This case report introduces Professor ZOU Wei 's experience of treating a patient with Wernicke encephalopathy using the "regulating spirit and promoting yang acupuncture method". The patient was diagnosed as spleen and stomach deficiency with internal liver wind. The treatment principle focused on regulating spirit and awakening the brain, strengthening the spleen, calming wind, and relaxing the tendons. Three groups of acupoints were selected: ①acupoints for awakening the brain by regulating spirit and unblocking meridians (Baihui [GV20], Qianshencong [EX-HN1] and bilateral Taiyang [EX-HN5], Fengchi [GB20]), etc.; ②acupoints for harmonizing the spleen, stomach, qi, and blood (bilateral Tianshu [ST25], Daheng [SP15], Taixi [KI3], etc.); ③acupoints for relaxing and softening the tendons (bilateral Waiguan [TE5], Hegu [LI4], Yanglingquan [GB34], Xuanzhong [GB39]).The needles were retained for 50 min per session, once daily, 7 days a week. After 16-week treatment, the patient was able to walk a few steps slowly with assistance, and other symptoms returned to normal. A two-month follow-up showed the patient's condition remained stable, walking distance further increased, and overall health significantly improved.
Humans ; Acupuncture Points ; Acupuncture Therapy ; Wernicke Encephalopathy/physiopathology*

Mitochondrial DNA (mtDNA) acts as a damage-associated molecular pattern to activate the stimulator of interferon genes (STING) signaling in macrophages, promoting tissue inflammation. However, its role in acute myocardial infarction (AMI) remains unclear. Macrophage-specific Sting1 knockout mice were used to validate STING's pathological role in AMI. Cardiac and liver mtDNA were used to activate macrophages in co-culture systems with cardiomyocytes to assess fibrosis and hypertrophy. Panaxatriol saponin (PTS) was tested for its ability to block mtDNA-driven macrophage activation and subsequent cardiomyocyte damage. STING-PTS binding ability was analyzed. AMI rats received PTS to evaluate its effects on myocardial inflammation and ventricular remodeling. In vivo, macrophage-specific Sting1 knockout reduced myocardial inflammation and injury after AMI. In vitro, mtDNA-activated macrophages induced cardiomyocyte fibrosis and hypertrophy through STING signaling. PTS suppressed mtDNA-driven macrophage activation by directly binding STING, thereby blocking inflammatory cascades. In AMI rats, PTS treatment attenuated acute inflammation and reversed ventricular remodeling. These findings establish the mtDNA-STING axis in macrophages as a critical driver of post-AMI inflammation and identify pharmacological STING inhibition with PTS as a promising therapeutic strategy. The study bridges genetic validation with translational applications, highlighting macrophage STING as a novel target for ischemic heart disease management.

As essential part of teachers' teaching practice, the design and arrangement of assignments is the main carrier of interaction between teachers and students, and is also an important learning way for students. According to the discipline characteristics and teaching modes of histology and embryology courses, we have developed a systematic assignment design model that covers theory, practice, and application with four types of assignments—pre-class assignments, exploratory assignments, practical assignments, and innovative assignments distributed before class, in class, after class, and throughout the teaching process. Behind this assignment design strategy is the concept of learner-centered teaching, which aims to help students learn professional knowledge and develop comprehensive literacy.

Based on the theory of "mutual interference of clear and turbid Qi" in Huangdi Neijing（《黄帝内经》）， this study explored the pathogenesis of spleen and stomach diseases and the therapeutic effects of Banxia Xiexintang on them. It suggested that "mutual interference of clear and turbid Qi" represents a pathological state of Yin and Yang disturbance and imbalance in Qi circulation due to the mixture of clear and turbid Qi， which can elucidate the pathogenesis of spleen and stomach diseases. According to this theory， the pathogenesis of spleen and stomach diseases was summarized as Qi disorder in spleen and stomach， disharmony between Ying Qi and Wei Qi， and conflict between cold and heat. Banxia Xiexintang， as a crucial prescription for treating spleen and stomach diseases， achieves its therapeutic effects by dispersing stagnation with pungent flavor， descending adverse Qi with bitterness， regulating Ying Qi and Wei Qi， and harmonizing cold and heat. By regulating Qi circulation， balancing internal and external factors， and addressing deficiency and excess， it can rectify the pathological state of "mutual interference of clear and turbid Qi" of spleen and stomach diseases. Modern research reveals that Banxia Xiexintang can modulate gastrointestinal motility， restore mucosal immune barrier function of the digestive system， and exhibit optimal therapeutic effects when combined with both cold-cool and warm-hot medicines， aligning with its therapeutic role under the theory of "mutual interference of clear and turbid Qi". By delving into the essence of the "mutual interference of clear and turbid Qi" theory and exploring the pathogenesis of spleen and stomach diseases and the therapeutic effects of Banxia Xiexintang based on this theory， this study further elucidated the inherent connection between spleen and stomach diseases and the "mutual interference of clear and turbid Qi" theory， offering insights and theoretical references for the clinical diagnosis and treatment of spleen and stomach diseases.

This paper summarizes the exploration process and academic significance of the academic thought of Zhou Zhongying,a master of traditional Chinese medicine,who took the creation of a new system of TCM pathogenesis theory as the core,and interprets its theoretical connotation.As a pioneer in the construction of higher education textbooks for traditional Chinese medicine,Professor Zhou Zhongying created the outline of TCM internal medicine viscera differentiation,persisted in carrying out innovative research on patho-genesis theory,achieved fruitful academic results,and enriched and developed the academic system of TCM theory.In the clinical di-agnosis and treatment of exogenous febrile diseases and acute and difficult internal injuries,he systematically created new pathogenesis theories such as stasis-heat theory and cancer toxicity theory.Based on this,the legislation of medication can improve the clinical effi-cacy,and it is realized that identifying the pathogenesis is the key link in syndrome differentiation and treatment.In his later years,Professor Zhou Zhongying,guided by the holistic view,proposed the"thirteen pathogenesis"and constructed a new system of TCM pathogenesis differentiation,highlighting the guiding value of complex pathogenesis and the causal chain of pathogenesis elements to complex clinical diseases and syndromes,forming a theory with the idea of"examining syndromes and seeking pathogenesis,activating syndrome differentiation"as its soul.This theory breaks through the rigid thinking of syndrome differentiation and treatment based on a single pathogenesis or fixed syndrome type,reconstructs the theoretical framework of TCM with the idea of holistic view,and is a major academic innovation in modern TCM.

Objective:To fabricate the composite scaffolds for bone regeneration with silk fibroin (SF), bacterial cellulose nanofibers (BCNR) and hydroxyapatite (HAp) and evaluate their osteogenic activity.Methods:HAp particles, BCNR and bone morphogenetic protein-2 (BMP2) were added into SF aqueous solution in turn, poured into molds of different sizes after being mixed evenly and processed at -25 ℃ for 24 hours to obtain frozen molds, and the composite scaffolds were frozen-dried by freezing-drying machine. The composite scaffolds with different mass ratios of SF and BCNR were divided into groups A (2∶1), B (4∶1) and C (6∶1), and the inactive composite scaffolds without BMP2 fell into group D. The surface morphology and pore structure of the scaffolds were detected by scanning electron microscopy. The porosity of the scaffolds was measured by mercury intrusion porosimeter. The stress-strain curve was obtained by using the universal material testing machine to compress the scaffolds, with which their compressive strength and Young′s modulus were analyzed. Immortalized mouse embryonic fibroblasts (iMEF) were inoculated on the composite scaffolds of group A, B, C and D. At 4 and 8 days after cell inoculation, the proportion of alive and dead cells in each group was detected by cell survival/death staining; the cell counting kit-8 (CCK-8) was used to detect cell proliferation activity in each group; the positive staining cells were detected in each group by alkaline phosphatase (ALP) staining; the ALP activity was observed in each group with ALP activity detection. A total of 15 female SD rats were selected to establish osteogenesis models with ectopic muscle bag. The composite scaffolds implanted with different SF/BCNR mass ratios and the inactive composite scaffolds without BMP2 fell into group A′ (2∶1), B′ (4∶1), C′ (6∶1) and D′ respectively, and a sham operation group was set at the same time, with 3 rats in each groups. In the sham operation group, the muscle bag and skin were sutured without scaffold implantation after the incision of skin, the blunt separation of the quadriceps muscle, and the formation of muscle bag in the muscle. In the other four groups, the corresponding scaffolds were implanted in the muscle bag and the muscle bag and skin were sutured. X-ray examination was performed at 2 and 4 weeks after operation to observe the osteogenesis in each group. At 4 weeks after operation, the implanted scaffolds and tissue complexes were collected by pathological tissue sectioning, HE staining and Masson staining, and for observing the osteogenesis by in each group. Immunohistochemical staining was also performed on the tissue sections to observe the expression of osteogenic markers type I collagen (COL1) and osteopontin (OPN) in each group.Results:Scanning electron microscopy showed that the lamellar and micropore structures of group B were more regular and uniform than those of groups A and C. The porosity rate analysis showed that the porosity rates of groups B and C were (89.752±1.866)% and (84.257±1.013)% respectively, higher than that of group A [(81.171±1.268)%] ( P<0.05 or 0.01), with the porosity rate of group C lower than that of group B ( P<0.01). The mechanical property test showed that the compressive strengths of groups B and C were (0.373±0.009)MPa and (0.403±0.017)MPa respectively, higher than that of group A [(0.044±0.003)MPa] ( P<0.01), and the Young′s moduli of groups B and C were (7.413±0.094)MPa and (9.515±0.615)MPa respectively, higher than that of group A [(1.881±0.036)MPa] ( P<0.01), with the compressive strength and Young′s modulus of group C higher than those of group B ( P<0.05 or 0.01). The cell survival/death staining showed that the number of dead cells of group B was significantly smaller than that of groups A, C and D at 4 days after cell inoculation, and that group B had the most living cells and the fewest dead cells at 8 days after cell inoculation. The results of CCK-8 experiment showed that at 4 days after cell inoculation, the cell proliferation activity of groups A and B was 0.474±0.009 and 0.545±0.018 respectively, higher than 0.394±0.016 of group D ( P<0.01); the cell proliferation activity of group C was 0.419±0.005, with no significant difference from that of group D ( P>0.05), while the cell proliferation activity of groups A and C were both lower than that of group B ( P<0.01). At 8 days after cell inoculation, the cell proliferation activity of group B was 1.290±0.021, higher than 1.047±0.011 of group D ( P<0.01); the cell proliferation activity of group C was 0.794±0.032, lower than that of group D ( P<0.01); the cell proliferation activity of group A was 1.086±0.020, with no significant difference from that of group D ( P>0.05); the cell proliferation activity of groups A and C was lower than that of group B ( P<0.01). At 4 and 8 days after cell inoculation, ALP staining showed that more positive cells were found in groups A, B and C when compared with group D, and more positive cells were found in group B than in groups A and C. At 4 days after cell inoculation, the ALP activity detection showed that the ALP activity of groups A, B and C was 1.399±0.071, 1.934±0.011 and 1.565±0.034 respectively, higher than 0.082±0.003 of group D ( P<0.01), while the ALP activity of groups A and C was lower than that of group B ( P<0.01). At 8 days after cell inoculation, the cell activity of groups A, B and C was 2.602±0.055, 3.216±0.092 and 2.145±0.170 respectively, higher than 0.101±0.001 of group D ( P<0.01), while the ALP activity of groups A and C was lower than that of group B ( P<0.01). X-ray examination results showed that at 2 weeks after operation, no obvious osteogenesis was observed in the sham operation group, group D′, A′ and C′, while it was observed in group B′. At 4 weeks after operation, obvious osteogenesis was observed in group A′, B′ and C′, with significantly more osteogenesis in group B′ than in the other two groups, while there was no obvious osteogenesis in the sham operation group and group D′. At 4 weeks after operation, the HE staining and Masson staining showed that a large number of uniformly distributed new bone tissue was formed in group B′, while only a small amount of new bone tissue was found locally in groups A′ and C′, and only part of new tissue was found to grow in group D′ with no obvious new bone tissue observed. The maturity of new bone tissue formed in group B′ was higher than that in group A′ and C′. Immunohistochemical staining showed more COL1 and OPN positive staining in group B′ when compared with groups A′ and C′. The expression intensity analysis of COL1 and OPN showed that in groups A′, B′ and C′, the expression intensity of COL1 was 2.822±0.384, 22.810±2.435 and 12.480±0.912 respectively and the expression intensity of OPN was 1.545±0.081, 5.374±0.121 and 2.246±0.116 respectively, with higher expression intensity of COL1 and OPN in groups B′ and C′ than that in group A′ ( P<0.01) and lower expression intensity of COL1 and OPN in group C′ than that in B′ group ( P<0.01). Conclusions:The composite scaffold for bone regeneration is successfully fabricated with SF, BCNR and HAp. The composite scaffold with a mass ratio of SF to BCNR of 4∶1 has uniform pore structure, high porosity, good mechanical properties and biocompatibility, excellent pro-osteogenic properties in vitro, as well as excellent osteo-inductivity and osteo-conductivity.

BackgroundPsychological problems such as depression and anxiety are common in pregnant women， and many studies have found that body image disturbance is closely related to depression and anxiety symptoms. Still， there is large variability in previous findings. ObjectiveTo review the researches on the relation of body image disturbance to depression and anxiety in pregnant women， and to provide a reference for interventions targeting maternal body image disturbance and depression and anxiety symptoms. MethodsOn January 10， 2023， well qualified literature focusing on the relationship between body image disturbance and depression and anxiety symptoms in pregnant women were searched in PubMed， Embase， CINAHL， Web of Science， China National Knowledge Infrastructure （CNKI）， VIP databases， Wanfang Data Database and China Biology Medicine disc （CBMdisc） from inception to January 1， 2023. The research content， factors influencing body image disturbance and relevant findings were extracted and summarized for analysis. ResultsA total of 14 articles were included in this review. The body image disturbance in pregnant women was manifested predominantly by an excessive concern about body weight and shape， and was affected by demographic characteristics， sociocultural factors， obstetric factors and other factors. Furthermore， body image disturbance significantly predicted the occurrence of depression， and proved a close relationship with anxiety symptoms. ConclusionBody image disturbance seriously affects the physical functioning and psychological status of pregnant women and may further exacerbate the symptoms of depression and anxiety.

This article gives a review on domestic and foreign researches on the non-drug intervention for patients with perimenopausal depression published from 2012 to 2022， so as to provide a reference for clinical treatment and nursing. Currently， pharmacotherapy is the mainstay of treatment for perimenopausal depression， while many existing problems remain to be solved such as the variation in treatment effect and the difficulty in maintaining emotional stability. however，high safety and relatively low cost are the characteristics of non-drug intervention， so this article expounds on the non-drug intervention measures for perimenopausal depression， such as music therapy， dietary therapy， exercise therapy， acupuncture therapy and repetitive transcranial magnetic stimulation （rTMS）.

Objective:To understand the predictive effect of orthostatic hypotension on frailty in nursing homes, and the effect of frailty on heart rate and blood pressure in supine positionand orthostatic position.Methods:A total of 214 elderly cases in three nursing homes (the Golden Years of Jinjialing Retirement Life Center, Hangzhou Boyang Pension Service Co., Ltd, Hangzhou Langhe International Medical Care Center) were interviewed by the general information questionnaire, the Frail Scale and Barthel Index. Systolic blood pressure, diastolic blood pressure, and heart rate were measured by electronic sphygmomanometer in supine position and orthostatic position of 1 and 3 minutes.Results:The incidence of frailty combined with orthostatic hypotension was 26.64%(57/214) in the elderly in nursing homes. The incidence of orthostatic hypotension in the robust elderly, pre-frailty and frailty gradually increased, 14.29%(5/35), 20.00%(12/60), 47.90%(57/119). The differences of heart rate and systolic blood pressure in supine position between the elderly with and without frailty were significant ( t=2.16, 3.25, P<0.05), the differences of systolic pressure difference in orthostatic position of 1 and 3 minutes between the elderly with and without frailty were significant ( H=3.16, 4.08, P<0.01). There was significant difference in systolic pressure between the prefrail elderly and the elderly without frailty in lying position ( t=2.02, P<0.05). The differences of systolic and diastolic pressure differences in orthostatic position of 3 minutes between the frail elderly and pre-frail elderly were significant ( H=3.13,2.44, P<0.05). Ordered Logistic regression analysis showed that orthostatic hypotension was a risk factor for frailty ( OR=2.425, 95% CI were 1.133-4.988, P<0.05). Conclusions:Elderly adults with orthostatic hypotension in nursing homes have a higher prevalence of frailty. Frailty also impairs blood pressure regulation during postural changes. Nurses should attach importance to the assessment, education and intervention of frailty and orthostatic hypotension.

ObjectiveTo investigate the value of two-dimensional shear wave elastography (2D-SWE) in the noninvasive evaluation of the presence or absence of esophageal varices (EV) in patients with hepatitis B cirrhosis by liver stiffness measurement (LSM) and spleen stiffness measurement (SSM). MethodsA total of 172 patients who were diagnosed with hepatitis B cirrhosis in Beijing Ditan Hospital, Capital Medical University, from April 2019 to February 2020 were enrolled in a prospective study, and according to the results of gastroscopy, they were divided into non-EV group and EV group. The two groups were compared in terms of spleen thickness (ST), spleen diameter (SD), LSM, and SSM. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data. The receiver operating characteristic (ROC) curve was used to investigate the value of LSM and SSM in the diagnosis of EV, and the Z test was used to compare the diagnostic accuracy of LSM and SSM. ResultsThere were 121 patients in the EV group and 51 patients in the non-EV group. There were significant differences between the two groups in ST (t=8143, P＜0.001), SD (t=7.363, P＜0.001), LSM (Z=3.024, P=0.002), SSM (t=15.142, P＜0.001), and presence or absence of ascites (χ2=22.101, P＜0.001). LSM had an area under the ROC curve (AUC) of 0.646 (95% confidence interval ［CI］: 0570-0.718) in the diagnosis of EV, with a sensitivity (Se) of 83.47%, a specificity (Sp) of 47.06%, a positive predictive value (PPV) of 78.9%, and a negative predictive value (NPV) of 54.5% at the optimal cut-off value of 13.16. SSM had an AUC of 0.951 (95% CI: 0.907-0.978) in the diagnosis of EV, with an Se of 80.99%, an Sp of 96.08%, a PPV of 98.0%, and an NPV of 68.1% at the optimal cut-off value of 38.08. SSM had a better diagnostic accuracy than LSM (Z=6.096, P＜0.001). ConclusionLSM and SSM can be used to predict the presence or absence of EV in patients with hepatitis B cirrhosis. SSM has a higher accuracy than LSM and can provide accurate diagnostic information for clinical practice.