This article summarizes Academician WANG Yongyan′s experience in the differentiation and treatment of motor neuron disease, which can be categorized into flaccidity syndrome, convulsive syndrome, and fei syndrome according to the clinical manifestations. These three syndromes may coexist, and the condition progressively worsens over time, which is believed to be caused by external pathogenic qi, based on "deficient-qi induced stagnation" , and with "toxins damaging collaterals" as the core etiology and pathogenesis. "Toxins damaging collaterals" involves three levels of qi collaterals, blood collaterals, and fluid collaterals, gradually overlapping and affecting the marrow collaterals. Academician WANG Yongyan′s theory is based on syndrome differentiation, breaking down the boundaries of flaccidity, convulsive, and fei syndromes according to different manifestations of the disease, and using the concept of "combined treatment" for treatment. The clinical presentation of motor neuron disease shows a bottom-up trend in the development of the sanjiao, and the combination of visceral syndrome differentiation and sanjiao syndrome differentiation can grasp the progress of the disease comprehensively. During the process of syndrome differentiation, the focus is on the use of xiang thinking, emphasizing the holistic correlation between diseases and syndromes and the integrated effect of reductionist analysis. Treatment is based on xiang differentiation and individualized treatment. The mid-stage of motor neuron disease is the key time point for the treatment of this disease. Based on the clinical symptoms of flaccidity, convulsive, and fei syndromes, where treatment should focus on reinforcing the spleen and kidney, combining moxibustion with herbal medicine. While targeting the disease, treatment should comprehensively apply the methods of "promoting, supplementing, softening, and warming" to eliminate toxins and unblock collaterals, and restore the neural regulation of the brain and spinal cord.

China is currently in an accelerated stage of population aging, and brain diseases pose a significant threat to the health of the elderly. " Preventing brain aging and maintaining brain health" has become a high-level goal of healthy aging. During the process of aging, the physiological and psychological states of elderly people change, making them prone to nervousness and exhaustion, which can disturb the brain spirit, damage the brain collaterals, and severely endanger brain health. Starting from the holistic view of cultivating both body and spirit in traditional Chinese medicine, based on the physical and mental characteristics of the elderly, this paper applies the concept and method of " relaxation and tranquility" in the protection of elderly brain health, focusing on maintaining relaxation and tranquility in both physical and mental aspects. Specific measures include emphasizing subjective consciousness, relaxing the heart and calming down; utilizing the daoyin method, relaxing the body and calming down, combining relaxation and tranquility, cultivating both body and spirit to prevent diseases and protect the brain, which enables the elderly to have a healthy mind and body, a sense of happiness and fulfillment, and to age gracefully. Simultaneously, advocating for tranquility is also called " respect" for relaxation, following nature to understand constant changes, and improving one′s ability to think positively in old age, in order to expand ideas for the protection of elderly brain health.

Objective:To explore the differences in sociodemographic and clinical characteristics between pa-tients with unipolar depression bipolar depression and to establish a nomogram for identifying bipolar depression.Methods:Using data from the China Mental Disorders Cohort Study,the sociodemographic and clinical characteristics of 2 643 patients with unipolar depression and 250 patients with bipolar depression diagnosed accord-ing to the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were includ-ed to compare their sociodemographic and clinical characteristics.These characteristics included general demograph-ic information,disease-related information,clinical examination results,and the severity of the disease assessed with the Global Assessment of Functioning(GAF)and Hamilton Depression Rating Scale.Logistic regression analysis was employed to identify factors influencing bipolar depression,and a nomogram was constructed for its identifica-tion.Results:The risk factors for bipolar depression included being male(OR=1.48),being employed(OR=1.38),having non-melancholic features during episodes(OR=2.33),a Body Mass Index ranging from normal to obese(OR=2.48,2.49,4.65),psychotic features(OR=2.14),mixed episode(OR=9.36),comorbid physical diseases(OR=2.47),four or more depressive episodes(OR=1.67),earlier age of onset(OR=0.95),longer ill-ness duration(OR=1.03),and higher GAF scores(OR=1.02).The nomogram model achieved an AUC of 0.81(95％CI:0.78-0.84).The Hosmer-Lemeshow test result was x2=6.96(P＞0.05),indicating good model fit.The calibration curve showed good performance.The decision curve analysis revealed that the nomogram pro-vides significant clinical benefit when the risk of bipolar depression was within the range of 0 to 0.9.Conclusion:The nomogram established based on the identified sociodemographic and clinical factors can accurately assess the risk of bipolar depression,providing a useful tool for early identification and intervention.

Objective To explore the characteristics of coagulation and immune function and their clinical significance in children with severe adenovirus pneumonia(SAP).Methods A total of 122 children with SAP and 120 children with non-severe adenovirus pneumonia(NSAP)were enrolled and assigned to severe group and non-severe group.The severe group was further subdivided into good prognosis subgroup(n=105)and poor prognosis subgroup(n=17)according to prognosis.Addition-ally,120 healthy children undergoing physical examination during the same period were included as control group.Coagulation function indicators,including prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),and thrombin time(TT)were measured.Levels of immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)were determined using the nephelometric immunoassay.Multivariate Cox regression analysis was conducted to explore the influencing factors of poor prognosis.Results Compared with the control group,children in both the non-severe and severe groups exhibited increased levels of white blood cells(WBC),neutrophils(N),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),procalci-tonin(PCT),FIB,and IgG,as well as decreased levels of B lymphocytes,natural killer(NK)cells,PT,APTT,IgA,and IgM(P＜0.05).Compared with the non-severe group,children in the severe group showed increased levels of WBC,N,CRP,ESR,IL-6,PCT,FIB,and IgG,as well as decreased levels of B lymphocytes,NK cells,PT,APTT,IgA,and IgM(P＜0.05).Compared with the good prognosis subgroup,the poor prognosis subgroup exhibited increased levels of CRP,IL-6,PCT,and IgG,as well as decreased levels of APTT,IgM,and IgA(P＜0.05).The results of multivariate Cox regression analysis showed that PCT,APTT,and IgM were influencing factors of poor prognosis in children with SAP(P＜0.05).Conclusion Children with SAP have decreased levels of PT,APTT,IgA,and IgM,as well as increased levels of FIB and IgG.Coagulation and im-mune function indicators are correlated with the prognosis of SAP.

This paper explored the significance and value of building a doctor-patient narrative community in clinical practice.It was clarified that clinical practice guided by evidence-based medicine thinking is essentially a"narrative"process:patients narrate their illness stories,and doctors,through a series of humanistic narrative practices,strengthen trust and empathy between patients and doctors on an emotional and ethical level,while bridging cognitive gaps,enhancing diagnostic and treatment outcomes,and ultimately fostering a harmonious and efficient doctor-patient narrative community relationship.The realization of a doctor-patient narrative community not only optimizes the treatment process but also enhances patients'self-efficacy and doctors'professional satisfaction,which is conducive to saving medical costs,optimizing public health governance,and highlighting a harmonious social atmosphere.

Neck rejuvenation technique continue to expand and evolve, this article reviews the principle and effect of various non-operative treatment of neck wrinkles in recent years, which includes botulinum toxin injection, hyaluronic acid injection, radiofrequency technology, high-intensity focused ultrasound, laser and combined therapy. This article can provide more options for plastic surgeons.

Objective:To identify competency evaluation indicators for psychological hotline professionals,provi-ding scientific reference for their training and assessment.Methods:Through literature review,initial competency evalua-tion indicators were selected,followed by Delphi consultation with sixteen experts across China.The analytic hierarchy process(AHP)was used to assign weights to each indicators.Results:The response rate of expert consultation question-naire was 100％,and the expert authority coefficients for the two rounds of consultation were 0.92 and 0.90 respective-ly.After two rounds of expert consultation,a competency evaluation index system for professional counselors of psycho-logical aids hotline was constructed,including four first-level indexes,nine second-level indexes,and 34 third-level inde-xes.The weight of each index was determined using the AHP.The Kendall coefficient of concordance of all level's inde-xes in the two rounds of consultation were 0.16-0.18 and 0.16-0.25,respectively.Conclusion:The expert consensus developed in this study serves as an reference for evaluating the competency of psychological hotline professionals,sup-porting their training and assessment.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective:To explore the differences in sociodemographic and clinical characteristics between pa-tients with unipolar depression bipolar depression and to establish a nomogram for identifying bipolar depression.Methods:Using data from the China Mental Disorders Cohort Study,the sociodemographic and clinical characteristics of 2 643 patients with unipolar depression and 250 patients with bipolar depression diagnosed accord-ing to the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were includ-ed to compare their sociodemographic and clinical characteristics.These characteristics included general demograph-ic information,disease-related information,clinical examination results,and the severity of the disease assessed with the Global Assessment of Functioning(GAF)and Hamilton Depression Rating Scale.Logistic regression analysis was employed to identify factors influencing bipolar depression,and a nomogram was constructed for its identifica-tion.Results:The risk factors for bipolar depression included being male(OR=1.48),being employed(OR=1.38),having non-melancholic features during episodes(OR=2.33),a Body Mass Index ranging from normal to obese(OR=2.48,2.49,4.65),psychotic features(OR=2.14),mixed episode(OR=9.36),comorbid physical diseases(OR=2.47),four or more depressive episodes(OR=1.67),earlier age of onset(OR=0.95),longer ill-ness duration(OR=1.03),and higher GAF scores(OR=1.02).The nomogram model achieved an AUC of 0.81(95％CI:0.78-0.84).The Hosmer-Lemeshow test result was x2=6.96(P＞0.05),indicating good model fit.The calibration curve showed good performance.The decision curve analysis revealed that the nomogram pro-vides significant clinical benefit when the risk of bipolar depression was within the range of 0 to 0.9.Conclusion:The nomogram established based on the identified sociodemographic and clinical factors can accurately assess the risk of bipolar depression,providing a useful tool for early identification and intervention.

Objective:To identify competency evaluation indicators for psychological hotline professionals,provi-ding scientific reference for their training and assessment.Methods:Through literature review,initial competency evalua-tion indicators were selected,followed by Delphi consultation with sixteen experts across China.The analytic hierarchy process(AHP)was used to assign weights to each indicators.Results:The response rate of expert consultation question-naire was 100％,and the expert authority coefficients for the two rounds of consultation were 0.92 and 0.90 respective-ly.After two rounds of expert consultation,a competency evaluation index system for professional counselors of psycho-logical aids hotline was constructed,including four first-level indexes,nine second-level indexes,and 34 third-level inde-xes.The weight of each index was determined using the AHP.The Kendall coefficient of concordance of all level's inde-xes in the two rounds of consultation were 0.16-0.18 and 0.16-0.25,respectively.Conclusion:The expert consensus developed in this study serves as an reference for evaluating the competency of psychological hotline professionals,sup-porting their training and assessment.