ObjectiveTo investigate the triglyceride-glucose (TyG) index and the level of serum homocysteine (Hcy) in association with the incidence of stroke in type 2 diabetes mellitus (T2DM) patients. MethodsBased on the chronic disease risk factor surveillance cohort in Pudong New Area, Shanghai, excluding those with stroke in baseline survey, T2DM patients who joined the cohort from January 2016 to October 2020 were selected as the research subjects. During the follow-up period, a total of 318 new-onset ischemic stroke patients were selected as the case group, and a total of 318 individuals matched by gender without stroke were selected as the control group. The Cox proportional hazards regression model was used to adjust for confounding factors and explore the serum TyG index and the Hcy biochemical indicator in association with the risk of stroke. ResultsThe Cox proportional hazards regression results showed that after adjusting for confounding factors, the risk of stroke in T2DM patients with 10 μmol·L⁻¹-¹ and Hcy>15 μmol·L⁻¹ was 1.532 times (95%CI: 1.017‒2.309 times, P=0.041) and 1.738 times (95%CI: 1.119‒2.699 times, P=0.014) higher respectively, compared to T2DM patients with Hcy≤10 μmol·L⁻¹. T2DM patients with TyG>9.074 had 1.396 times higher risk of stroke (95%CI: 1.091‒1.787, P=0.008) compared to those with TyG≤9.074. The study found that urea and α1-antitrypsin (α1-AT) were independent risk factors for the incidence of stroke in T2DM patients. For every unit increase in urea andα1-AT, the risk of stroke in T2DM patients increased by 233.6% (HR=3.336, 95%CI: 1.588‒7.009, P=0.001) and 11.3% (HR=1.113, 95%CI: 1.028‒1.205, P=0.008), respectively. Cumulative risk curves showed that Hcy>10 μmol·L⁻¹ and TyG>9.074 accelerated the time to stroke occurrence in T2DM patients. ConclusionElevated levels of Hcy>10 μmol·L⁻¹ and a higher TyG index are risk factors for stroke in T2DM patients. Effective interventions for Hcy and TyG should be conducted for diabetic patients to reduce the incidence of stroke.

Ankylosing spondylitis (AS) is linked to an increased prevalence of myocardial infarction (MI). However, research dedicated to elucidating the pathogenesis of AS-MI is lacking. In this study, we explored the biomarkers for enhancing the diagnostic and therapeutic efficiency of AS-MI. Datasets were obtained from the Gene Expression Omnibus database. We employed weighted gene co-expression network analysis and machine learning models to screen hub genes. A receiver operating characteristic curve and a nomogram were designed to assess diagnostic accuracy. Gene set enrichment analysis was conducted to reveal the potential function of hub genes. Immune infiltration analysis indicated the correlation between hub genes and the immune landscape. Subsequently, we performed single-cell analysis to identify the expression and subcellular localization of hub genes. We further constructed a transcription factor (TF)-microRNA (miRNA) regulatory network. Finally, drug prediction and molecular docking were performed. S100A12 and MCEMP1 were identified as hub genes, which were correlated with immune-related biological processes. They exhibited high diagnostic value and were predominantly expressed in myeloid cells. Furthermore, 24 TFs and 9 miRNA were associated with these hub genes. Enzastaurin, meglitinide, and nifedipine were predicted as potential therapeutic agents. Our study indicates that S100A12 and MCEMP1 exhibit significant potential as biomarkers and therapeutic targets for AS-MI, offering novel insights into the underlying etiology of this condition.
Humans ; Spondylitis, Ankylosing/complications* ; Systems Biology/methods* ; Myocardial Infarction/diagnosis* ; Biomarkers/metabolism* ; MicroRNAs/genetics* ; Gene Regulatory Networks ; Gene Expression Profiling ; Machine Learning

Autism spectrum disorder（ASD）is a multifactorial，pervasive neurodevelopmental disorder.As the morbidity rate of ASD in children increases year by year，feeding and eating behaviors，as an important and common clinical problem in children with ASD，are gaining more and more attention.Many children with ASD often have food selection issues，chewing problems，food allergy and related gastrointestinal symptoms，and even serious diseases such as eating disorders，which negatively impact on their growth and development.There are many factors affecting feeding and eating behavior problems in children with ASD，such as sensory processing，ritualistic eating behavior，gastrointestinal symptoms，age，and parenting pressure.There are also a variety of interventions that can help to improve feeding and eating behavior problems in children with ASD.Strengthening the understanding of these influencing factors and intervention treatment methods is beneficial for improving the quality of life in children with ASD.

Objective To investigate the efficacy of Yiqi Wenyang Sanjie Decoction in the treatment of patients with pulmonary ground glass nodules and yang-deficiency constitution,and to observe its effect on serum inflammatory factors and immune function.Methods From January 2020 to June 2024,a total of 106 patients with pulmonary ground glass nodules and yang-deficiency constitution admitted to the Department of Respiratory Medicine and Preventive Treatment of Disease Center of Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected.The patients were randomly divided into control group and Chinese medicine group by random number table method,with 53 cases in each group.The patients in the control group were only given follow-up without any intervention,and the patients in the Chinese medicine group were treated with Yiqi Wenyang Sanjie Decoction for 3 months.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,maximum diameter of pulmonary ground glass nodules,serum levels of inflammatory factors of interleukin-6(IL-6),interleukin-17A(IL-17A),and tumor necrosis factor-α(TNF-α),and levels of immune function indicators of peripheral blood CD3+,CD4+cell percentage and CD4+/CD8+ratio.After treatment,the efficacy and safety of the two groups were evaluated.Results(1)During the trial,5 cases fell off from the control group and 3 cases fell off from the Chinese medicine group.A total of 98 cases were eventually included,and 48 cases were in the control group and 50 cases were in the Chinese medicine group.(2)After 3 months of treatment,the total effective rate of the Chinese medicine group was 46.00%(23/50),and that of the control group was 10.42%(5/48).The intergroup comparison(tested by chi-square test)showed that the efficacy of the Chinese medicine group was significantly superior to that of the control group(P＜0.01).(3)After treatment,the TCM syndrome score and the maximum diameter of pulmonary ground glass nodules in the Chinese medicine group were lowered(P＜0.05),while the TCM syndrome score and the maximum diameter showed no obvious changes compared with those at enrollment(P＞0.05);the intergroup comparison showed that the reduction of TCM syndrome score and the maximum diameter of pulmonary ground glass nodules in the Chinese medicine group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the levels of serum inflammatory factors of IL-6,IL-17A and TNF-α in the Chinese medicine group were significantly lowered compared with those at enrollment(P＜0.05),while there was no significant change in serum IL-6,IL-17A and TNF-α levels of the control group(P＞0.05);the intergroup comparison showed that the decrease of serum IL-6,IL-17A and TNF-α levels in the Chinese medicine group was significantly superior to that in the control group(P＜0.05).(5)After treatment,the percentage of T lymphocyte subset CD4+and the ratio of CD4+/CD8+in the Chinese medicine group were significantly increased compared with those at enrollment(P＜0.05),while there was no significant change in the percentage of CD3+,CD4+cells and the ratio of CD4+/CD8+of the control group and in the percentage of CD3+cells of the Chinese medicine group(P＞0.05).The intergroup comparison showed that the increase of CD4+percentage and CD4+/CD8+ratio in the Chinese medicine group was significantly superior to that in the control group(P＜0.05).(6)There were no obvious adverse reactions occurring in the Chinese medicine group during the treatment,showing relatively high safety.Conclusion Yiqi Wenyang Sanjie Decoction exerts certain effect in the treatment of patients with pulmonary ground glass nodules and yang-deficiency constitution.It can effectively promote the reduction of nodules,relieve clinical symptoms,decrease serum levels of inflammatory factors,improve immune function,and has good safety.

Objective To observe the clinical efficacy of filiform-heated needle stimulation on myofascial trigger points(MTrPs)based on the"pivot mechanism"theory in treating neck-shoulder myofascial pain syndrome(MPS).Methods Sixty-four patients diagnosed with neck-shoulder MPS from the Acupuncture Department(inpatient and outpatient)of Guangzhou University of Chinese Medicine Dongguan Hospital between January 2023 and September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 32 cases per group.The control group received oral administration of Celecoxib Capsules,while the observation group received additional filiform-heated needle therapy.The treatment duration was 2 weeks and 1 course per week.Clinical efficacy was evaluated after 2 weeks,with observing the changes in the Short-Form McGill Pain Questionnaire(SF-MPQ)scores,Neck Disability Index(NDI)scores.The cervical range of motion(ROM)was compared between the two groups.Results(1)After treatment,the SF-MPQ scores of the two groups of patients were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the SF-MPQ scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the NDI scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the NDI scores,and the difference was statistically significant(P＜0.05).(3)After treatment,the cervical joint mobility of patients in the two groups was significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving cervical joint mobility,with a statistically significant difference(P＜0.05).(4)The total effective rate was 96.88%(31/32)in the observation group and 84.38%(27/32)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Filiform-heated needle stimulation on MTrPs based on the"pivot mechanism"theory significantly alleviates pain,improves soft tissue injury,and enhances neck-shoulder mobility in patients with neck-shoulder MPS,demonstrating remarkable clinical efficacy.

Case 1: A 27-year-old female with ALK-positive anaplastic large cell lymphoma/leukemia; Case 2: A 27-year-old male with acute myeloid leukemia; Case 3: A 56-year-old male with myelodysplastic syndrome. These three patients underwent haploid hematopoietic stem cell transplantation and experienced severe oral mucosal inflammation, nausea, vomiting, diarrhea, and other symptoms over a long period, which significantly restricted eating. Neurological and psychiatric symptoms appeared at 50, 38, and 50 days following transplantation, respectively. The diagnosis of Wernicke encephalopathy was made by head magnetic resonance imaging, whereas the condition improved significantly after intravenous infusion of vitamin B 1.

Objective:To explore the psychological experiences of lung cancer patients during treatment based on the perspective of narrative medicine,and to provide references for targeted nursing interventions.Methods:Guided by the concept of narrative medicine,the phenomenological method of qualitative research was used to conduct in-depth interviews with 20 lung cancer patients.The interview data were analyzed,refined,and summarized by using the content analysis method.Results:From the perspective of the humanistic value of narrative medicine,four themes were extracted from the interview contents with 20 lung cancer patients,including the loss of patients'role identity,the experience of disease uncertainty,the fear and expectation of death,and the helplessness and perception of life.Conclusion:During the treatment process of lung cancer patients,there are negative psychological experiences,such as loss of role identity,uncertainty of disease,fear of death,and hope to leave with dignity.Meanwhile,there are positive perceptions,such as contemplation of the meaning of life and actively coping with it.

To meet the emerging demands of clinical medicine development and transformation of doctor-patient relationship models,enhance medical students'theoretical knowledge and practical application level of medical humanities,as well as improve the educational experience,the medical humanities teaching team of Harbin Medical University introduced and innovated the workshop teaching model in teaching.By summarizing the basic connotation of workshop teaching mode and its innovation in medical humanities education,taking the"doctor-patient communication"course of Harbin Medical University as an example,this paper shared the specific practice and application of workshop teaching mode in course teaching from three aspects,including preparation,implementation,and evaluation and feedback of teaching,as well as explored its innovation and application prospects in medical humanities education,with a view to providing valuable references for the organic integration of medical humanities education and clinical professional education,professional theory and practice.

The article presents the diagnosis and treatment of an imported case with severe Plasmodium falciparum malaria, and the effect of plasma exchange combined with continuous renal replacement therapy. Severe P. falciparum malaria is characterized by complex clinical symptoms and multiple complications, and plasma exchange combined with continuous renal replacement therapy has a satisfactory therapeutic efficacy for severe P. falciparum malaria.