With the technological innovation and the advances in information technology, acupuncture-moxibustion is on the path of modernization and high-quality development. The research on ancient acupuncture-moxibustion literature has been gradually transformed from traditional sorting and digital research to intelligent knowledge services, so as to realize the deep integration of ancient acupuncture-moxibustion knowledge with the needs of modern clinical practice and scientific research. Guided by the characteristics of acupuncture-moxibustion knowledge and based on the knowledge meta-theory, the in-depth analytical indexing and knowledge organization are conducted on more than 400 kinds of ancient acupuncture-moxibustion literature. Taking ancient literature of meridian symptoms/manifestations as an example, thematic literature research and database construction are carried out. Integrated with database, cloud platform, knowledge domain mapping and other technologies, the sharing service platform of ancient acupuncture-moxibustion knowledge is constructed. As a result, the research and development achievements can be adopted by the researchers in the field of basic theory, clinical practice and research of acupuncture-moxibustion. Finally, through the way of "digital reconstruction + intelligent application", the path and paradigm of digital research of ancient acupuncture-moxibustion literature are explored to provide the references for the innovative utilization of ancient acupuncture-moxibustion literature.
Moxibustion/history* ; Humans ; Acupuncture Therapy/history* ; History, Ancient ; Knowledge

Based on the analysis of the relevant records of the contralateral bloodletting technique, it is believed that this needling technique has 3 key characteristics, including "contralateral selection of points", "points on the four extremities dominated" and "collaterals selected rather than meridian points". Through the studies on philology and the annotation by the doctors in the past dynasties, a part of point prescriptions for the contralateral bloodletting is investigated, and those not belonged to the category of this needling technique in Suwen: Miuci Lun (On Contralateral Bloodletting) are distinguished. It is concluded that the failure of consensus-making in classifying point prescriptions is due to the lack of understanding on the characteristics of contralateral bloodletting and the misunderstanding on the errors of sentences and words. It is suggested that the study on theoretic concepts should lay on the problems relevant with the generalization and alienation of concepts. The mode of "combination of the detail with the whole" should be adopted. It starts from grasping the overall by systematic review, and followed by deliberating in details, so as to correctly identify the original concept and connotation.
Humans ; Bloodletting/methods* ; Acupuncture Points ; History, Ancient ; Meridians ; China

This paper presents a textual research on the author, year of composition, basic content, and academic value of Zhenjiu Neipian (Inner Analects of Acupuncture and Moxibustion). This acupuncture-moxibustion work was written by DA Zhongguang, alias Jiang Shang Wai Shi, a renowned painter and calligrapher of the Qing Dynasty. The work was compiled around the reign of Emperor Kangxi (1661-1692). It includes four parts. The first part covers general theories and needle-forging techniques; the second part introduces meridian and acupoint diagrams and the verses of acupoints; the third part is the verses of contraindications of acupuncture and moxibustion; and the fourth part discusses reinforcing and reducing techniques. Zhenjiu Neipian is mainly based on Dou's acupuncture books, Pu Ji Fang (Formulas for Universal Relief), Lei Jing Tu Yi (Pictorial Appendices to 'The Classified Classic'), Zhenjiu Dacheng (The Great Compendium of Acupuncture and Moxibustion), Gu Jin Yi Tong Da Quan (The Complete Compendium of Ancient and Modern Medical Works), Zi Hui (Dictionary of Chinese Characters) , and Ling's acupuncture books. Zhenjiu Neipian preserves some lost writings in lost medical books such as Dou's acupuncture books and Ling's acupuncture books. In addition, it plays an important role in acupoint selection methods, acupuncture and moxibustion techniques, and the indications of acupoints, presenting a high literature and clinical value. This book is an invaluable acupuncture-moxibustion book for studying Ling's acupuncture techniques.
Humans ; China ; Acupuncture Therapy/history* ; Moxibustion/history* ; History, 17th Century ; Acupuncture/education* ; Books/history* ; Acupuncture Points

BACKGROUND: Neoadjuvant chemoradiotherapy followed by radical surgery has been a common practice for patients with locally advanced rectal cancer, but the response rate varies among patients. This study aimed to develop a ResNet-Vision Transformer based magnetic resonance imaging (MRI)-endoscopy fusion model to precisely predict treatment response and provide personalized treatment. METHODS: In this multicenter study, 366 eligible patients who had undergone neoadjuvant chemoradiotherapy followed by radical surgery at eight Chinese tertiary hospitals between January 2017 and June 2024 were recruited, with 2928 pretreatment colonic endoscopic images and 366 pelvic MRI images. An MRI-endoscopy fusion model was constructed based on the ResNet backbone and Transformer network using pretreatment MRI and endoscopic images. Treatment response was defined as good response or non-good response based on the tumor regression grade. The Delong test and the Hanley-McNeil test were utilized to compare prediction performance among different models and different subgroups, respectively. The predictive performance of the MRI-endoscopy fusion model was comprehensively validated in the test sets and was further compared to that of the single-modal MRI model and single-modal endoscopy model. RESULTS: The MRI-endoscopy fusion model demonstrated favorable prediction performance. In the internal validation set, the area under the curve (AUC) and accuracy were 0.852 (95% confidence interval [CI]: 0.744-0.940) and 0.737 (95% CI: 0.712-0.844), respectively. Moreover, the AUC and accuracy reached 0.769 (95% CI: 0.678-0.861) and 0.729 (95% CI: 0.628-0.821), respectively, in the external test set. In addition, the MRI-endoscopy fusion model outperformed the single-modal MRI model (AUC: 0.692 [95% CI: 0.609-0.783], accuracy: 0.659 [95% CI: 0.565-0.775]) and the single-modal endoscopy model (AUC: 0.720 [95% CI: 0.617-0.823], accuracy: 0.713 [95% CI: 0.612-0.809]) in the external test set. CONCLUSION The MRI-endoscopy fusion model based on ResNet-Vision Transformer achieved favorable performance in predicting treatment response to neoadjuvant chemoradiotherapy and holds tremendous potential for enabling personalized treatment regimens for locally advanced rectal cancer patients.
Humans ; Rectal Neoplasms/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Male ; Female ; Middle Aged ; Neoadjuvant Therapy/methods* ; Aged ; Adult ; Chemoradiotherapy/methods* ; Endoscopy/methods* ; Treatment Outcome

Objective To investigate the effect of early use of ivabradine on cardiac function in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods Eighty patients with AMI who were hospitalized in our hospital from Feb.2020 to May 2021 were enrolled,and were randomly assigned to ivabradine group or control group(1∶1).All patients were successfully treated with emergency PCI,and the ivabradine group was treated with ivabradine combined with metoprolol after PCI,while the control group was treated with metoprolol only.Both groups were followed up for 1 year.Echocardiography-derived parameters,heart rate and myocardial markers were analyzed.Results The left ventricular ejection fraction was significantly higher in the ivabradine group than in the control group at 1 week,3 months,and 1 year after PCI(all P＜0.05).The heart rate of the ivabradine group was significantly lower than that of the control group at 1 week after PCI(P＜0.05),while there was no significant difference in heart rates between the 2 groups at 3 months or 1 year after PCI(both P＞0.05).The brain natriuretic peptide of the ivabradine group was significantly lower than that of the control group on day 2 and day 3 after PCI(both P＜0.05).The troponin Ⅰ level of the ivabradine group was significantly lower than that of the control group on day 5 after PCI(P＜0.05).Conclusion Early use of ivabradine in patients with AMI after PCI can achieve effective heart rate control,reduce myocardial injury and improve cardiac function.

Hypoxia inducible factors(HIFs)are core molecules that enable the body to adapt to hypoxia environments.By sensing changes in intracellular oxygen pressure,HIFs regulate gene expression related to hypoxia adaptation,thereby enhancing the body's hypoxia tolerance at cellular,tissue and organ levels.On the other hand,HIFs promote the generation of red blood cells,angiogenesis,and regulate the body's energy metabolism,thereby improving its hypoxia tolerance.The enhancement of hypoxia tolerance is of great significance for the prevention and treatment of hypoxia-related diseases,upgrading of athletes'performance,enhancement of workers'efficiency at high-altitudes,and the improvement of individu-als'quality of life.This article reviews the relationships between HIFs and hypoxia tolerance as well as related mechanisms in order to provide strategies for enhancing hypoxia tolerance in the body.

Objective To investigate the effect of Shugan Lipi Prescription on patients with diarrhea-predominant irritable bowel syndrome(IBS-D)of liver stagnation and spleen deficiency type from the perspective of bile acid-intestinal flora axis imbalance.Methods From May 2022 to May 2023,a total of 122 patients with IBS-D of liver stagnation and spleen deficiency type admitted to the Xi'an No.9 Hospital were enrolled into the investigation.The patients were randomly divided into the control group and the observation group by random number table method,with 61 patients in each group.The control group was given conventional western medicine treatment with oral administration of Dicetel plus Compound Diphenoxylate Tablets and Bifidobacterium Quadruple Viable Tablets,and the observation group was treated with Shugan Lipi Prescription on the basis of treatment for the control group.One course of treatment covered seven days,and both groups were treated for four courses in total.The changes of Irritable Bowel Syndrome Symptom Severity Scale(IBS-SSS)score,levels of serum bile acid and the fecal levels of intestinal flora such as Bifidobacterium,Lactobacillus,and Enterococcus in the two groups of patients before and after treatment were observed.Moreover,the clinical efficacy and the incidence of adverse reactions during the treatment of the two groups were compared.Results(1)After four courses of treatment,the total effective rate of the observation group was 96.72%(59/61)and that of the control group was 83.61%(51/61),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the scores of IBS-SSS items such as abdominal pain,abdominal pain duration,abdominal distension,defecation satisfaction and life interference in the two groups were all decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the levels of serum taurodeoxycholic acid(TDCA),taurocholic acid(TCA)and taurolithocholic acid(TLCA)in the two groups were decreased when compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(4)After treatment,the fecal level of Enterococcus,a kind of pathogenic bacterium,in both groups was decreased when compared with that before treatment(P<0.05),and the fecal levels of probiotics of Bifidobacterium and Lactobacillus in both groups were increased when compared with those before treatment(P<0.05).The effects on the decrease of fecal Enterococcus level and on the increase of fecal Bifidobacterium and Lactobacillus levels in the observation group were significantly superior to those in the control group(P<0.05 or P<0.01).(5)The incidence of adverse reactions in the observation group was 8.20%(5/61)and that in the control group was 6.55%(4/61),and the intergroup comparison showed that the difference was not statistically significant(P>0.05).Conclusion Shugan Lipi Prescription exerts certain therapeutic effect for IBS-D patients of liver stagnation and spleen deficiency type,and is with higher safety.Its therapeutic mechanism may be related to the restoration of the function of bile acid-intestinal flora axis.

Objective:To investigate the clinical characteristics of non-typhoidal Salmonella（NTS）enteritis in children and the drug resistance of NTS strains.Methods:The clinical data of 138 children who were hospitalized in Children's Hospital Affiliated to Xi'an Jiaotong University from 2022 to 2023 with diarrhea as the main complaint and NTS detected in stool culture were analyzed retrospectively, and the clinical characteristics and drug resistance were summarized.Results:Among 138 children with NTS enteritis，89 were males and 49 were females，with a male-to-female sex ratio of 1.81∶1 and an average age of 1.9（1.0,3.6）years，with a high incidence rate in June,July and August.Seventeen（12.31%）cases had a history of suspected unclean diet before illness.All the children had diarrhea symptoms with changes in fecal frequency and character，including 74 cases of pus and bloody stool，119 cases of mucus stool，and 70 cases of watery stool.One hundred and twenty-five（90.57%）cases had fever.Among 138 cases of fecal culture,there were 47 (34.05%) strains of Salmonella typhimurium,36(26.09%) strains of Salmonella enteritidis,and 55(39.85%) strains of other serotypes of Salmonella .One hundred and twenty-two（88.40%）NTS strains were resistant to more than one antimicrobial agent，and 29（21.01 %）were multi-drug resistant.The resistance rates to ampicillin，ampicillin/sulbactam，ceftriaxone，trimethoprim/sulfamethazole，ceftazidime，cefepime and piperacillin/tazobactam were 73.91%，71.01%，29.71%，29.71%，23.19%，11.59%，and 3.62%，respectively.All strains were sensitive to carbapenem antibiotics（meropenem，imipenem，and ertapenem）.The drug resistance rates of Salmonella typhimurium to ceftazidime and trimethoprim/sulfamethoxazole were higher than those of Salmonella enteritidis（38.30% vs 8.33%），the difference was statistically significant ( P < 0.05). Conclusion:Infants and young children are the high-incidence group of NTS enteritis，with the peak incidence period being from June to August each year，manifested by mucus-pus-blood stools, abdominal pain, vomiting，fever and other symptoms.Reasonable selection of antibiotics in time according to the local epidemic strains,changes of antimicrobial resistance and the results of drug sensitivity test of strains can effectively resist infection and reduce the production of drug-resistant beads.

Objective:To investigate the clinical characteristics of non-typhoidal Salmonella（NTS）enteritis in children and the drug resistance of NTS strains.Methods:The clinical data of 138 children who were hospitalized in Children's Hospital Affiliated to Xi'an Jiaotong University from 2022 to 2023 with diarrhea as the main complaint and NTS detected in stool culture were analyzed retrospectively, and the clinical characteristics and drug resistance were summarized.Results:Among 138 children with NTS enteritis，89 were males and 49 were females，with a male-to-female sex ratio of 1.81∶1 and an average age of 1.9（1.0,3.6）years，with a high incidence rate in June,July and August.Seventeen（12.31%）cases had a history of suspected unclean diet before illness.All the children had diarrhea symptoms with changes in fecal frequency and character，including 74 cases of pus and bloody stool，119 cases of mucus stool，and 70 cases of watery stool.One hundred and twenty-five（90.57%）cases had fever.Among 138 cases of fecal culture,there were 47 (34.05%) strains of Salmonella typhimurium,36(26.09%) strains of Salmonella enteritidis,and 55(39.85%) strains of other serotypes of Salmonella .One hundred and twenty-two（88.40%）NTS strains were resistant to more than one antimicrobial agent，and 29（21.01 %）were multi-drug resistant.The resistance rates to ampicillin，ampicillin/sulbactam，ceftriaxone，trimethoprim/sulfamethazole，ceftazidime，cefepime and piperacillin/tazobactam were 73.91%，71.01%，29.71%，29.71%，23.19%，11.59%，and 3.62%，respectively.All strains were sensitive to carbapenem antibiotics（meropenem，imipenem，and ertapenem）.The drug resistance rates of Salmonella typhimurium to ceftazidime and trimethoprim/sulfamethoxazole were higher than those of Salmonella enteritidis（38.30% vs 8.33%），the difference was statistically significant ( P < 0.05). Conclusion:Infants and young children are the high-incidence group of NTS enteritis，with the peak incidence period being from June to August each year，manifested by mucus-pus-blood stools, abdominal pain, vomiting，fever and other symptoms.Reasonable selection of antibiotics in time according to the local epidemic strains,changes of antimicrobial resistance and the results of drug sensitivity test of strains can effectively resist infection and reduce the production of drug-resistant beads.

Objective:To explore the clinical and electrophysiological characteristics of peripheral neuropathy in prediabetic patients.Methods:Subjects aged 20-65 years with high-risk factors of impaired glycemia enrolled in Beijing Tiantan Hospital, Capital Medical University from 2019 to 2022 were recruited to conduct oral glucose tolerance test, after excluding other causes of neuropathy or radiculopathy. Patients with impaired fasting glucose or impaired glucose tolerance were defined by American Diabetes Association criteria. These patients were divided into clinical polyneuropathy (PN) and clinical non-PN groups, according to the 2010 Toronto consensus criteria and the presence of PN symptoms and signs or not. Nerve conduction studies (NCS), F wave, sympathetic skin response (SSR), R-R interval variation (RRIV) and current perception thresholds (CPT) were performed and the abnormal rate was compared between different electrodiagnostic methods and between clinical subgroups.Results:Among the 73 prediabetic patients ultimately enrolled, only 20 (27.4%) can be diagnosed as clinical PN according to the Toronto consensus criteria. The abnormal rate of CPT (68.5%, 50/73) was significantly higher than those of F wave (2.7%, 2/73), lower limb NCS (0, 0/73), upper limb NCS changes of carpal tunnel syndrome (26.0%, 19/73), SSR (6.8%, 5/73) and RRIV (5.5%, 4/73; McNemar test, all P<0.001). With sinusoid-waveform current stimuli at frequencies of 2 000 Hz, 250 Hz and 5 Hz, the CPT device was used to measure cutaneous sensory thresholds of large myelinated, small myelinated and small unmyelinated sensory fibers respectively. CPT revealed a 21.9% (16/73) abnormal rate of unmyelinated C fiber in the hands of prediabetic patients, significantly higher than that of large myelinated Aβ fibers [8.2% (6/73), χ2=5.352, P=0.021]. Both abnormal rates of small myelinated Aδ [42.5% (31/73)] and unmyelinated C fibers [39.7% (29/73)] in the feet of prediabetic patients were significantly higher than that of large myelinated Aβ fibers [11.0% (8/73), χ2=18.508, 15.965, both P<0.001]. Compared with the clinical non-PN group, the abnormal rates of CPT [90.0% (18/20) vs 60.4% (32/53), χ2=5.904, P=0.015] and SSR [20.0% (4/20) vs 1.9% (1/53), P=0.016) were significantly higher in the clinical PN group. Conclusions:Peripheral neuropathies in prediabetic patients are usually asymptomatic or subclinical, and predispose to affect unmyelinated and small myelinated sensory fibers. Selective electrodiagnostic measurements of small fibers help to detect prediabetic neuropathies in the earliest stages of the disease.