This paper introduces the clinical experience of Professor AN Junming in treating spinal cord injury(SCI)with FANG's scalp acupuncture plus body acupuncture.Professor AN Junming holds that the key pathogenesis of SCI should be"deficient kidney and cold Governor Vessel",and the treatment should target the axis of"brain-Governor Vessel-kidney-Conception Vessel".SCI will definitely cause damage to the Governor Vessel and the counterflow of Qi and blood.Hence,treating SCI with acupuncture-moxibustion should unblock the Governor Vessel and strengthen Yang.The kidney and the Governor Vessel mutually benefit and support each other.After SCI,the kidney essence is weakened and damaged,and the kidney Yang is deficient.Thus,warming and tonifying kidney Yang should be the key to the treatment.Further,as the Governor Vessel is injured,the disease of Yang will gradually affect Yin,and the Conception Vessel will consequently get involved over time.Therefore,in the treatment,points from the Conception and Governor Vessels should be selected simultaneously to"treat Yang from Yin"and balance Yin and Yang.Based on the above considerations,Professor AN Junming usually treats SCI with FANG's scalp acupuncture plus body acupuncture to unblock the Conception and Governor Vessels,supplement the kidney and marrow,harmonize Qi and blood,and balance Yin and Yang,providing novel ideas and methods for clinical treatment.

This study aims to investigate the biological function of the Clumping factor B(clfB)gene in Staphylococcus aureus.The recombinant plasmid pBT2-△clfB was constructed and elec-troporated into Staphylococcus aureus J57 to delete clfB by homologous recombination.The ex-pression plasmid pLI50-clfB was constructed,modified,and electroporated into clfB gene deletion strain △clfB and constructed a complementation strain(C△clfB).J57,△clfB,and C△clfB were cultured at 37℃ for 12 h,and the growth curves of each strain were plotted.The hemolytic properties of each strain were analyzed by contact method,the motility of each strain on TSA plates was determined,and the autolysis rate of each strain under the action of TritonX-100 was determined.Crystal violet staining was used to detect each strain's biofilm formation ability,and biofilm components formed by each strain were quantitatively analyzed.The K-B method was used to determine the sensitivity of each strain to commonly used antibiotics.ClfB gene deletion strain△clfB and the complemented strain C△clfB were successfully constructed.The growth curves of the deletion strain were almost consistent with those of the wild and complemented strains,and there was no significant difference.Compared with J57 and C△clfB,the hemoly ability and the athletic of △clfB decreased.In the condition of TritonX-100,the autolysis rate of △clfB was significantly lower than that of J57 and C△clfB(P＜0.01).Compared with J57 and C△clfB,the ability of △clfB to form biofilm was significantly lower than that of J57 and C△clfB(P＜0.05),and the content of extracellular DNA and protein in the biofilm was significantly decreased.In con-trast,the content of soluble polysaccharides was significantly increased(P＜0.05).Compared with J57 and C△clfB,△clfB was more sensitive to chloramphenicol,gentamicin,and kanamycin while more resistant to linezolid.ClfB gene is closely related to the autolysis,hemolytic activity,athlet-ic,and biofilm formation ability of Staphylococcus aureus,affecting the sensitivity of bacteria to certain antibiotics.

This study aims to investigate the biological function of the Clumping factor B(clfB)gene in Staphylococcus aureus.The recombinant plasmid pBT2-△clfB was constructed and elec-troporated into Staphylococcus aureus J57 to delete clfB by homologous recombination.The ex-pression plasmid pLI50-clfB was constructed,modified,and electroporated into clfB gene deletion strain △clfB and constructed a complementation strain(C△clfB).J57,△clfB,and C△clfB were cultured at 37℃ for 12 h,and the growth curves of each strain were plotted.The hemolytic properties of each strain were analyzed by contact method,the motility of each strain on TSA plates was determined,and the autolysis rate of each strain under the action of TritonX-100 was determined.Crystal violet staining was used to detect each strain's biofilm formation ability,and biofilm components formed by each strain were quantitatively analyzed.The K-B method was used to determine the sensitivity of each strain to commonly used antibiotics.ClfB gene deletion strain△clfB and the complemented strain C△clfB were successfully constructed.The growth curves of the deletion strain were almost consistent with those of the wild and complemented strains,and there was no significant difference.Compared with J57 and C△clfB,the hemoly ability and the athletic of △clfB decreased.In the condition of TritonX-100,the autolysis rate of △clfB was significantly lower than that of J57 and C△clfB(P＜0.01).Compared with J57 and C△clfB,the ability of △clfB to form biofilm was significantly lower than that of J57 and C△clfB(P＜0.05),and the content of extracellular DNA and protein in the biofilm was significantly decreased.In con-trast,the content of soluble polysaccharides was significantly increased(P＜0.05).Compared with J57 and C△clfB,△clfB was more sensitive to chloramphenicol,gentamicin,and kanamycin while more resistant to linezolid.ClfB gene is closely related to the autolysis,hemolytic activity,athlet-ic,and biofilm formation ability of Staphylococcus aureus,affecting the sensitivity of bacteria to certain antibiotics.

This paper introduces the clinical experience of Professor AN Junming in treating spinal cord injury(SCI)with FANG's scalp acupuncture plus body acupuncture.Professor AN Junming holds that the key pathogenesis of SCI should be"deficient kidney and cold Governor Vessel",and the treatment should target the axis of"brain-Governor Vessel-kidney-Conception Vessel".SCI will definitely cause damage to the Governor Vessel and the counterflow of Qi and blood.Hence,treating SCI with acupuncture-moxibustion should unblock the Governor Vessel and strengthen Yang.The kidney and the Governor Vessel mutually benefit and support each other.After SCI,the kidney essence is weakened and damaged,and the kidney Yang is deficient.Thus,warming and tonifying kidney Yang should be the key to the treatment.Further,as the Governor Vessel is injured,the disease of Yang will gradually affect Yin,and the Conception Vessel will consequently get involved over time.Therefore,in the treatment,points from the Conception and Governor Vessels should be selected simultaneously to"treat Yang from Yin"and balance Yin and Yang.Based on the above considerations,Professor AN Junming usually treats SCI with FANG's scalp acupuncture plus body acupuncture to unblock the Conception and Governor Vessels,supplement the kidney and marrow,harmonize Qi and blood,and balance Yin and Yang,providing novel ideas and methods for clinical treatment.

Objective:To investigate the effect of mucosal thickness around implants on marginal bone resorption.Methods:A retrospective analysis was conducted on the clinical data of 75 patients who received single-tooth implant restorations at Shaoxing Stomatological Hospital from December 2020 to May 2022. The patients were divided into two groups based on mucosal thickness: the thin gingiva group ( n = 40) and the thick gingiva group ( n = 35). In the thin gingiva group, implants were placed 1.5 mm below the bone surface, while in the thick gingiva group, implants were placed at the bone surface. Implant survival rates, marginal bone resorption, bone remodeling, and the incidence of adverse reactions were compared between the two groups. Results:The implant survival rate in the thin gingiva group was significantly lower than that in the thick gingiva group [75.00% (30/40) vs. 94.29% (33/35), χ 2 = 5.17, P < 0.05]. After 9 months of weight bearing, marginal bone resorption value in the thin gingiva group was significantly higher than that in the thick gingiva group [(0.16 ± 0.04) vs. (0.14 ± 0.02), t = 2.83, P < 0.05]. The bone remodeling value in the thin gingiva group was significantly lower than that in the thick gingiva group [(1.03 ± 0.21) vs. (1.25 ± 0.34), t = 3.48, P < 0.05]. The incidence of adverse reactions including infection, bleeding, occlusal weakness, and pain in the thin gingiva group was significantly higher than that in the thick gingiva group [25.00% (10/40) vs. 5.72% (2/35), χ 2 = 5.17, P < 0.05]. Conclusion:A mucosal thickness of ≥ 3 mm is associated with a higher survival rate of implants placed below the bone surface, which better maintains bone tissue stability, reduces bone resorption, promotes bone remodeling, and decreases the incidence of adverse reactions.

Objective:To analyze the clinical features of 6 patients with spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks.Methods:The clinical characteristics, auxiliary examinations, treatment, and outcomes in 6 patients of spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks enrolled in the Xuanwu Hospital, Capital Medical University from February 2021 to April 2022 were retrospectively reviewed.Results:All the 6 patients had orthostatic headaches. Brain magnetic resonance imaging showed dural enhancement and brain sagging and magnetic resonance myelography showed longitudinal extradural collection in all the patients. The high-flow spinal cerebrospinal fluid leaks were demonstrated in upper thoracic segments by the dynamic myelography. The headache disappeared after conservative treatment in 2 patients and treatment with targeted epidural blood patch in 4 patients.Conclusions:The diagnosis of spontaneous intracranial hypotension caused by high-flow spinal cerebrospinal fluid leaks with typical orthostatic headache and brain magnetic resonance imaging and myelography findings is not difficult. However, the localization of the site of high-flow spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension depends on the dynamic myelography. Targeted epidural blood patch is effective, but conservative treatment does not always work.

Objective:To summarize the clinical features, radiological characteristics, therapy, and outcome of patients with spontaneous intracranial hypotension (SIH).Methods:The general information, clinical manifestations, auxiliary examinations, treatment, and outcomes in consecutive patients of SIH hospitalized in the Xuanwu Hospital, Capital Medical University from November 2018 to October 2022 were analyzed.Results:A total of 118 patients with a female-to-male ratio of 5∶4 were included and the ages were 17.00-71.00[39.00(34.00,46.75)]years with a preponderance in the age of 30-49 years. Almost all patients had orthostatic headaches (117/118, 99.2%), accompanied by nausea (90/118, 76.3%), vomiting (70/118, 59.3%), neck stiffness (88/118, 74.6%), tinnitus (57/118, 48.3%), and ear fullness (57/118, 48.3%). Brain magnetic resonance imaging (MRI) showed dural enhancement (97/113, 85.8%), enlarged venous sinus (88/113, 77.9%), subdural fluid collection (46/113, 40.7%), decreased suprasellar cistern (86/113, 76.1%), effacement of the prepontine cistern (86/113, 76.1%), diminished mamillopontine distance (80/113, 70.8%). The cerebrospinal fluid (CSF) leaks were detected in 90.7% (107/118) of the patients by magnetic resonance myelography but 54.3% (25/46) and 52.6% (20/38) by CT myelography and magnetic resonance myelography with gadolinium. Lumber puncture found CSF pressure<60 mmH 2O (1 mmH 2O=0.009 8 kPa) in 18.4% (19/103) of patients, increased CSF red blood cell counts in 50.6% (44/87) of patients, CSF pleocytosis in 44.8% (39/87) of patients, increased CSF protein concentrations in 57.5% (50/87) of patients. The headache completely disappeared after conservative treatment in 24.6% (31/118) of patients and after a single targeted epidural blood patch in 89.7% (78/87) of patients. A rebound headache after epidural blood patch treatment occurred in 66.0% (58/87) of patients. Conclusions:The patients with SIH almost manifested with orthostatic headache, and brain MRI and magnetic resonance myelography were suggested in those patients instead of CSF pressure by lumber puncture. Targeted epidural blood patch was effective and safe in SIH patients.

Objective:To analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Qiqihar City, and to understand the epidemic and development rules of HFRS, and to provide scientific basis for formulating targeted prevention and control measures.Methods:The data of HFRS cases in Qiqihar City from 2016 to 2020 were collected from the China Disease Control and Prevention Information System by retrospective analysis, and the three distributions (time, region and population distribution) of HFRS were analyzed by descriptive epidemiology. At the same time, the monitoring data of rats in Nehe City from 2016 to 2020 were collected from the Nehe Municipal Center for Disease Control and Prevention for descriptive analysis.Results:From 2016 to 2020, 868 HFRS cases were reported in Qiqihar City, with 10 deaths. The average annual incidence rate was 3.26/100 000, the average annual mortality rate was 0.04/100 000, and the case fatality rate was 1.15%. From 2016 to2020, the incidence rates were 3.23/100 000, 3.31/100 000, 3.22/100 000, 4.10/100 000 and 2.43/100 000, respectively. Incidence occurred in all months of the year, with the peak period from October to December (490 cases in total). The top five counties(cities) with the incidence of HFRS were Nehe City (7.46/100 000), Keshan County (5.03/100 000), Gannan County (3.84/100 000), Fuyu County (3.82/100 000) and Tailai County (3.63/100 000). Among the patients, 76.04% (660/868) were male and 23.96% (208/868) were female; the age of onset was mainly 30-69 years old, accounting for 81.57% (708/868) of the total cases; the occupation distribution was mainly farmers, accounting for 75.46% (655/868) of the total cases. The results of rat monitoring in Nehe City from 2016 to 2020 showed that Rattus norvegicus was the dominant species in the field and village, accounting for 65.13% (581/892) and 80.21% (466/581), respectively. In spring, the rat density in the field and village was 3.37% (397/11 771) and 6.64% (275/4 141), respectively; in autumn, the rat density in the field and village was 8.47% (495/5 843) and 9.40% (306/3 254), respectively. The virus carrying rate of Rattus norvegicus was high, 13.14% (131/997); the infection rate of Rattus norvegicus was also high, 15.15% (151/997); the virus carrying rate and infection rate in the village were higher than those in the field (χ 2 = 6.87, P = 0.009; χ 2 = 13.05, P < 0.001). Conclusions:The incidence of HFRS in Qiqihar City is relatively stable from 2016 to 2018, rising in 2019 and falling back in 2020; the onset time is mainly in autumn and winter, mainly male and farmers. From 2016 to 2020, among all counties (cities, districts) in Qiqihar City, the incidence of HFRS in Nehe City is high, and the density of rats in autumn is higher than that in spring. Rattus norvegicus is the main species of rats, with high virus carrying rate and infection rate.

Spontaneous intracranial hypotension can frequently result in several complications including subdural hygroma, subdural hematoma and cerebral venous thrombosis, but coma rarely. A case of spontaneous intracranial hypotension presented with orthostatic headaches was described. He experienced somnolence, disorientation, incontinence, and then coma, though received conservative treatment. Brain imaging demonstrated acute-on-chronic subdural hematoma, magnetic resonance myelography using heavily T 2-weighted fast spin-echo pulse sequences showed spinal longitudinal extradural collection, and magnetic resonance myelography with intrathecal gadolinium revealed cerebrospinal fluid leak at the level of T 6, T 7. The patient recovered consciousness after surgical evacuation of the hematoma, and the headache disappeared after a targeted epidural blood patch. The hematoma resolved 2 months later and the patient kept free from headache during follow-up.

Objective:To investigate the serum level and significance of complement factor B (CFB) and complement factor D (CFD) in patients with type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN).Methods:From October 2019 to October 2020, 110 patients with T2DM in the endocrinology department of Affiliated Hospital of Jining Medical College were divided into DPN group ( n=60) and simple T2DM group ( n=50) according to whether or not DPN was combined. In addition, 52 cases of physical examination population in the physical examination center in the same period were selected as the normal control group ( n=52). The serum levels of CFB, CFD and tumor necrosis factor-α (TNF-α) were measured by enzyme linked immunosorbent assay (ELISA). The correlation between CFB, CFD and clinical indexes was analyzed, and the influencing factors of DPN were analyzed by logistic regression. Results:The serum levels of CFB and CFD in DPN group were higher than those in T2DM group and normal control group [CFB: (845.43±101.10)μg/ml vs (792.19±116.59)μg/ml, (739.20±123.43)μg/ml, P<0.05], [CFD: (491.71±41.03)mg/L vs (467.58±45.16)mg/L, (445.16±50.47)mg/L, P<0. 05]. Pearson correlation analysis showed that the serum level of CFB was positively correlated with glycosylated hemoglobin (HbA 1c), fasting plasma glucose (FPG) and TNF-α (all P<0.05) and negatively correlated with triiodothyronine (FT3) and total bilirubin (TBIL) (all P<0.05). Serum CFD level was positively correlated with systolic blood pressure, HbA 1c, FPG and TNF-α (all P<0.05), but negatively correlated with FT3 and TBIL (all P<0.05). Logistic regression analysis showed that CFB and CFD were still influential factors for the occurrence and development of DPN after excluding confounding factors such as systolic blood pressure, HbA 1c, FPG, FT3, DBIL, TBIL and TNF-α. Conclusions:(1) Serum CFB and CFD levels were significantly increased in DPN patients, suggesting that CFB and CFD may be involved in the occurrence and development of DPN. (2) Serum TNF-α level was significantly increased in DPN patients, confirming the role of TNF-α in the pathogenesis of DPN.