The modern statistical and data mining technology is used to analyze the law of the acupoint selection in the treatment of insomnia with acupuncture and moxibustion. The clinical literature on the treatment of insomnia with acupuncture and moxibustion in recent 10 years is collected from China National Knowledge Infrastructure (CNKI). Excel software is applied to establish the database of acupuncture prescriptions for insomnia so as to conduct the descriptive analysis, association rule analysis and clustering analysis on the data. In the treatment of insomnia with acupuncture and moxibustion, Shenmen (HT 7) is of the highest frequency and most acupoints were selected from the Governor Vessel. The commonly used acupoints are located on the head, face, neck and nape region. The combination of the local acupoints with the distal ones is predominated. The crossing points among the specific points present the advantage in the treatment. The association: rule analysis indicates the highest, correlation among Taixi (KI 3), Sishencong (EX-HN 1) and Shenmen (HT 7). The clustering analysis results in 6 effective clusters and 10 pairs of key points and summarizes the common law of the acupoint combination for insomnia. All of these provide the reference to the treatment of insomnia with acupuncture and moxibustion.
Acupuncture Points ; Acupuncture Therapy ; China ; Data Mining ; Databases, Factual ; Humans ; Moxibustion ; Sleep Initiation and Maintenance Disorders ; therapy ; Software

This study was aimed to analyze acupoint selection principle for acute gouty arthritis treatment. Literatures on acupuncture treatment of acute gouty arthritis were collected from CNKI in recent 20 years. Excel software was used in the establishment of database on main acupoints for acute gouty arthritis treatment. On Windows 8 platform, SPSS 17.0 and Clementine 12.0 software were used in the descriptive analysis, association rules analysis and cluster analysis. The results showed that the top three acupionts with the highest frequency of application were Sanyinjiao (SP 6), Zusanli (ST 36), and Y inlingquan (SP 9). The meridian used with the highest frequency was the spleen meridian of foot Taiyin. The result of association rules analysis showed that Sanyinjiao (SP 6)-Xuehai (SP 10)-Quchi (LI 11) was the most relational one. The cluster analysis indicated the top four core cluster groups including Xiangu (ST 43)-Neiting (ST 44)-Xingjian (LR 2), Xuehai (SP 10)-Hegu (LI 4)-Quchi (LI 11), Taibai (SP 3)-Y inbai (SP 1)-Dadu (SP 2)-Fenglong (ST 40), and Zhubin (KI 9)-Zhigou (TE 6)-Gongsun (SP 4)-Bafeng (EX-LE 10). It was con-cluded that the clinical acupoint selection and combination principle in acute gouty arthritis treatment were analyzed through large amount of data. It can provide evidences and references for acupuncture clinical practice.

Aim To study the absorption mechanism of apigenin-7-O-glucronide, 3,4-Dihydroxycinnamic acid and chlorogenic acid in Erigeron breviscapus extract ( Ebe) by Caco-2 cell monolayer model. Methods The three active ingredients were quantified by UPLC-MS/MS method, and the effect of Ebe concentrations, conveying times, pH values and P-glycoprotein inhibi-tor on the transport of three active ingredients were also investigated. Results Apigenin-7-O-glucronide and chlorogenic acid in Caco-2 cell monolayer model were time-dependent and concentration-dependent. The 3, 4-Dihydroxycinnamic acid in Caco-2 cell uptake was concentration-saturate and P-glycoprotein inhibitor was involved in the uptake process. Conclusion The mechanism of apigenin-7-O-glucronide and chlorogenic acid absorption in cells is mainly through passive trans-port, and the absorption of 3, 4-Dihydroxycinnamic acid is mainly realized by the carrier transport.

Objective The effect of serum exosome isolation method on obtained exosomal RNA is not yet clear .The aim of this study was to provide evidences to selected exosome isolation methods .Methods This was a method comparison study to assess three methods .Vein blood samples were collected from 3 healthy donors from Nanfang hospital , 4 ℃ 12 h was taken to make blood natural coagulated and the supernatant was taken as the serum . Exosomes extracted by Ultracentrifugation , ExoQuick and Total Exosome Isolation Reagent ( TEI ) kits from serum were assessed by transmission electron microscopy , nanoparticle tracking analysis and protein analysis to identify morphology , protein expression , concentration and size distribution of particles .ExoRNA extracted by Trizol-LS, SeraMir, Total Exosome RNA Isolation ( TER) and exoRNeasy were assessed by Bioanalyzer 2100 and qPCR to ascertain RNA distribution and miRNA expression.Results For exosomes isolation , two commercial kits ( ExoQuick and TEI ) showed higher exosomes recovery and protein concentration than ultracentrifugation , but exosome isolated by ultracentrifugation expressed abundant protein makers mostly .For exo-RNA isolation, the distribution of RNA and expression of miRNAinfluenced by three methods , but there was no effect on the relative expression trend of miRNA.ExoRNeasy resulted in the highest yield and most narrow size distribution pattern of small RNA with higher level of miRNA expression .Results of TEI with TER kits showed no obvious bands of small RNA and moderate miRNA expression among methods .Ultra with Trizol-LS or ExoQuick with SeraMir showed low concentration measurable bands around 100 nt, with changeable miRNA profiling irregularly . Conclusions Extraction of exosomes using traditional ultracentrifugation method is applicable for proteomics research work .Extraction using ExoQuick and TEI kits is suitable for preparing exosomes from scarce samples such as serum.

Objective: To probe the incidence and risk factors for thrombosis in Chinese immune thrombocytopenia through a retrospective analysis of the inpatients referred to the Blood Disease Hospital, CAMS & PUMC. Methods: A retrospective survey of 3 225 patients with ITP from October 2005 to December 2017 was performed, the clinical data of the patients with thrombosis were collected to analyze the causes, diagnosis, treatment and prognosis. Results: A total of 46 patients experienced a thrombotic event with a prevalence of 1.43%(46/3 225 cases) with the median age of thrombosis as 54 years (26-83) years, the prevalence of thrombosis was 3.37% (40/1 187 cases) in>40 years old, which was significantly higher than 0.58% (6/1 030 cases) in those under 40 years old, in adults (P=0.00). There were 20 males and 26 females, there was no statistical difference in the incidence of thrombosis between males and females[1.53% (20/1 309) vs 1.36% (26/1 916), P=0.187]; The prevalence of arterial thrombosis was 1.12% (36/3 225) higher than venous thrombosis[0.22% (7/3 225), P=0.00]when 82.61%(38/46 cases) of patients with PLT<100×10⁹/L. Post-splenectomy are risk factors for thrombosis in ITP patients, P values was 0.022, There was no statistical difference in the presence or absence of thrombotic events whether received glucocorticoid or TPO/TPO-Ra treatment, the P values were 0.075 and 0.531, respectively. Conclusions In Chinese population, ITP disease maybe with a higher risk of thrombosis, there was no positive correlation between thrombosis and platelet level; and had obvious age distribution characteristics. The history of tobacco, hypertension, diabetes and post-splenectomy are risk factors for thrombosis in ITP patients.

Objective: To investigate the safety and efficacy of eltrombopag for adult patients with chronic immune thrombocytopenia (cITP). Methods: It was a randomised, single-centre, 6 weeks, placebo-controlled study. Beginning in January 29^th, 2013, 35 patients were enrolled, and the trial was completed on May 16^th, 2014. 17 patients were assigned to receive eltrombopag (starting dose 25 mg/d) and 18 were assigned to receive placebo. Results: A total of 35 cases of adult cITP, 6 males and 29 females with a median age of 42(22-66) years were enrolled. One patient withdrew from eltrombopag treatment group for the adverse event (AE) and discontinued treatment. In first two weeks, 27.78% (5/18) of placebo-treated compared with 64.71%(11/17) of eltrombopag-treated patients achieved platelet counts ≥ 30×10⁹/L(P=0.031); Treatment 6 weeks, the proportion of platelet counts reached ≥50×10⁹/L and ≥ 30×10⁹/L in eltrombopag-treated were higher than placebo-treated ones with statistically significant differences in both groups [64.71%(11/17) vs 11.11% (2/18), P=0.001; 76.47% (13/17) vs 38.89% (7/18), P=0.028]; The study also indicated a statistically significant difference in favour of eltrombopag compared with placebo in the odds of achieving the outcome of a platelet count ≥ 50×10⁹/L at least once during 6-week treatment (94.11% vs 33.33%, P<0.001), and 70.59%(12/17) of patients with the platelet count continuously ≥ 50×10⁹/L in 50% of treatment time in eltrombopag-treated group was more than placebo-treated one [11.11%(2/18), P<0.001]. Proportions of patients who required rescue treatment were 44.44% in placebo group and none in eltrombopag-treated one, respectively (P=0.002); The odds of bleeding symptoms with the WHO bleeding scale had no difference in both groups after 6 weeks (P=0.066). Adverse events that occurred more frequently due to eltrombopag than placebo included increased transaminase (3/17) and blood bilirubin (5/17), cerebral infarction(1/17). Conclusions The thrombopoietin receptor agonist eltrombopag was a suitable therapeutic option for Chinese adults with cITP.

Objective: To evaluate the applicability of Chinese disseminated intravascular coagulation scoring system (CDSS) in the diagnose of DIC in patients with acute promyelocytic leukemia (APL) patients. Methods: Medical records of 220 APL patients diagnosed and receiving induction therapy in Blood Disease Hospital, CAMS & PUMC from January 2004 to February 2018 were retrospectively analyzed. Each patient was evaluated by CDSS, the International Society of Thrombosis and Haemostais (ISTH) scoring system for overt DIC and Japanese Ministry of Health and Welfare (JMHW) scoring system for overt DIC, respectively. Results: A total of 220 APL patients were enrolled in the study, with a median age of 38.5 (12-70) years, 114 male and 106 female. Among them, 173 were in the low-medium risk group, 47 high-risk group; 11 patients died during induction treatment. The positive rates of DIC diagnosed by CDSS criteria, ISHT criteria, JMHW criteria was 62.27%, 54.09%, 69.09%, respectively. The consistency rate of CDSS and ISTH in diagnosing DIC was 78.10%; the consistency rate of CDSS and JMHW was 88.32%. There was significant difference in PT, APTT, FIB, D-Dimer and FDP in DIC(+) and DIC(-) group by CDSS (all P<0.05), but patients in the DIC(+) group had lower level of D-Dimer than in the DIC(-) group [21.9(1.2-477.1) mg/L vs 26.3(0.6-488.7) mg/L, χ²=1.871, P=0.002] by ISTH, and there was not significant difference in APTT by JMHW [27.05(18.0-181.0) s vs 26.15(18.2-35.5) s, χ²=1.162, P=0.134]. In this study, both of the gender and age had no difference in the DIC (+) and DIC (-) group by CDSS. Univariate analysis showed that the level of WBC and the percent of abnormal promyelocytic cells in bone marrow when diagnosed were different in DIC (+) and DIC (-) group by CDSS (P<0.05). Multiple analysis showed the level of WBC (OR=3.525, 95% CI 1.875-6.629, P<0.001) was the only independent predictor in DIC diagnosis by CDSS. Conclusion The sensitivity of diagnosing DIC by CDSS was higher than the ISTH; and the specificity was superior to JMHW. Using CDSS can help to make the DIC diagnosis and treatment in time for APL patients who with the coagulation abnormalities.

Objective:To analyze the application effects of anchored instruction combined with problem-based learning (PBL) in the clinical teaching of department of gynecology.Methods:Taking the implementation time (June 2020) of anchored instruction combined with PBL in the hospital, 86 clinical interns who entered the department of gynecology before the implementation (from April 2019 to May 2020) were included in control group, and this group adopted traditional teaching method; 82 interns enrolled after the implementation (between June 2020 and December 2020) were selected as observation group and were given new teaching method. The theoretical assessment results, practical operation results, independent learning ability and teaching satisfaction were compared between the two groups after 1 month of training. SPSS 22.0 was used for t test and rank sum test. Results:After 1 month of training, the scores of theoretical assessment results [(81.20±10.64) vs. (73.96±8.25)] and mini-clinical evaluation exercise (Mini-CEX) scale of observation group were significantly higher than those of control group, and the independent learning ability and teaching satisfaction evaluation were significantly better than those of control group ( P<0.05). Conclusion:Anchored instruction combined with PBL can effectively improve the independent learning ability and learning satisfaction of interns in department of obstetrics and gynecology, with good application effects.

Objective: To examine the eating behaviors and associated factors among preschool children from multiple child families, so as to provide a basis for promoting healthy eating habits in this population. Methods: From April to June 2022, a stratified random cluster sampling method was employed to selected 2 647 guardians of preschool children in 11 kindergartens in Tongling City. Parenting style questionnaire, Identification and Management of Feeding Difficulty Questionnaire (IMFeD), Caregiver s Feeding Style Questionnaire (CFSQ) and a self designed questionnaire were administered. Multiple linear regression was performed to analyze the factors influencing eating behaviors among preschool children. Results: In the study, the detection of eating behavior problems among preschool children was 71.4%, and the detection of reduced appetite was the highest (55.6%). The detection rates of anorexia, picky eating, poor eating and improper eating behavior in only child families were higher (60.6%, 41.0%, 32.0%, 19.5%), compared with those in multiple child families (51.7%, 36.4%, 27.2%, 16.6%) ( χ 2=20.05, 5.95, 7.16, 3.92, P < 0.05 ). Among multiple child families, the detection rates of fear of eating and underlying disease were the lowest in 5-<10-year-old group (2.3%, 0.6%) ( χ 2=11.54, 8.51, P <0.05). In multiple child families, the detection rates of picky eating and poor eating habits for the first-born child were higher (42.0%, 32.5%), compared with second born and third born child (34.6%, 25.6%)( χ 2= 6.15, 6.38, P <0.05). The results of multiple linear regression analysis showed that multiplechild families ( β =-1.40), democratic parenting style ( β =-0.07), higher feeding response scores ( β =-0.33) were negatively associated with eating behavior problems among preschool children ( P <0.05). Eating behavior problems among preschool children were positively correlated with less educated mothers [high and junior high school education ( β =0.87), primary school education and below ( β =3.69)], longer average daily screen time ( β =0.10), higher feeding requirements scores ( β =0.64), doting parenting styles ( β =0.21), permissive parenting styles ( β =0.27) and inconsistent parenting styles ( β =0.14)( P <0.05). Conclusion The detection rate of the eating behaviors problems among preschool children is high in schools. Greater attention should be paid to only child and first born child of multiple child families, and appropriate feeding and parenting styles, so as to promote healthy eating habits among this population.

Objective: To explore the immune tolerance induction (ITI) in a case of severe hemophilia B patient with inhibitor. Methods: The F Ⅸ∶C was detected using a one-stage method and FIX inhibitor was assayed using Bethesda method. ITI was performed with prothrombin complex concentrates (PCC) in combination with rituximab. Results: His past exposure days (ED) with PCC were 20 ED and his peak FⅨ inhibitor titer was 56 BU/ml. When his FIX inhibitor titer decreased to 10.4 BU/ml in Nov. 2015 and after receiving the informed consent from his parents, ITI was started. PCC with low dose rituximab successfully eradicated the high titer inhibitor within 17 months. There was no anaphylaxis, thrombotic event and infection. Conclusion This is the first case report for successful immune tolerance induction therapy in Chinese hemophilia B patient. ITI using PCC combined with rituximab is an effective choice to induce immune tolerance of hemophilia B with inhibitor.