Objective To explore the characteristics of Xin'an doctors in the syndrome differentiation and treatment of liver cirrhosis from the dimensions of symptoms,syndromes and medication using data mining methods.Methods Medical cases and prescriptions for liver cirrhosis were collected from Xin'an medical literature.Data mining was performed using frequency analysis,complex network analysis,Louvain clustering analysis and factor analysis to investigate syndromes,symptoms,and medicines.Results A total of 363 prescriptions were analyzed,involving 15 syndromes and 325 kinds of Chinese materia medica,with 33 identified as core medications.Tonifying herbs were the most frequently used;the primary syndromes were liver qi stagnation and water retention;core symptoms of liver qi stagnation included emotional distress,reduced appetite and hypochondriac pain,with core medications such as Bupleuri Radix and Poria;core symptoms of water retention included lower limb edema and abdominal distension,with core medications such as Pinelliae Rhizoma,Citri Reticulatae Pericarpium,Magnoliae Officinalis Cortex and Poria.Factor analysis of core medications identified 12 common factors.Conclusion The pathogenesis of liver cirrhosis involves deficiency in nature and excess in superficiality,primarily affecting the liver and closely related to the spleen and kidneys.Xin'an doctors emphasize treating the symptoms with qi-regulating,blood-activating,dampness-drying and heat-clearing strategies,while simultaneously addressing the root with qi-tonifying,spleen-strengthening,liver-nourishing and kidney-replenishing therapies.

Objective:To explore the effect of combining intermittent θ pulse stimulation (iTBS) of the cerebellum with lower extremity exoskeleton robot support on the balance and walking function of stroke survivors.Methods:Seventy-five stroke survivors complicated with lower extremity dysfunction were divided into an iTBS group, an exoskeleton group and a combined group, each of 25, according to a random number table. In addition to conventional rehabilitation training, the iTBS group was given cerebellar iTBS combined with traditional walking training, the exoskeleton group received sham cerebellar iTBS combined with walking training assisted by a lower extremity exoskeleton robot. The combined group received both therapies. The schedule was once a day, 5 days a week for 3 weeks. Before and after the treatment, the 10-metre walking test (10MWT), the Berg Balance Scale (BBS) and the Fugl-Meyer lower extremity assessment (FMA-LE) were used to evaluate the subjects′ walking ability, balance and lower extremity motor ability. Gait and neuro-electrophysiological tests were also conducted in all three groups.Results:After the treatment, a significant improvement was observed in the 10MWT times, BBS scores, FMA-LE scores, stride frequency and stride speed of all three groups compared with before the treatment. On average, the results of the exoskeleton and combined groups were significantly better than those of the iTBS group, and those of the combined group were significantly better than among the exoskeleton group. Almost everyone′s MEP latency and amplitude had improved significantly compared with before the treatment, but the improvements in the exoskeleton group tended to be superior to those in the iTBS group ( P≤0.05). The latency in the combined group averaged (21.25±1.70)ms, and the amplitude averaged (184.17±6.54)μV, both significantly better than the exoskeleton group′s averages. Conclusions:Cerebellum iTBS combined with lower extremity exoskeleton walker training can significantly improve the motor functioning, balance and walking ability of stroke survivors.

Objective:To explore the effect of combining repeated peripheral (rPMS) and central transcranial magnetic stimulation (rTMS) in treating upper limb motor dysfunction after a stroke.Methods:Seventy-eight patients with upper limb motor dysfunction after a stroke were randomly divided into a control group, an rTMS group and a combined magnetic stimulation group, each of 26. All three groups underwent routine rehabilitation, while the rTMS group was repeatedly given low frequency transcranial magnetic stimulation of the M1 region on the unaffected side, and the combined group also received repeated peripheral magnetic stimulation at Erb′s point on the affected upper limb. There was one treatment session a day, 5 days a week for 3 weeks. Before and after the treatment, everyone′s upper limb motor function was quantified using the Fugl-Meyer upper extremity assessment (FMA-UE) and the Wolf motor function test (WMFT). Skill in the activities of daily living was quantified in terms of a Barthel index (BI). Motor recovery of the upper limbs and hands was assessed using Brunnstrom staging. The latency and amplitude of the motor evoked potentials (MEPs) in the subjects′ affected abductor pollicis brevis muscles were also recorded before and after the treatment. Pearson correlation coefficients quantified the correlation between the changes in FMA-UE scores and MEP amplitudes before and after the treatment in the three groups.Results:There were no significant differences among the three groups before the treatment. Afterward, however, the average FMA-UE, WMFT and BI scores, as well as the upper limb and hand Brunnstrom stages and the average MEP latencies and amplitudes of all the three groups had improved significantly. The combined group′s average results were then significantly better than the other two groups′ averages, except for the upper limb Brunnstrom stages. The increases in MEP amplitude were positively correlated with the increases in FMA-UE scores among the rTMS and the combined group, but there was no significant correlation between them in the control group.Conclusions:The combined application of rPMS and contralateral low frequency rTMS can effectively relieve motor dysfunction in the upper limbs in the early stages after a stroke.

Objective:To assess the value of chromosomal microarray analysis (CMA) for the detection of low-level mosaicisms in amniotic fluid samples, and to retrospectively analyze the rare cases of mosaicisms.Methods:Chromosomal karyotype of the fetus was determined by G-banding analysis of cultured amniotic fluid cells. CMA was used to detect copy number variation of fetal chromosomes, and fluorescence in situ hybridization (FISH) was used to determine the proportion of fetal chromosomal mosaicisms in uncultured amniotic fluid cells. Results:Among 825 prenatal samples, 4 cases of true fetal mosaicisms were detected, which yielded an incidence of 0.48%. Two cases were sex chromosomal mosaicisms, and two were autosomal mosaicisms, which involved chromosomes 8 and 9, respectively. All cases were verified by G-banding analysis of cultured amniotic fluid cells, CMA, and/or FISH.Conclusion:CMA has a great value for detecting low-level mosaicisms in amniotic fluid samples, though the positive results need to be verified by other techniques and should be interpreted with caution. The review of rare cases can provide a basis for prenatal genetic counseling.

Objective:To discuss the improvement effect of epicatechin(EC)on acetaminophen(APAP)-induced liver injury in the mice,and to clarify its possible mechanism.Methods:A total of 60 C57BL/6J mice were randomly divided into blank control group,APAP model group,low dose of EC group(10 mg·kg-1),middle dose of EC group(20 mg·kg-1)and high dose of EC group(40 mg·kg?1),with 12 mice in each group.Except for blank control group,the mice in the other groups were given intraperitoneal injection of APAP(200 mg·kg?1)to establish the liver injury models.At 1 h before APAP injection,the mice in low,middle and high doses of EC groups were intraperitoneally injected with 10,20 and 40 mg·kg-1 EC,respectively.A total of 36 nuclear factor E2-related factor 2(Nrf2)deficient mice(Nrf2-/-mice)were randomly divided into control group,APAP group and APAP+EC group,with 12 mice in each group.After modeling 24 h,the mice were sacrificed,and the blood and liver tissue of the mice were collected for subsequent detection.HE staining was used to observe the pathomorphology of the liver tissue in the mice in various groups;kit assay was used to detect the activities of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)in serum of the mice in various groups and the myeloperoxidase(MPO)activity and the levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),malondialdehyde(MDA),adenosine triphosphate(ATP),glutathione(GSH)and ferrous ion(Fe2?)in liver tissue of the mice in various groups;Western blotting method was used to detect the expression levels of nuclear factor-κB(NF-κB)and Nrf2 signaling pathway-related proteins in liver tissue of the mice in various groups.Results:The HE staining results showed that compared with APAP model group,the APAP-induced liver pathology injury in the mice in different doses of EC groups was significantly improved.Compared with blank control group,the levels of ALT and AST in serum of the mice in APAP model group were significantly increased(P<0.01).Compared with APAP model group,the activities of ALT and AST in serum of the mice in low,middle and high doses of EC groups were significantly decreased(P<0.05 or P<0.01).Compared with blank control group,the MPO activity and the levels of TNF-α and IL-1β in liver tissue of the mice in APAP model group were significantly increased(P<0.01).Compared with APAP model group,the MPO activity and the levels of TNF-α and IL-1β in liver tissue of the mice in low,middle and high doses of EC groups were decreased(P<0.05 or P<0.01).Compared with blank control group,the levels of MDA and Fe2? in liver tissue of the mice in APAP model group were significantly increased(P<0.05),and the levels of ATP and GSH were significantly decreased(P<0.05).Compared with APAP model group,the levels of MDA and Fe2? in liver tissue of the mice in low,middle and high doses of EC groups were significantly increased(P<0.05 or P<0.01),and the levels of ATP and GSH were significantly increased(P<0.01).Compared with blank control group,the expression levels of amino acid exchange transporter(xCT)and glutathione peroxidase 4(GPX4)proteins in liver tissue of the mice in APAP model group were significantly decreased(P<0.05);compared with APAP model group,the expression levels of xCT and GPX4 proteins in liver tissue of the mice in low,middle and high doses of EC groups were significantly increased(P<0.01).Compared with blank control group,the expression levels of nuclear factor-κB(NF-κB)p-p65 and phosphorylated NF-κB inhibitor α(p-IκBα)proteins in liver tissue of the mice in APAP model group were significantly increased(P<0.05);compared with APAP model group,the expression levels of NF-κB p-p65 and p-IκBα proteins in liver tissue of the mice in low,middle and high doses of EC groups were significantly decreased(P<0.01).Compared with blank control group,the expression levels of Nrf2 and heme oxygenase-1(HO-1)proteins in liver tissue of the mice in APAP model group were significantly increased(P<0.05);compared with APAP model group,the expression levels of Nrf2 and HO-1 proteins in liver tissue of the mice in low,middle and high doses of EC groups were significantly increased(P<0.01).Compared with control group,the ALT level in serum and the levels of MDA and Fe2+in liver tissue of the Nrf2-/-mice in APAP group were significantly increased(P<0.01),and the levels of ATP and GSH in liver tissue were significantly decreased(P<0.01).Conclusion:EC can improve APAP-induced liver injury in the mice,and its mechanism may be related to the inhibition of ferroptosis by activating the Nrf2/GPX4 signaling pathway.

Diabetic foot ulcers(DFU)are the primary manifestations of diabetic foot,and the diabetic foot is one of the complications of diabetes mellitus.DFU present the characteristics of high morbidity,high disability rate and high recurrence rate.Clinically,DFU can be classified into the category of finger-toe gangrene in traditional Chinese medicine(TCM).In the view of Professor Huang Shuling,DFU develop from diabetes after a long time,and are caused by insufficiency of kidney yin together with phlegm and blood stasis blocking collaterals,which results in the internal retention of damp-heat and toxins under the conditions of insufficiency of healthy qi and attack of external pathogens.According to the progression of DFU,DFU can be differentiated as five syndromes,namely heat-toxin and blood stasis accumulation syndrome,heat retention impairing yin syndrome,spleen deficiency and phlegm-stasis syndrome,qi and blood deficiency complicated by blood-stasis obstructing collaterals syndrome,and liver-kidney yin deficiency complicated by blood-stasis obstruction syndrome.Following the therapeutic principle of supporting healthy qi to eliminate pathogens,Professor Huang formulated the therapies for DFU,i.e.,clearing heat and removing toxins and activating blood,clearing heat and nourishing yin and activating blood,invigorating spleen and resolving phlegm and unblocking collaterals,tonifying qi-blood and removing blood stasis,and nourishing liver-kidney and unblocking blood stasis.Moreover,three-level prevention and treatment strategies for DFU were put forward by Professor Huang.The strategies include early diagnosis and early treatment of high-risk diabetic foot,delaying the progression of peripheral neuropathy and vascular disease of diabetes mellitus and treating tinea pedis positively,and effectively treating DFU to reduce amputation rate.The preventive and therapeutic strategies for DFU cover the therapies of integrated Chinese and western medicine,and therapies of simultaneous internal and external treatment.In treating DFU with TCM therapy,Professor Huang addressed the importance of combined use of Zizhuye Lotion for wet compressing on the wound continuously based on oral administration of Chinese medicine,which achieves a stronger therapeutic effect.

BACKGROUND:Magnesium and magnesium-based materials have good biocompatibility,stable osteogenic properties,and biological activities such as vascularization and immune regulation,and show a broad application prospect in stomatology.OBJECTIVE:To summarize the mechanism of magnesium-based materials in the treatment of oral diseases in terms of osteogenesis,angiogenesis,and immunomodulation,and to review the application prospects of magnesium and magnesium-based materials in the field of oral diseases in recent years.METHODS:Chinese search key words were"magnesium,magnesium alloys,magnesium-based metals,fractures,implants,restorations,endodontics,periodontitis,periodontal disease,cysts,oral cancer."English search key works were"magnesium,magnesium-based alloy,fracture,facial bone fractures,denture,dental implant,restorative dentistry,pulpitis,periodontitis,periodontal diseases,oral cancer."The articles were retrieved on CNKI,WanFang,PubMed,and Web of Science databases.By analyzing and reading literature for screening,84 articles were finally included for review.RESULTS AND CONCLUSION:Magnesium and magnesium-based materials can be used as bone internal fixation devices for jaw fracture or orthognathic surgery.Due to the special biological properties of magnesium,it can not only ensure stable osteogenesis,but also avoid the possibility of secondary surgery,which has the potential to be widely used.In the field of bone regeneration in stomatology,magnesium,relying on its superior biological properties,shows better mechanical properties and antibacterial properties than existing clinical materials,providing more options for the development and application of materials in this field.With the help of the biological activity of magnesium,magnesium-based coating materials give full play to the anti-inflammatory and antioxidant effects,further promote implant bone bonding and soft tissue integration,and have great application prospects in implant surface modification and promoting implant stability.Although magnesium has been involved in maxillofacial intraoral soft tissue regeneration and treatment,dental tissue engineering,there are still a lot of gaps.To ensure the stable biological characteristics of magnesium,it is usually necessary to add other alloys or carry out magnesium surface modification.However,the biological evaluation system of degradable metal implants is not perfect at present.The clinical application of magnesium in oral diseases still needs to be further clarified in the future.

Objective:To describe the temporal trend of disease burden of idiopathic epilepsy in China from 1990 to 2021 and predict the incidence of idiopathic epilepsy in China from 2022 to 2035 to provide references for the formulation of relevant health policies and measures.Methods:Based on data from the Global Burden of Disease Study 2021 (GBD 2021) database regarding idiopathic epilepsy in China, changes in disease burden from 1990 to 2021 were acquired. Disease burden was quantified using age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years (DALYs) rate (ASDR) and their 95% uncertain interval (UI). Temporal trend analysis was performed using a linear regression model to estimate the estimated annual percent change (EAPC) and annual percentage change (APC) in incidence of idiopathic epilepsy and their 95% CI. Additionally, incidence and number of patients with idiopathic epilepsy in China from 2022 to 2035 were predicted using Bayesian age-period-cohort model. Results:The ASIR of idiopathic epilepsy increased from 22.35 per 100,000 population in 1990 (95% UI: 15.04-30.92 per 100,000 population) to 28.19 per 100,000 population in 2021 (95% UI: 19.03-37.89 per 100,000 population), with an EAPC of 0.12% (95% CI: -0.10%-0.34%); ASPR of idiopathic epilepsy increased from 189.27 per 100,000 population in 1990 (95% UI: 132.48-252.95 per 100,000 population) to 214.71 per 100,000 population in 2021 (95% UI: 150.10-278.56 per 100,000 population), with an EAPC of -0.32% (95% CI: -0.57%-0.06%); ASMR of idiopathic epilepsy decreased from 1.86 per 100,000 population in 1990 (95% UI: 1.59-2.24 per 100,000 population) to 0.80 per 100,000 population in 2021 (95% UI: 0.67-1.00 per 100,000 population), with an EAPC of -2.96% (95% CI: -3.09%-2.82%); ASDR of idiopathic epilepsy decreased from 178.60 per 100,000 population in 1990 (95% UI: 143.44-220.63 per 100,000 population) to 101.39 per 100,000 population in 2021 (95% UI: 72.51-139.40 per 100,000 population), with an EAPC of -2.38% (95% CI: -2.54%-2.22%). The prediction model showed that by 2035, the prevalence of idiopathic epilepsy in China will be 28.27 per 100,000 (95% CI: 23.19-38.66), with an estimated 394,928 incident cases (95% CI: 324,037-540,128). Conclusions:From 1990 to 2021, the ASIR and ASPR of idiopathic epilepsy in China show an upward trend, while the ASMR and ASDR hace a decline trend. Incidence of idiopathic epilepsy in China is expected to remain stable over the next decade.

Objective To explore the effect of prominent cortical vein(PCV)sign on the clinical prognosis of patients undergoing endovascular recanalization for acute anterior circulation cerebral infarction.Methods A total of 102 patients with acute anterior circulation large-vessel occlusion in Zhongshan Municipal Hospital of Tradiontional Chinese Medicine from January 1,2020 to December 21,2022,who received endovascular recanalization,were enrolled in this study.The clinical data and radiographic materials were collected.According to whether PCV sign was present or not,the patients were divided into PCV group and non-PCV group.The clinical data were compared between the two groups.Logistic regression analysis was used to analyze the correlation between the postoperative 90-day mRS score and the occurrence of PCV.Results Compared with non-PCV group,in PCV group the incidence of atrial fibrillation was even higher,and the good rate of collateral compensation was even lower,and the postoperative(7±2)-day NIHSS score was even lower;the differences in above indexes between the two groups were statistically significant(all P＜0.05).Ninety days after treatment,the proportion of patients having modified Rankin Scale(mRS)score ≤2 points in the non-PCV group was 76.3％,which was higher than 58.6％in the PCV group,but the difference was not statistically significant(P=0.074).Logistic regression analysis indicated that a positive correlation existed between the presence of PCV sign and atrial fibrillation(OR=9.679,95％CI=1.264-74.364)and a negative correlation existed between the presence of PCV sign and good collateral compensation(OR=0.015,95％CI=0.033-0.331).No relationship existed between the postoperative 90-day good prognosis and the presence of preoperative PCV sign(OR=2.078,95％CI=0.680-6.348),but patient's age,preoperative intravenous thrombolysis were negatively correlated with the preoperative Alberta Stroke Program Early CT(ASPECT)score(P＜0.005).Conclusion In patients with anterior circulation acute ischemic stroke(AIS),the occurrence of PCV sign is associated with the impaired collateral compensation and atrial fibrillation,but its impact on the clinical outcomes of patients after receiving reperfusion therapy remains uncertain.PCV sign may be used as a potential evaluation indicator for inadequate cerebrovascular collateral compensation.

OBJECTIVE: To assess the value of chromosomal microarray analysis (CMA) for the detection of low-level mosaicisms in amniotic fluid samples, and to retrospectively analyze the rare cases of mosaicisms. METHODS: Chromosomal karyotype of the fetus was determined by G-banding analysis of cultured amniotic fluid cells. CMA was used to detect copy number variation of fetal chromosomes, and fluorescence in situ hybridization (FISH) was used to determine the proportion of fetal chromosomal mosaicisms in uncultured amniotic fluid cells. RESULTS: Among 825 prenatal samples, 4 cases of true fetal mosaicisms were detected, which yielded an incidence of 0.48%. Two cases were sex chromosomal mosaicisms, and two were autosomal mosaicisms, which involved chromosomes 8 and 9, respectively. All cases were verified by G-banding analysis of cultured amniotic fluid cells, CMA, and/or FISH. CONCLUSION CMA has a great value for detecting low-level mosaicisms in amniotic fluid samples, though the positive results need to be verified by other techniques and should be interpreted with caution. The review of rare cases can provide a basis for prenatal genetic counseling.
Humans ; Female ; Amniotic Fluid/metabolism* ; Pregnancy ; Mosaicism/embryology* ; Prenatal Diagnosis/methods* ; Adult ; In Situ Hybridization, Fluorescence ; Microarray Analysis/methods* ; Karyotyping ; Retrospective Studies ; Male