[Objective] Expound the correlation of the du meridian and du meridian acupuncture points with qi and blood deficiency type cervical vertigo. [Method] Introduce the author’s clinical experience through using the du meridian points treatment of cervical vertigo with qi and blood deficiency type, and take consilia as confirmation. [Result]After the du meridian acupoints treatment 10 times, vertigo symptom relieved obviously, reduced the neck and shoulder acid hemp sense, fol owed up for 3 months, there's no recurrence. [Conclusion]In the clinic, application of du meridian acupoints treatment of cervical vertigo with qi and blood deficiency type can obtain obvious curative effect.

Objective:To discuss the clinical effects of Buzhong Yiqi Wuling decoction combined with carvedilol in the patients with chornic heart failure. Methods:Totally 68 patients with chornic heart failure from June 2014 to January 2016 in our hospital were randomly selected and divided into the control group with 34 patients treated with carvedilol and the research group with the other 34 patients treated with Buzhong Yiqi Wuling decoction combined with carvedilol. The TCM symptom integral, distances of 6-minute walk-ing test, NT-ProBNP plasma levels, LVEF, LVEDD and LVESD before and after the treatment in the two groups were compared, and the clinical symptoms, cardiac function and adverse reactions in the two groups were observed to evaluate the clinical effects. Results:The TCM symptom integral and NT-ProBNP levels in the research group after the treatment were lower than those in the control group, and the distances of 6-minute walking test in the research group after the treatment was longer than that in the control group, the LVEF in the research group after the treatment was higher than that in the control group, the LVEDD and LVESD in the research group after the treatment were smaller than those in the control group, and all the differences were statistically significance(P<0. 05). The total effective rate was 91. 2% in the research group, which was higher than that in the control group (70. 6%), and the difference was sta-tistically significance(P<0. 05). No difference in the incidence of adverse reactions was shown between the groups (P>0. 05). Con-clusion:Buzhong Yiqi Wuling decoction combined with carvedilol in the patients with chornic heart failure can improve the clinical symptoms, cardiac function and exercise tolerance with fewer adverse reactions, which is worthy of clinical use.

Objective:To discuss the clinical effects of Buzhong Yiqi Wuling decoction combined with carvedilol in the patients with chornic heart failure. Methods:Totally 68 patients with chornic heart failure from June 2014 to January 2016 in our hospital were randomly selected and divided into the control group with 34 patients treated with carvedilol and the research group with the other 34 patients treated with Buzhong Yiqi Wuling decoction combined with carvedilol. The TCM symptom integral, distances of 6-minute walk-ing test, NT-ProBNP plasma levels, LVEF, LVEDD and LVESD before and after the treatment in the two groups were compared, and the clinical symptoms, cardiac function and adverse reactions in the two groups were observed to evaluate the clinical effects. Results:The TCM symptom integral and NT-ProBNP levels in the research group after the treatment were lower than those in the control group, and the distances of 6-minute walking test in the research group after the treatment was longer than that in the control group, the LVEF in the research group after the treatment was higher than that in the control group, the LVEDD and LVESD in the research group after the treatment were smaller than those in the control group, and all the differences were statistically significance(P<0. 05). The total effective rate was 91. 2% in the research group, which was higher than that in the control group (70. 6%), and the difference was sta-tistically significance(P<0. 05). No difference in the incidence of adverse reactions was shown between the groups (P>0. 05). Con-clusion:Buzhong Yiqi Wuling decoction combined with carvedilol in the patients with chornic heart failure can improve the clinical symptoms, cardiac function and exercise tolerance with fewer adverse reactions, which is worthy of clinical use.

Objective To observe the splenocytes immune response elicited by different concentrations of recombinant Toxo?plasma gondii profilin(rTgPRF)through the nasal route,and determine the optimal dose. Methods Fifty female BALB/c mice were randomly divided into 5 groups. The immunized groups were intranasally administered with 10,20,30μg or 40μg of rTgPRF that was separately dissolved in 20μl of phosphate?buffered saline(PBS)on days 0,14,and 21 respectively,while the control mice were given PBS solution instead. Two weeks after the last immunization,all mice were killed. Under asceptic conditions,the spleens from the immunized mice were dissected,and then the splenocyte proliferative responses in vitro were tested by CCK?8 kit. The levels of IFN?γ,IL?2,IL?4 and IL?10 of splenocyte culture supernatant were detected by ELISA. Re?sults Compared to the control group,the splenocytes from the 30μg and 40μg groups exhibited a significantly higher prolifer?ative response to rTgPRF(P<0.05),and SI from the 30μg rTgPRF group was higher than that from the 40μg group(P<0.05). The levels of IFN?γin all the immunized groups(P<0.05)and IL?2 in the 20,30μg and 40μg groups were significant?ly stronger than those in the control(P<0.05),and the 30μg group presented the highest concentrations of IFN?γ(P<0.01) and IL?2(P<0.01). There were no statistical differencesa mong the groups in the levels of IL?4 and IL?10. Conclusions The intranasal immunization with rTgPRF can induce the splenocyteproliferation and Th1?type mediated immunity. The best immu?nized dose is confirmed as 30μg.

OBJECTIVE:To observe the clinical efficacy and safety of Buzhong yiqi wuling decoction combined with western medicine in the treatment of chronic congestive heart failure(CHF). METHODS:120 CHF patients were divided into observation group and control group by random number table method,with 60 cases in each group. Control group received conventional western medicine treatment as rest,low salt diet and diuretics. Observation group was additionally given Buzhong yiqi wuling decoction,one dose a day,at twice,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Average TCM symptom score, level of plasma NT-proBNP,6 min walk test(6MWT)distance before and after treatment,clinical efficacy and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in average TCM symptom score,level of plasma NT-proBNP and 6MWT distance between 2 groups(P>0.05). After treatment,average TCM symptom score and level of plasma NT-proBNP of 2 groups were decreased significantly,and the observation group was more significant than the control group,with statistical significance(P<0.05);6MWT distance of 2 groups were improved significantly compared to before treatment,and the observation group was significantly longer than the control group,with statistical significance(P<0.05). After treatment,total effective rate of observation group(93.33%)was significantly higher than that of control group(83.33%),with sta-tistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Buzhong yiqi wuling decoction is an ef-fective prescription to treat CHF,and can relieve clinical symptoms,improve the cardiac function,decrease NT-proBNP level and en-hance the patient exercise tolerance with good safety.

Objective To systematically review the risk prediction models for intradialytic hypotension in maintenance hemodialysis patients,with a view to provide references for clinical practice.Methods PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,VIP,Wanfang and CBM were searched from inception to May 29,2023.2 reviewers independently screened the literature,extracted information and assessed methodological quality using the Prediction Model Risk of Bias Assessment Tool.Results A total of 20 studies and 25 models were included with the sample size of 68～9 292 cases and the incidence of outcome events of 2.1～51％.Baseline systolic blood pressure,age,ultrafiltration rate,diabetes and dialysis duration were the top 5 predictors of repeated reporting of the models.20 models reported the area under the curve of ranging from 0.649 to 0.969,and 5 models reported calibration metrics.There were 9 internal validations and 4 combined internal and external validation models.The overall applicability of the 20 studies was good,but all had a high risk of bias,mainly in data analysis.Conclusion Research on risk prediction models for intradialytic hypotension in maintenance hemodialysis patients is still in the developmental stage.Future studies should improve the research design and reporting process,and validation studies of existing models should be carried out to further evaluate the effectiveness and feasibility in clinical practice.

Objective:To investigate the clinicopathological characteristics of renal leukocyte chemotactic factor 2 amyloidosis (ALECT2).Methods:The patients with renal ALECT2 diagnosed by renal biopsy in Peking University First Hospital, Shanxi Medical University Second Hospital and Shanxi Bethune Hospital from January 2001 to October 2021 were retrospectively enrolled. According to whether the patients had concurrent glomerular diseases, they were classified into two groups: isolated ALECT2 group and ALECT2 with concurrent renal diseases group. Clinicopathological data of the two groups were compared. Light microscopy, immunofluorescence and immunoelectron microscopy were applied to investigate pathological characteristics of renal tissues. Mass spectrometry was used to analyze the composition of renal amyloid deposits. Gene sequencing was employed to detect the leukocyte chemotactic factor 2 ( LECT2) gene sequence in peripheral blood of the patients. Results:Sixteen patients with ALECT2 were enrolled in this study and nine of them had concurrent renal diseases. The age of 16 patients was (65.00±8.45) years old. The sex ratio of males to females was 7 to 9. Most of patients were Han ethnicity (15/16). Eight patients came from Shanxi province. Fifteen patients presented with varying degree of proteinuria [2.16(1.07, 4.72) g/24 h]; 5 patients had nephrotic syndrome; 11 patients had renal insufficiency; 12 patients had microscopic hematuria. Part of patients also had hypertension (12/16) and diabetics (6/16). Compared with isolated ALECT2, the ALECT2 group with concurrent renal diseases had a higher proportion of nephrotic syndrome (5/9 vs 0/7, P=0.034). Renal biopsy results showed that all patients (16/16) had amyloid deposits in the interstitium of renal cortex with varying degree of inflammatory cell infiltration and fibrosis, and glomeruli (12/16) and arterioles (14/16) were involved by amyloid deposits. The amyloid deposits were strongly congophilic and immunohistochemistry for LECT2 was positive. By semi-quantitative analysis, the proportions of glomerular and overall amyloid loads in ALECT2 with concurrent renal diseases group were lower than those in isolated ALECT2 group (both P<0.05). Electron microscopy revealed randomly oriented and non-branching fibrils with a diameter of 8-12 nm. The LECT2 peptides were detected by mass spectrometry in renal amyloid deposits of 8 patients, and homozygous G allele of LECT2 was found in 7 patients by gene sequencing. Complete follow-up data of 13 patients showed that 2 patients died, 1 patient developed end-stage renal disease at the time of renal biopsy, and most of the rest patients had stable renal function (8/10). Conclusions:Patients with renal ALECT2 mainly present with proteinuria, along with a high incidence of renal insufficiency, microscopic hematuria, and concurrent renal diseases. The pathologic feature is the preferential deposition of amyloid in renal cortical interstitium.

Objective:To analyze the relationship between serologically biochemical response and the disease progression trend and prognosis evaluated by traditional structural imaging in patients with radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) treated by apatinib.Methods:A retrospective study was performed on apatinib-treated (phase Ⅱ) patients ( n=19; 9 males, 10 females; age 46.0 (41.0, 57.5) years) with locally advanced/metastatic RAIR-DTC in Peking Union Medical College Hospital from March 2016 to June 2022. The relationships between serum thyroglobulin (Tg) and response evaluation criteria in solid tumors (RECIST) 1.1 structural imaging efficacy evaluation and disease progression trend were analyzed. The relationships between change of Tg after dose adjustment and the change of maximum diameter of target lesions in structure imaging were also discussed. Mann-Whitney U test and Wilcoxon signed-rank test were used to analyze the data. Results:During the median 49.41 months follow-up, the baseline Tg was 363.20(13.08, 2 490.50) μg/L. The Tg time-to-response was 0.47(0.47, 0.98) months, which was 1.80 (1.30, 1.90) months for RECIST 1.1. After 2, 4 and 8 weeks of initial treatment, the median Tg of the whole cohort decreased by 38.68%, 64.70% and 78.94%, respectively. After 8 weeks, the reducing degree of maximum diameter of target lesions was 33.48%. According to the best response, patients were divided into two groups: partial response (PR) group ( n=15) and stable disease (SD) group ( n=4). The median decreasing degree of Tg in PR group and that in SD group were 87.00% and 28.79%, and the reducing degree of maximum diameter of target lesions in corresponding groups were 45.00% and 21.22%. According to the final efficacy evaluation, patients were further divided into two groups: progressive disease (PD) group ( n=13) and non-PD (including PR and SD) group ( n=5). The median increasing degree of Tg in PD group was higher than that in non-PD group (381.55% vs 175.43%; U=10.00, P=0.037). The increasing degree of Tg and that of the maximum diameter of target lesions were 167.31% and 2.14% after the 1st adjustment, which were 231.06% and 9.73% after the 2nd adjustment. The differences of changes in Tg and maximum diameter of target lesions before and after the 1st dose adjustment were statistically significant ( z values: -3.06 and -2.23, P values: 0.002 and 0.026). Conclusion:During the apatinib treatment of RAIR-DTC, Tg can reflect the therapeutic effect of apatinib earlier than traditional imaging (RECIST 1.1), indicating the disease progression trend more sensitively.