RR = 0.59, 95% CI: 0.41–0.84), infection (RR = 0.49, 95% CI: 0.34–0.70), insomnia (RR = 0.41, 95% CI: 0.32–0.54), hyperglycemia (RR = 0.36, 95% CI: 0.19 to 0.68), Cushing syndrome (RR = 0.55, 95% CI: 0.41–0.75), psychiatric adverse reactions (RR = 0.55, 95% CI: 0.44–0.69), abnormal heat sensation (RR = 0.51, 95% CI: 0.39–0.68), dizziness with tinnitus (RR = 0.55, 95% CI: 0.32–0.93), and xerostomia (RR = 0.51, 95% CI: 0.33–0.77). Adding Chinese herbal medicine also effectively treats the adverse reactions, including dizziness and tinnitus, and xerostomia induced by steroid use. Conclusion: : Adding Chinese herbal medicine during the treatments among autoimmune diseases might not only prevent the occurrence of steroid-induced adverse reactions but also treat the adverse reactions caused by steroid use. Registry: : The present systematic review was registered in PROSPERO under the following number: CRD420251016486.

Objective To evaluate the efficacy and safety of Ruyi Zhenbao tablet (RYZBT), a traditional Tibetan medicinal formula, for the treatment of lumbar disc herniation (LDH), that is frequently associated with lower back pain (LBP), through rigorous randomized controlled trials (RCTs). Methods This multicenter, randomized, positive-controlled trial study will include 400 participants diagnosed with LDH, and include an enrollment period, a 4-week treatment period, and a 4-week follow-up period. Participants will be randomly assigned at a 1:1 ratio for treatment with either RYZBT or diclofenac sodium sustained-release tablet (DSSRT) for 4 weeks. The time points of visits are set at baseline, during treatment (weeks 1, 2, and 4), and during follow-up (weeks 2 and 4 post-treatment). The relevant outcome will be recorded at each timepoint. The primary outcomes include the Visual Analog Scale (VAS) scores for LBP and leg pain, as well as the Japanese Orthopaedic Association scores for functional assessment. Secondary outcomes comprise the VAS scores for numbness, Oswestry Disability Index, rescue treatments, patient health education, and safety assessments. Discussion This study has been designed to provide robust and reliable evidence of the efficacy and safety of RYZBT in alleviating LDH symptoms, with the goal of supporting evidence-based clinical applications. By using DSSRT as a positive control, the placebo effect will be effectively minimized, enabling a more accurate assessment of RYZBT efficacy.

OBJECTIVE:This study aimed to assess the accessibility and regulatory compliance of online antibiotic sales in mainland China, a growing public health concern due to potential antimicrobial misuse and resistance. STUDY DESIGN:A descriptive cross-sectional survey. METHODS:We conducted a descriptive assessment of eligible online antibiotic purchasing pathways on platforms accessible across mainland China from October 29, 2024, to March 31, 2025. Trained investigators, simulating patients with conditions not warranting antibiotic use (e.g., viral upper respiratory infections, pediatric cough, and pet illness), attempted to obtain antibiotics without prescription. Outcomes included dispensing without valid indication, consultation process characteristics, whether a prescription was displayed or issued, adherence to national 14-day supply limits, and platform accountability. RESULTS:Antibiotics were dispensed in 92.6% of attempts (50/54) in scenario of human use of antibiotics, with 62.0% of prescriptions issued less than 3 s upon request. No platform required real-time video consultation or verified patient identity. Although some platforms collected self-reported allergy information, no verified or mandatory allergy screening prior to dispensing was observed. Half of prescriptions exceeded the national 14-day supply limit. The sales process of veterinary antibiotics, no veterinary pharmacy displayed professional qualifications and no other personal or animal health information was collected by any veterinary platform. Antibiotics can be purchased less than 3 s in all veterinary drug procurement scenarios, and no prescription or prescription audit procedures have been found. CONCLUSIONS:In this simulated patient study, antibiotics were readily dispensed through nationally accessible online pharmacy platforms in China, including in clinically inappropriate scenarios, with limited observable safeguards. The findings highlight gaps in the regulation and stewardship of online antibiotic supply.

PURPOSE:Patient-reported outcomes (PROs) assist patients and clinicians in assessing treatment effectiveness and enhancing healthcare quality. This study aims to explore and analyze the application and characteristics of PROs in clinical trials of Traditional Chinese Medicine (TCM). METHODS:This cross-sectional study was based on randomized clinical trials of TCM between January 1, 2010, and December 31, 2022 in International Clinical Trials Registry Platform. For each included trial, data including study phase, design, participant demographics, target diseases, PROs, and PRO measurements were extracted. Trials were categorized into three groups: (1) recorded specified patient-reported outcome tools, (2) referenced patient subjective outcomes without specified tools, and (3) did not mention any PROs. Further descriptive statistical analysis were conducted on the most commonly used PRO tools in different countries and for different diseases. RESULTS:Among a total of 7783 eligible trials, 4858 (62.4%) listed explicit PRO tools, and 850 (10.9%) referenced PROs without specified tools. The most common conditions evaluated by PRO tools were musculoskeletal diseases (935 trials, 19.2%), symptoms (714, 14.7%), and neurological diseases (500, 10.3%). Frequently used PRO tools included the Visual Analogue Scale (VAS), 36-item Short-Form Health Questionnaire, and Pittsburgh Sleep Quality Index. Regionally, most PRO-related trials were in the Western Pacific (3904, 68.4%) and fewest in Africa (8, 0.1%). Countries conducting the most PRO-related trials were China, Iran, the USA, South Korea, and Brazil, focusing on musculoskeletal, symptoms, neurological, genitourinary, and digestive diseases, with varying popular disease-specific PRO tools by country. Musculoskeletal diseases were the primary focus in China, Brazil, and South Korea. CONCLUSIONS:The use of PROs in TCM clinical trials has grown during the study period. However, there was an uneven regional distribution of PRO application and a lack of standardized, reliable PRO tools tailored for TCM. Great efforts are needed to enhance the quality and promote the use of PRO tools in TCM clinical research.

Objective:To evaluate effectiveness and safety of Asparagus officinalis in cancer care. Methods:PubMed, the Cochrane Library, EMBASE, Web of Science, Scopus and four Chinese databases were searched up to January 9, 2025. Randomized and non-randomized clinical studies, cohort studies, or case-control studies were included for cancer patients using A. officinalis products alone or combined with conventional treatments. Primary outcomes were survival, response rates, and quality of life (QoL). GRADE approach was used to assess evidence certainty. Results:Ten studies (seven randomized trials, two non-randomized studies, one cohort study) with 8,898 participants were included. Compared to chemotherapy alone, A. officinalis granules plus chemotherapy improved survival-based effective rate [two studies, risk ratio (RR) 1.55, 95% confidence interval (CI) (1.24, 1.92), low certainty] and QoL-based effective rate [three studies, RR 1.76, 95% CI (1.47, 2.11), low certainty]. The objective response rate (ORR) was improved when chemotherapy was combined with either A. officinalis granules or syrup [four studies, RR 1.88, 95% CI (1.43, 2.48), low certainty]. A. officinalis products (syrup, granules or oral liquid) plus chemotherapy or radiotherapy, all found to have effects in improving immune function as CD4 and CD4/CD8. A. officinalis oral liquid combined with chemotherapy was associated with fewer adverse events, nausea and vomiting, and myelosuppression. Conclusion:A. officinalis products may improve survival, ORR, QoL and immune function as a complementary add-on therapy. Despite the limited number of studies and low certainty of evidence, the observed signals indicate a need for verification in well-designed, cancer-type-specific trials, particularly in lung cancer, using standardized, well-characterized extracts to establish definitive clinical applications and dosing protocols. Systematic review registration:The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO, CRD42025646003).

Diabetic cardiomyopathy (DCM) is a distinct cardiac disorder that develops independently of coronary artery disease and hypertension. Mitochondrial dysfunction is widely recognized as a hallmark pathological feature of DCM. Effective mitochondrial quality control (MQC) is critical for preserving cardiomyocyte metabolism and contractile performance, and its disruption substantially contributes to both disease initiation and progression. We synthesize current evidence on disruptions of MQC in diabetic cardiomyopathy. The spectrum covers imbalanced fission–fusion dynamics, attenuated mitochondrial biogenesis, compromised mitophagy, disturbed Ca2+ homeostasis, heightened ferroptotic vulnerability, loss of proteostasis, and epigenetic dysregulation. We emphasize the intricate cross-talk among these processes, which collectively exacerbate mitochondrial deterioration and myocardial injury. Building on these mechanistic insights, we also summarize recent therapeutic advances targeting MQC, such as natural compounds, antidiabetic agents, and non-pharmacological approaches. These interventions show promise in modulating mitochondrial signaling and restoring homeostasis. Nevertheless, substantial barriers remain for clinical translation, including the limitations of existing experimental models, the low quality of supporting evidence, and pronounced inter-individual variability. Future research should focus on developing integrated, multi-target therapeutic strategies, particularly those addressing the regulatory roles of non-coding RNAs, epigenetic modifications, and post-translational protein regulation. Advancing these areas will be essential for establishing precise and effective MQC-targeted therapies in both preclinical and clinical contexts.

Background: Burning mouth syndrome (BMS) lacks optimal treatments. This systematic review assessed Asparagus officinalis, a natural product with anti-inflammatory/antioxidant properties, for managing this chronic pain disorder. Methods: PubMed, the Cochrane Library, EMBASE, Web of Science, Scopus, and four Chinese databases were searched until February, 2025 for randomized controlled trials (RCTs) involving adults with BMS. Asparagus officinalis products alone or in combination with conventional medications were included. Outcomes included pain, symptoms, psychological outcomes and salivary function. The GRADE approach was used to assess evidence certainty. Results: Six RCTs with 336 participants were included. Compared to vitamin B complex alone, Asparagus officinalis capsules alone significantly improved the pain-intensity-based effective rate (RR 6.00, 95 % CI [1.61, 22.34]). Compared to conventional medicines, Asparagus officinalis capsules with conventional medicines significantly increased subjective pain scores (MD 1.51, 95 % CI [1.19, 1.83]), symptom-based effective rate (RR 1.27, 95 % CI [1.14, 1.42]), daily water intake score (MD 1.32, 95 % CI [1.00, 1.64]), sleep duration score (MD 1.88, 95 % CI [1.61, 2.15]), and decreased anxiety and depression scores, while Asparagus officinalis oral liquid combined with mecobalamin significantly reduced 10-point VAS (MD -1.40, 95 % CI [-2.19, -0.61]) and increased the unstimulated salivary flow rate (USFR).The certainty of evidence was all graded as low. Conclusions: Asparagus officinalis products may improve pain intensity, symptoms, psychological outcomes, and salivary function in patients with BMS. However, the low certainty of evidence due to study limitations and small sample sizes suggests the need for well-designed, large-scale real-world studies to confirm these findings and establish their clinical applicability. Protocol registration: PROSPERO (CRD420250651920).

Objectives:This systematic review aimed to evaluate the clinical efficacy and safety of Taohe Chengqi (THCQ) decoction as an adjuvant therapy for sepsis, and to provide evidence for clinical practice. Methods:Eight databases were systematically searched from inception until June 2024. The study included randomized controlled trials (RCTs) involving sepsis patients, where THCQ was used as an adjunctive therapy alongside conventional treatments. The primary outcome assessed was 28-day mortality rates, secondary outcomes included severity scores, inflammatory and coagulation markers, and adverse events. Two authors independently conducted the literature screening, data extraction, and evaluation of methodological quality. Meta-analysis was performed using RevMan 5.4.1 and Stata 17 software. The Risk of Bias (ROB) 2.0 and GRADE were employed for quality assessment. Results:A total of sixteen RCTs involving 1,034 participants were included. Most of the studies were rated as having "some concerns" according to the ROB 2.0. Compared with conventional treatments, THCQ plus conventional treatments resulted in lower 28-day mortality rate (RR = 0.57, 95% CI [0.38, 0.86]; low-certainty), lower Acute Physiology and Chronic Health Evaluation II score (APACHE-Ⅱ) (MD = -2.37, 95% CI [-3.12, -1.63]; low-certainty), lower Sequential Organ Failure Assessment score (SOFA) (MD = -1.41, 95% CI [-2.12, -0.70]; low-certainty), lower white blood cell (WBC) (MD = -1.78 109/L, 95% CI [-2.97, -0.59]; low-certainty), lower procalcitonin (PCT) (MD = -1.20 ng/mL, 95% CI [-1.71, -0.69]; low-certainty), lower C-reactive protein (CRP) (MD = -9.82 mg/L, 95% CI [-13.98, -5.66]; low-certainty), and no serious adverse effects were observed (RR = 0.67, 95% CI [0.12, 3.71]; very low-certainty). Conclusion:Chinese medicine formula THCQ may offer potential benefits as an adjunctive treatment for sepsis patients, suggesting a reduction in the 28-day mortality rate, improvements in inflammatory markers, and enhancement of coagulation function, with no severe adverse reactions observed. Given the low quality of the included studies, the findings should be interpreted with caution. Future large-scale, multicenter RCTs are needed to confirm these findings and provide robust evidence. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/view/CRD42024562595, identifier CRD42024562595.

Acupuncture and moxibustion are increasingly gaining recognition in the clinical and research fields of integrative oncology. This review synthesizes findings from clinical guidelines, systematic reviews, meta-analyses, and randomized controlled trials (RCTs) of acupuncture and moxibustion for cancer care. Clinical evidence highlights acupuncture’s efficacy in managing symptoms such as hot flashes, pain, insomnia, fatigue, and constipation. Acupuncture also demonstrates potential effects in reducing chemotherapy and radiotherapy-induced side effects. Recent advancements in China shows integrated therapies combining acupuncture with chemotherapy to enhance therapeutic outcomes. Additionally, laboratory studies reveal the potential of acupuncture and moxibustion to modulate the tumor microenvironment, boost chemotherapy efficacy, and strengthen immunity. Despite these promising results, there is a pressing need for well-designed trials and real-world studies to evaluate the long-term effects of standardized acupuncture and moxibustion treatments in cancer care.

ObjectiveThis study aimed to describe and summarize the evidence from systematic reviews (SRs) of the efficacy and safety of acupuncture in the treatment of post-stroke hiccup and to provide a reference for clinical practice and future research.MethodsWe conducted a systematic search across eight electronic databases from their inception up to February 2025. This search encompassed systematic reviews focusing on acupuncture for post-stroke hiccup. The methodological quality was assessed using the AMSTAR 2. The corrected coverage area was used to calculate the degree of overlap of the original studies. The evidence quality was assessed using the GRADE approach.ResultsOf the 10 eligible systematic reviews included, the methodological quality was evaluated as 1 (10.00%) low and 9 (90.00%) very low quality. The corrected coverage area of the preliminary studies was moderate or high overlap. Acupuncture may alleviate hiccups symptoms and improve the quality of life (certainty: moderate to very low). Safety data were limited and insufficient to draw firm conclusions.ConclusionAcupuncture may be a potential intervention for the treatment of a post-stroke hiccup. These results should be interpreted with caution due to the methodological shortcomings and low evidence quality observed in current systematic reviews. There is an urgent need for more well-designed, high-quality randomized controlled trials.

Background:Menopausal syndrome is a common condition in women during menopause, characterized by hormonal imbalances and various symptoms that negatively impact quality of life. Ding Kun Dan (DKD), a traditional Chinese herbal medicine, has been used to alleviate these symptoms, but its clinical efficacy and safety require further evaluation. Methods:A systematic search of eight databases was conducted through March 15, 2025. Randomized controlled trials (RCTs) were included if DKD was used alone or with conventional Western treatments. The primary outcome was the Kupperman Index; secondary outcomes included the Pittsburgh Sleep Quality Index, SF-36, Self-Rating Anxiety Scale, Self-Rating Depression Scale, estradiol, follicle-stimulating hormone, luteinizing hormone, and adverse events. Meta-analysis was performed using RevMan 5.4.1 and Stata 17. Results:A total of 21 RCTs involving 1981 participants were included. DKD combined with menopause hormone therapy (MHT) demonstrated superior efficacy in improving overall symptoms, sleep quality, quality of life, and reducing anxiety and depression, with a positive impact on hormone levels and fewer adverse events. DKD alone also showed comparable effects to MHT in improving symptoms and hormone levels. Additionally, DKD combined with oryzanol positively impacted hormone levels. Conclusions:DKD, both alone and in combination with MHT or oryzanol, demonstrates potential therapeutic effects for managing menopausal symptoms, but due to the low quality of included studies, results should be interpreted cautiously. Larger, high-quality RCTs are needed to confirm these findings. Protocol registration:PROSPERO, CRD42024621022.

Background: Acupressure has been widely used for quitting smoking for a long time in China. This study explores the feasibility and effects of acupressure on smoking cessation in young smokers with nicotine dependence to inform policy and decision-making. Methods: This was a single group study using pre/post-test design. Participants received four weeks of auricular acupressure treatment, led by a registered acupuncturist. Smoking cravings, nicotine dependence, withdrawal symptoms, and cigarettes per day (CPD) were recorded before and after treatment. Changes in outcomes were analyzed at 2 weeks and 4 weeks using SPSS software version 22.0. Semi-structured interviews were conducted with participants to explore their experience and attitude towards auricular acupressure. Thematic analysis was applied to analyze the data. Results: A total of 20 participants completed this study. A significant reduction was observed in smoking cravings (F = 11.02, P < 0.05), nicotine dependence (F = 11.09, P < 0.05), withdrawal symptoms (F = 11.19, P < 0.05), and CPD (F = 19.03, P < 0.05) over sessions. Additionally, withdrawal symptoms decreased significantly from 2 weeks to 4 weeks (P < 0.05) of acupressure treatment. Three inter-related themes emerged from interviews: personal and external resources, psychological and physical effects of acupressure, and satisfaction with acupressure for smoking cessation. Conclusion: The quantitative and qualitative data suggest that acupressure maybe effective in decreasing nicotine dependence and smoking cravings. However, this was a pilot and single arm study, these effects need to be further verified. The study supports the feasibility and safety of introducing acupressure therapy for smoking cessation in young smokers.

The rapid development of high-speed rail (HSR) is regarded as a pivotal catalyst for social and economic advancement. With the aim of assessing its multifaceted effects on human well-being (HWB), this study proposes the novel C4 conceptual framework to comprehensively evaluate the social impacts of HSR projects on HWB. Kernel density estimation (KDE) is employed to examine the spatial distribution and influence scope of the HSR network. A total of 40,000 samples from the Chinese General Social Survey (CGSS) data spanning 2010, 2011, 2012, 2013, and 2015 were utilized in a hierarchical multiple regression model to investigate the impact of HSR on HWB. The findings indicate that (1) The development of HSR has a significant positive effect on individual health and economic well-being, while its environmental impact has transitioned from negative to positive; (2) From a social connection perspective, HSR development has transformed public emotional connection dynamics, decreasing trust in strangers while strengthening ties with relatives and friends; (3) HSR has been found to enhance employability and results in extended working hours, suggesting a potential impact on work-life balance; (4) In its initial stages, HSR construction can contribute to perceived inequities among the population, though such negative effects are alleviated as the network expands and coverage increases.

BACKGROUND:To evaluate the efficacy, effectiveness and safety of fermented Ophiocordyceps sinensis mycelium (FOSM) products for preventing contrast-associated acute kidney injury (CA-AKI).METHODS:Randomized controlled trials were searched from four Chinese and four English electronic databases and three clinical trial registries up to July 2023. Methodological quality was assessed by using the Cochrane risk-of-bias tool 2.0. Risk difference (RD) or risk ratio (RR) and mean difference (MD) were calculated along with the 95% confidence intervals (CIs).RESULTS:Fourteen trials testing three types of FOSM products (Bailing, Zhiling, and Jinshuibao capsules) involving 1271 participants injected contrast agents were included. For the risk of bias, all trials were rated as some concerns. Compared with routine preventive procedure (RPP) (saline hydration and alprostadil), FOSM products plus RPP showed beneficial effects in reducing the incidence of CA-AKI (14.62% and 5.35%, respectively; RD -0.06, 95% CI -0.09 to -0.03). Subgroup analysis showed that Bailing/Jinshuibao plus RPP demonstrated lower incidence of CA-AKI compared to RPP. However, there was no statistically significant difference between Zhiling with RPP and RPP in the incidence of CA-AKI. Additionally, only when FOSM products were taken before injection of the contrast, it was superior to RPP in reducing the incidence of CA-AKI. There was no statistical difference in adverse events between these two groups.CONCLUSIONS:Low certainty evidence suggests that preventive oral use of FOSM products as an adjuvant agent was safe and might decrease the incidence of CA-AKI. However, high-quality placebo-controlled trials are needed to confirm its benefit.

Background From 2004 onwards, the Chinese government has freely offered complimentary Chinese herbal medicine (CHM) to Chinese HIV/AIDS patients, alongside the prescribed first line therapy of highly active antiretroviral therapy (HAART). Thus, we aimed to explore the effectiveness and safety of CHM for patients with HIV/AIDS. Methods The data from the Guangxi pilot database and antiviral treatment sites database have been respectively developed into two datasets in this prospective cohort real-world study, the CHM combined HAART group (the integrated group) and the HAART group. A 1:1 propensity score matching (PSM) was performed and the longitudinal data were analyzed using a generalized estimating equation (GEE) model with an autocorrelation matrix and log link function attached to the Gamma distribution. Results A final sample of 629 patients, 455 and 174 in the integrated group and HAART group respectively, were obtained from the full dataset. As covariates for PSM, gender, age, baseline CD4+ and CD4+/ CD8+ were assessed based on the results of the logistic regression analyses. Following PSM, 166 pairs from the full dataset were matched successfully, with 98 pairs in the baseline CD4+ > 200 subgroup, and 55 pairs in the baseline CD4+ ≤ 200 subgroup. In the full dataset, HAART group achieved higher CD4+ count (OR = 1.119, 95%CI [1.018, 1.230]) and CD4+/CD8+ ratio (OR = 1.168, 95%CI [1.045, 1.305]) than the integrated group, so did in the CD4+ > 200 subgroup. For the CD4+ ≤ 200 subgroup, the CD4+ (OR = 0.825, 95%CI [0.694, 0.980]) and CD4+/CD8+ (OR = 0.826, 95%CI [0.684, 0.997]) of the integrated group were higher than those of the HAART group. The safety outcomes showed that there were no significant differences in BUN, ALT and AST levels between the groups but Cr showed significantly higher levels in HAART groups of all three datasets. Conclusions Compared to HAART alone, CHMs combined with HAART had better effects in improving the immune function of HIV/AIDS in patients with baseline CD4+ count ≤ 200. The results of the two subgroups are in opposite directions, and chance does not explain the apparent subgroup effect. A study with larger sample size and longer follow-up period is warranted in order to increase study credibility.