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Expert consensus on multidisciplinary diagnosis and treatment of primary Sjögren syndrome (2024 edition) CHENG Fang, ZHAO Futao, SHEN Xuemin, LI Jin, CHEN Xiangjun, WANG Guifang, LI Huilin, XUE Luan, QI Junyuan Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 357-362.   DOI: 10.16138/j.1673-6087.2024.06.01 Abstract （729）   HTML （31）    PDF（pc） （923KB）（188）       Knowledge map    Save Primary Sjögren syndrome (PSS) is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands and other organs. PSS shows strong clinical heterogeneity, presents different degrees of topical and systemic damage, and multidisciplinary collaboration are required to develop PSS treatment strategies. However, our country currently has not unified diagnosis and treatment consensus for PSS. Based on domestic and foreign diagnosis and treatment experience, consensus and guideline, experts from multiple related disciplines achieved consensus using the nominal group technique, providing guidance and reference for standardized diagnosis and treatment of PSS. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Treatment strategies for renal impairment in multiple myeloma: a review of new drugs and novel therapies SHI Hao, WANG Zhaohui Journal of Internal Medicine Concepts & Practice    2025, 20 (03): 185-190.   DOI: 10.16138/j.1673-6087.2025.03.01 Abstract （91）   HTML （10）    PDF（pc） （892KB）（40）       Knowledge map    Save Multiple myeloma (MM) is associated with a high incidence of renal impairment, which correlates with decreased overall survival and increased risk of early mortality in these patients. In recent years, there has been great progress in the treatment of MM, and new drugs and therapies have improved prognosis of the patients. However, the prognosis of MM patients with concurrent renal impairment remains poorer compared with those with normal renal function. This article reviews the advancements in treatment and relevant strategies for MM patients with renal impairment. Current research supports the regime of combining monoclonal antibodies with proteasome inhibitors or immunomodulatory drugs in MM treatment. Chimeric antigen receptor T cells therapy, T-cell directing bispecific antibodies and antibody-drug conjugates have only been evaluated in small-scale retrospective studies for patients with renal impairment. Although the benefits of mechanical approaches aiming at rapid clearance of free light chains, such as plasmapheresis and high-cutoff hemodialysis, have not been confirmed, they may provide opportunities for renal recovery as combing with chemotherapy. The efficacy and safety of treatment in MM patients with renal impairment should be proactively assessed in prospective randomized controlled trials. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Medicine de-escalation strategies in inflammatory bowel disease for remission maintenance GU Yubei, HONG Yu Journal of Internal Medicine Concepts & Practice    2025, 20 (02): 101-106.   DOI: 10.16138/j.1673-6087.2025.02.01 Abstract （179）   HTML （13）    PDF（pc） （968KB）（38）       Knowledge map    Save Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn disease (CD), requires long-term medication to maintain remission. Developing a medicine de-escalation strategies during remission is crucial for reducing side effects and alleviating economic burdens, but the risks and benefits of medicine discontinuation remain controversial. The dose of 5-aminosalicylic acid (5-ASA) can be reduced in partial UC patients during remission, but the risk of relapse increases after medicine discontinuation. Long-term use of immunomodulators such as azathioprine has safety issues, but safe discontinuation of the medicine can be achieved through a medicine monitoring systems. The relapse rate after discontinuation of biologics agents during remission is high, especially in patients who have not achieved deep remission. The medicine de-escalation strategy for patient receiving combination therapy requires comprehensive assessment. Relapse monitoring after medicine discontinuation is critical, endoscopy and biomarkers such as C-reactive protein (CRP) and fecal calprotectin (FCP) can be used as effective predictive tools. This review summarizes recent studies on medicine de-escalation in IBD remission to provide reference for clinical practice and promote shared decision-making between patients and physicians. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Efficacy analysis of Shuangbai tablets and irbesartan in treatment of proteinuria in chronic glomerulonephritis CHEN Zijin, YU Haijin, WANG Zhaohui, MA Jun, WANG Zhiyu, WANG Jie, XU Yaowen, ZHENG Lan, CHEN Xiaonong Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 1-6.   DOI: 10.16138/j.1673-6087.2025.01.01 Abstract （385）   HTML （14）    PDF（pc） （1307KB）（34）       Knowledge map    Save Objective To compare the efficacy and safety of Shuangbai tablets and irbesartan in the treatment of proteinuria. Methods A retrospective analysis was conducted on patients with chronic glomerulonephritis who visited the outpatient department of Ruijin Hospital from January 2016 to February 2018. All the patients received irbesartan or Shuangbai tablets as monotherapy and were classified with syndrome differentiation of traditional Chinese medicine(TCM). Their clinical information, blood pressure and laboratory test were performed at 0, 4, 8, 12, and 24 weeks. Results One-hundred and nineteen patients were enrolled in the study, in which 54 cases were in the irbesartan group and 65 cases were in the Shuangbai tablet group. In all patients, the main TCM types were “pifeixiqu” type (56.3%), “pishenyangxu” type (20.2%), and “qiyinliangxu” type (21.8%). The 24-hour urinary protein of baseline level in the irbesartan group was 704 (448，1 090) mg/d, and it was significantly decreased to 456 (300,660), 428 (288,793), 510 (327,949), and 446 (273,801) mg/d at 4, 8, 12, and 24 weeks, respectively. The 24-hour urine protein level of baseline in the Shuangbai tablet group was 571 (390,1 049) mg/d, and it was significantly decreased to 491 (200，861), 432 (252，925), 478 (267，858) mg/d and 420 (175，742) mg/d at 4, 8, 12, and 24 weeks, respectively. There was no significant difference in proteinuria between the two groups. There was no statistical difference in the therapeutic effect among patients with different TCM syndrome types. The symptoms of lower back pain (59.3% vs 13.8%, P<0.001) and dry mouth and throat (24.1% vs 6.2%, P=0.005) in the Shuangbai tablet treatment group were significantly improved compared to those in the irbesartan group. The blood pressure of patients in the irbesartan treatment group decreased significantly at 12 and 24 weeks compared to it at enrollment. There were no significant adverse reactions in the Shuangbai tablet treatment group. Conclusions Shuangbai tablets can effectively reduce the urine protein level in chronic glomerulonephritis patients. It can also significantly improve the symptoms of lower back pain, dry mouth and throat in patients. Shuangbai tablet treatment showed a lower incidence of adverse reactions and can be used as an alternative medicine for patients with normal blood pressure, angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptor blocker(ARB) intolerance, or chronic glomerulonephritis without renal biopsy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Progress in diagnosis and treatment of oral ulcer with traditional Chinese medicine and Western medicine WU Jingyi, WANG Xiaoli, CHEN Jie, ZHENG Lan Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 84-88.   DOI: 10.16138/j.1673-6087.2025.01.18 Abstract （380）   HTML （1）    PDF（pc） （997KB）（27）       Knowledge map    Save Oral ulcer is a common oral mucosal disease, the pathogenesis of it is complex. It may relate to genetics, immune disorders, nutritional deficiency, infection, drug response and psychological factors, while currently there is no specific treatment for the disease. In recent years, the research on the treatment of oral ulcers with traditional Chinese medicine has gradually increased, especially the combination of traditional Chinese medicine and Western medicine has showed a good application prospect. The article reviews the diagnosis and treatment of oral ulcer with traditional Chinese medicine and Western medicine to explore new ideas for further promotion relevant clinical research. Reference | Related Articles | Metrics | Comments（0）

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Importance of early diagnosis of Sjögren syndrome FAN Kaijian, LIU Jinyu, ZHAO Futao Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 417-421.   DOI: 10.16138/j.1673-6087.2024.06.12 Abstract （289）   HTML （6）    PDF（pc） （888KB）（26）       Knowledge map    Save There are several challenges in the early diagnosis of Sjögren syndrome (SS), such as prominent glandular dysfunction in patients to make long diagnostic delays. These challenges are mainly attributed to the lack of adequate understanding of the early-stage characteristic of SS. Clinical and experimental studies have shown that early diagnosis and intervention in SS can help delay disease progression and reduce the risk of complications. To achieve early diagnosis and treatment of SS, it’s necessary to identify more useful biomarkers for the early stages of SS, and to identify high-risk people for SS through appropriate screening. Reference | Related Articles | Metrics | Comments（0）

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Retrospective study of efficacy and safety of hetrombopag in treatment of chemotherapy-induced thrombocytopenia in patients with solid tumors CHEN Yong, CHEN Zixuan, WU Wenjuan, WANG Xiaoqing, CHEN Xiaojun, LI Ying, WANG Rui, LI Yue Journal of Internal Medicine Concepts & Practice    2025, 20 (02): 126-131.   DOI: 10.16138/j.1673-6087.2025.02.05 Abstract （212）   HTML （3）    PDF（pc） （966KB）（23）       Knowledge map    Save Objective To evaluate efficacy and safety of hetrombopag in the treatment of chemotherapy-induced thrombocytopenia (CIT) in patients with solid tumors. Methods From September 2021 and June 2022, patients with CIT who were treated with hetrombopag from four hospitals were enrolled. The clinical efficacy of either hetrombopag monotherapy or hetrombopag combined with recombinant human thrombopoietin (rhTPO)/ recombinant human interleukin (rhIL)-11 and the efficacy of different doses of hetrombopag were analyzed. The frequency of platelet transfusions and the incidence of adverse events were also analyzed. Results A total of 57 patients were included, in which 12 patients were in the monotherapy group (83.3% with Ⅰ-Ⅱ CIT) and 45 patients were in the combination group (64.5% with Ⅰ-Ⅱ CIT). The proportion of patients who received thrombopoietic therapy during the CIT period was significantly higher in the combination group compared to the monotherapy group (66.7% vs. 0.0%, P < 0.001). The overall responses rate was 89.5%, and responses rates at 7, 14 and 21 days after treatment were 40.4%, 77.2% and 87.7%, respectively. The responses rate was 91.7% in the monotherapy group and 88.9% in the combination group, which had no significant difference between the two groups (P = 1.000). The median peak platelet count after treatment was significantly higher in the combination group compared to the monotherapy group (151.5×10⁹/L vs. 126.0×10⁹/L, P = 0.013). In the monotherapy groups, the responses rates of 2.5 mg/d and 5 mg/d were 100.0% and 85.7%, respectively. In the combination therapy groups, the responses rates of 2.5, 5 and 7.5 mg/d were 71.4%, 91.7% and 100.0%, respectively. The response rates had no significant differences among different doses of hetrombopag in both the monotherapy and combination therapy groups (P > 0.05). After treatment, one patient need a platelet transfusion, and 4 patients in the combination group developed thrombocytosis. Conclusions Hetrombopag is effective and safe for treating CIT, in which monotherapy shows significant efficacy in mild to moderate cases, and hetrombopag combin with rhTPO or rhIL-11 is effectiveness in moderate to severe or refractory cases. However, the optimal dosage and combination regimen still need further investigation. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress on treatment of orthostatic hypotension in Parkinson disease with integrated traditional Chinese and Western medicine ZHANG Fengjuan, YANG Zhao Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 34-37.   DOI: 10.16138/j.1673-6087.2025.01.07 Abstract （271）   HTML （1）    PDF（pc） （1037KB）（22）       Knowledge map    Save From the perspective of interdisciplinary integration of traditional Chinese and Western medicine, this article systematically reviews the research trends and progress on treatment of orthostatic hypotension in Parkinson disease, aiming to provide solid theoretical support for clinical medical practice. Orthostatic hypotension, as a prominent non-motor symptom in Parkinson disease, often poses risks of syncope and falls, and becomes adverse factor affecting patient prognosis. Therefore, a comprehensive understanding of the etiology, pathogenesis analysis, diagnostic methods, and treatment methods of orthostatic hypotension in Parkinson disease from both traditional Chinese and Western medicine perspectives is of immeasurable importance to clinical medical workers. This in-depth understanding will not only enhance the understanding and treatment skills of the disease but will also help to provide patients with more comprehensive, accurate, and effective diagnosis and treatment strategies. Reference | Related Articles | Metrics | Comments（0）

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Application of mesenchymal stem cells in systemic rheumatic diseases: current situation and prospects SU Chuanxin, ZHU Zhenhang, WANG Wang, LIANG Rongzhen, ZHENG Songguo, ZHAO Futao Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 422-426.   DOI: 10.16138/j.1673-6087.2024.06.13 Abstract （379）   HTML （7）    PDF（pc） （893KB）（22）       Knowledge map    Save Mesenchymal stem cell (MSC), a type of cell with the ability to differentiate into multiple lineages and immunomodulatory properties, have gained widespread attention in the treatment of systemic rheumatic diseases recently. Systemic rheumatic diseases such as systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, and Sjögren syndrome often led to a significant decline in patients’ quality of life, while current treatment methods have limitations. Therefore, it’s important to explore new method, and the application of MSC in these diseases has great significance. Current research indicates that MSC can exert therapeutic effects through various mechanisms, including regulating immune responses, promoting tissue repair, and reducing inflammation, and some clinical studies have showed the potential efficacy of MSC in systemic rheumatic diseases. However, many issues still need to be addressed, such as the source of cells, optimization of treatment protocols, and long-term safety assessments. This article systematically reviews the current application status of MSC in systemic rheumatic diseases, analyze their efficacy, safety, and future research directions, to provide a reference for development in this field. Reference | Related Articles | Metrics | Comments（0）

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Effects of nursing management based on theory of planned behavior on self-efficacy, health attitude and health behaviors in patients during stroke convalescence LI Lingling, LIU Min, ZHANG Lijuan, WANG Xiaoping Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 399-404.   DOI: 10.16138/j.1673-6087.2024.06.08 Abstract （343）   HTML （2）    PDF（pc） （959KB）（21）       Knowledge map    Save Objective To explore the effects of nursing management based on theory of planned behavior (TPB) on self-efficacy, health attitude and health behaviors in patients during stroke convalescence. Methods A total of 102 patients during stroke convalescence in the hospital from October 2022 to April 2023 were enrolled and randomly divided into observation group and control group, and each group had 51 patients. The control group was given routine nursing, while observation group was additionally given TPB-based nursing management. After 6 months of observation, the indexes including cognitive function, limb function [mini-mental state examination (MMSE), Fugl-Meyer assessment (FMA)], health belief [Champion health belief model scale (CHBMS)], self-efficacy [stroke self-efficacy questionnaire (SSEQ)], health behaviors [health promotion lifestyle profile (HPLP)], compliance of medication and life-style, and psychological state [Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD)] in the two groups were compared. Results After intervention, scores of MMSE, FMA, CHBMS, SSEQ and HPLP were higher in observation group than those in control group (all P<0.05). The compliance rates of medication (96.08%), diet control (90.20%), stopping smoking and drinking (96.08%), and appropriate exercise (82.35%) in observation group were respectively higher than those in control group (80.39%, 72.55%, 80.39%, 56.86%) (all P<0.05), while the score of HAMA and HAMD were lower in observation group than those in control group (all P<0.05). Conclusions TPB-based nursing management is beneficial to improve health attitude and self-efficacy in patients during stroke convalescence, thereby enhancing behavior control, promoting the maintenance of healthy behaviors, relieving negative psychological emotions and promoting health management. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Pathogenesis and management principles of extraintestinal manifestations in inflammatory bowel disease CAO Zhijun, LU Juntao Journal of Internal Medicine Concepts & Practice    2025, 20 (02): 112-119.   DOI: 10.16138/j.1673-6087.2025.02.03 Abstract （171）   HTML （10）    PDF（pc） （878KB）（20）       Knowledge map    Save Inflammatory bowel disease (IBD) is a group of chronic relapsing inflammatory gastrointestinal diseases, including Crohn disease (CD) and ulcerative colitis (UC). 30%-50% of IBD patients develop extraintestinal manifestations (EIM), which affect multiple organs such as the musculoskeletal, skin, eyes, and hepatobiliary systems. The occurrence of some EIM parallels the activity of IBD inflammation, while others may progress independently. The pathogenesis of EIM involves multiple factors, including genetic susceptibility, dysbiosis of the gut microbiota, and immune dysregulation. The diagnosis and management of EIM require multidisciplinary team (MDT) collaboration. EIM associated with IBD activity can be alleviated by controlling the underlying IBD, while EIM with independent progression requires individualized treatment strategies according to its pathogenesis. In addition to conventional treatments, tumor necrosis factor (TNF)-α inhibitors are core biological agents suitable for the treatment of most EIM. In the future, precision diagnosis, personalized treatment, and multidisciplinary collaboration will be essential directions in EIM research. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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A case of systemic lupus erythematosus complicated with calcinosis cutis LIU Yanming, SUN Shuyu, LI Song, WU Jian Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 409-412.   DOI: 10.16138/j.1673-6087.2024.06.10 Abstract （235）   HTML （5）    PDF（pc） （2950KB）（20）       Knowledge map    Save Calcinosis cutis is one of the complications of dermatomyositis and systemic sclerosis, while it is rare in other autoimmune diseases, especially in systemic lupus erythematosus(SLE). This article reports a female patient who had been diagnosed with SLE for 8 years ago, and developed extensive calcification, mainly affecting the limbs. Her condition improved after receiving treatment with tofacitinib. SLE patients complicated with calcinosis are rare, and their pathogenesis and treatment strategies still require doing more exploration and research. Early detection, early diagnosis, and early treatment are essential for the patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Exploring the mechanism of Huhuang decoction promoting diabetic wound healing based on network pharmaco-logy and transcriptomics ZHANG Jie, XU Shun, LIU Yan, SHI Yan Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 18-23.   DOI: 10.16138/j.1673-6087.2025.01.04 Abstract （315）   HTML （4）    PDF（pc） （3929KB）（19）       Knowledge map    Save Objective To investigate the effect and mechanism of Huhuang decoction on diabetic wound healing.Methods The active ingredients and target genes of each component of Huhuang decoction were queried through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database. The gene targets of diabetic foot ulcer were screened through the Comparative Toxicogenomics Database (CTD) and GeneCards database. The component-target interaction network was drawn using Cytoscape software draw and gene ontology（GO） and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed using DAVID. The wound tissue of diabetic rats was collected to undergo transcriptomic sequencing analysis. The effect of Huhuang decoction on wound healing of diabetic rats was verified in vivo, and the expressions of inflammatory factors interleukin 6 (IL-6), tumor necrosis factor α (TNF-α) and IL-1β in wound tissue were detected by enzyme-linked immunosorbent assay (ELISA). Results Network pharmacology and transcriptomic sequencing analysis showed that the potential targets of Huhuang decoction were closely related to inflammatory regulation. Local application of Huhuang decoction on the wound surface could promote the healing of diabetic wounds. Hematoxylin and eosin （HE） staining results displayed that Huhuang decoction promoted epithelialization of diabetic wounds.ELISA test results showed that Huhuang decoction could inhibit the expression of inflammatory factors IL-6, TNF-α and IL-1β in wound tissue. Conclusions Huhuang decoction could inhibit inflammation of diabetic wounds and promote wound healing. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Study on efficacy and transcriptomics characteristics of Fuzheng Xiaoji recipe based on subcutaneous transplanted tumor model in mice LYU Lingling, WU Zhiyuan, WANG Shenjie, HUANG Yuqing, LI Yuxi, ZHENG Lan, NING Guang Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 24-29.   DOI: 10.16138/j.1673-6087.2025.01.05 Abstract （254）   HTML （2）    PDF（pc） （2726KB）（19）       Knowledge map    Save Objective To explore the efficacy and safety of Fuzheng Xiaoji recipe in the treatment of colorectal cancer based on the subcutaneous transplanted tumor model in mice. Methods The subcutaneous tumor transplantation mouse model was established and the mice received Fuzheng Xiaoji recipe treatment, which could strengthen the body resistance and eliminate stagnation. The high-throughput transcriptome sequencing technology was used to evaluate treatment effect. The differentially expressed genes were annotated through Ensembl, gene oncology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases, and the related biological functions of abnormally expressed genes were compared and analyzed. Hematonylin and eosin （HE) staining was used to observe the effect of Fuzheng Xiaoji recipe on liver and kidney of tumor-bearing mice. Results Tumor volume and weight in both the low-dose and high-dose groups of Fuzheng Xiaoji treatment were significantly lower than those in the control group (P<0.001). Transcriptomic analysis revealed 166 upregulated and 328 downregulated genes in the tumor tissues after Fuzheng Xiaoji recipe treatment. Hierarchical clustering analysis, based on transcripts per million (TPM) values, demonstrated significant differences in gene expression between the treatment group and control groups. KEGG pathway analysis indicated that the top 20 enriched metabolic pathways included the calcium signaling pathway, cyclic guanosine monophosphate (cGMP)-protein kinase G signaling pathway, and cyclic adenosine monophosphate (cAMP) signaling pathway (P<0.05). HE staining results showed there were no significant hepatotoxicity or nephrotoxicity in Fuzheng Xiaoji recipe treated mice. Conclusions Fuzheng Xiaoji recipe could reduce the growth of CT26 subcutaneous transplanted tumors in a dose-dependent manner in mice, and it didn’t show obvious hepatorenal toxicity. Transcriptome analysis showed that the therapeutic effect of Fuzheng Xiaoji recipe on colorectal cancer may relate to regulating the proliferation of colorectal cancer, inducing apoptosis of colorectal cancer cells and inhibiting tumor migration and invasion. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Two cases of staged treatment of non-small cell lung cancer with traditional Chinese medicine CHENG Dongfeng, ZHOU Ziyi, XU Rongzhong, FANG Zhihong Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 30-33.   DOI: 10.16138/j.1673-6087.2025.01.06 Abstract （258）   HTML （2）    PDF（pc） （2482KB）（18）       Knowledge map    Save Lung cancer is one of the malignant tumors with the highest incidence and mortality rates globally. The prognosis of advanced lung cancer is poor, and drug resistance and toxic side effects limit clinical efficacy on it, and new treatment strategies are urgently needed. Traditional Chinese medicine (TCM) regards lung cancer as “lung accumulation”,which belonging to “general deficiency and local excess”, and the treatment emphasizes strengthening the body and eliminating pathogens. The TCM treatment of lung cancer is divided into three phases: postoperative support and nurturing, TCM combined with chemotherapy to enhance efficacy and reduce toxicity, and prevention of recurrence and metastasis. Based on this, professor Fang Zhihong mentioned that lung cancer was fundamentally characterized as deficiency of both qi and yin, with symptoms of qi stagnation, blood stasis, phlegm coagulation and toxin accumulation. He advocated the ideas of combination of disease differentiation, syndrome differentiation, and stage differentiation during the disease treatment, emphasized strengthening the spleen and stomach, cultivate righteous qi, and eliminating evil toxins. This article presents two case studies demonstrating the effectiveness of individualized staged treatment with TCM. Case 1 (stage Ⅲ B) was treated with TCM to strengthen body and eliminate pathogens after receiving targeted therapy and chemotherapy. The lesion had been stable for nearly 3 years and a total survival time was nearly 6 years; Case 2 (stage Ⅱ A) underwent postoperative TCM-assisted chemotherapy, and the survival time exceeded 8 years, and achieved clinical cure. The therapeutic effect was significant in 2 cases after using TCM methods to tonify qi and nourish yin, clear heat and detoxify, strengthen the spleen and resolve phlegm. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Progress in conservative treatment of knee osteoarthritis with traditional Chinese medicine ZONG Ya, JIA Jinxuan, XIE Qing, XIANG Jing, LI Qinghai Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 89-93.   DOI: 10.16138/j.1673-6087.2025.01.19 Abstract （288）   HTML （4）    PDF（pc） （1083KB）（18）       Knowledge map    Save The knee osteoarthritis is a common chronic degenerative joint disease in clinical practice, with high disability and recurrence rates. Long-term clinical practice and research have shown that the treatment of patients with mild to moderate knee osteoarthritis tends to use conservative therapies such as oral medications, rehabilitation training, and traditional Chinese medicine (TCM) therapies (acupuncture and massage). The patients with moderate or severe disease need surgical treatment while conservative treatments are ineffective. TCM conservative treatments of knee osteoarthritis show the advantages of significant efficacy, simple operation, few adverse effects, and high patient acceptance. The paper reviews the research progress of knee osteoarthritis treatment from the perspective of TCM, including acupuncture, moxibustion, massage, small needle knife, acupoint injection, Chinese medicine, and the integration of TCM and Western medicine. It aims to provide a multidimensional diagnostic and treatment approach for clinical management of knee osteoarthritis, enrich and optimize treatment plans, and improve clinical outcomes. Reference | Related Articles | Metrics | Comments（0）

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Integration of modern technologies in cardiological education: applications and prospects JIANG Jie, CHEN Yanjia, SUN Zhuoyan, QIU Zeping, HUA Sha, JIN Wei Journal of Internal Medicine Concepts & Practice    2025, 20 (03): 262-266.   DOI: 10.16138/j.1673-6087.2025.03.13 Abstract （74）   HTML （11）    PDF（pc） （893KB）（16）       Knowledge map    Save With the rapid progress of technology, cardiovascular education is undergoing unprecedented transformation. The introduction of augmented reality (AR), virtual reality (VR), artificial intelligence (AI), and medical simulation technologies offers new possibilities for innovation in teaching methods. These advanced technologies not only enhance the effectiveness of teaching and students’ learning experiences, but also effectively promote the development of clinical skills. However, despite the enormous potential for these technologies, various challenges persist in practical teaching applications, including technological costs, insufficient teacher training, and difficulties in integrating teaching content. This paper aims to review the integration of these technologies in cardiovascular education, analyze their respective advantages and limitations, and explore future development directions, thereby providing valuable insights for educators and researchers in the field of medical education. Reference | Related Articles | Metrics | Comments（0）

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Heavy and light chain renal amyloidosis with biclonal paraproteinemia: a case study and literature review TIAN Xiaofang, LIU Liping, YUAN Liying, REN Hong, WANG Zhaohui, SHI Hao Journal of Internal Medicine Concepts & Practice    2025, 20 (03): 191-197.   DOI: 10.16138/j.1673-6087.2025.03.02 Abstract （82）   HTML （7）    PDF（pc） （3558KB）（16）       Knowledge map    Save Objective To explore the diagnostic and therapeutic strategies for non-traditional immunoglobulin-related renal amyloidosis by analyzing the clinical management of a patient with heavy and light chain renal amyloidosis and biclonal paraproteinemia. Methods The clinical data of a patient diagnosed with biclonal paraproteinemia and renal amyloidosis at the Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine and long-term follow-up from 2021 to 2024 were collected and analyzed, and relevant domestic and foreign literature was reviewed. Results The main symptoms in a 72-year-old male presented with foamy urine, facial and bilateral lower limb edema. Biclonal (IgM κ and IgA, λ) gammopathy were detected, heavy and light-chain renal amyloidosis (IgA-λ) was diagnosed by renal biopsy. There was no obvious involvement in the heart. A small number of monoclonal CD38+ B cells were detected through immunophenotyping in bone marrow, while the L265P mutation of the MYD88 gene was negative in it. There was no lymph node enlargement or extranodal lesions, the underlying hematological disease was a B-lymphocyte proliferative disorder. After initial treatment with a rituximab-based regimen, the treatment was adjusted to daratumumab combined with lenalidomide which was targeting CD38. The patient quickly achieved complete hematological remission and a renal response, and complete renal remission was achieved during subsequent treatment. Literature review showed that there are only a few case reports on biclonal paraprotein associated with renal amyloidosis, and only one case of renal amyloidosis associated with heavy and light-chain. In amyloidosis caused by B cell or lymphoplasmacytic clones, rituximab-based regimens are the main treatment, but hematological and organ responses are not ideal. The daratumumab combination regimen may be effective for patients with pathogenic clones of CD38+ B cells. Conclusions There is no consensus or guideline for the diagnosis and treatment of light-chain amyloidosis with biclonal paraprotein. Accurately identifying the pathogenic clone, determining the treatment target, and formulating individualized combination drug regimens are helpful for patients to achieve more profound remission of hematology and organs. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Relapsing polychondritis mainly with airway involvement: analysis of clinical characteristics HU Jiaqi, JIN Zhengyi, LIU Qilong, JI Lianmei, MA Taiyan, GAO Jie Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 379-384.   DOI: 10.16138/j.1673-6087.2024.06.05 Abstract （263）   HTML （4）    PDF（pc） （963KB）（16）       Knowledge map    Save Objective To investigate the clinical characteristics of patients with relapsing polychondritis (RP) involving airway. Methods The clinical data of 141 RP patients hospitalized in the First Affiliated Hospital of Naval Medical University from July 2007 to December 2023 were analyzed retrospectively. Results The incidence of airway involvement in RP patients was 58.87%, among which airway wall thickening was the most common. RP patients with airway involvement were diagnosed at a later age (P=0.011). RP patients without airway involvement were more likely to have ear cartilage, eye and cardiovascular system involvement (P=0.008, P=0.009 and P=0.021); the hypersensitive C-reactive protein and platelet counts in RP patients without airway involvement were higher than those in RP patients with airway involvement (P=0.023, P=0.013), while the neutrophil counts in the patients were lower than those in RP patients with airway involvement (P=0.018). Univariate Logistic regression analysis showed that age at diagnosis and neutrophil count were positively correlated with airway involvement. In contrast, ear cartilage, eye and cardiovascular involvement, erythrocyte sedimentation rate, hypersensitive C-reactive protein, platelet count, and alanine transferase were negatively correlated with airway involvement. Multivariate Logistic regression analysis confirmed that age at diagnosis and neutrophil count were independent risk factors for airway involvement. Conclusions Airway involvement in RP patients is related to age at diagnosis and neutrophil count. The patients should receive regular chest CT and bronchial examination if necessary. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Application of multimodal magnetic resonance in identification of early brain damage in systemic lupus erythematosus YANG Yifan, ZHANG Guofang, XU Jian Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 372-378.   DOI: 10.16138/j.1673-6087.2024.06.04 Abstract （246）   HTML （3）    PDF（pc） （1308KB）（15）       Knowledge map    Save With the growing number of autoimmune disorders globally, systemic lupus erythematosus (SLE), a common autoimmune disease, has received increased attention for its associated brain damage. Brain damage is common in SLE patients, and the prognosis is poor. Accurate detection of early brain damage is critical for timely diagnosis and therapy. Magnetic resonance imaging, as a non-invasive imaging technology, can provide multi-modal, high-resolution and rich data, which has good application value for quantitative research, clinical diagnosis and evaluation of early SLE brain damage. The aim of the article is to explore the role of multimodal magnetic resonance in the mechanism research and clinical diagnosis of early brain damage in SLE patients, as well as to give additional support for early intervention and treatment of brain damage. Table and Figures | Reference | Related Articles | Metrics | Comments（0）