This article aims to summarize the clinical experiences of Professor Zhou Peng in treating post-thoracotomy pain syndrome(PTPS)by application of integrated acupuncture and moxibustion based on spirit-regulating and essence-consolidating therapy.In the view of Professor Zhou Peng,PTPS is prone to disturb the heart and spirit due to recurrent attacks,thus over consumption of the"spirit of the body";and various factors during and after the operation damage the"essence of the body",so the treatment is based on the principle of spirit-regulating and essence-consolidating,the disease can be treated from the perspective of heart,liver,spleen,and kidneys.Clinical use of multi-dimensional integration of acupuncture and moxibustion mode of external treatment,with local encircled acupuncture,plum-blossom needling to relieve the patient's urgent needs,and then use the spirit-regulating and essence-consolidating therapy,refined moxibustion,embedding needling for comprehensive treatment,treating symptom and root cause simultaneously,so as to exert certain therapeutic effect.

Objective:To develop a post competence assessment scale for nurses in the health management (physical examination) center and assess its reliability and validity.Methods:This study adopted an empirical approach. A total of 801 nurses from the health management (physical examination) center were recruited to participate in this study. A research team was formed in August 2024. This team transformed the previously constructed core competence evaluation index system for health management specialist nurses in the health management (physical examination) center (comprising 6 first-level indicators and 70 third-level indicators) into a preliminary post competence assessment scale. Seven experts evaluated the content validity of the scale. In September 2024, a pilot survey was conducted among 27 nurses from the health management (physical examination) center of Sichuan Provincial People′s Hospital using convenience sampling. From October to November 2024, the first main survey was administered to 385 nurses of health management (physical examination) center across 54 cities in China using both convenience sampling and snowball sampling methods, followed by exploratory factor analysis (EFA). Subsequently, utilizing the refined scale obtained after eliminating certain items, a second main survey was conducted among 389 nurses in the health management (physical examination) center, followed by a confirmatory factor analysis (CFA). The reliability of the final scale was assessed using Cronbach′s α coefficient, split-half reliability, composite reliability, and test-retest reliability.Results:The finalized scale for nurses′ post competency in health management (physical examination) center comprises five dimensions—basic nursing service competency, health management practice competency, knowledge integration competency, professional development competency, and professional attitude—with a total of 57 items. The item level content validity index (I-CVI) of the items of the content validity display scale ranged from 0.857 to 1.000, and the content validity index of each dimension ranged from 0.984 to 1.000. The scale-level Content Validity index/average (S-CVI/Ave) was 0.995. The contribution rate of the 6 factors extracted by EFA was 74.07%. After group discussion and CFA, the scale of the 5-factor structural equation model was constructed. The total Cronbach′s α coefficient of the scale was 0.986, the split-half reliability was 0.865, the composite reliability was 0.960-0.980, the total table test-retest reliability was 0.762, and the test-retest reliability of each dimension was 0.681-0.731.Conclusion:The developed assessment scale for assessing the post competence of nurses in the health management (physical examination) center demonstrates excellent reliability and validity.

Objective:To investigate the clinical characteristics and prognosis of T-lymphoblastic lymphoma (T-LBL).Methods:A retrospective case series study was conducted. Clinical data of patients diagnosed with T-LBL at the Affiliated Hospital of Jining Medical University from January 2013 to March 2023 were retrospectively analyzed, and their clinical characteristics and prognosis were statistically analyzed.Results:A total of 22 T-LBL patients were included. Among them, there were 19 males (86.4%) and 3 females (13.6%), and the median age at onset was 19.5 (15, 28) years old. Based on Ann Arbor staging, 3 cases (13.6%) were classified as stage Ⅰ-Ⅱ, while 19 cases (86.4%) were stage Ⅲ-Ⅳ; 10 cases (45.5%) presented with B symptoms, 12 cases (54.5%) without B symptoms; 16 cases (72.7%) showed elevated lactic dehydrogenase (LDH) level. At onset, 7 patients (31.8%) had mediastinal masses, 3 patients (13.6%) had central nervous system involvement, and 17 patients (77.3%) had bone marrow involvement. The overall response rate (ORR) and complete remission rate among the 22 patients were 81.82% (18/22) and 31.82% (7/22), respectively. The ORR was 84.21% (16/19) in 19 patients treated with ALL-like regimens. Among 3 patients treated with NHL-like regimens, 1 case achieved complete remission and 1 case achieved partial remission. Seven patients received allogeneic hematopoietic stem cell transplantation, with a median overall survival (OS) time of 22 months; the median OS time of patients without allogeneic hematopoietic stem cell transplantation was 14 months. The 3-year OS rates in the allogeneic hematopoietic stem cell transplantation group and group without allogeneic hematopoietic stem cell transplantation were 64.30% and 16.00%, and the difference in OS between the two groups was statistically significant ( P = 0.043). Two patients with disease progression prior to transplantation died of multidrug-resistant bacterial infections after transplantation. Conclusions:T-LBL is rare, and it is a highly aggressive tumor that predominantly occurs in adolescent males. Allogeneic hematopoietic stem cell transplantation can prolong OS, reduce relapse and improve the prognosis of patients.

Objective To explore the efficacy of eye-movement tracking training in improving attention disorders in children with traumatic brain injury.Methods A total of 96 children with traumatic brain injury admitted to the hospital from March 2022 to March 2024 were selected and randomly divided into an observa-tion group and a control group using a random number table method,with 48 cases in each group.The control group received conventional treatment including intracranial pressure reduction,cerebral edema alleviation,and infection prevention,while the observation group received additional eye-movement tracking training.Atten-tion function scores,Digit Span Test scores,Digit Symbol Substitution Test scores,Digit Cancellation Test scores,and satisfaction were compared between the two groups before and after the intervention.Results Af-ter the intervention,the scores of the Mini-Mental State Examination(MMSE)and the Montreal Cognitive Assessment(MoCA)in both groups were higher than those before the intervention,moreover,MMSE score(23.54±4.42 vs.19.78±5.23)and MoCA score(3.95±1.06 vs.3.14±0.89)of the observation group were higher than those of the control group(P<0.05).After the intervention,Trail Making Test(TMT)-A scores and TMT-B scores of the two groups were lower than those before the intervention,moreover,TMT-A score(61.52±24.80 vs.75.78±26.23)and TMT-B score(120.24±37.81 vs.164.18±36.27)of the ob-servation group were lower than those of the control group(P<0.05).After the intervention,the scores of sequential recitation and reverse recitation in both groups were higher than those before the intervention,mo-reover,the scores of sequential recitation(7.04±1.85 vs.5.48±1.54)and reverse recitation(5.38±1.53 vs.3.96±1.48)in the observation group were higher than those in the control group(P<0.05).The satis-faction rate of the observation group(95.83%vs.77.08%)was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Eye tracking training is beneficial for im-proving attention levels and cognitive function in children with traumatic brain injury.

Objective To investigate the effects of meropenem and amikacin on gut microbiota diversity and composition in a neonatal rat model of necrotizing enterocolitis(NEC).Methods Neonatal SD rats(1～2 d,weighing 5～10 g,both sexes)were subjected to establish a NEC model through artificial formula feeding,hypoxic-cold stress,and lipopolysaccharide(LPS)gavage.The rats were randomly divided into normal control group(Group C,n=12),NEC group(Group N,n=20),meropenem intervention group(Group M,n=20),and amikacin intervention group(Group A,n=20).Following modeling,Group M and Group A received intraperitoneal injections of meropenem(125 mg/kg)or amikacin(468 mg/kg),twice daily for 3 consecutive days.Groups C and N were administered an equal volume of normal saline.At the end of the intervention,colonic contents or fecal samples were collected.The gut microbiota structure was analyzed using 16S rDNA high-throughput sequencing.Bioinformatics analysis was performed using the QIIME2 platform.Alpha diversity was evaluated using Chao1,Shannon,and Simpson indices.Beta diversity was assessed based on Bray-Curtis distance through principal coordinate analysis(PCoA)and non-metric multidimensional scaling(NMDS).Venn and UpSet plots were generated to visualize the composition and overlap of operational taxonomic units(OTUs).Linear discriminant analysis effect size(LEfSe)was applied to identify differentially abundant taxa across groups.Results High-throughput 16S rDNA sequencing showed that the N group had significantly lower 3 indices of α diversity than the C group(P<0.01),that is,a Chao1 index from 230 to 40,a Shannon index from 1.65 to 0.85,and a Simpson index from 0.65 to 0.42.After antibiotic intervention,both the M group and A group obtained obvious increases in the Chao1 index than the N group(P<0.001),with a greater increase observed in the M group than in the A group(P<0.05).However,neither antibiotic group exhibited notable improvements in the Shannon index or Simpson index compared with the N group(P>0.05).Venn and UpSet analyses revealed that the M group had the highest number of unique OTUs(283),while the A group shared the most OTUs(63)with the C group.PCoA and NMDS analyses indicated that the microbial structure of the A group was closer to that of the C group,with better clustering.Taxonomic composition and LEfSe analysis demonstrated that the N group was enriched with potentially pathogenic taxa such as Escherichia coli B2 and Klebsiella under the phylum Proteobacteria,while beneficial bacteria including Lactobacillaceae and Bifidobacteriaceae(phylum Firmicutes)were significantly reduced,indicating severe dysbiosis.In contrast,the A group exhibited a significant increase in beneficial bacteria and a structural tendency toward ecological recovery.The M group,however,was enriched with various conditionally pathogenic and environmentally associated genera,displaying a microbial configuration notably deviating from a healthy state.Conclusion Meropenem and amikacin exhibit differential regulatory effects on the intestinal microbiota in the context of NEC.Amikacin demonstrates superior efficacy in restoring microbial stability and levels of beneficial bacteria,whereas meropenem,although effective for early infection control,warrants caution due to its potential long-term impact on the gut microbiome.

Objective: To investigate the mediating role of children s sleep quality in the association between mother-child relationship and the executive function of preschool children, providing a reference for promoting the development of the executive function of preschool children. Methods: A stratified cluster sampling method was used to select 842 preschoolers from 12 kindergartens in Wuhu City, Anhui Province in December 2021 as the subjects of the first follow up study with follow up every six months thereafter. Finally, 746 children were included in the study after 3 follow up. Spearman correlation analysis was used to explore the associations among mother-child relationship, sleep quality and executive function in preschool children. Bootstrap program and PROCESS software were applied to test the mediating effect of sleep quality in the association between mother-child relationship and the executive function of preschool children. Results: Conflictual mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory, and organizational planning ( r=0.40, 0.37, 0.36, 0.41, 0.38 , 0.34, all P <0.05). Dependent mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory , and organizational planning ( r=0.23, 0.20, 0.21, 0.22 , 0.22, 0.19, all P <0.05). Sleep quality was positively correlated with the total executive function score ( r=0.27, P <0.01). After adjusting for confounding factors, sleep quality played a partial mediating role in the associations between dependent and conflictual mother-child relationships and executive function, the mediating effects were 19.40% and 11.22% respectively. Conclusions Sleep quality plays a mediating role in the association between mother-child relationship and the executive function of preschool children. Improving sleep quality in the early stage can promote the executive function of preschool children.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

Objective To investigate the effect of moxibustion on different phenotypic expression of macrophages in rheumatoid arthritis(RA).Methods Thirty rats were randomly divided into the blank group,the model group and the moxibustion group,with 10 rats in each group.Rats in the model group and the moxibustion group were injected with complete Freund's adjuvant(CFA)into right foot pad to prepare RA model.The moxibustion group received moxibustion treatment.The blank group was injected with the same amount of normal saline.The thickness of foot pad was measure and arthritis index score was performed.Pathological changes of joints were observed by hematoxylin eosin staining(HE),and the expressions of CD80,CD163 and SPP1 in macrophages of synovial tissue were detected by immunofluorescence.Results Compared with the blank group,arthritis index score and thickness of foot pad were increased in the model group and the moxibustion group(P＜0.05).After moxibustion treatment,compared with the model group,the score of arthritis index and thickness of foot pad were decreased in the moxibustion group(P＜0.05).HE staining showed joint space narrowing,subchondral bone destruction and inflammatory cell infiltration in the model group.The degree of joint space narrowing,subchondral bone destruction and inflammatory cell infiltration were less in the moxibustion group than those in the model group.Compared with the blank group,the scores of synovial tissue hyperplasia,synovial fibrous tissue hyperplasia and inflammatory cell infiltration increased in the model group.Compared with the model group,scores of synovial tissue hyperplasia,fibrous tissue hyperplasia and inflammatory cell infiltration decreased in the moxibustion group(P＜0.05).Results of immunofluorescence detection showed that compared with the blank group,the expressions of CD80 and SPP1 in synovial tissue were up-regulated in the model group,while the expression of CD163 was down-regulated.Compared with the model group,the expressions of CD80 and SPP1 were down-regulated,and the expression of CD163 was up-regulated in the moxibustion group(P＜0.05).Conclusion Moxibustion can regulate the expression of different phenotypes of macrophages and reduce synovial inflammation of RA.The mechanism may be related to regulating the expression of different phenotypes of macrophages.

Objective:To formulate the audit standards of Chinese patent medicine prescriptions, and provide reference for rational prescriptions of Chinese patent medicine.Methods:A three-level evidence system for prescription review of Chinese patent medicine was established according to the national regulatory documents, drug labels, relevant guidelines, and expert consensuses. The catalog of Chinese patent medicines in Army Medical Center of the People′s Liberation Army was integrated and classified, preliminary review criteria including indications, drug selection, usage and dosage, and combination drugs was established and submitted to clinical experts of traditional Chinese medicine for review and revision, and finally the prescription review standard was confirmed.Results:The Chinese patent medicine catalog of the Medical Center contained 218 drugs, which were divided into 23 kinds according to efficacy and 17 kinds according to dosage forms. The prescription review standards of Chinese patent medicine were as follows. (1) Indications: both traditional Chinese medicine and Western medicine diagnosis were required. (2) Drug selection: 37 kinds of Chinese patent medicines were marked as forbidden for pregnant women in the labels, and 16 kinds were not marked but contained forbidden ingredients; 4 kinds were marked with caution for patients with liver dysfunction, and 24 kinds were not marked but contained ingredients with caution; 2 kinds of Chinese patent medicines were marked with caution for patients with renal insufficiency, and 9 kinds were not marked but contained ingredients with caution. (3) Usage and dosage: the usage and dosage rules of Chinese patent medicines for children, the elderly and patients with liver and kidney dysfunction were formulated. (4) Combined medication: 5 and 21 kinds of Chinese patent medicines were marked as "highly toxic" and "toxic" in the labels, respectively, 11 kinds of Chinese patent medicines contained incompatible ingredients of "Shibafan" (eighteen antagonisms) and "Shijiuwei (nineteen incompatibilities), and a new review scale for repeated use of Chinese patent medicine was developed.Conclusions:Based on the existing evidence-based medicine, the evidence system of prescription review of Chinese patent medicine is established, the prescription review standards of Chinese patent medicine prescription based on the pharmaceutical interaction mode is formulated and constructed.