Shanghai Pudong New District Zhoupu Hospital

Atopic dermatitis (AD) is the most common chronic inflammatory skin condition. It has significant socioeconomic consequences and complex pathophysiology, necessitating updated management guidelines that consider the age, sex and geographic location of patients. Despite the widespread use of Western medicine (WM), including topical corticosteroids, as the primary treatment for AD, the possible negative effects of WM therapies are inescapable. Although there is still a lack of strong evidence, the integration of traditional Chinese medicine (TCM) with WM may yield a more favorable therapeutic response for AD than WM alone, due to the synergistic effects involved. Balancing the application of diagnostic and therapeutic approaches from TCM and WM is crucial for the management of AD, enhancing treatment efficacy for patients, and averting disease recurrence. In 2025, a new clinical guideline for the diagnosis and treatment of AD was released; it emphasized the integration of TCM with WM. This guideline is crucial as it consolidates global expertise and data to provide a standardized framework for the practical integration of techniques to bridge divides among clinical disciplines. As more substantial data emerge, the development and enhancement of integrative medicine for AD management should be prioritized globally, particularly in Asian regions. Please cite this article as: Chen M, Liao WQ. Atopic dermatitis management in the era of integrative medicine. J Integr Med. 2026; 24(2):137-139.

Atrial fibrillation (AF), with a prevalence of 1–2%, is the most common cardiac arrhythmia. AF is associated with a fivefold increased risk of cardioembolic events; approximately 20% of all strokes are caused by AF. Pulmonary vein isolation (PVI) has become the first-line treatment for AF. However, PVI cannot eliminate the residual stroke risk. Current guidelines recommend that anticoagulation be continued in this specific group of patients, regardless of the presence or absence of AF. In this large AF population post-PVI, who are considered to be in an earlier stage of AF, it is unknown whether left atrial appendage closure (LAAC) offers an alternative to direct oral anticoagulant (DOAC) therapy.

The trial will be a prospective, randomised, multicentre non-inferiority study comparing two treatment strategies in AF patients after atrial ablation. Patients will be randomly assigned to either percutaneous LAAC (group A) or DOAC treatment (group B) in a 1:1 ratio; both sequential and concomitant planned ablation with or without LAAC are accepted. Randomisation will be conducted using web-based randomisation software. A total of 1012 participants (506 patients per group) will be enrolled. The primary effectiveness measure will be the occurrence of any of the specified events within 24 months after randomisation: stroke/transient ischaemic attack/systemic thromboembolism, cerebral haemorrhage, other major haemorrhages (Bleeding Academic Research Consortium ≥2), cardiovascular mortality and all-cause mortality.

The study was approved by the Ethical Review Board of Shanghai Chest Hospital, China (KS(Y)20287). Written informed consent will be obtained from all participants. The trial will follow the Declaration of Helsinki and Good Clinical Practice. Confidentiality will be maintained with anonymised, securely stored data. Findings will be disseminated through peer-reviewed publications and conferences.

ChiCTR2000036538.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma worldwide. Novel treatment strategies are still needed for this disease.

The present study aimed to systematically explore the potential targets and molecular mechanisms of matrine in the treatment of DLBCL.

Potential matrine targets were collected from multiple platforms. Microarray data and clinical characteristics of DLBCL were downloaded from publicly available database. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were applied to identify the hub genes of DLBCL using R software. Then, the shared target genes between matrine and DLBCL were identified as the potential targets of matrine against DLBCL. The least absolute shrinkage and selection operator (LASSO) algorithm was used to determine the final core target genes, which were further verified by molecular docking simulation and receiver operating characteristic (ROC) curve analysis. Functional analysis was also performed to elucidate the potential mechanisms.

A total of 222 matrine target genes and 1269 DLBCL hub genes were obtained through multiple databases and machine learning algorithms. From the nine shared target genes of matrine and DLBCL, five final core target genes, including CTSL, NR1H2, PDPK1, MDM2, and JAK3, were identified. Molecular docking showed that the binding of matrine to the core genes was stable. ROC curves also suggested close associations between the core genes and DLBCL. Additionally, functional analysis showed that the therapeutic effect of matrine against DLBCL may be related to the PI3K-Akt signaling pathway.

Matrine may target five genes and the PI3K-Akt signaling pathway in DLBCL treatment.