At present,some new tongue manifestations with distinct characteristics and high clinical value have not yet gained widespread consensus,which is unfavorable to their research and promotion.This paper representatively explores four types of tongue texture manifestations(liver gall line,bulging vein tongue,concave tip tongue,convex surface tongue)and two types of tongue coating manifestations(cracked tongue coating,white saliva line)among them.It is found that the liver gall line manifests as dark stagnation of various forms on the tongue surface,indicating liver qi stagnation and blood stasis as well as heat-toxin accumulation;the bulging vein tongue is characterized by clearly raised blood vessels on the tongue surface,suggesting blood stasis due to yang deficiency or cold congelation;the concave tip tongue is characterized by a depressed tip,indicating an abnormal tongue frenulum or malnutrition of heart,lung,and kidney;the convex surface tongue features a broad and thick tongue body with an overall"convex"shape,which is observed in healthy individuals or suggests qi movement disorder and spleen and stomach stagnation;the cracked tongue coating is characterized by cracks only on the tongue coating,indicating qi deficiency with disordered fluid or yin consumption due to intense heat;the white saliva line presents as strip-like white foam bands on the tongue margin,suggesting liver qi stagnation and dampness stagnancy due to spleen deficiency.No consensus exists regarding issues such as naming and description,reflecting the necessity of expanding and standardizing the theory of tongue diagnosis.This paper aims to emphasize the value and standardization of such new tongue manifestations,enrich the theoretical system of tongue diagnosis in traditional Chinese medicine,and provide novel insights and reference basis for clinical syndrome differentiation.

At present,some new tongue manifestations with distinct characteristics and high clinical value have not yet gained widespread consensus,which is unfavorable to their research and promotion.This paper representatively explores four types of tongue texture manifestations(liver gall line,bulging vein tongue,concave tip tongue,convex surface tongue)and two types of tongue coating manifestations(cracked tongue coating,white saliva line)among them.It is found that the liver gall line manifests as dark stagnation of various forms on the tongue surface,indicating liver qi stagnation and blood stasis as well as heat-toxin accumulation;the bulging vein tongue is characterized by clearly raised blood vessels on the tongue surface,suggesting blood stasis due to yang deficiency or cold congelation;the concave tip tongue is characterized by a depressed tip,indicating an abnormal tongue frenulum or malnutrition of heart,lung,and kidney;the convex surface tongue features a broad and thick tongue body with an overall"convex"shape,which is observed in healthy individuals or suggests qi movement disorder and spleen and stomach stagnation;the cracked tongue coating is characterized by cracks only on the tongue coating,indicating qi deficiency with disordered fluid or yin consumption due to intense heat;the white saliva line presents as strip-like white foam bands on the tongue margin,suggesting liver qi stagnation and dampness stagnancy due to spleen deficiency.No consensus exists regarding issues such as naming and description,reflecting the necessity of expanding and standardizing the theory of tongue diagnosis.This paper aims to emphasize the value and standardization of such new tongue manifestations,enrich the theoretical system of tongue diagnosis in traditional Chinese medicine,and provide novel insights and reference basis for clinical syndrome differentiation.

Bone remodeling and bone regeneration are essential for preserving skeletal integrity and maintaining mineral homeostasis.T cells,as key members of adaptive immunity,play a pivotal role in bone remodeling and bone regeneration by producing a range of cytokines and growth factors.In the physiological state,T cells are involved in the maintenance of bone homeostasis through interactions with mesenchymal stem cells,osteoblasts,and osteoclasts.In pathological states,T cells participate in the pathological process of different types of osteoporosis through interaction with estrogen,glucocorticoids,and parathyroid hormone.During fracture healing for post-injury repair,T cells play different roles during the inflammatory hematoma phase,the bone callus formation phase and the bone remodeling phase.Targeting T cells thus emerges as a potential strategy for regulating bone homeostasis.This article reviews the research progress on related mechanisms of T cells immunity involved in bone remodeling and bone regeneration,with a view to providing a scientific basis for targeting T cells to regulate bone remodeling and bone regeneration.

Objective:To verify the effect of Fu′s massage combined with physical therapy technology in rapidly relieving neck and low back pain caused by long-haul flight.Methods:Forty-two male volunteers were divided into 8, 12, 16, 24 and 48 h groups according to the simulated flying hours. After the completion of the simulated long-haul flight, the 5 groups of volunteers were immediately treated with Fu′s massage combined with physical factors for neck and low back pain. The Visual Analogue Scale (VAS) was used to evaluate the cervical and lumbar pain of volunteers after simulated flight and after treatment, and the treatment effect was before treatment analyzed.Results:There were significant differences in the VAS scores of cervical and lumbar regions before treatment among volunteers with different flying hours ( H=-30.15, -28.25, both P<0.001). The VAS scores of cervical and lumbar regions of volunteers in the 24 h and 48 h groups were higher than those in the 8 h group ( P=0.002, <0.001, =0.002, <0.001). The VAS scores of cervical and lumbar regions of volunteers in the 48 h group were higher than those in the 12 h group ( P=0.016, 0.001). The VAS score of cervical region of volunteers in the 48 h group was higher than that in the 16 h group ( P=0.033). After the intervention of Fu's massage combined with physical therapy, the VAS scores of cervical and lumbar regions in each group were lower than those before treatment, and the differences were significant ( t/ Z=-3.00-17.00, all P<0.05 or 0.01). Conclusions:Fu′s massage manipulation combined with physical treatment can effectively relieve the neck and low back pain caused by long-haul flight, which can be widely used as a relief method.

Objective:To verify the effect of Fu′s massage combined with physical therapy technology in rapidly relieving neck and low back pain caused by long-haul flight.Methods:Forty-two male volunteers were divided into 8, 12, 16, 24 and 48 h groups according to the simulated flying hours. After the completion of the simulated long-haul flight, the 5 groups of volunteers were immediately treated with Fu′s massage combined with physical factors for neck and low back pain. The Visual Analogue Scale (VAS) was used to evaluate the cervical and lumbar pain of volunteers after simulated flight and after treatment, and the treatment effect was before treatment analyzed.Results:There were significant differences in the VAS scores of cervical and lumbar regions before treatment among volunteers with different flying hours ( H=-30.15, -28.25, both P<0.001). The VAS scores of cervical and lumbar regions of volunteers in the 24 h and 48 h groups were higher than those in the 8 h group ( P=0.002, <0.001, =0.002, <0.001). The VAS scores of cervical and lumbar regions of volunteers in the 48 h group were higher than those in the 12 h group ( P=0.016, 0.001). The VAS score of cervical region of volunteers in the 48 h group was higher than that in the 16 h group ( P=0.033). After the intervention of Fu's massage combined with physical therapy, the VAS scores of cervical and lumbar regions in each group were lower than those before treatment, and the differences were significant ( t/ Z=-3.00-17.00, all P<0.05 or 0.01). Conclusions:Fu′s massage manipulation combined with physical treatment can effectively relieve the neck and low back pain caused by long-haul flight, which can be widely used as a relief method.

Objective:To analyze the difference of maternal and neonatal outcomes for the living infant of surgically and spontaneously reduced dichorionic pregnancies following assisted reproductive technology (ART).Methods:We used a retrospective cohort study to analyze the clinical data of 11 050 fresh/frozen-thawed double embryos transfer with singleton live birth cycles in the Center for Reproductive Medicine of Jiangxi Maternal and Child Health Hospital from March 2014 to October 2021, including 226 cases in the surgical reduction group, 1 506 cases in the spontaneous reduction group, and 9 318 cases of singleton pregnancy in control group. The basic clinical data, maternal and fetal complications and birth outcomes of the three groups were compared by univariate analysis. Multivariate logistic regression was used to analyze the factors affecting maternal and infant outcomes.Results:The rate of premature rupture of membranes in the natural fetal reduction group, the surgical reduction group and control group was 1.4% (21/1 506), 1.3% (3/226) and 0.6% (56/9 318), respectively, with a significant difference among the three groups ( P=0.003). The differences of the risk of preterm birth, very premature birth, low birth weight, very low birth weight, and small for gestational age among the surgical fetal reduction group [17.3% (39/226), 4.0% (9/226), 15.5% (35/226), 3.1% (7/226), 9.3% (21/226)], the natural fetal reduction group [11.6% (175/1 506), 1.9% (28/1 506), 8.6% (129/1 506), 1.3% (20/1 506), 9.1% (137/1 506)] and control group [7.7% (721/9 318), 0.9% (86/9 318), 3.9% (367/9 318), 0.5% (45/9 318), 6.0% (560/9 318)] were statistically significant (all P<0.001). Compared with the spontaneous reduction group, the surgical reduction group had a higher risk of premature birth [(a OR=2.37, 95% CI: 1.64-3.42, P<0.001) vs. (a OR=1.54, 95% CI: 1.29-1.84, P<0.001)], very preterm birth [(a OR=4.26, 95% CI: 2.02-8.97, P=0.001) vs. (a OR=1.95, 95% CI: 1.26-3.01, P=0.003)], low birth weight [(a OR=4.35, 95% CI: 2.94-6.44, P<0.001) vs. (a OR=2.26, 95% CI: 1.83-2.79, P<0.001)] and small-for-gestational age[(a OR=1.82, 95% CI: 1.14-2.92, P=0.013) vs. (a OR=1.60, 95% CI: 1.31-1.95, P<0.001)]. There was no statistical difference in birth defect rate among the three groups ( P>0.05). Conclusion:The risk of maternal and fetal complications and birth defects for the living singletons of surgically and spontaneously reduced dichorionic diamniotic pregnancies were similar to those singleton pregnancies following ART, but the proportion of premature rupture of membranes is higher, and the risk of premature birth and low birth weight of surgical reduction were higher than that of spontaneous reduction. Surgical reduction is not recommended to use as a rescue measure of dichorionic twins conceived by ART.

Objective:To analyze the difference of maternal and neonatal outcomes for the living infant of surgically and spontaneously reduced dichorionic pregnancies following assisted reproductive technology (ART).Methods:We used a retrospective cohort study to analyze the clinical data of 11 050 fresh/frozen-thawed double embryos transfer with singleton live birth cycles in the Center for Reproductive Medicine of Jiangxi Maternal and Child Health Hospital from March 2014 to October 2021, including 226 cases in the surgical reduction group, 1 506 cases in the spontaneous reduction group, and 9 318 cases of singleton pregnancy in control group. The basic clinical data, maternal and fetal complications and birth outcomes of the three groups were compared by univariate analysis. Multivariate logistic regression was used to analyze the factors affecting maternal and infant outcomes.Results:The rate of premature rupture of membranes in the natural fetal reduction group, the surgical reduction group and control group was 1.4% (21/1 506), 1.3% (3/226) and 0.6% (56/9 318), respectively, with a significant difference among the three groups ( P=0.003). The differences of the risk of preterm birth, very premature birth, low birth weight, very low birth weight, and small for gestational age among the surgical fetal reduction group [17.3% (39/226), 4.0% (9/226), 15.5% (35/226), 3.1% (7/226), 9.3% (21/226)], the natural fetal reduction group [11.6% (175/1 506), 1.9% (28/1 506), 8.6% (129/1 506), 1.3% (20/1 506), 9.1% (137/1 506)] and control group [7.7% (721/9 318), 0.9% (86/9 318), 3.9% (367/9 318), 0.5% (45/9 318), 6.0% (560/9 318)] were statistically significant (all P<0.001). Compared with the spontaneous reduction group, the surgical reduction group had a higher risk of premature birth [(a OR=2.37, 95% CI: 1.64-3.42, P<0.001) vs. (a OR=1.54, 95% CI: 1.29-1.84, P<0.001)], very preterm birth [(a OR=4.26, 95% CI: 2.02-8.97, P=0.001) vs. (a OR=1.95, 95% CI: 1.26-3.01, P=0.003)], low birth weight [(a OR=4.35, 95% CI: 2.94-6.44, P<0.001) vs. (a OR=2.26, 95% CI: 1.83-2.79, P<0.001)] and small-for-gestational age[(a OR=1.82, 95% CI: 1.14-2.92, P=0.013) vs. (a OR=1.60, 95% CI: 1.31-1.95, P<0.001)]. There was no statistical difference in birth defect rate among the three groups ( P>0.05). Conclusion:The risk of maternal and fetal complications and birth defects for the living singletons of surgically and spontaneously reduced dichorionic diamniotic pregnancies were similar to those singleton pregnancies following ART, but the proportion of premature rupture of membranes is higher, and the risk of premature birth and low birth weight of surgical reduction were higher than that of spontaneous reduction. Surgical reduction is not recommended to use as a rescue measure of dichorionic twins conceived by ART.

Objective To observe the effect of abdominal electrical stimulation combined with high-frequency chest wall oscillation on airway clearance ability in critical ill patients with tracheostomy. Methods From January to June, 2021, a total of 84 critical ill patients with tracheostomy in the department of Critical Care Medicine, Zhongda Hospital, Southeast University, were randomly divided into control group (n = 28),experimental group A (n = 28) and experimental group B (n = 28). All the groups received routine therapy and early activities; while high-frequency chest wall oscillation was added to experimental group A, and abdominal electrical stimulation combined with high-frequency chest wall oscillation were added to experimental group B, for two weeks. Their involuntary cough peak flow (ICPF), Clinical Pulmonary Infection Score (CPIS), diaphragmatic excursion (DE), diaphragmatic thickness fraction (DTF) and thickness of abdominal muscle (Tab) were measured before and after treatment. Results The improvement of CPIS, ICPF and Tab were better in the experimental group B than in the other two groups (P < 0.05). The improvement of DE and DTF were slightly better in experimental group B, however, there was no significant difference among groups (FDE = 0.514, FDTF = 1.582, P > 0.05). The thickness d-values of rectus abdominis, musculi obliquus internus abdominis and musculus transversus abdominis were positively correlated with the d-value of ICPF in the exprimental group B (r > 0.415, P < 0.05). ICPF was highly negatively correlated with CPIS before treatment for all the patients (r = -0.702, P < 0.001). No adverse events occurred during the intervention period. Conclusion Abdominal electrical stimulation combined with high-frequency chest wall oscillation could improve airway clearance ability in critical ill patients with tracheostomy.

Objective:To analyze the effect of transtracheal pressure (TTP) on the application of a speaking valve in critically ill patients after tracheostomy.Methods:A retrospective analysis was conducted of 50 patients wearing a speaking valve after tracheostomy. Patients who had been wearing a speaking valve for 30min or more were the tolerance group, while those with less than 30min were the intolerance group. Transtracheal pressure was monitored during resting breathing, forced expiration and speaking. Linear regression models were evaluated to isolate the factors best predicting tolerance. The changes in respiratory muscle contraction before and after wearing a speaking valvs were evaluated using ultrasound. The patients′ satisfaction with wearing a speaking valve was also recorded.Results:TTP during speaking significantly predicted tolerance. The baseline values of diaphragmatic thickening fraction and physical functioning also positively predicted tolerance. Acute physiology and chronic health (APACHE II) score was a significant negative predictor. After wearing the speaking valve, the average contraction of the rectus abdominis, external oblique, internal oblique and transverse abdominis muscles increased significantly. Both groups expressed high satisfaction with the speaking valves.Conclusions:Transtracheal pressure during speaking can help predict the tolerance for wearing a speaking valve among critically ill patients after a tracheostomy. Baseline diaphragmatic thickening fraction, physical functioning and APACHE II score can predict the duration of speaking valve tolerance.

OBJECTIVES: Idiopathic intracranial hypertension (IIH) is a syndrome that excludes secondary causes such as intracranial space-occupying lesion, hydrocephalus, cerebrovascular disease, and hypoxic ischemic encephalopathy. If not be treated promptly and effectively, IIH can cause severe, permanent vision disability and intractable, disabling headache. This study aims to explore the clinical and image features for IIH, to help clinicians to understand this disease, increase the diagnose rate, and improve the outcomes of patients. METHODS: We retrospectively analyzed 15 cases of IIH that were admitted to Xiangya Hospital, Central South University, during January 2015 to September 2020. The diagnosis of IIH was based on the updated modified Dandy criteria. We analyzed clinical data of patients and did statistical analysis, including age, gender, height, weight, medical history, physical examination, auxiliary examination, treatment and outcome. RESULTS: There were 10 females and 5 males. Female patients were 22 to 42 years old with median age of 39.5. Male patients were 27 to 52 years old with the median age of 44.0. The BMI was 24.14-34.17 (28.71±2.97) kg/m CONCLUSIONS IIH primarily affects women of childbearing age who are overweight. The major hazard of IIH is the severe and permanent visual loss. Typical image signs have high specificity in IIH diagnosis. Prompt diagnosis and effective treatment are significantly important to improve the outcomes of patients.
Adult ; Anemia, Iron-Deficiency ; Female ; Humans ; Intracranial Hypertension ; Male ; Middle Aged ; Pseudotumor Cerebri/diagnostic imaging* ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Young Adult