The pattern differentiation method is the most representative part of the inheritance of the experience of renowned practitioners of traditional Chinese medicine,reflecting their clinical thinking characteristics. Among them,Professor LYU Renhe proposed and developed the theory of abdominal masses in the long-term diagnosis and treatment of kidney diseases. Based on his clinical experience,he formed the method of differentiation of Shenluozhengjia (tangible or intangible abdominal masses of kidney collaterals). This differentiation method is characterized by its simple and easy clinical application. Tangible or intangible abdominal masses of kidney collaterals refer to chronic kidney disease,which is based on the basic cause of kidney deficiency. External or internal pathogenic factors cannot be eliminated,and prolonged illness invades the kidney collaterals,causing pathological products,such as qi stagnation,blood stasis,phlegm dampness,heat toxin,and turbid toxin to stagnate in the kidney collaterals,resulting in damage to the kidney body and loss of kidney function. The basic pathogenesis is a deficiency of kidney qi and the formation of tangible or intangible abdominal masses of the kidney collaterals. During pattern differentiation,the type is determined by the deficiency,which is fixed,and the pattern is determined by the excess,which is constantly changing with the condition and can be combined. Furthermore,he summarized the dietary principles as having more essence and less coarseness,more milk and less meat,a phased diet,and the selection of the symptomatic diet. To inherit and improve the theory and clinical practice of the pattern differentiation theory of tangible or intangible abdominal masses of kidney collaterals,this article reviews and summarizes the unique pattern differentiation method of the kidney collateral pattern from the aspects of definition,theoretical origin,etiology and pathogenesis,differentiation and treatment,and regulation,providing a basis for forming suitable diagnosis and treatment method for clinical promotion.

BACKGROUND:Spheroid culture of mesenchymal stem cells in bioreactors is an in vitro culture method to maintain their stemness properties and allow for large-scale expansion.Clarifying its effects on the immunoregulation effect of stem cells is beneficial for their clinical application. OBJECTIVE:To investigate the effects of spheroid culture in a rotating bioreactor on the secretion of inflammatory factors by human placenta-derived mesenchymal stem cells. METHODS:Placenta-derived mesenchymal stem cells isolated from human placenta tissue were cultured in two-dimensional culture or a rotating bioreactor culture.Cell morphology and proliferation ability were observed using inverted phase contrast microscopy,immunohistochemical staining,and CCK-8 assay.The gene expression and protein secretion of several inflammatory factors were detected by RT-qPCR and flow immunofluorescence assay. RESULTS AND CONCLUSION:(1)Mesenchymal stem cells cultured in a rotating bioreactor aggregated into multicellular spheroids,which gradually increased in number and volume.(2)The hematoxylin-eosin staining results showed that the mesenchymal stem cells cultured in the rotating bioreactor for 4 days were evenly distributed and had normal morphology in the spheroids.(3)Immunohistochemical staining results revealed many mesenchymal stem cells with Ki-67 positive in the spheroids.(4)The CCK-8 assay results exhibited that the viability of mesenchymal stem cells derived from spheroid culture was significantly higher than that of cells cultured in two-dimensional culture.(5)The results of RT-qPCR and flow immunofluorescence assay demonstrated that the gene expression and protein secretion(interleukin 1β,interleukin-4,interleukin-6,interleukin-8,interleukin-10,interleukin-17,tumor necrosis factor α and interferon α)of inflammatory factors derived from mesenchymal stem cells cultured in the rotating bioreactor were significantly higher than those in two-dimensional culture.(6)Our results indicate that spheroid culture in a rotating bioreactor can significantly elevate the secretion ability of various inflammatory factors by human placenta-derived mesenchymal stem cells,and enhance the immunoregulatory effect of human placenta-derived mesenchymal stem cells.

Background Patients with schizophrenia of Yangming Fushi syndrome experience more severe symptoms,and a substantial proportion of patients derive inadequate benefit from antipsychotics and suffer from serious adverse effects,yet few studies have been conducted on the treatment of schizophrenia of Yangming Fushi syndrome with Zengye Chengqi decoction.Objective To explore the efficacy of Zengye Chengqi decoction combined with olanzapine in the treatment of schizophrenia of Yangming Fushi syndrome,in order to provide references for the treatment of schizophrenia with the combination of traditional Chinese and western medicine.Methods A total of 60 patients attending the Second Affiliated Hospital of Xinxiang Medical College from January 2022 to August 2023 and fulfilling the International Classification of Diseases(ICD-10)diagnostic criteria for schizophrenia were enrolled,and assigned into study group(n=30)and control group(n=30)using random number table methods.All patients were treated with olanzapine,and study group was given Zengye Chengqi decoction on this basis.Treatment for both groups lasted for 4 weeks.All participants were assessed using Positive and Negative Syndrome Scale(PANSS),Montreal Cognitive Assessment(MoCA)and Event-Related Potential P300 at baseline and end of treatment.The occurrence of adverse reactions was recorded at the end of treatment.Results Study group reported a higher treatment effective rate compared with control group(χ2=9.320,P=0.002).After treatment,study group detected a significant reduction in PANSS subscales and total scores(F=10.287,8.258,8.844,20.079,P<0.01),and a notable increase in scores of delayed recall and orientation domains from MoCA(F=4.463,22.255,P<0.05 or 0.01)when compared with control group,with statistical difference.For the P3 component of event-related potential,study group produced significantly larger amplitudes than control group(F=4.247,P<0.05).The incidence rate of abnormal liver function,constipation and increased body mass index(BMI)in study group was lower than those in control group(χ2=4.320,4.463,7.200,P<0.05 or 0.01).Conclusion Zengye Chengqi decoction combined with olanzapine are found to be effective in improving the psychotic symptoms and cognitive function and alleviating the adverse reactions of patients with schizophrenia of Yangming Fushi syndrome.

Objective:To analyze the temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Beijing and provide reference evidence in HFMD prevention and control.Methods:The monthly incidence data of HFMD in Beijing from 2008 to 2023 were collected from Notifiable Disease Management Information System of the Chinese Information System of Disease Control and Prevention, and the epidemiological characteristics of HFMD were analyzed by the methods of time series seasonal decomposition graph, concentration degree, and circular distribution.The WPS office software 2019 was used to clean the data, Python software 3.12 was used to analyze and make statistical charts.Results:The monthly incidence fluctuation of HFMD in Beijing from 2008 to 2015 was higher than that from 2016 to 2022. From 2016 to 2022, the fluctuation range of monthly incidence showed a gradually decreasing trend.From 2008 to 2015, the concentration ( M) was 0.58, indicating a relatively strong seasonality; the mean angle ( α) calculated by the circular distribution method was 174.95°, and the mean angle standard deviation ( s) was 60.43°. The annual incidence peak occurred on June 27, and the incidence peak period was from April 27 to August 27. From 2016 to 2019 and 2023, the M was 0.57, indicating a relatively strong seasonality. The α was 228.05°, and s was 61.44°. The annual incidence peak occurred on August 20, and the incidence peak period was from June 18 to October 21. From 2020 to 2022, the M was 0.42, indicating a seasonality, the α was 238.27° and s was 76.35°. The annual incidence peak occurred on July 15, and the incidence peak period was from June 14 to November 14. The α of 2008-2015, 2016-2019 and 2023, and 2020-2022 were tested by the Watson-Williams method and the difference was statistically significant ( F=33 443.09, P<0.001). In 2023, the M was 0.77, indicating a strong seasonality. The incidence peak occurred on September 16, and the incidence peak period was from August 5 to October 28. Conclusions:The seasonality of HFMD in Beijing was obvious from 2008 to 2023, and the incidence peak day and peak period overall had rearward shifts. It is necessary to strengthen the comprehensive analysis of the distribution characteristics at different dimensions and the comprehensive prevention and control in key areas, places, and populations during the peak incidence period.

Objective To explore the interaction between multiple governance subjects of the medical service system and their governance roles,and to provide theoretical support for the effectively enhancing of patients'sense of access to medical care.Methods Outpatients of different types of public hospitals in Hangzhou were selected as the research objects,question-naire surveys were conducted using quota sampling method,and hypotheses and models were verified using structural equation modelling technology.Results Statistical tests and path correction showed that the model had a good fit,and that the manage-ment of government departments,internal management of hospitals,service of medical staff,and cognitive attitudes had a positive impact on the sense of access to healthcare,with total effects of 0.71,0.63,0.38,and 0.12,respectively.Conclusion The construction of a collaborative governance model that takes government departments as the leader,public hospitals as the carrier,medical staff as the center axis,and patients as the centre is the best way to practice a collaborative governance model of various subjects,and is an excellent way to practice a collaborative governance model of various subjects.The synergistic governance model of various subjects is one of the critical strategies to practise people's co-construction and sharing and to enhance the sense of access to healthcare effectively.

With the increasing maturity of liver transplantation technology and the improvement of postoperative management, liver transplantation has become one of the important means for treating hepatocellular carcinoma (HCC). However, the postoperative recurrence is the main reason for treatment failure. Therefore, it is of great clinical significance to accurately predict the risk of postoperative recurrence in patients undergoing liver transplantation for HCC. PET/CT can reflect cellular metabolism and function changes in target organ at the molecular level. The tumor metabolic burden parameters of PET/CT have been included in the post-transplant evaluation system for liver transplantation and have good prognostic value. This article provides a review of prediction of HCC recurrence after liver transplantation using PET/CT.

Objective:To analyze the clinical characteristics of patients with spontaneous splenorenal shunt (SSRS) in liver cirrhosis, and to compare the effects and prognosis of different treatments.Methods:The data of cirrhotic patients with SSRS at the First Affiliated Hospital of Zhengzhou University between 2016-2022 were retrospectively analyzed.Patients were divided into Group A receiving conservative treatment, Group B by simple embolization, Group C undergoing TIPS combined with embolization, and Group D given liver transplantation. Life status, liver function changes, incidences of adverse events, and survival between groups were compared.Results:SSRS diameter was positively correlated with blood ammonia ( R=0.478) and negatively correlated with portal vein diameter ( R=-0.301). SSRS diameter is a protective factor for gastrointestinal hemorrhage and ascites and a risk factor for hepatic encephalopathy; Blood ammonia decreased and prothrombin time prolonged after treatment in group A ( P<0.05), blood ammonia decreased and albumin increased in group B ( P<0.05). Hemoglobin and bilirubin increased in group C ( P<0.05), blood ammonia and bilirubin decreased and platelets and albumin increased in group D ( P<0.05); Survival analysis showed that the prognosis of groups A and C was related to liver function, and the survival rate of group D was the highest of all ( P<0.05). Conclusions:SSRS embolization is safe and effective, and liver transplantation improves patient survival. Individualized treatment should be selected based on patient symptoms, liver function, and shunt diameter.

Objective: To understand the exposure to second hand smoking (SHS) and associated factors among middle school students in Beijing, and to provide data support for tobacco control. Methods: The two stage stratified cluster random sampling method were used to select 10 532 students from 370 classes in 48 junior middle schools, 34 senior high schools and 14 vocational high schools in 16 districts of Beijing. The national unified paper questionnaire was used to collect the information. Results: During the past 7 days, 71.5% (95% CI =70.2%-72.7%) of students reported exposure to SHS. The proportion of exposure was highest (60.3%) in outdoor public places, followed by indoor public places (48.9%), at home (34.1%), and public transport (19.1%). About 31.6% of students reported people smoking in the campus in the past 30 days. Risk factors of SHS exposure included one or more parents was smoker( OR =2.62), friends who smoked( OR =2.13), received education on tobacco hazards in school( OR = 0.74 ), and senior high school( OR =0.68-0.73)( P <0.05). Conclusion High exposure to second hand smoking among middle school students in Beijing is common. Implementation of the regulations and the publicity of tobacco hazards and tobacco control in schools should be strengthened. Smoke free household should be advocated, and middle school students, especially junior middle school students, should be protected from the harm of SHS.

Depressive disorder is one of the common mental disorders, and its occurrence is usually attributed to the combined effects of multiple factors.The single genetic factor can't fully explain the cause of depressive disorder.Family factors have an important impact on the occurrence of depressive disorder, however, the impact of family factors on depressive disorder and its treatment has not been paid enough attention to.This paper reviewed the recent researches on family factors affecting depressive disorder and family therapy for depressive disorder.The results showed that family factors had an impact on depression patients of any age, and adverse family factors were risk factors for the occurrence, sustainable development and recurrence of depressive disorder.Most of the previous studies were horizontal, but few were longitudinal research.Family therapy plays a positive role in the treatment of depressive disorder and has a significant effect on the acute phase of depression except for major depressive disorder (MDD). Family therapy can quickly relieve the symptoms of depression.Further studies on family-based treatment intervention strategies for MDD are needed in the future, and more longitudinal studies are needed to further analysis of the influence of family factors on depressive disorder.

ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ²=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.