The doctor-patient relationship is a set of social relationships based on shared interests， mutual trust， and emotional bonds， to relieve illnesses and promote health. However， the doctor-patient relationship often falls into tensions and conflicts. How to build a trusting and harmonious doctor-patient destiny community has become one of the most important issues of concern to the whole society. Based on the biopsychosocial concept of disease， the emotion management technique （EMT） emphasizes that doctors take the patient’s emotion as a clue in clinical diagnosis and treatment， regard emotions as one of the important indicators for disease diagnosis， understand the emotional events behind the disease， and provide patients with appropriate empathy and emotional management， so as to provide clinical methods for managing diseases and building a trusting and harmonious doctor-patient relationship.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective To investigate the reliability and validity of the assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period(ICSAKOPP). Methods From May,2022 to April,2023,320 patients undergoing knee arthroplasty were selected in Peking University Third Hospital,China-Japan Friendship Hospital,Peking University First Hospital and Chinese PLA General Hospital.Trained assessors used Brief ICSAKOPP to evaluate all enrolled patients before arthroplasty,three days(±one day)after arthroplasty,three weeks(±one week)after arthroplasty,and three months(±one month)after ar-throplasty.Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores were recorded at the same time.Five professionals were asked to score all the items of Brief ICSAKOPP,and the content validity index(CVI)was caculated. Results A total of 64 cases were dropped down.CVI of all the items of the Brief ICSAKOPP were above 0.8,with a av-erage CVI of the scale of 0.938.The Cronbach's α coefficient of the Brief ICSAKOPP was 0.813.There was a moderate correlation(r=0.681,P<0.001)between the overall Brief ICSAKOPP and WOMAC scores,as well as body functional dimension score(r=0.668,P<0.001)and activities and participation dimension score(r=0.657,P<0.001). Conclusion Brief ICSAKOPP is good in content validity,internal consistency reliability and criterion validity.

Advances in novel drugs, therapies, and genetic techniques have revolutionized the diagnosis and treatment of cancers, substantially improving cancer patients' prognosis. Although rare tumors account for a non-negligible number, the practice of precision medicine and development of novel therapies are largely hampered by many obstacles. Their low incidence and drastic regional disparities result in the difficulty of informative evidence-based diagnosis and subtyping. Sample exhaustion due to difficulty in diagnosis also leads to a lack of recommended therapeutic strategies in clinical guidelines, insufficient biomarkers for prognosis/efficacy, and inability to identify potential novel therapies in clinical trials. Herein, by reviewing the epidemiological data of Chinese solid tumors and publications defining rare tumors in other areas, we proposed a definition of rare tumor in China, including 515 tumor types with incidences of less than 2.5/100 000 per year. We also summarized the current diagnosis process, treatment recommendations, and global developmental progress of targeted drugs and immunotherapy agents on the status quo. Lastly, we pinpointed the current recommendation chance for patients with rare tumors to be involved in a clinical trial by NCCN. With this informative report, we aimed to raise awareness on the importance of rare tumor investigations and guarantee a bright future for rare tumor patients.
Humans ; Neoplasms/pathology* ; Biomarkers ; Prognosis ; Oceans and Seas ; China/epidemiology*

Objective:To evaluate the effect of lipoxin A4 on lipopolysaccharide (LPS)-induced activation of microglia and role of silent information regulator sirtuin 1 (SIRT1)/NF-κB signaling pathway.Methods:This experiment was performed in two parts.PartⅠ The well-growth BV2 microglia were divided into 4 groups ( n=30 each) using a random number table method: control group (group C), LXA4 group (group LXA4), LPS group (group LPS) and LPS+ LXA4 group (group LLI). PartⅡ The well-growth BV2 microglia were divided into 2 groups ( n=30 each) using a random number table method: LPS+ LXA4 group (group LL2) and LPS+ LXA4+ SIRT1 inhibitor EX527 group (group LLE). Cells in group C were commonly cultured without any treatment. In LXA4 group and LPS group, LXA4 (final concentration 100 nmol/L) and LPS (final concentration 100 ng/ml) were added respectively, and then the cells were incubated for 24 h. In LL1 group and LL2 group, LXA4 (final concentration 100 nmol/L) was added at 1 h before treatment with LPS, and the other treatments were similar to those previously described in LPS group. EX527 (final concentration of 5 μmol/L) was added at 30 min before treatment with LXA4, and the other treatments were similar to those previously described in LL2 group.The expression of inducible nitricoxide synthase (iNOS), CD32, arginine synthase 1 (Arg-1), CD206, interleuckin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α) and IL-10 mRNA was detected by real-time polymerase chain reaction. The concentrations of IL-1β, IL-6, TNF-α and IL-10 in the supernatant were measured using enzyme-linked immunosorbent assay. The content of ROS was detected by DCFH-DA. The activity of SOD was measured by WST-8 assay. The expression of NADPH oxidase 2 (NOX2), superoxide dismutase 1 (SOD1), heme oxygenase-1 (HO-1), SIRT1 and acetylated NF-κB p65 was detected by Western blot. Results:Compared with group C, the expression of iNOS, CD32, IL-1β, IL-6 and TNF-α mRNA was significantly up-regulated, the concentrations of IL-1β, IL-6 and TNF-α in the supernatant were increased ( P<0.05), no significant change was found in the expression of Arg-1, CD206 and IL-10 mRNA and IL-10 concentrations in the supernatant, the expression of NOX2 and HO-1 was up-regulated, SOD1 expression was down-regulated, the activity of SOD was decreased, the content of ROS was increased, the expression of SIRT1 was down-regulated, and the expression of acetylated NF-κB p65 was up-regulated in group LPS ( P<0.05). Compared with group LPS, the expression of iNOS, CD32, IL-1β, IL-6 and TNF-α mRNA was significantly down-regulated, the expression of Arg-1, CD206 and IL-10 mRNA was up-regulated, concentrations of IL-1β, IL-6 and TNF-α in the supernatant were decreased, the concentration of IL-10 was increased, the expression of NOX2 was down-regulated, the expression of HO-1 and SOD1 was up-regulated, the activity of SOD was increased, the content of ROS was decreased, the expression of SIRT1 was up-regulated, and the expression of acetylated NF-κB p65 was down-regulated in group LL1 ( P<0.05). Compared with group LL2, the concentrations of IL-1β, IL-6 and TNF-α in the supernatant were significantly increased, the activity of SOD was decreased, the content of ROS was increased ( P<0.05), and no significant change was found in the IL-10 concentration in the supernatant in group LLE ( P>0.05). Conclusions:LXA 4 can inhibit LPS-induced polarization of microglia to M1 phenotype, and the mechanism may be related to enhancement of SIRT1 activity and inhibition of NF-κB transcriptional activity.

ObjectiveTo explore the characteristics of tongue manifestations and traditional Chinese medicine （TCM） syndromes in patients with primary Sjogren's syndrome （pSS） of different time. MethodpSS patients who visited TCM Department of Rheumatism in China-Japan Friendship Hospital from December 2018 to October 2021 were included and grouped according to the disease courses （short<5 years， medium 5-10 years， long > 10 years）. Chi-square test was used for comparison between three groups and Bonferroni method for multiple comparisons. In the pairwise comparison， P<0.017 indicated significant difference. Chi-square test was performed on the syndrome and specific tongue manifestations with inter-group differences to analyze the trend of tongue manifestations and TCM syndromes over time （interval： two years）. ResultA total of 193 pSS patients were enrolled， with 85 （44.0%） of short disease course， 69 （35.8%） of medium disease course， and 39 （20.2%） of long disease course. The common tongue manifestations were crimson tongue， fissured tongue， thin tongue， lack of fluid， and dry coating， which showed no significant difference among the three groups. Higher proportion of patients with light red tongue was observed in the group with short disease course than in group with medium disease course （χ²=6.407， P<0.017）. Higher proportions of patients with thick coating （χ²=6.784， P<0.017） and phlegm-dampness syndrome （χ²=11.545， P<0.017） and lower proportion of patients with Qi deficiency syndrome （χ²=12.706， P<0.017） were found in the group with short disease course than in the group with long disease course. Patients with medium （χ²=6.358， P<0.017） and long （χ²=8.279， P<0.017） disease course tended to have exfoliated coating compared with those with short disease course， and the proportion of patients with exfoliated coating rose and the proportion of patients with thick greasy coating decreased over time （P_trend<0.05）. In addition， the proportion of patients with phlegm-dampness syndrome decreased and that with Qi deficiency syndrome increased over time （P_trend<0.05）. ConclusionIn the early stage， patients with pSS often show both dryness and dampness， as manifested by the thick greasy coating and phlegm-dampness syndrome. In the medium and late stage， patients often have Qi-Yin deficiency， as evidenced by exfoliated coating and Qi deficiency. In the clinical practice， medicines should be prescribed based on tongue manifestations and TCM syndrome of patients.

ObjectiveTo analyze the clinical characteristics of geographic tongue in patients with primary Sjögren's syndrome （pSS）. MethodPatients with pSS treated in the China-Japan Friendship Hospital from December 2018 to October 2021 were enrolled and divided into different groups according to the presence of geographic tongue or the severity. Phi correlation analysis，Chi-square test， and Mann-Whitney test were used to analyze the clinical characteristics of patients with geographic tongue. ResultA total of 182 pSS patients were included in this study，including 75 （41.2%） patients with geographic tongue and 107 （58.8%） without geographic tongue. Partial exfoliation was more common than total exfoliation， and the anterior part of the tongue was the most common exfoliation site. The number of patients with severe geographic tongue was more than those with mild-to-moderate geographic tongue. Compared with pSS patients without geographic tongue，those with geographic tongue were more common in fissured tongue （92.0%/41.1%，χ²=48.491，P<0.05），red or crimson tongue （48.0%/23.3%，χ²=12.009，P<0.05），Yin deficiency syndrome （100.0%/43.9%，χ²=62.739，P<0.05），and Qi deficiency syndrome （94.7%∶50.5%，χ²=40.046，P<0.05），less common in phlegm-dampness syndrome （33.3%/72.0%，χ²=26.709，P<0.05），and showed higher proportions in hyperglobulinemia （89.3%/65.4%，χ²=13.547，P<0.01），ANA ≥1∶160 （78.1%/57.3%，χ²=8.227，P<0.01），and positive RF （51.4%/36.5%，χ²=3.877，P<0.05）. Compared with pSS patients with mild geographic tongue，pSS patients with moderate-to-severe geographic tongue had higher proportions in hyperglobulinemia （98.1%/68.2%，χ²=14.617，P<0.01），positive anti-CENP-B （26.0%/4.8%，χ²=4.214，P<0.05），and reduced complement 3 （26.4%/4.5%，χ²=4.647，P<0.05）. The geographic tongue was positively associated with fissured tongue （φ=0.531），Yin deficiency syndrome （φ=0.587），and Qi deficiency syndrome （φ=0.469），negatively associated with phlegm-dampness syndrome （φ=-0.447），and weakly associated with tongue color （φ<0.4）. There was no statistical difference in the disease activity index between patients with or without geographic tongue and severity. ConclusionMore than 40% of pSS patients had geographic tongue accompanied by fissured tongue. Geographic tongue is positively associated with Yin deficiency syndrome and Qi deficiency syndrome，and negatively associated with phlegm-dampness syndrome， indicating that treatment should be based on tonifying Qi and nourishing Yin. Compared with pSS patients without geographic tongue， those with geographic tongue may have higher positive rate of some immune indicators，which deserves further exploration.

ObjectiveTo summarize the characteristics of traditional Chinese medicine （TCM） syndrome in primary Sjögren's syndrome （pSS） patients with interstitial lung disease （ILD） and to explore associated factors. MethodA survey was conducted and pSS patients who were treated in TCM department of rheumatism at China-Japan Friendship Hospital from December 2018 to April 2022 were included. Tongue manifestations and syndromes of patients were recorded. pSS patients with ILD were classified into the pSS-ILD group and those without the ILD were included in the pSS-non-ILD group. The tongue manifestations， syndromes， and laboratory indexes were compared between the two groups， and logistic regression was used to explore the factors associated with pSS-ILD. ResultA total of 200 pSS patients were included， with 186 （93.0%） females， median age of 57 years， and median disease course of 60 months， of which 44 （22%） had pSS-ILD. In terms of tongue manifestations， pSS-ILD patients generally had dark/purple/stasis tongue， fissured tongue， and tongue with little fluid， thick coating， yellow coating， and greasy coating. The proportion patients with yellow coating was higher in pSS-ILD group than in the pSS-non-ILD group （χ²=4.799，P<0.05）. In terms of syndrome， more than 40% of pSS-ILD patients had Qi deficiency， Yin deficiency， phlegm-dampness， Qi stagnation， and/or blood stasis syndrome. As for Yin deficiency， liver-kidney Yin deficiency syndrome ranked the first. For Qi deficiency， lung Qi deficiency syndrome was most commonly seen. The proportion of patients with lung Qi deficiency was higher in the pSS-ILD group than in the pSS-non-ILD group （χ²=18.667，P<0.01）. As to laboratory indexes， compared with the pSS-non-ILD group， pSS-ILD group had high proportion of anti-SSA-positive patients （P<0.05） and high levels of C-reactive protein （CRP） （P<0.01）， complement C3 （χ²=4.332，P<0.05）， and complement C4 （P<0.05）. Logistic regression analysis showed that pSS with ILD was positively associated with lung Qi deficiency ［odds ratio （OR）=6.079， 95% confidence interval （CI） 2.585-14.298， P<0.01）］ and yellow coating （OR=5.260， 95% CI 1.337-20.692， P<0.05） and negatively associated with low C4 （OR=0.199， 95% CI 0.070-0.564， P<0.01）. ConclusionAbout 22% of pSS patients had ILD， and patients with pSS-ILD generally have Qi deficiency， Yin deficiency， phlegm-dampness， Qi stagnation， and/or blood stasis syndrome. Yellow coating， lung Qi deficiency and C4 level are factors associated with pSS combined with ILD.

Objective:To determine the optimal concentration of inhaled oxygen in pediatric patients undergoing laparoscopic choledochal cyst resection under general anesthesia.Methods:Seventy-five pediatric patients of both sexes, aged 1-3 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with body mass index of 15-18 kg/m 2, with expected operation time≥3 h, scheduled for elective laparoscopic choledochal cyst resection with general anesthesia, were divided into 3 groups ( n=25 each) using a random number table method: C 40 group (FiO 2=40%), C 30 group (FiO 2=30%) and C 21 group (FiO 2=21%). Blood samples were collected from the radial artery for blood gas analysis after operation for determination of oxygenation index (OI), respiratory index (RI), alveolar-arterial oxygen partial pressure difference (PA-aO 2) and arterial-alveolar oxygen partial pressure ratio (PaO 2/PAO 2). The occurrence of high risk events of hypoxia (SpO 2<94%), extubation time, and occurrence of pneumonia and atelectasis at day 7 after operation were recorded. Results:Compared with C 21 group, PaO 2, PAO 2, PA-aO 2 and RI were significantly increased, PaO 2/PAO 2 was decreased, and the incidence of high risk events of hypoxia was decreased in C 30 and C 40 groups, and the incidence of atelectasis in C 30 group and pneumonia and atelectasis in C 40 group was increased at day 7 after operation ( P<0.05). Compared with C 30 group, PaO 2, PAO 2, PA-aO 2 and RI were significantly increased, and PaO 2/PAO 2 was decreased in C 40 group ( P<0.05). Conclusions:The optimal concentration of inhaled oxygen recommended is 21%-30% in the pediatric patients undergoing laparoscopic choledochal cyst resection under general anesthesia.

ObjectiveTo analyze the research status, research hotspots and trends at home and abroad in the field of rehabilitation assistive devices in the past ten years. MethodsThe relevant articles of rehabilitation assistive devices from 2012 to 2021 in CNKI and Web of Science (WoS) core collection database were retrieved. The authors, countries, institutions, research hotspots, and trends were extracted with CiteSpace and VOSviewer to draw knowledge mapping. Results and ConclusionThe annual articles published at home and abroad has shown an upward trend year by year. The team with the most articles in China is the Yu Hongliu team, and the institution with the most articles is China Assistive Devices and Technology Center for Persons with Disablities. The team with the most foreign articles is the Maysam G team, and the institution with the most articles is the University of Pittsburgh. The United States has the largest number of literatures and the highest intermediary centrality. Research hotspots related to rehabilitation assistive devices at domestic and abroad mainly focus on the design and development of rehabilitation assistive device products, the application of rehabilitation assistive devices in special/vulnerable populations, the application effect of rehabilitation assistive devices and related professional services; the development trend of intelligent assistive device product design and application research based on intelligent perception, brain-like computing, deep learning and virtual/augmented reality is predicted.