Objective: To observe the clinical efficacy of row needling at the Governor Vessel on the head for poststroke insomnia, analyze the changes of sleep structure, serum amino acid neurotransmitters, vascular endothelial cell function and cognitive function, in order to explore the mechanism of this therapy.Methods: A total of 41 patients with poststroke insomnia were included in an observation group and treated with row needing at the Governor Vessel on the head; 33 patients with poststroke insomnia were included in a control group and given routine acupuncture treatment. The patients in both groups were treated consecutively for one month. The efficacy was observed and the changes of related indicators were compared. Results: After treatment, the efficacy of the observation group was better than that of the control group (P<0.05). The sleep latency in the observation group was shorter than that in the control group (P<0.05); the total sleep duration, deep sleep duration, light sleep duration and rapid eye movement sleep duration in the observation group were significantly longer than those in the control group (P<0.05); the total waking duration and the waking times over 5 min were significantly less than those in the control group (P<0.05). The serum glutamic acid, γ-aminobutyric acid, calcitonin gene-related peptide, brain-derived neurotrophic factor, nerve growth factor and nitric oxide levels were significantly higher than those in the control group (P<0.01). The tumor necrosis factor-α, interleukin-6, bradykinin, and endothelin-1 levels were lower than those in the control group (P<0.01). The Pittsburgh sleep quality index score in the observation group was lower than that in the control group (P<0.01), and the mini-mental state examination score was higher than that in the control group (P<0.05). Conclusion: Row needling at the Governor Vessel on the head can effectively improve the sleep structure, cognitive function, and sleep quality of patients with poststroke insomnia. The possible mechanisms are regulating serum amino acid neurotransmitters and improving the function of vascular endothelial cells.

Objective:To observe the efficacy of traditional Qigong exercise combined with Tuina(Chinese therapeutic massage)manipulations in treating lower cervical disc herniation(CDH).Methods:A total of 120 CDH patients who met the inclusion criteria were randomly divided into an observation group and a control group,with 60 cases in each group.Patients in both groups were given the same Tuina manipulations.In addition,patients in the observation group practiced traditional Qigong exercise,and those in the control group did conventional neck exercise.After 8 weeks of treatment,the efficacy of the two groups was observed.Follow-up was conducted 3 months after the end of the treatment to record any recurrence.Results:The total effective rate of the observation group was higher than that of the control group(P＜0.05).The improvement in symptom scores was more significant in the observation group than in the control group(P＜0.05).There was inter-group statistical significance in comparing the cross-sectional area and fatty infiltration of certain cervical muscles(P＜0.05).In addition,the recurrence rate in the observation group was lower than that in the control group(P＜0.05).Conclusion:On the basis of the same Tuina manipulation treatment,the efficacy of traditional Qigong exercise in treating CDH is superior to that of conventional neck exercise,with more significant improvements in pain and quality of life and a lower recurrence rate.

Objective: To observe the clinical efficacy of pushing Qiaogong point with varying intensities for treating stage Ⅰ essential hypertension. Methods: A total of 72 patients diagnosed with stageⅠ essential hypertension were enrolled in this study. They were divided into three groups using the random number table method, including a control group, a gentle pushing group, and a heavy pushing group, with 24 patients in each group. All three groups received the same therapeutic lifestyle interventions. The control group received no additional interventions, the gentle pushing group received additional pushing Qiaogong point with gentle strength, and the heavy pushing group received additional pushing Qiaogong point with heavy strength. The treatment duration was 4 weeks, followed by a 4-week follow-up period, during which blood pressure changes were observed and analyzed in all three groups. Results: After treatment, the blood pressure levels in all three groups showed a significant decrease (P<0.05). The effective rate in the control group was 43.5％, in the gentle pushing group was 78.3％, and in the heavy pushing group was 33.3％. The reduction in blood pressure levels in the gentle pushing group was significantly superior to that in both the control group and the heavy pushing group, indicating inter-group statistical significance (P<0.01). The efficacy of the heavy pushing group was comparable to that of the control group, indicating no statistical significance (P>0.05). During the follow-up period, compared with the end of the treatment within the same group, the blood pressure levels remained stable in both the control group and the gentle pushing group, indicating no intra-group statistical significance (P>0.05). The heavy pushing group showed a significant decrease in diastolic blood pressure (DBP) and mean blood pressure (MBP) compared with the end of the treatment, indicating intra-group statistical significance (P<0.05). During the follow-up, the gentle pushing group had lower systolic blood pressure (SBP) and MBP compared with both the heavy pushing group and the control group, indicating inter-group statistical significance (P<0.01), while there was no inter-group statistical significance in comparing the DBP (P>0.05). There was no statistical significance in comparing the SBP, DBP, and MBP between the heavy pushing group and the control group (P>0.05). Conclusion: Pushing Qiaogong point with gentle strength combined with lifestyle interventions showed a higher effective rate and long-term blood pressure stability in the treatment of stage Ⅰ essential hypertension. Pushing Qiaogong point with varying intensities showed varying effects on patients with stage Ⅰ essential hypertension.

Objective:To investigate the differences in personality characteristics and cognitive functions in depression patients with and without obsessive-compulsive.Methods:From October 2020 to October 2021, 31 patients diagnosed as major depressive disorder(MDD) with obsessive-compulsive symptoms(OCS), totally 29 patients diagnosed as MDD without OCS, and 30 healthy controls(HC group) were recruited.The personality characteristics of all subjects were assessed with Eysenck personality questionnaire(EPQ), personality diagnostic questionnaire-4(PDQ-4) and Minnesota multiphasic personality inventory(MMPI), while cognitive functions were assessed with measurement and treatment research to improve cognition in schizophrenia(MATRICS)consensus cognitive battery(MCCB). SPSS 25.0 software was used for data processing, and univariate analysis of variance and simple effect analysis were used to compare the differences in personality characteristics and cognitive functions among the three groups of subjects.Results:The comparison of EPQ scores showed that the psychoticism scores of the group with and without OCS((50.32±10.08), (49.83±11.69)) were significantly lower than that of the HC group(59.47±10.41)( P=0.004, 0.003), while the neuroticism scores((61.94±12.36), (63.10±10.56)) were significantly higher than that of the HC group(46.13±8.33)(both P<0.05). The comparison of PDQ-4 scores showed that the schizoid score of the group with OCS(5.00(2.00, 7.00)) was significantly higher than that of the group without OCS(3.00(1.00, 5.00))( P=0.024). The comparison of MMPI scores showed that except for the two dimensions of masculinity-femininity and hypomania, the scores of the other eight dimensions in the group with and without OCS were significantly higher than those in the HC group(all P<0.01). The comparison of MCCB scores showed that the attention/alertness and visual learning scores of the group with OCS were significantly lower than those of the HC group( P=0.042, 0.004), meanwhile there was no difference of the all dimension scores of MCCB between the MDD patients with and without OCS. Conclusion:There are differences in personality and cognitive function between MDD patients with and without OCS and healthy controls.There is no difference in score of schizotypal personality traits between MDD patients with OCS and MDD patients without OCS, however the related cognitive function of MDD patients without OCS is not significantly different from that of MDD patients with OCS.It is suggested that MDD patients with OCS may have more deviated personality characteristics than those without OCS.Further research is needed to investigated the differences in cognitive impairment.

Objective:To compare the efficacy and safety of standard treatment with or without adjuvant chemotherapy in patients with highly malignant non-metastatic prostate cancer.Methods:In this prospective non-randomized controlled study, consecutive non-metastatic prostate cancer patients with pathologically proven Gleason score of 9-10 or Gleason score of 5 admitted to Peking University First Hospital were enrolled. Four to six cycles of chemotherapy using docetaxel ± carboplatin regimen were added or not after standard radical therapy. The primary end point was 5-year event-free survival (EFS), and the secondary end points were distant metastasis-free survival (MFS), overall survival (OS), and treatment-related adverse events. The survival curve was drawn by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test.Results:A total of 176 patients were consecutively enrolled from November 2019 to January 2022 of which 138 patients received only standard radical therapy (control group), and 38 patients received adjuvant chemotherapy after standard radical therapy (chemotherapy group). The median follow-up time was 13.4 (2.0-34.0) months. All patients survived. The 30-month EFS rates in the chemotherapy and control groups were 100% and 85.6%, respectively ( P=0.064). There were no events in the chemotherapy group, while there were 12 cases of events in the control group, including 6 cases of biochemical recurrence and 6 cases of imaging progression. The 30-month MFS rates in two groups were 100% and 91.9%, respectively ( P=0.205). After the 1 vs. 2 propensity score matching, the EFS and MFS rates in two groups were 100% vs. 85.7% ( P=0.056), and 100% vs. 92.2% ( P=0.209), respectively. The incidence rates of grade 2 and above urinary toxicity in the chemotherapy and control groups were 2.6% and 7.2% ( P=0.354), respectively. The incidence rates of grade 2 and above rectal toxicity were 5.3% and 5.1% ( P=0.711), respectively. Grade 3 and above chemotherapy-related toxicity in the chemotherapy group were leukopenia (31.6%), thrombocytopenia (2.6%) and alopecia (13.2%). Conclusion:The addition of adjuvant chemotherapy after standard radical therapy tends to improve the overall EFS of patients with highly malignant prostate cancer, and the adverse effects are tolerable, which should be confirmed by long-term follow-up results.

Objective An HPLC-MS/MS method was established for the simultaneous determination of 7 components in Qingkailing Oral Liquid.Methods The assay was performed on a Waters ACQUITY UPLC BEH C18 column(2.1 mm×10 mm,1.7 μm)and the sample was eluted with a gradient mobile phase containing 10 mmol·L-1 of ammonium acetate and 0.1%of formic acid in water(A)-methanol(B).The mass spectrometry was carried out by electrospray ionization(ESI)with positive/negative ions in multiple reaction monitoring(MRM)mode for quantitative analysis.Results The linear ranges of adenine,chlorogenic acid,caffeic acid,geniposide,baicalin,hyodeoxycholic acid and cholic acid were 0.100 4-3.213,0.784 5-8.982,0.998-3.194,0.622 5-19.92,25.05-300.6,2.513-30.15 and 7.775-93.30 μg·mL-1(r≥0.999 0).The average recoveries(n=6)were 100.9%,98.74%,101.2%,100.2%,100.8%,99.97%and 98.94%with RSD of 1.58%,0.59%,1.78%,1.25%,0.65%,1.69%and 1.07%.The contents of the above mentioned 7 components in 15 tested samples were in the ranges of 0.12-0.18,0.19-0.24,0.06-0.09,0.34-0.37,4.54-4.85,0.49-0.67 and 1.82-2.19 mg·mL-1.The contents of 7 components in tested sample from different manufacturers were closed.Conclusion The method has shown good sensitivity,accuracy,and repeatability.The study can provide reference and data support for the quality control and subsequent research of Qingkailing Oral Liquid.

Objective To understand the epidemiologic characteristics and pathogen spectrum of hand,foot and mouth disease (HFMD) in Hunan Province during 2008-2017 and provide the basis for the prevention and control strategy of hand,foot and mouth disease.Methods Collecting data from national disease reporting information system throughout 2008-2017,the descriptive epidemiological method were used to analyze the data of HFMD monitoring and the result of pathogenic agent detection.Results A total of 1,255,530 HFMD cases were reported throughout 2008-2017,including 10097 severe cases and 394 deaths.The average annual attack rate is 190.38/100,000.The peak incidence of HFMD occurred in summer and fall.The reported incidence is on the rise.The number of critically ill and the number of deaths is declining.Proportion of male cases was higher than that of females.The majority of the children were those under 5 years of age.Enterovirus (EV)-A71,coxsackievirus (CV)-A16 and other other EV positive cases accounted for 33.29％,20.04％ and 46.67％ of laboratory diagnosed cases.Conclusions The epidemic of hand,foot and mouth disease in Hunan has obvious seasonal and population characteristics.There are different dominant pathogens causing HFMD in different years.

Objectives:To investigate the risk factors of early postoperative complications in patients with a-cute subaxial cervical spinal cord injury after anterior bone grafting and fusion surgery.Methods:The clinical data of 168 cases of traumatic cervical spinal cord injury who underwent anterior surgery in our hospital from January 2017 to November 2021 were retrospectively analyzed.There were 133 males and 35 females.The age ranged from 23 to 82 years,with an average age of 53.8±11.2 years.There were 33 patients with preop-erative comorbidities(19.6％).ASIA classification of preoperative neurological impairment was as follows:34 patients of grade A,10 patients of grade B,62 patients of grade C,and 62 patients of grade D.50 patients were treated with high-dose methylprednisolone(29.8％).135 cases(80.4％)were treated with anterior cervical discectomy and fusion(ACDF),and 33 cases(19.6％)were treated with anterior cervical corpectomy and fusion(ACCF).Early postoperative complications and death of patients during hospitalization period were collected.Univariate logistic regression analysis was used to evaluate possible relationships between early postoperative complications and the factors including sex,age,preoperative comorbidities,cause of injury,neurological level of injury,preoperative ASIA grade,whether there was brain,thoracic and abdominal injury,whether high-dose methylprednisolone treatment was used,time from injury to surgery,preoperative hemoglobin(HGB),preopera-tive albumin(ALB),extent of surgery,surgical method,operative time,and intraoperative blood loss.A multi-variate logistic analysis was performed on the variables with P＜0.2 in the univariate analysis to identify signif-icant independent risk factors.Results:The incidence of early postoperative complications was 29.1％(49/168).Univariate logistic regression analysis showed that the cause of injury(P=0.032),preoperative ASIA grade(P＜0.001),whether combined with brain,thoracic and abdominal injury(P=0.043),whether high-dose methylpred-nisolone treatment was used(P=0.017),preoperative HGB(P=0.002),preoperative ALB(P=0.001)and surgical method(P=0.002)were correlated with early postoperative complications.Multivariate logistic regression analysis showed that preoperative ASIA grades A and B(P＜0.001,OR=5.389,95％CI 2.243-12.950)and high-dose methylprednisolone treatment(P=0.044,OR=2.541,95％CI 1.024-6.303)were independent risk factors for early postoperative complications.Conclusions:Preoperative ASIA grades A and B and high-dose methylpred-nisolone treatment are the independent risk factors for early postoperative complications in patients with acute subaxial cervical spinal cord injury.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective: To understand the epidemiologic characteristics and pathogen spectrum of hand, foot and mouth disease (HFMD) in Hunan Province during 2008—2017 and provide the basis for the prevention and control strategy of hand, foot and mouth disease. Methods: Collecting data from national disease reporting information system throughout 2008—2017, the descriptive epidemiological method were used to analyze the data of HFMD monitoring and the result of pathogenic agent detection. Results: A total of 1, 255, 530 HFMD cases were reported throughout 2008—2017, including 10097 severe cases and 394 deaths. The average annual attack rate is 190.38/100, 000. The peak incidence of HFMD occurred in summer and fall. The reported incidence is on the rise. The number of critically ill and the number of deaths is declining. Proportion of male cases was higher than that of females. The majority of the children were those under 5 years of age. Enterovirus (EV)-A71, coxsackievirus (CV)-A16 and other other EV positive cases accounted for 33.29%, 20.04% and 46.67% of laboratory diagnosed cases. Conclusions The epidemic of hand, foot and mouth disease in Hunan has obvious seasonal and population characteristics. There are different dominant pathogens causing HFMD in different years.