Pulmonary sarcoidosis is an immune system disease with an unclear etiology. Guided by the yang-reinforcing method， it is believed that the fundamental pathogenesis of pulmonary sarcoidosis lies in the disharmony between water and fire and the reckless movement of the ministerial fire. The failure of the spleen and stomach to maintain warmth， leading to the production of phlegm and blood stasis， is an important pathogenesis. The invasion of external pathogenic toxins， deeply penetrating into the interior， is considered a triggering factor for the disease. The treatment focuses on supplementing the yang， consolidating the kidney， drawing fire back to its source， warming the yang， benefiting the kidney， and nourishing the spleen to generate metal. It also emphasizes unblocking the yang， transforming turbidity， and eliminating phlegm and blood stasis.

BackgroundThe issue of school absenteeism due to school refusal in adolescents has become increasingly prominent. Acceptance and Commitment Therapy （ACT） has been applied successfully to improve depression， anxiety， and psychological flexibility in adolescents， while few studies have tested the effect of ACT intervention on above-mentioned psychological aspects and return-to-school rate in adolescents with school absenteeism. ObjectiveTo explore the effect of ACT on depression， anxiety， psychological flexibility and return-to-school rate in school absenteeism adolescents， and to provide a broader evidence base for clinical interventions. MethodsFrom May to June 2024， a sample of 50 adolescents with Shenzhen school registration who had been suspended from school for more than a consecutive month for school refusal were recruited based on Wechat official account platform. The adolescents were divided into study group and control group by random number table method. Both groups received psychological education with the theme of 'Causes and Coping Strategies of School Refusal'， and study group added a 6-week ACT intervention with weekly 1-hour sessions. At baseline and after treatment， Patients’ Health Questionnaire Depression Scale-9 item （PHQ-9）， Generalized Anxiety Disorder Scale-7 item （GAD-7） and Comprehensive assessment of Acceptance and Commitment Therapy processes （CompACT） were used for the clinical evaluation. ResultsA total of 45 （90.00%）adolescents completed the study， including 25 in study group and 20 in control group. Analysis revealed that study group scored higher on PHQ-9 and GAD-7， while lower on total CompACT score， openness dimension and awareness dimension compared with control group， with statistical significance （F=7.786， 10.334， 12.922， 14.374， 3.075， P<0.05 or 0.01）. After intervention， the rate of return-to-school was higher in study group than in control group （40.00% vs 10.00%， χ²=5.114， P<0.05）. ConclusionACT intervention for adolescents with school absenteeism may alleviate depression and anxiety， improve their psychological flexibility and increase return-to-school rate.［Funded by the "14^th Five Year Plan" for Social Sciences Project in Jiangxi Province （number， 24JY41D）； Science and Technology Planning Project of Shenzhen Municipality （number， 20210617155253001）］

Objective : To investigate the effects of D ⁃allose on the restoration of neurological function , Galectin⁃3 (Gal⁃3) , adenosine monophosphate⁃activated protein kinase/mammalian target of rapamycin (AMPK/mTOR) and the expression of some inflammatory factors in ischemia⁃reperfusion injury ( CIRI) mice . Methods : A total of 50 male mice were randomly divided into control group (Con group) , sham group (Sham group) , cerebral ischemia⁃reperfusion injury group (MCAO group) , cerebral ischemia⁃reperfusion injury + D ⁃alolose group (MCAO + D ⁃allose group) and cerebral ischemia⁃reperfusion injury + modified citrus pectin group (MCAO + MCP group) . The middle cerebral artery occlusion/reperfusion (MCAO/R) model (reperfusion after 2 hours of MCA ischemia) was established by thread embolism . After successful modeling , the neurological function of mice was evaluated Longa score and rotated rod walking . TTC staining was used to observe the volume of cerebral infarction foci . The expression levels of Gal⁃3 and autophagy⁃related molecules were detected by Western blot and RT⁃PCR . Immunofluorescence was applied to detect the distribution of Gal⁃3 in brain tissue , and TNF⁃α , IL⁃8 secretion was detected with ELISA KIT . Results : Compared with Con group and Sham group , the MCAO model represented significant increase in the Longa neurofunction score (P < 0. 01) , cerebral infarction volume ( P < 0. 01) , Gal⁃3 expression and manifasted enhanced autophagy (P < 0. 01) . After treatment with D ⁃allose , it could significantly improve neurological dysfunction , reduce cerebral infarction volume (P < 0. 01) , reduce the expression of Gal⁃3 ( P < 0. 01) , inhibit AMPK phosphorylation , promote mTOR phosphorylation , and inhibit autophagy (P < 0. 01) . The use of the Gal⁃3 inhibitor MCP alone could also achieve the effect of inhibiting autophagy . Conclusion D ⁃allose can effectively promote the recovery of neurological function and reduce the volume of infarct foci in CIRI mice . The mechanism may involve inhibiting excessive cell autophagy by downregulating the expression of Gal⁃3 , and reducing the release of inflammatory factors such as TNF⁃α and IL⁃8 , thereby exerting neuroprotective effects .

Bronchiectasis is a refractory chronic airway disease characterized by chronic cough and phlegm production. Airway mucus hypersecretion is one of the important causative factors for acute exacerbation of bronchiectasis. Thus， reducing airway mucus secretion during the stable phase of bronchiectasis is the key to the treatment. Phlegm-dispelling therapy is commonly used in modern medicine， which， however， fails to radically reduce mucus secretion. At the moment， it is difficult and urgent to find an intervention that can improve the quality of life of patients and reduce the recurrence of disease during the stable phase of bronchiectasis. Chinese medicine shows remarkable efficacy in reducing airway mucus secretion. Nonetheless， there is a lack of research on the airway mucus hypersecretion of bronchiectasis， and no registered research outcome is available. Traditional Chinese medicine boasts a lot of experience in the treatment of phlegm. It combines clearing and tonifying methods and identifies Yin and Yang and internal organs， thus being advantageous in the treatment of airway mucus hypersecretion of bronchiectasis. Therefore， it is an important topic to improve the effectiveness of Chinese medicine on airway mucus hypersecretion of bronchiectasis by focusing on the "generation"， "transformation" and "excretion" of phlegm.

Objective:To systematically evaluate the intervention effect of acceptance commitment therapy on anxiety disorder.Methods:The full-text databases of Web of Science Core Collection, MEDLINE, KCI-Korean Journal Database, SciELO Citation Index, SpringerLink, Pubmed, EMBASE, Cochrane Library, CNKI Wanfang and Weipu were searched and randomized controlled studies related to acceptance commitment therapy for patients with anxiety disorder were collected.All randomized controlled studies met the criterion were included.Meanwhile, the literature quality of the included literatures was evaluated.The outcome indicators such as anxiety index, psychological flexibility and quality of life index were selected, and RevMan 5.3 software was used to analyze the literature data that met the inclusion criteria.Results:A total of 12 studies with 1 062 patients were included, including 513 cases in ACT group and 549 cases in control group.Meta analysis showed that ACT can effectively reduce anxiety level of patients with anxiety disorder (MD=-0.58, 95% CI: -0.85- -0.32, P<0.001), anxiety level in follow-up period (MD=-0.42, 95% CI: -0.75- -0.08, P=0.01), improving psychological flexibility (MD=0.46, 95% CI: 0.24~0.68, P<0.001); In the study of CBT(cognitive behavioral therapy) as the control group, there was no significant difference between ACT group and control group, among which after intervention (MD =-0.06, 95% CI: -0.47- 0.36, P=0.79), follow-up period (MD = 0.17, 95% CI: -0.07-0.41, P=0.16) .In the study with the control group as the blank control, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.76, 95% CI: -0.97- -0.56, P<0.001), and the difference is statistically significant.Excluding the non-blank control study, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.82, 95% CI: -1.09--0.55, P<0.001) in the studies where the proportion of women is greater than or equal to 70%.In the study of 50%-70% females, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.68, 95% CI: -1.09 --0.28, P=0.01). All the differences were statistically significant.There was no significant difference between ACT and the control group for quality of life(MD=0.24, 95% CI: -0.01-0.49, P=0.06). Conclusion:ACT has a certain effect on patients with anxiety disorder, which not only improves the anxiety level of patients, but also keeps the effect of anxiety improvement during the follow-up period, and the improvement of psychological flexibility has also been verified.The immediate and long-term efficacy of ACT is similar to that of CBT, which further improve the reliability of ACT curative effect.Gender difference has not been confirmed for the therapeutic effect.ACT has no obvious improvement on the quality of life, and the conclusion of this study needs more randomized controlled studies with large samples and high quality to verify it.

Objective: To understand the characteristics of injury deaths of children and adolescents aged 0 to 19 years in Kunming during 2010-2019,and to provide injury prevention and control basis. Methods: Injury mortality data in 2010-2019 were from Kunming population based mortality surveillance system. The characteristics of injury death of children and adolescents were analyzed by descriptive statistical analysis, including mortality rate, composition ratio, the annual percent change,etc. Results: Child and adolescent injury mortality was 23.18/10 5,decreasing by year(t=7.13,P<0.05). Male mortality(31.59/10 5) was higher than female(14.27/10 5)(χ2=376.24,P<0.05),the APC of male was -8.82% and -7.48% in female.The injury mortality of male was higher than that of female at all age group. The injury mortality rate of rural children and adolescents(28.65/10 5) was higher than that of urban children(12.37/10 5)(χ2=297.30,P<0.05),the APC was -8.53% in urban areas and -7.78% in rural areas.The top five causes of injury death of children and adolescents were traffic accident drowning, accidental fall, suicide and accidental mechanical suffocation, accounting for 80.88% of the total injury deaths of children and adolescents.In urban and rural areas,injury death by traffic accident, drowning and rural unintentional falls decreased significantly(t urban=3.17,3.20,t rural=5.66,3.12,4.42,P<0.05). The leading cause of death varied by different age groups. Conclusion The injury mortality rate of children and adolescents in Kunming city is on the decline. Rural children and adolescents, as vulnerable population to injury death, should receive protective strategies according to their specific characteristics of injuries and deaths in different age groups.

Objective To explore the effect Tiaoli-Qixue decoction on bleeding and coagulation during perioperative period of total hip arthroplasty (THA).Methods A total of 180 THA patients who met the inclusion criteria were randomly divided into three groups with 60 cases in each group.All patients underwent routine anti-infection treatment after unilateral THA through lateral hip approach.The patients took the Tiaoli-Qixue decoction 3 days before THA in the treatment group.The patients in the Xuesaitong control group received intravenous Xuesaitong on the day of operation and rivaroxaban tablets were administered orally on the day of operation in the westem medicine control group.The continuous medication was administered until 7 days after operation in three groups.The amount of hemorrhage and drainage after operation were recorded and the total amount of dominant hemorrhage was calculated.The Degao M4 semi-automatic hemagglutination instrument was used to detect plasma D-dimer level and observe thrombosis.Harris scale was used before and after operation to calculate the excellent and good rates of Harris score.Results The total amount of dominant hemorrhage (376.67 ± 61.44 ml vs.400.08 ± 61.16 ml,413.33 ± 53.76 ml,F=5.963),intraoperative hemorrhage (165.50 ± 15.67 ml vs.174.75 ± 14.68 ml,175.42 ± 11.13 ml,F=9.452) and postoperative drainage (211.17 ± 58.12 ml vs.225.33 ± 56.93 ml,237.92 ± 54.28 ml,F=3.370) in the treatment group of traditional Chinese medicine were significanlty less than those in the Xuesaitong control group and the Western medicine control group (P＜0.01 or P＜0.05).On the 7th day after operation,there were 6 cases of thrombosis in the treatment group of traditional Chinese medicine,4 cases in the Xuesaitong control group and 4 cases in the Western medicine control group.There was no significant difference between the three groups (x2=0.667,P=0.881).Six months after operation,the excellent and good rate of that the treatment group of traditional Chinese medicine was 45.0％ (27/60),which of the the Xuesaitong control group was 11.7％ (7/60),and which of the the Western medicine control group was 13.3％ (8/60).There was significant difference among the three groups.Conclusions The Tiaoli-Qixue decoction bleeding and coagulation can reduce the amount of dominant bleeding during perioperative period in patients with THA,and effectively prevent and treat deep venous thrombosis of lower limbs after THA.

Objective To investigate the cognitive functions in first-degree relatives of patients with schizophrenia by meta-analysis. Methods Collect case-control studies of cognitive function in first-degree relatives of patients with schizophrenia,then extract data and assess the risk of bias of included studies,and use RevMan 5.3 to perform meta-analysis. Results A total of 27 studies involving 1708 people were includ-ed. Trail Marking A test(MD=3.59,P<0.01) and B test (MD=12.71,P=0.02),Stroop Color test((MD=-7.22,P<0.01),Stroop Color-Word test(MD=-7.25,P<0.01),Digit Symbol Coding test(MD=-7.29,P<0.01),Digit Span test(MD=-1.17,P<0.01),Hopkins Verbal Leaning test-Revised(MD=-4.58,P<0.01), Verbal Fluency test(MD=-2.92,P<0.01),Hanoi Tower(MD=-5.38,P<0.01),the number of corrected of WCST(MD=-3.10,P<0.01),number of completed categories of WCST (MD=-0.74,P<0.01),Persevera-tive Errors of WCST (MD=4.82,P<0.01) and Nonperseverative Errors of WCST (MD=8.00,P<0.01) scores between the first-degree relatives groups(FDR)and health control groups (HC)showed significant differences. Conclusion Cognitive impairment appears in the first-degree relatives populations of patients with schizophrenia,including the attention,verbal learning,working memory,and executive function.

Objective: To evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily and dasabuvir (DSV) 250 mg twice daily combined with ribavirin in adult patients of Mainland China with chronic HCV genotype 1b infection and compensated cirrhosis. Methods: An open-label, multicenter, phase 3 clinical trial study was conducted in mainland China, Taiwan, and South Korea. Adult patients with compensated cirrhosis (Metavir score =F4) who were newly diagnosed and treated for hepatitis C virus genotype 1b infection with ombitasvir/paritaprevir/ritonavir and dasabuvir combined with ribavirin for 12 weeks were included. Assessed SVR rate of patients obtained at 12 and 24 weeks after drug withdrawal. Efficacy and safety were evaluated in patients who received at least one time study drugs. Results: A total of 63 patients from mainland China were enrolled, 62 of whom (98.4%) had a baseline Child-Pugh score of 5 points. The overall rate of SVR12 and SVR24 in patients was 100% (95% CI: 94.3% to 100.0%). Most of the adverse events that occurred were mild. The incidence of common (≥10%) adverse events and laboratory abnormalities included elevated total bilirubin (36.5%), weakness (19.0%), elevated unconjugated bilirubin (19.0%) and conjugated bilirubin (17.5%), and anemia (14.3%). Three cases (4.8%) of patients experienced Grade ≥ 3 adverse events that were considered by the investigators to be unrelated to the study drug. None patients had adverse events leading to premature drug withdrawal. Conclusion Mainland Chinese patients with chronic HCV genotype 1b infection and compensated cirrhosis who were treated with OBV/PTV/r plus DSV combined with RBV for 12 weeks achieved 100 % SVR at 12 and 24 weeks after drug withdrawal. Tolerability and safety were good, and majority of adverse events were mild.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.