This Consensus aims to establish a physician–pharmacist co-management model to standardize the rational clinical application of anti-immunoglobulin E monoclonal antibodies in the treatment of allergic asthma. Focusing on the critical components of physician–pharmacist co-management, key issues related to anti-immunoglobulin E monoclonal antibody therapy were identified through a systematic literature review and clinical practice experience. Evidence quality was evaluated using an evidence grading system, and the Delphi method was applied to reach expert consensus. Centered on omalizumab, the Consensus presents 12 recommendations covering the work model of physician–pharmacist co-management, clinical management pathways, hierarchical diagnosis and treatment systems, as well as training and competency assessment. The Delphi process achieved a high degree of consensus (agreement >80%) on 12 key recommendations, emphasizing a 60-min observation period post-injection and quarterly follow-up evaluations. It establishes a standardized framework for the co-management of omalizumab therapy in allergic asthma. Results highlighted that co-management effectively monitors omalizumab dosage (75–600 mg) and maintains a consensus threshold of >80% for patient safety protocols. The Consensus provides a standardized framework for physician–pharmacist co-management, which is expected to facilitate rational drug use and improve patient care pathways in omalizumab therapy.

Autoimmune hepatitis (AIH) frequently coexists with extrahepatic autoimmune diseases (EADs), but their prevalence, characteristics, progression, and treatment effect in the Han Chinese population remain unclear. This study aimed to evaluate the prevalence and spectrum of EADs and to assess their clinical features, disease course, and treatment outcomes in Han Chinese patients with AIH.

Medical records of 371 Han Chinese patients with AIH (diagnosed from March 2016 to October 2023) were retrospectively analyzed.

Among the 371 AIH patients, 304 (81.94%) were female, with a median age of 52.5 years (interquartile range, 46.0–61.0). A total of 23.98% (89/371) had at least one EAD, including 27.06% (82/303) in type 1 AIH, 11.11% (7/63) in antibody-negative AIH, and none in type 2. A single EAD was the most common (20.21%, 75/371). The most frequent EADs were Sjogren’s syndrome (8.63%) and autoimmune thyroid disease (8.36%). Compared with patients without EADs, those with EADs had lower alanine aminotransferase, red blood cell, and hemoglobin levels, but higher aspartate aminotransferase/alanine aminotransferase ratio and antinuclear antibody (ANA) positivity (all P < 0.05). ANA positivity was independently associated with EADs (odds ratio = 2.209, 95% confidence interval = 1.242–3.927, P = 0.007). After three months of treatment, the complete biochemical response rate was lower in the EADs group than in the non-EADs group (40.0% vs. 55.3%, P = 0.024), whereas no significant differences were observed at 6, 12, 24, or 36 months (all P > 0.05).

In the Han Chinese population, 23.98% of AIH patients had EADs, with Sjogren’s syndrome and autoimmune thyroid disease being the most common. ANA positivity was a significant risk factor for EADs. EAD patients had a poorer initial treatment response at three months, but comparable long-term biochemical response from six months.

Antralization is considered a critical, reversible stage preceding gastric cancer. However, available biomarkers for identifying antralization are lacking. This study aimed to explore antralization-specific biomarkers in peripheral blood and gastric mucosa.

In this prospective cohort study, adult patients presenting with upper gastrointestinal symptoms were enrolled and categorized into antralization and non-antralization groups based on pathological examination of gastric mucosa. Helicobacter pylori (H. pylori) infection was detected using the 13C-urea breath test, rapid urease test, and/or H. pylori serological test. Blood samples and gastric biopsies were collected for biomarker analysis.

Of the 92 patients studied, 42 (45.7%) were diagnosed with H. pylori infection and 61 (66.3%) with antralization. The rate of H. pylori infection and the incidence of acid reflux were higher in the antralization group than in the non-antralization group (both P < 0.05). Patients with antralization had higher plasma lymphocyte counts and lower serum levels of lipopolysaccharide (both P < 0.05). The positive rates and intensity of trefoil factor-2 and mucin (MUC) 6 expression were higher, whereas the positive rate and intensity of MUC5AC expression were lower in the incisura and body mucosa with antralization compared with those without antralization (all P < 0.05). Additionally, the intensity of MUC5B expression was higher in the gastric body mucosa with antralization than in those without antralization (P < 0.05).

Increased lymphocyte counts and decreased lipopolysaccharide levels in the blood, along with increased expression of trefoil factor-2, MUC6, and MUC5B and decreased MUC5AC expression in the proximal gastric mucosa, appear to be antralization-specific.

Stroke patients have a high incidence of venous thromboembolism (VTE). Improving the prevention and control rates of VTE in stroke patients can enhance their quality of life. The aim of this study was to analyze the effect of 4R crisis management combined with the health belief model in the prevention and control of VTE in stroke patients.

A randomized controlled trial was conducted on 86 stroke patients in the neurosurgery department of a tertiary hospital in Wuhan. The control group was treated with the routine VTE prevention and control strategy, while the experimental group was treated with 4R crisis management combined with the health belief model. The primary outcome measures were the incidence rates of deep vein thrombosis and pulmonary thromboembolism, while the secondary outcome measures were the Short Form Health Belief Model Scale score, medical quality evaluation, and stroke patients’ health behavior scale score. The statistical analysis methods included t-tests and non-parametric tests.

After the intervention, the incidence rate of deep vein thrombosis in the control group was 14.6% (6/41), while in the experimental group it was 2.4% (1/41). The difference was statistically significant (χ2 = 3.905, P = 0.048). The incidence rates of pulmonary thromboembolism in both groups were 0%. The scores of all dimensions of the Short Form Health Belief Model Scale in the experimental group were higher than those in the control group, and the difference was statistically significant (P < 0.05, P < 0.01). The medical quality for each item showed that the experimental group performed better than the control group, with the difference being statistically significant (P < 0.05, P < 0.01). The scores on the stroke patients’ health behavior scale in the experimental group were higher than in the control group, except for responsibility, tobacco, and alcohol (P < 0.01).

The application of 4R crisis management combined with the health belief model can effectively improve the health beliefs and health behaviors of stroke patients to prevent VTE, thereby reducing the incidence of VTE.

The incidence and mortality of stroke are gradually increasing. In this context, post-stroke neuronal loss and the related long-term complications, along with costly treatment strategies, are significant concerns for healthcare professionals, and effective, convenient, and inexpensive therapeutic modalities are required. Natural and easily accessible herbal remedies may be the optimal option in post-stroke recovery. This narrative review aims to summarize the neuroprotective properties of Withania somnifera (Ashwagandha) and its therapeutic efficacy in neuronal plasticity and recovery after stroke. Original research articles, reviews, and case studies were sourced from databases such as PubMed, Web of Science, Scopus, Google Scholar, Medline, and Embase. Only full articles published in English up to July 2025 were considered. Keywords including W. somnifera, Ashwagandha, stroke, cerebral ischemia, neurodegeneration, neuronal loss, and post-stroke recovery were utilized for the literature search. It has been found that various plant parts of W. somnifera are abundant in bioactive compounds. The neuroprotective effects of W. somnifera are documented in numerous diseases. Nevertheless, W. somnifera is reported to be involved in modulating various biological pathways to mitigate neuroinflammation, apoptosis, and oxidative stress in stroke. W. somnifera promotes cell proliferation and enhances neurogenesis. Preclinical experiments on murine models show the effectiveness of W. somnifera in post-stroke recovery by enhancing neural plasticity and reducing neuronal loss in the infarct area. Furthermore, W. somnifera boosts neurotransmitter levels, improves motor functions, and enhances memory. It also decreases neutrophil infiltration in the infarct region and lessens neuronal loss. Therefore, the application of W. somnifera may prove advantageous in facilitating post-stroke recovery by enhancing neural function. However, well-designed clinical trials are needed to confirm the efficacy of W. somnifera in post-stroke recovery in humans.

Helicobacter pylori infection represents a significant modifiable risk factor in the pathogenesis of gastric cancer. Nevertheless, conventional antibiotic treatments have increasingly proven inadequate due to challenges such as antibiotic resistance, microbial dysbiosis, and mucosal damage. In response to these issues, this review introduces an innovative intervention strategy based on the “nanotechnology-based 3R” approach (Remove H. pylori, Remodel the microenvironment, Repair the gastrointestinal tract), which aims to offer a comprehensive solution for managing H. pylori infection. This strategy comprises three principal components. Firstly, the utilization of pH/light/magnetic multi-responsive nanomaterials facilitates the precise eradication of the pathogen and its biofilm. Secondly, to address bacterial immune evasion, these nanomaterials are engineered to target and neutralize virulence factors such as VacA, thereby contributing to the reversal of the local immunosuppressive environment. Thirdly, the utilization of nanomaterials presents a promising approach for the concurrent repair of the mucosal barrier and the maintenance of intestinal microbiome homeostasis. Finally, this paper provides a comprehensive analysis of the specific mechanisms employed by typical nanomaterials, including metal-organic frameworks, charge-reversal nanoparticles, nanozymes, and antimicrobial peptide crystals. These mechanisms involve targeted microbial eradication, activation of autophagy, and the upregulation of tight junction proteins. Furthermore, the study delves into the critical roles played by multimodal external field stimulation and material–host interaction network analysis, which are essential for future clinical translation. Ultimately, this review suggests a potential roadmap for system-precision intervention that transcends the conventional “sterilization first” paradigm. Nonetheless, the current evidence regarding the efficacy and safety of this approach is predominantly derived from cell and mouse models. Therefore, its clinical applicability requires validation through studies involving large animal models and prospective clinical trials.

For individuals with decompensated advanced chronic liver disease (dACLD), the onset of refractory ascites (RA) represents a dramatic event. In this setting, a relevant proportion of RA patients develop kidney dysfunction, as well as hepatorenal syndrome-acute kidney injury, with limited therapeutic and survival chances. An 81-year-old woman with dACLD-RA was admitted with severe ascites and stage IV chronic kidney dysfunction. On the second day, hepatorenal syndrome-acute kidney injury occurred, requiring standard medical therapy. Intravenous human albumin (HA) and terlipressin administration were compromised by poor venous access and severe respiratory dysfunction. After excluding transjugular intrahepatic portosystemic shunt and transplantation due to age and comorbidities, peritoneal dialysis (PD) was initiated, leading to renal recovery and ascites resolution. Two weeks later, she was readmitted due to the unfeasibility of accessing peripheral veins for the intravenous administration of HA, which was essential to support circulatory function, preserve oncotic balance, and properly manage both RA and chronic kidney dysfunction. A novel PD+HA protocol was therefore started, with intraperitoneal infusion of HA-enriched dialysate to allow a positive albumin gradient from dialysate to blood. Over 12 months, serum albumin levels increased, and clinical stability and improved nutritional status were observed, with no additional hospitalizations or complications. This is the first case describing the application of HA-enriched PD in managing a dACLD patient with RA and kidney dysfunction. HA-enriched PD may represent a promising strategy in complex dACLD care by guaranteeing frequent and small-volume paracentesis and preservation of oncotic pressure without dialytic albumin loss.

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects approximately 32% of the US adult population. The present study aimed to utilize the All of Us electronic health record-linked large cohort to assess seven metabolic risk factors (MRFs) simultaneously, the impact by ethnicity and age, and clinical presentations of MASLD.

This study included a MASLD group (n = 15,060) and a frequency-matched control group (n = 75,300). Multivariable analyses were performed to compare the frequencies of MRFs and clinical outcomes between the two groups. Type 1 diabetes was not included in the multivariable analysis. Subgroup analyses were conducted according to race and ethnicity, as well as age.

The overall frequency of MASLD was 6.0%. Compared with the control group, individuals with MASLD had significantly higher independent frequencies of obesity (66.1% vs. 41.3%), type 2 diabetes (39.5% vs. 16.9%), hypertension (64.3% vs. 38.6%), hyperlipidemia (59.8% vs. 37.3%), obstructive sleep apnea (28.9% vs. 13.4%), and hypothyroidism (21.2% vs. 13.4%). Obesity was identified as the strongest independent MRF among Asians, Whites, and Hispanics, particularly in individuals younger than 50 years, whereas hypertension was the strongest independent MRF in Blacks. MASLD was also associated with significantly higher frequencies of cardiac events, including coronary artery disease (17.1% vs. 9.4%) and myocardial infarction (7.1% vs. 4.2%); hepatic events, including cirrhosis (7.5% vs. 1.1%) and hepatocellular carcinoma (0.5% vs. 0.1%); and elevated liver enzymes, including alanine aminotransferase (27.7% vs. 10.1%), aspartate aminotransferase (18.0% vs. 6.4%), and alkaline phosphatase (19.8% vs. 13.1%), compared with the control group.

Our study demonstrated that obesity, hypertension, hyperlipidemia, type 2 diabetes, obstructive sleep apnea, and hypothyroidism were independent MRFs for MASLD overall, but the ranking of these MRFs by odds ratios could vary by ethnicity and age. MASLD presents with significantly higher rates of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase elevation, as well as cardiac and hepatic events.