Teaching of clinical practice is the most important part of education of Tradi-tional Chinese Medicine(TCM).We plan to make clinical rotation internships,standardize the whole process of internships,standardized management of clinical teaching,in order to achieve our objectives of TCM Clinical teaching.We hope to guide the medical students to link theory with clinical practice during clinical rotation internships,set up clinical thinking of intern,and practice the basic skills and operating specifications of intern.

Objective: To investigate the value of combined chemical exchange saturation transfer (CEST) and conventional magnetizationtransfer imaging (MT) in detecting metabolic and structural changes of renal fibrosis in rats with unilateral ureteral obstruction(UUO) at 3T MRI. Materials and Methods: Thirty-five Sprague-Dawley rats underwent UUO surgery (n = 25) or sham surgery (n = 10). Theobstructed and contralateral kidneys were evaluated on days 1, 3, 5, and 7 after surgery. After CEST and MT examinations,18F-labeled fluoro-2-deoxyglucose positron emission tomography was performed to quantify glucose metabolism. Fibrosis wasmeasured by histology and western blots. Correlations were compared between asymmetrical magnetization transfer ratio at1.2 ppm (MTRasym(1.2ppm)) derived from CEST and maximum standard uptake value (SUVmax) and between magnetization transferratio (MTR) derived from MT and alpha-smooth muscle actin (α-SMA). Results: On days 3 and 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those ofcontralateral kidneys (p < 0.05). On day 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly differentfrom those of sham-operated kidneys (p < 0.05). The MTRasym(1.2ppm) of UUO renal medulla was fairly negatively correlated withSUVmax (r = -0.350, p = 0.021), whereas MTR of UUO renal medulla was strongly negatively correlated with α-SMA (r = -0.744, p <0.001). Conclusion CEST and MT could provide metabolic and structural information for comprehensive assessment of renal fibrosisin UUO rats in 3T MRI and may aid in clinical monitoring of renal fibrosis in patients with chronic kidney disease.

Objective:To discuss dominant symptoms and compatibility rules of Dazhui(GV14) based on data mining.Methods:Literature related to Dazhui (GV14) was retrieved from CNKI, Wangfang, VIP, China Biomedical Literature Database (CBM) and Pubmed databases from January 1, 2012 to August 15, 2022, and the main symptoms of Dazhi (GV14) and the compatibility of acupoints were summarized. Gephi 0.9.5 software was used for complex network analysis to compare the treatment for dominant symptoms with single acupoint of Dazhi (GV14) and the compatibility of the acupoint. SPSS Modeler 18.0 software was used to analyze the association rules of acupoint combination based on Apriori algorithm. The clustering analysis of high frequency acupoints was carried out by SPSS Statistics 26.0 software.Results:A total of 722 articles were included, involving 732 prescriptions. The dominant symptoms of single acupoint were cervical spondylosis, acne, and cold; the treatment for dominant symptoms with compatibility included 14 types, such as cervical spondylosis, allergic rhinitis, ischemic stroke sequelae. The meridian compatibility was dominated by bladder meridian, and the frequency of yang meridians was higher than yin meridians. The compatibility of specific acupoints such as Xiahe acupoint, Beishu acupoint and Bahui acupoint were the main acupoints, and the high frequency acupoints were 33 acupoints such as Feishu (BL13), Baihui (GV20), Fengchi (GB20) and Zusanli (ST36), obtaining 4 series and 8 types of compatible combinations of Dazhui (GV14).Conclusions:Dazhui (GV14) is widely used in the treatment of internal diseases, such as respiratory diseases, nervous system diseases and vertebral artery type of cervical spondylosis. It tends to be flexibly used with multiple compatibility and clustering combination of specific acupoints.

Objective:To summarize the clinical features,diagnosis and treatment of multisystem inflammatory syndrome in children (MIS-C) after novel coronavirus infection(COVID-19),so as to improve the early recognition of MIS-C.Methods:The general information,clinical manifestations,treatment and length of hospital stay of fifteen children diagnosed with MIS-C and hospitalized in the Department of Cardiology,Children's Hospital,Capital Institute of Pediatrics from December 1，2022 to January 31，2023 were retrospectively analyzed.Fifteen children were divided into shock group( n=6) and non-shock group( n=9) according to the criteria of shock,and the differences in general conditions and laboratory examinations before treatment were compared between two groups. Results:The mean age of fifteen children were (3.28±2.48) years (ranging from 9 months to 7.9 years),with a male to female ratio of 4:1.The mean time interval from COVID-19 to the onset of MIS-C was (30.60±9.91) days.The novel coronavirus vaccination rate was 7%.Fever,enlarged lymph nodes,cracked lips and a strawberry tongue were present in all children,with just one exhibiting peeling of the hands and feet.Compared with the non-shock group,patients in the shock group were older,the level of platelet decreased significantly,the level of procalcitonin,interleukin-10,N-terminal pro-brain natriuretic peptide(NT-proBNP) and ferritin significantly increased,the left ventricular ejection fraction and left ventricular fractional shortening decreased significantly,and the Z score of left ventricular end-systolic diameter significantly increased,and there were significant differences between two groups ( P<0.05).All 15 patients were treated with human intravenous immunoglobulin,and five patients with severe myocarditis and shock accepted combined high-dose methylprednisolone pulse therapy over a period of five days,with the doses gradually tapering off afterwards.The mean hospital stay of all patients was (11.00±4.80) days,while the mean shock correction time of six patients was (5.14±2.12) days.After six months of follow-up,15 patients showed excellent prognosis with coronary lesions recovered and without any new complications. Conclusion:Generally,MIS-C tends to occur 3-6 weeks after COVID-19,with more boys than girls.Older ones are more likely to suffer from shock.Focusing on NT-proBNP and cardiac function indicators could identify shock early.High-dose methylprednisolone pulse therapy may be effective and benefit for prognosis improvement in children complicated with both shock and severe myocarditis.

Objective:To analyze the relevant records of Taibai (SP3) in ancient literature based on data mining technology; To summarize its application law.Methods:Ancient book materials included in the Zhong Hua Yi Dian (5th edition) were retrieved. Relevant information of Taibai (SP3) such as main treatment syndrome and compatibility of acupoints was extracted, and a database was established. The frequency of the data was counted. Gephi 0.10.1 software and SPSS Statistics 21.0 statistical software were used to carry out visualization analysis and clustering analysis on data. Results:A total of 248 articles were included, involving 43 ancient books, including 65 prescriptions for single acupoint application and 183 prescriptions for compatibility application. The main treatment of Taibai (SP3) involved internal medicine, surgery, gynecology and infectious diseases. There were 35 kinds of main treatment of single acupoint, and 12 kinds of dominant diseases, including vomiting, fever and dysentery. There were 47 kinds of main diseases and 14 kinds of dominant diseases such as fever, heartache and constipation. There were 138 acupoints, most of which were specific acupoints, mainly the spleen meridian, and the high frequency acupoints were Zusanli (ST36), Dadu (SP2), Gongsun (SP4) and so on. Clustering analysis obtained 8 kinds of acupoint combinations, which were potential prescriptions for Taibai (SP3).Conclusion:Taibai (SP3) was widely used in clinical practice in ancient times, with 8 kinds of diseases such as fever, constipation and abdominal pain as the main dominant diseases, and most of them were compatible with specific acupoints such as Zusanli (ST36), Dadu (SP2), Gongsun (SP4).

Objective To explore the value of plaque-to-aorta CT value ratio(standardized CT value)in differentiating coronary lipid and fibrous plaques,and to preliminarily analyze the stability of the cutoff.Methods Patients who underwent coronary computed tomography angiography(CCTA)and intravascular ultrasound(IVUS)within 1 week were included.The plaque CT value was obtained by measuring the all,four and two short-axis planes,respectively.The CT value of the ascending aorta was measured and standardized(plaque-to-aorta CT value ratio).The receiver operating characteristic(ROC)curves of the standardized and the traditional CT values were drawn.Results A total of 60 patients with 74 plaques were included,35 lipid and 39 fibrous plaques were diagnosed by IVUS.The aorta CT value was significantly correlated with the plaque(r=0.420,P<0.01);the cutoffs for the CT value of all,four and two plaque slices were 55 HU,48 HU and 52 HU,respectively,and all there of the cutoffs of standardized CT value were 0.149;the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of four-slice traditional and standardized CT values to differentiate lipid and fibrous plaques were 69%,87%,83%,76%and 91%,82%,82%,91%,respectively.Conclusion Compared with traditional CT value,the standardized CT value can greatly improve the sensitivity and NPV in differentiating coronary lipid and fibrous plaques,while maintaining modest to high specificity and PPV.Furthermore,the cutoff is stable.

Objective To analyze the transcriptome data of Zika virus(ZIKV)-infected human neuroblastoma cells SH-SY5Y by bioinformatics method,and to identify the potential genes involved in the pathogenic mechanism of ZIKV.Methods SH-SY5Y cells were infected with ZIKV.The total RNA was extracted and the differentially expressed genes(DEGs)were screened by transcriptome sequencing.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were performed to predict the biological processes,molecular functions,and signaling pathways mainly involved in the DEGs,and the results were verified by quantitative polymerase chain reaction(qPCR).Results A total of 259 DEGs were identified,including 172 up-regulated genes and 87 down-regulated genes.GO functional enrichment analysis showed that the DEGs were mainly related to extracellular matrix,response to stimulus,antimicrobial humoral response,and developmental process.KEGG pathway enrichment analysis revealed that the DEGs were predominantly associated to inflammatory reaction and immune response.The qPCR validation results of DEGs were basically consistent with the transcriptome sequencing results.Conclusion The expression of genes involved in extracellular matrix,response to stimulus,and regulation of inflammatory reaction is significantly altered in SH-SY5Y cells after ZIKV infection,suggesting that ZIKV may cause neurological lesions by remodeling the extracellular matrix and regulating inflammatory reaction.

Dysphagia is a common complication of stroke. Combining the principles of traditional Chinese medicine with modern research findings， it is proposed that "latent pathogen in the cerebral collaterals" constitutes the core pathogenesis of post-stroke dysphagia （PSD）. In clinical practice， treatment is tailored according to the location of PSD. During the oral stage， when the pathogen invades the face and mouth， resulting in excessive salivation， acupoints are primarily selected from the foot shaoyin （少阴） kidney channel， in combination with ren mai （任脉） ， du mai （督脉）， chong mai （冲脉） and the spleen channel， to replenish essence and fill the marrow， dispel dampness and unblock the channels. In the pharyngeal stage， as the pathogen obstructs the throat， disrupting normal swallowing， the therapy emphasizes dredging the shaoyang （少阳） channel and warming and tonifying the jueyin （厥阴） channel， by taking acupoints mainly from the hand and foot shaoyang channels， along with the jueyin channels， so as to soothe the liver and promote bile secretion， regulate and harmonize qi and blood. During the esophageal stage， where the pathogen damages the esophagus， impeding food passage， the treatment emphasizes activating the yangming （阳明） channels and regulating taiyin （太阴） channels； acupoints are mainly selected from the foot yangming stomach channel， along with the taiyin channels， aiming to warm yang， unblock the channels and dispel stasis.

OBJECTIVE： To provide experience and reference for the study of medical insurance budget impact analysis （BIA） in China. METHODS： Retrieved from PubMed， ProQuest， CNKI， Wanfang database and CBM， related literatures about medical insurance BIA research in China and the United States were collected since the establishment of the database. The basic information， analysis results and data sources were summarized and sorted out， and descriptive analysis of the included literature was carried out on basis of seven key elements such as model design， research perspective， treatment cost， reference scenario， target population， research time limit and discount/inflation， sensitivity analysis. RESULTS： A total of 72 literatures were included in this study， involving 24 （33.33％） studies in China， 48 （66.67％） studies in the United States； the indications of 45 studies were chronic diseases （62.50％）， and those of 21 studies were acute diseases （37.50％）. Among the research methods， 49 studies （68.06％） used BIA alone and 23 studies （31.94％） adopted BIA combined with pharmaceutical economics. In terms of model design， 50 studies （69.44％） adopted cost calculation models. In terms of research perspective， 60 studies （81.94％） were based on the perspective of medical insurance department research. In the calculation of treatment cost， 69 studies （95.84％） included drug cost. In terms of reference scenarios， 61 studies （84.72％） compared the economics of different drug-based treatment groups. For target population， only 31  （43.06％） studies used real world data. In terms of research duration and discount/inflation， 14 studies （19.44％） used treatment or length of hospitalization to indicate research duration， and 19 studies （26.39％） used discount rate or inflation rate to adjust costs. As for sensitivity analysis， 62 studies （86.11％） conducted sensitivity analysis， of which 49 （68.06％） used single factor sensitivity analysis. CONCLUSIONS： There are still some limitations in medical insurance BIA research literature in China and the United States， such as unreasonable use of data， incomplete coverage of the cost， and unreasonable setting of sensitivity analysis variables. It is recommended that BIA research should standardize data sources to improve the quality of budget evidence quality， reasonably evaluate market size to improve the authenticity of prediction， scientifically set variables and their scope of change to improve the stability of results， establish BIA research paradigms or evaluating standards so as to guide BIA research scientifically.