By analyzing the meridian related diseases of the heart in the Lingshu · Meridians chapter, this study summarizes the characteristics of heart diseases caused by the Heart Channel of Hand-Shaoyin, Pericardium Channel of Hand-Jueyin, and other meridians from the perspectives of pathogenic meridians, lesion sites, and disease nature. The pathogenesis and connotation of these diseases are analyzed, providing new ideas for the prevention and treatment of heart related diseases. Among the twelve meridians, besides the Heart Channel of Hand-Shaoyin and Pericardium Channel of Hand-Jueyin, there are five meridians that cause heart diseases, namely the Lung Channel of Hand-Taiyin, Stomach Channel of Foot-Yangming, Spleen Channel of Foot-Taiyin, Kidney Channel of Foot-Shaoyin, and Gallbladder Channel of Foot-Shaoyang. Diseases are more common in the yin meridian, with pain and heat as the main symptoms. They are related to the fact that the heart is a yang zang-organ, and evil qi is easily converted from yang to heat, causing diseases through the transmission of heart fire. There are three mechanisms by which other meridians can affect the Heart Channel of Hand-Shaoyin and Pericardium Channel of Hand-Jueyin, leading to symptoms such as heart pain and palpitations. Firstly, pathogenic factors can be transmitted along the meridians, causing discomfort and heartache to the heart; secondly, due to the abnormal pathogenic behavior of the Five Elements, where the gallbladder wood do not generate heart fire, and the heart yang is weak and painful; kidney water does not control heart fire, and the heat disturbs the mind and causes palpitations; thirdly, qi function is abnormal, which leads to abnormal opening and closing of the Yangming and Shaoyang channels, causing palpitations due to insufficient yin qi in the pericardium meridian or pain due to yang deficiency in the heart channel. External pathogens enter the lung through the channels, causing obstacles in the generation and distribution of pectoral qi, affecting the qi function of the heart channel and causing distress. The three mechanisms can exist independently or simultaneously as diseases.

BackgroundClinical supervision is a critical component in the training and professional development of psychological counselors. Scientifically evaluating the effectiveness of clinical supervision is essential， yet reliable and effective tools for such assessments are lacing in China. ObjectiveTo translate Supervision Evaluation and Supervision Competence （SE-SC） Scale into Chinese version and evaluate its reliability and validity in clinical supervision in China， so as to provide a tool for the evaluation of supervisory effectiveness. MethodsThe SE-SC scale was translated， back-translated and culturally adapted， followed by a pilot survey to develop the Chinese version of SE-SC scale. A total of 42 counselors engaged in clinical counseling and receiving supervision at a counseling center in Shanghai from July 2021 to February 2022 were selected as the study participants. Item analysis was conducted to assess item discrimination， with critical ratio method applied to determine which items retention. Hierarchical cluster analysis was performed to compare the structure of Chinese version with the original scale. Criterion-related validity and convergent validity were used to evaluate the validity of the scale， while Cronbach's α coefficient was used to assess its reliability. ResultsChinese version of SE-SC scale consisted of a total of 28 item， including six clusters. Registered supervisors scored significantly higher than internship supervisors on the total score and on clusters three， four， five and six （t=2.536， 2.747， 5.881， 3.718， 6.090， P<0.05）. The total and cluster scores of the Chinese version of the SE-SC scale were positively correlated with self-rated supervision helpfulness and overall satisfaction （r=0.492~0.758， 0.412~0.815， P<0.01）. The Cronbach's α coefficient for the overall scale was 0.975，with values for the six clusters were 0.938， 0.821， 0.962， 0.871， 0.884 and 0.823， respectively. ConclusionChinese version of SE-SC scale demonstrates good reliability and validity， and it can be considered as a promising assessment tool for evaluating the effectiveness of clinical supervision.

The theoretical basis of premature aging originates from The Yellow Emperor's Inner Classic. The etiology of premature aging is complex， and the disease mechanism is based on deficiency. The treatment for premature aging is based on tonicity. The essence-Qi-spirit theory of Qiluo doctrine summarizes that "essence is the origin of life， Qi is the driving force of life， and spirit is the embodiment of life"， which is the law of life. The theory puts forward the core disease mechanism of aging， which states that "deficiency of kidney essence is the root of aging， deficiency of primordial Qi is the key to aging， impairment of soma and spirit is the manifestation of aging". The theory also proposes the treatment of "tonifying kidney and supplementing essence， harmonizing Yin and Yang， warming and supporting primordial Qi， and nourishing soma and spirit" and the representative anti-aging drugs. The article unfolds from the perspective of the concepts of natural life span， premature senility before fifty， decline， and aging and also explains the origins and connotations of premature aging. The article explains the disease mechanism of premature aging under the guidance of the essence-Qi-spirit theory of Qiluo doctrine， which is "early deprivation of kidney essence， deficiency of primordial Qi， accumulation of deficiencies into impairment， and decline and impairment of soma and spirit"， summarizes the progress of modern medical research on the treatment of premature aging and representative drugs， and finds that Bazi Bushen capsules have a precise therapeutic effect on the overall premature aging， systematic functional decline， and related diseases. The study provides theoretical basis and new ideas to solve the problems of premature aging and geriatric diseases.

Objective To investigate the causal relationship between circadian rhythm disruption and inflammatory bowel disease(IBD)and the mediating effect of gut microbiota based on Mendelian randomization(MR).Methods Summary statistics of Genome-wide Association Study(GWAS)for circadian rhythm disruption(n=205 527)and IBD(n=214 053)were obtained from IEU OpenGWAS database.Summary statistics of GWAS for the gut microbiota were obtained from the MiBioGen database(n=18 340).Two-sample MR analysis was used to estimate the genetic correlation and causality between circadian rhythm disruption and IBD,and the mediating effect of the gut microbiota was analyzed by two-step MR analysis.Results There was a suggestive causal relationship between circadian rhythm disruption and IBD(odds ratio=1.255,P＜0.05).Rikenellaceae id.967 played a mediating role in the causal chain between them(the mediating effect was-0.028 740).Sensitivity analysis confirmed that the results were not interfered by level pleiotropy and heterogeneity.Conclusion There is a genetic correlation between circadian rhythm disruption and IBD,and gut microbiota may play a mediating role between them.

Objective To establish a mouse model of bronchiectasis with acute infection and evaluate the immunogenicity and protective effect of a self-assembling Pseudomonas aeruginosa(PA)nanoparticle vaccine rePO-FN based on fusion of PcrV-OprI(rePO)protein with self-assembling ferritin(Ferritin).Methods ① SPF-grade female C57BL/6 mice(aged 6～8 weeks,weighing 18～20 g)were randomly allocated into normal saline group,and low-,medium-and high-dose elastase groups(n=6).A mouse model of bronchiectasis was established via intratracheal instillation of different doses of elastase(30 μL of normal saline containing 0.65,1.30 and 2.60 IU elastase)for 3 consecutive days.At 14 and 21 d after modeling,ELISA and HE staining were performed respectively to detect the concentration of IL-6 and to observe pathological changes in lung tissue in order to confirm the modeling.② A recombinant plasmid encoding the gene of fusion protein rePO-FN was constructed and expressed in E.coli.The target protein was purified via affinity chromatography and renatured to obtain the desired protein.The physicochemical properties of the rePO-FN protein were characterized using SDS-PAGE protein gel electrophoresis,dynamic light scattering,molecular sieve chromatography,and transmission electron microscopy.③ C57BL/6J mice were randomly divided into PBS group,rePO group,rePO-FN group,and Ferritin group(n=10).The mice in the above groups were immunized intramuscularly with 100 μL PBS buffer alone or containing 10 μg of corresponding proteins on days 0,7,and 14.ELISA was used to measure the specific antibodies in serum.In 7 d after the final immunization,an acute PA infection model was used to compare the survival rates and bacterial colonization among the PBS,rePO,and rePO-FN groups.After establishing a bronchiectasis model by intratracheal instillation of 2.60 IU of elastase in C57BL/6J mice as described above,the mice were randomly divided into bronchiectasis PBS group,bronchiectasis rePO group,and bronchiectasis rePO-FN group(n=10).Immunization was conducted at the same dose and procedure as described above,in 21 d after bronchiectasis modeling.At the 7th d after the final immunization,an acute PA infection model was used to compare the survival rates and bacterial colonization among the groups.Results ①Repeated intratracheal instillation of elastase significantly increased the concentration of IL-6 in the lung tissue when compared to the content of the normal saline group(P＜0.05).Pathological observations revealed varying degrees of bronchial wall destruction,alveolar fusion,edema,neutrophil infiltration,and hemorrhage,with the severity increasing with elastase dose,which confirming successful establishment of the mouse model of bronchiectasis.② Well-dispersed rePO-FN nanoparticles were successfully prepared,with an average particle size of 91.28 nm,a Zeta potential of approximately-6.5 mV,and a polydispersity index(PDI)of 0.306.Molecular sieve chromatography determined the elution volume of rePO-FN protein to be 8.80 mL,corresponding to a molecular weight of approximately 1 400 kDa.③ Under acute PA XN-1 strain infection,the survival rate of the rePO-FN immunization group and the bronchiectasis rePO-FN immunization group were significantly higher than that of the PBS control group(P＜0.05).Additionally,bacterial colonization in the lung tissues was significantly lower in the rePO-FN immune group and the bronchiectasis rePO-FN immune group under acute PA XN-1 strain infection than that in the rePO group and the bronchiectasis rePO group(P＜0.05).Conclusion Our vaccine rePO-FN can effectively trigger a strong humoral immune response and provide significant protection against PA infection in a mouse bronchiectasis model.

Objective:To investigate the teaching effect of the single-circulation organ system integration course Nervous System and Disease for pediatrics 5+3 program, to guide the teaching practice of the integration course, and to promote the education and teaching reform of pediatrics.Methods:A total of 56 students of the class of 2019 in the pediatrics 5+3 program of Shanghai Jiao Tong University School of Medicine were selected as subjects, and the single-circulation organ system integration course was used for teaching. With the course of Nervous System and Disease as an example, evaluation results and questionnaires were used to assess the teaching effect of the single-circulation organ system course for pediatrics from the aspects of general information, course scores, student satisfaction, and expert supervision. SPSS 22.0 was used to perform descriptive statistics and analyses.Results:The course of Neurological System and Diseases integrated the contents of 11 related disciplines, with a mean score of (74.60±7.52) points. The scores of the students for course content, teaching mode, teaching resources, teaching effect, and the degree of overall satisfaction with the course were (4.71±0.54), (4.35±0.81), (4.50±0.69), (4.50±0.72), and (4.30±0.66), respectively. The score of expert supervision was (26.38±2.06) for teaching content and (26.52±2.03) for teaching methods, which still needed to be improved.Conclusions:The construction of the single-circulation organ system integration course provides new ideas for the curriculum reform of pediatrics; however, it is necessary to improve the construction of system and mechanism, explore the coordinated development of teachers, and strengthen deep integration and student guidance, thereby improving the teaching effect of the integrated course of pediatrics and promoting the training of medical talents in pediatrics.

Objective To explore the content and the psychometric properties of assessment tools used for evaluating functioning and adaptive behavior in school-age children with intellectual and developmental disabilities within educational settings. Methods The most used assessment tools included Vineland Adaptive Behavior Scales(VABS),Supports Intensity Scale for Children(SIS-C),Strengths and Difficulties Questionnaire(SDQ)and Repetitive Behavior Scale-Revised(RBS-R),for assessing functioning and adaptive behavior children with intellectual and developmental disabili-ties.Employing the framework and methods of the International Classification of Functioning,Disability,and Health(ICF),this research encoded and categorized the assessment dimensions and items of the four tools,and explored their psychometric properties. Results VABS's assessment content was solely focused on activities and participation,including speaking(d330),con-versation(d350),toileting(d530),eating(d550),drinking(d560),basic interpersonal interactions(d710),com-plex interpersonal interactions(d720),changing and maintaining body positions(d410-d429),carrying,moving and handing objects(d430-d449),and walking and moving(d450-d469).SIS-C assessed activities and participa-tion,and environmental factors,including washing oneself(d510),caring for body parts(d520),community life(d910),using transportation(d470),school education(d820),basic learning(d130-d159),looking after one's health(d570),basic interpersonal interactions(d710),and products and technology for education(e130).SDQ fo-cused on body functions,and activities and participation,including emotional functions(b152),global psychoso-cial functions(b122),attention functions(b140),and basic interpersonal interactions(d710).RBS-R focused on body functions,and activities and participation,including involuntary movement reaction functions(b755),invol-untary movement functions(b765),looking after one's health(d570),energy and drive functions(b130),under-taking a single task(d210),carrying out daily routine(d230),attention functions(b140),and handling stress and other psychological demands(d240).VABS was characterized by good specificity and excellent sensitivity.SIS-C demonstrated very good internal consistency,reliability and validity.SDQ was good in internal consistency,with excellent credibility and validity.RBS-R showed good internal consistency,reliability and validity. Conclusion SDQ and RBS-R cover both body functions,and activities and participation,SIS-C covers activity and par-ticipation,and environmental factors,while VABS solely assesses activities and participation.In terms of body functions,the assessment items primarily focus on mental functions(b130-b189)and movement functions(b750-b799).For activities and participation,the tools assess content across eight domains of functioning.Regarding en-vironmental factors,the assessment content mainly includes products and technology for education(e130),as well as design,construction and building products and technology of buildings for public use(e150).VABS,SIS-C,SDQ,and RBS-R are all norm-referenced measures,with moderate to excellent internal consistency,and good to excellent reliability and validity.

Objective:To examine the impact of berberine on polycystic ovary syndrome (PCOS) in mice, and to investigate the effects of berberine on the intestinal flora and the intestinal flora on PCOS.Methods:A mouse model of PCOS was established by administering dehydroepiandrosterone in combination with high fat diet, and the mouse model was given a berberine treatment. The study consisted of a blank control group (C group), a PCOS model group (M group) and a berberine treatment group (T group). During the experiment, the mice were closely monitored through timed body weight measurements and estrous cycle monitoring; intraperitoneal glucose tolerance test and insulin tolerance test were done. Upon completion of the pharmacological intervention, the wet weights of liver, ovary and fat deposits of mice were assessed and subjected to HE staining to confirm the success of PCOS modeling and the efficacy of berberine. Additionally, fecal samples were analyzed for intestinal flora through 16S rRNA analysis.Results:The PCOS model was established successfully, berberine alleviated the disturbance of estrous cycle in mice, and significantly alleviated fat accumulation and metabolic abnormalities of glucose in mice. The cross-sectional area of fat pad cells in T group was (2 858±146) μm2, which was significantly lower than that in M group [(9 518±347) μm2], and the difference was statistically significant ( P<0.001). The blood glucose levels in T group were significantly lower than those in M group ( P<0.05). The composition and structure of intestinal flora in mice of M group with PCOS (compared with C group) and in mice of T group after berberine intervention (compared with M group) were significantly altered. However, alpha diversity did not change significantly among three groups ( P>0.05). Conclusion:Berberine could alleviate PCOS by intervening in the alterations of gut microbiota.

Objective:To investigate the clinical outcomes of sublingual gland flap in the repair of postoperative jaw defects because of chronic phosphorous osteomyelitis(PNJ)and medication-related osteonecrosis of the jaw(MRONT).Methods:3 patients with PNJ and 2 with MRONJ were treated by sublingual gland flap in the repair of the postoperative jaw defet.The treatment effects were evalua-ted by clinical obseration.Results:In the 5 patients the wound healed well within 2 weeks postoperatively,with no infection and with normal sublingual gland function after surgery.Conclusion:The use of sublingual gland flap is an effective and feasible method for re-pairing local defects in the mandibles after surgery for chronic PNJ and MRONJ.

Objective:To investigate the anatomy of rectus femoris muscle flap and the anterolateral thigh muscle flap and their clinical application in reconstruction of large soft tissue defects after the removal of oral malignant tumour.Methods:From December 2006 to June 2009, 8 specimens of Chinese adult cadavers fixed in 10% formaldehyde were dissected to perform anatomy of anterolateral thigh region at the School of Basic Medical Sciences, Kunming Medical University. Anatomical images were analysed using Image-Pro Plus 6.0. Then, a retrospective study was performed on 19 patients who had postoperative defects after oral malignant tumour surgery and the defects were reconstructed with the rectus femoris muscle flap and the anterolateral thigh muscle flap from March 2020 to July 2022 at the Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital, Kunming Medical University. The postoperative defects of the 19 patients ranged from 3.0 cm×6.0 cm to 5.0 cm×10.0 cm. Ten rectus femoris muscle flaps, 8 anterolateral thigh muscle flaps and 1 combined rectus femoris muscle flap and anterolateral thigh muscle flap were used. The muscular flaps sized from 4.0 cm × 8.0 cm to 6.0 cm × 11.0 cm. Regular postoperative outpatient follow-ups were conducted.Results:The lengths of vessels of the harvested rectus femoris muscle flap and anterolateral thigh muscle flap were 63.4 mm± 12.9 mm and 112.5 mm± 19.6 mm, respectively. The starting outer diameters of the lateral circumflex thigh artery, the oblique branch of the lateral circumflex thigh artery and the descending branch of the lateral circumflex thigh artery were 2.92 mm±0.72 mm, 1.88 mm±0.23 mm and 2.29 mm±0.43 mm, respectively. Postoperative follow-up lasted for 7 to 32 months, with 17.5 months in average. Seventeen flaps were completely survived and the rectus femoris muscle flap was completely mucosalised 5 weeks after surgery. However, 2 rectus femoris muscle flaps had necrosis of which one was changed to a tongue flap reconstruction and the other encountered flap necrosis during postoperative radiotherapy and healed after debridement and dressing changes. There was no postoperative complication in the donor sites. Other than the 2 patients, all other 17 patients had satisfactory clinical outcomes.Conclusion:Both of the starting outer diameters and length of vessels of the femoris muscle flap and the anterolateral thigh muscle flap meet the requirements for reconstruction of maxillofacial defects, and both muscular flaps are simple to prepare, in good reconstructive results with few complication, as well as an excellent outcome. They are feasible approaches for reconstruction of large soft tissue defects left after the removal of an oral malignant tumour.