Attention deficit hyperactivity disorder （ADHD） is often accompanied by tic disorder. The core pathogenesis is considered to be ministerial fire scorching yin and internal stirring of deficient wind， which leads to disharmony between the body and spirit， resulting in clinical manifestations. The treatment principles emphasize nourishing yin fluids， calming ministerial fire， and extinguishing endogenous wind （内风）. The method of nourishing yin fluids is applied throughout the entire treatment process， commonly using ingredients such as Shudihuang （Rehmanniae Radix Praeparata）， Shanzhuyu （Corni Fructus）， Gouqizi （Lycii Fructus）， Wuweizi （Schisandrae Chinensis Fructus）， and Tusizi （Cuscutae Semen）. These are combined with approaches to harmonize the zang-fu organs， primarily including extinguishing liver wind， clearing heart fire， nourishing kidney water， and strengthening spleen earth， thereby stabilizing ministerial fire and extinguishing endogenous wind. Additionally， emotional regulation and smoothing emotional constraint are essential to improve clinical symptoms in children with ADHD comorbid with tic disorder.

This paper discusses the pathogenesis and treatment strategies of skin cancer based on the theory of "spleen deficiency-sweat pore obstruction-toxin accumulation". It is believed that although the disease is located in the skin and body hair， it is not only the localized disorder but closely related to the imbalance of qi and blood of zang-fu （脏腑） organs. The core of the disease is the synergistic disorder of spleen， sweat pore， and skin and body hair. The disease progression follows a dynamic evolution from spleen deficiency with loss of nourishment， initial closure of sweat pore to binding of dampness and stasis with obstruction of sweat pore， and then to cancer toxin consolidation with damage to sweat pore. Based on this， three principles of building earth， opening sweat pore and attacking toxin are established. The method of fortifying spleen and raising the clear aims to consolidate the root and restore validity， with commonly used prescriptions including modifications of Buzhong Yiqi Decoction （补中益气汤）， Liujunzi Decoction （六君子汤） and Guipi Decoction （归脾汤）. The method of opening sweat pores with acrid-moistening medicinals is suggested when dredging and unblocking the sweat pore， commonly using acrid and warm dispersing medicinals， supplemented with herbs that nourish fluids and moisten dryness. The method of clearing heat and removing toxin is to break cancer toxin directly， and modifications of prescriptions such as Wuwei Xiaodu Beverage （五味消毒饮）， Xiaolei Pills （消瘰丸） and Xihuang Pills （犀黄丸） are commonly used. These approaches provide valuable ideas for the prevention and treatment of skin cancer with traditional Chinese medicine.

The core pathogenesis of attention deficit hyperactivity disorder （ADHD） lies in deficiency， stasis and stagnation. Deficiency arises from kidney essence depletion and spleen dysfunction in transportation and transformation， leading to inadequate nourishment of the marrow sea. Stasis caused by qi deficiency leads to obstruction in channels and collaterals， resulting in obstructed marrow transport. Stagnation is associated with the excess of the five minds transforming into fire， which scorches the brain orifices and leads to loss of control over marrow utilisation. Based on this， a "supplementation-unblocking-regulation" therapeutic approach is proposed. For deficiency， the focus is on supplementing kidney and fortifying spleen， and replenishing the marrow sea. For stasis， the priority is to unblock and open the orifices， and clear the marrow channels. For stagnation， the core is to clear fire and contain the mind， regulate and restore vital activity. In clinical practice， it is necessary to identify the primary and secondary pathogenic mechanisms and apply dynamic， combined treatment， integrating Chinese herbal medicine， acupuncture， and guiding exercises throughout the process， aiming to provide a reference for the diagnosis and treatment of ADHD with traditional Chinese medical.

This paper discusses the pathogenesis and treatment strategies of skin cancer based on the theory of "spleen deficiency-sweat pore obstruction-toxin accumulation". It is believed that although the disease is located in the skin and body hair， it is not only the localized disorder but closely related to the imbalance of qi and blood of zang-fu （脏腑） organs. The core of the disease is the synergistic disorder of spleen， sweat pore， and skin and body hair. The disease progression follows a dynamic evolution from spleen deficiency with loss of nourishment， initial closure of sweat pore to binding of dampness and stasis with obstruction of sweat pore， and then to cancer toxin consolidation with damage to sweat pore. Based on this， three principles of building earth， opening sweat pore and attacking toxin are established. The method of fortifying spleen and raising the clear aims to consolidate the root and restore validity， with commonly used prescriptions including modifications of Buzhong Yiqi Decoction （补中益气汤）， Liujunzi Decoction （六君子汤） and Guipi Decoction （归脾汤）. The method of opening sweat pores with acrid-moistening medicinals is suggested when dredging and unblocking the sweat pore， commonly using acrid and warm dispersing medicinals， supplemented with herbs that nourish fluids and moisten dryness. The method of clearing heat and removing toxin is to break cancer toxin directly， and modifications of prescriptions such as Wuwei Xiaodu Beverage （五味消毒饮）， Xiaolei Pills （消瘰丸） and Xihuang Pills （犀黄丸） are commonly used. These approaches provide valuable ideas for the prevention and treatment of skin cancer with traditional Chinese medicine.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Objective:To explore the efficacy of Qingjin Huatan Decoction combined with conventional Western medicine for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with phlegm-heat obstructing lung syndrome.Methods:A randomized controlled trial was conducted. Totally 90 hospitalized patients with AECOPD phlegm-heat obstructing lung syndrome in the respiratory department of Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital from January 2023 to June 2024 were selected as the observation subjects. According to the simplified randomization method (single-double number method), the patients were divided into two groups, with 45 cases in each group. The conventional Western medicine group was given conventional Western medicine treatment, and the combined Chinese materia medica group was given Qingjin Huatan Decoction on the basis of the conventional Western medicine group. The treatment for both groups lasted for 7 d. TCM symptoms were scored before and after treatment; FEV 1 and FVC were detected by pulmonary function analyzer, PaO 2, PaCO 2, PaO 2/FiO 2 were detected by blood gas biochemical analyzer, CRP and PCT were detected by ELISA, and white blood cell count (WBC) was detected by automatic blood cell analyzer. Adverse reactions were recorded, and the clinical efficacy was evaluated. Results:The total effective rate was 93.33% (42/45) in the combined Chinese materia medica group and 77.78% (35/45) in the conventional Western medicine group, with statistical significance ( χ2=4.41, P=0.036). After treatment, the scores of cough, wheezing, chest tightness and shortness of breath and fever and the total score in the combined Chinese materia medica group were lower than those in the conventional Western medicine group ( t=4.83, 2.26, 5.36, 10.43, 5.27,respectively, P<0.01 or P<0.05); the levels of FEV 1 and FVC in the combined Chinese materia medica group were higher than those in the conventional Western medicine group ( t=3.03, 2.64, respectively, P<0.01); the levels of PaO 2 and PaO 2/FiO 2 in the combined Chinese materia medica group were higher than those in the conventional Western medicine group ( t=4.83, 5.36, P<0.01), while the level of PaCO 2 in the combined Chinese materia medica group was lower than that in the conventional Western medicine group ( t=2.26, P<0.05); the levels of CRP, PCT and WBC in the combined Chinese materia medica group were lower than those in the conventional western medicine group ( t=10.53, 11.29 and 2.59, respectively, P<0.01 or P<0.05). During the treatment, the incidence of adverse reactions was 6.67% (3/45) in the combined Chinese materia medica and 8.89% (4/45) in the conventional Western medicine group, without statistical significance ( χ2=0.16, P=0.694). Conclusion:Qingjin Huatan Decoction can effectively improve the lung function and blood gas indicators of AECOPD with phlegm-heat obstructing lung syndrome, and relieve the inflammation, with safety and effectiveness.

Objective In this study,we investigated the correlation between the scores for different Liebowitz Social Anxiety Scale(LSAS)subscale models and the metabolic activity in specific regions of the brain using 18F-fluorodeoxyglucose(FDG)positron emission tomography/computed tomography(PET/CT)(18F-FDG PET),thereby improving the understanding of the neurobiological characteristics of social anxiety.Methods A total of 39 cognitively normal participants(29 men and 10 women,aged 30-63 years)were enrolled.All participants underwent LSAS assessment and brain 18F-FDG PET scanning.Correlations between metabolic activities in various brain regions and scores from the different LSAS subscales were analyzed accordingly.Results LSAS subscale scores were significantly correlated with metabolic activity in specific brain regions.In the Safren model,the score for the observation by others subscale was positively correlated with the left fusiform gyrus(P<0.001,false discovery rate[FDR]-corrected)and the left caudate tail(P<0.001,FDR-corrected),suggesting a close association between mood states related to observation by others and the metabolic activity in these regions.In the Baker model,the score for the eating and drinking subscale was negatively correlated with the right precuneus(P<0.001,FDR-corrected),while the score for the assertiveness subscale was positively correlated with the left caudate nucleus(P<0.001,FDR-corrected).These findings revealed the complex associative patterns between various mood and behavioral dimensions and metabolic activities in specific brain regions.Conclusion Social anxiety symptoms are closely associated with metabolic changes in specific brain regions,including the left insula,left caudate tail,and right precuneus.Moreover,different social situations activate distinct brain regions.Compared with individuals with social anxiety disorder,normal individuals exhibit involvement of fewer brain regions when experiencing social anxiety.These findings provide new experimental evidence for understanding the neural mechanisms underlying social anxiety.

Objective To explore the biomechanical characteristics of different types of lumbar disc herniation(LDH),and provide a theoretical basis for the clinical classification,diagnosis,and treatment of LDH.Methods A normal lumbar spine model with spinal nerves and four types of LDH models(central type,paracentral type/lateral recess type,intervertebral foramen type,extreme type)were constructed,and the biomechanical characteristics of the intervertebral discs and nerve roots in neutral posture and under six degrees of freedom conditions were analyzed.Results In neutral position,the stress of normal intervertebral disc was carger than that of the herniated intervertebral disc,and the stress ratio of annulus fibrosus and nucleus pulposus in normal model was greater than that of annulus fibrosus and nucleus pulposus in herniated models.In neutral position,the disc stress was mainly concentrated at the incisor between the protrusion and normal part,and recruitment occurred at outer edge of the disc.In flexion and extension position,the stress of the herniated intervertebral disc shifted to the right side.The maximum stress of herniated intervertebral disc appeared during right flexion,and the nerve root stress on the right side was carger than that on the left side.The stress of the herniated intervertebral disc during right rotation was slightly lower than that during right flexion,and the stress of nerve root on the right side was smaller than that on the left side.Conclusions The intervertebral disc is important in maintaining lumbar dynamic and static stability and flexibility.Different positions have an obvious effect the intervertebral disc stress.For patients with LDH,forward bending,flexion of the affected side and large extension should be avoided.Appropriate rotation of the affected side can help relieve the symptoms of nerve root compression.

Objective·To explore the value of combined diaphragm and intercostal muscle ultrasound assessment compared with conventional diaphragm ultrasound in predicting the weaning outcome in mechanically ventilated patients with sepsis.Methods·Mechanically ventilated patients with sepsis,consecutively admitted to the Department of Critical Care Medicine of Affiliated Hospital of Nantong University from October 2022 to December 2023,were selected.During the peri-weaning period,after the patient's sepsis condition improved and the patient passed the spontaneous breathing trial(SBT),ultrasound evaluation of respiratory muscles was performed by ultrasound qualified personnel with ultrasound qualification and experience in bedside ultrasound examination.Diaphragm excursion(DE),thickening fraction of diaphragm(TFD),and thickening fraction of intercostal muscle(TFic)were measured,respectively.The patients were divided into a successful weaning group(n=114)and a failed weaning group(n=24)according to the weaning results.Receiver operating characteristic(ROC)curves were used to analyze the value of diaphragm ultrasound and intercostal muscle ultrasound,alone and in combination,in predicting ventilator weaning outcome.Results·TFic and TFic/TFD were significantly higher in the failed weaning group during SBT than in the successful weaning group(all P<0.05).The areas under the ROC curve(AUROC)of DE,TFD,and TFic to predict weaning failure in mechanically ventilated patients with sepsis during the period of SBT were 0.689(0.591?0.776),0.657(0.557?0.747),and 0.769(0.676?0.846),respectively,whereas the combined indexes TFic/TFD and TFic&TFD_mix had AUROCs of 0.867(0.786?0.925)and 0.860(0.778?0.920),respectively.TFic/TFD with a cutoff value of>0.95 had a sensitivity of 86.7%and a specificity of 75.3%in predicting weaning failure,and TFic&TFD_mix with a cutoff value of>0.13 had a sensitivity of 86.6%and a specificity of 80.9%in predicting weaning failure.Moreover,the intercostal muscle ultrasonography method had an intra-observer intraclass correlation coefficient(ICC)of 0.890 and an extra-observer ICC of 0.876 for measurement reliability,which were both rated as good(P<0.001).Conclusion·Combined diaphragm and intercostal muscle ultrasonography provides a more comprehensive picture of the patient's overall respiratory muscles,and has a higher guiding value in predicting the weaning outcomes in mechanically ventilated patients with sepsis than diaphragm ultrasound alone.

Objective To explore the biomechanical safety of applying traditional Chinese orthopedic manipulation therapy after anterior cervical discectomy and fusion(ACDF)surgery,so as to provide a theoretical basis for clinical treatment in biomechanics.Methods Based on CT data,a three-dimensional finite element model of the normal C0-T1 cervical spine was established,and an ACDF postoperative finite element model of the C5-6 segment was constructed on this basis.Cervical spine rotation manipulation was simulated at the C4 and C7 segments of both models,and the von Mises stresses of the vertebral body,bilateral facet joints,intervertebral discs,and internal fixation system under manipulation loading of the C4 and C7 segments in both models were compared and analyzed.Results When the C4 segment was manipulated,the stress on the C5,C6,and C7 vertebral bodies in the ACDF postoperative model decreased by 12.3％,11.5％,and 26.4％,compared to the normal model.The stress on the left facet joints of the C4-5,C5-6,and C6-7 segments decreased by 12.3％,58.8％,and 15.4％,and the stress on the right facet joints decreased by 16.6％,92.1％,and 17.2％.The stress on the C4-5 and C6-7 segments decreased by 13.2％and 4.0％,while the maximum stress of the fusion cage,titanium plate,and screws in the C5-6 segment were 9.349,111.9,and 300.8 MPa.When the C7 segment was manipulated,the stress on the C4,C5,and C6 vertebral bodies in the ACDF postoperative model increased significantly compared to the normal model,especially the C5 vertebral body,with an increase of nearly 18 times.Except for the stress on the left facet joint of the C4-5 segment increased by 57.7％,the stress on the bilateral facet joints of other segments generally decreased,but the stress on the C4-5 and C6-7 segments increased by 43.2％and 21.7％and the stresses on the fusion cage,titanium plate,and screws in the C5-6 segment were 2.926,205.4,and 256.2 MPa.Conclusions The safety of performing manipulation on the upper vertebral body of the fusion segment after ACDF surgery is relatively high,but performing manipulation on the lower vertebral body of the fusion segment may lead to stress concentration and increase the risk of injury.When postoperative conservative treatment is implemented,the manipulation safety and indications should be considered to avoid operations in high-risk areas,and more precise and safe manipulation intervention treatment should be implemented based on the specific postoperative biomechanical state of the patient.