The traditional Chinese medicine （TCM） myocardial infarction （MI） unit is a standardized， regulated， and continuous integrated care unit guided by TCM theory and built upon existing chest pain centers or emergency care units. This unit emphasizes multidisciplinary collaboration and forms a restructured clinical entity without altering current departmental settings， offering comprehensive diagnostic and therapeutic services with full participation of TCM in the treatment of MI. Its core medical model is patient-centered and disease-focused， providing horizontally integrated TCM-based care across multiple specialties and vertically constructing a full-cycle treatment unit for MI， delivering prevention， treatment， and rehabilitation during the acute， stable， and recovery phases. Additionally， the unit establishes a TCM-featured education and prevention mechanism for MI to guide patients in proactive health management， reduce the incidence of myocardial infarction， and improve quality of life.

Objective To observe the effect of combination of partial body weight support and functional electrical stimulation on lower limb motor function for stroke patients. Methods From January,2023 to February,2024,60 stroke patients from Rehabilitation Hospital of Chancheng District People's Hospital in Foshan City were randomly divided into control group(n=30)and observation group(n=30).The control group received routine rehabilitation,while the observation group received a combination of ce-lestial orbit system and functional electrical stimulation in addition,for three weeks.They were assessed with Balance assessment and training system,Berg Balance Scale(BBS),Fugl-Meyer Assessment-Lower Extremities(FMA-LE)and Holden Functional Ambulation Category(FAC)before and after treatment. Results X-axis trajectory length,average speed of swaying,total wobble trajectory,Y-axis trajectory length,trajectory length per unit area,BBS score,FMA-LE score and FAC score improved in both groups after treatment(|t|＞4.809,P＜0.001);and all the indexes improved more in the observation group than in the control group(|t|＞2.268,P＜0.05),except X-axis trajectory length and average speed of swaying. Conclusion Supplement of the combination of partial body weight support and functional electrical stimulation is more effective on lower limb motor function,balance and walking for stroke patients.

Objective　To analyze the drug resistance, genomic information, and genetic relationships of Extended-Spectrum β-Lactamases (ESBLs)-positive Acinetobacter strains colonized in the intestinal tract of children with and without diarrhea, and to explore the carrying status and distinguishing features of two group ESBLs-positive Acinetobacter strains. Methods　A total of 842 fresh fecal samples were collected from children with and without diarrhea from a hospital in Shanghai, 2017-2019. ESBLs-resistant Acinetobacter strains were isolated and identified, followed by a drug sensitivity test and whole genome sequencing. A phylogenetic tree was constructed to explore the genetic relationship between Acinetobacter baumannii strains in this study and those isolated in China during the same period. Results　A total of 13 ESBLs-positive Acinetobacter strains were isolated, including 11 strains in the diarrhea group and two strains in the non-diarrhea group, the positive rate of ESBLs strains in the diarrhea group was significantly higher than that in the non-diarrhea group (χ2=5.206, P=0.023). All strains showed a high resistance rate to the first-generation cephalosporins (100.0%) and the second-generation cephalosporins (100.0%), with a multidrug resistance rate of 53.8% (7/13). There was no significant difference in the rates of resistance to individual antibiotics and multidrug resistance between the two groups (P>0.05). The blaOXA resistance gene was carried by all strains on the chromosome, which encode enzymes that hydrolyze clinically important antibiotics such as third-generation cephalosporins and carbapenems. Adhesion-type virulence genes were carried by 92.3% (12/13) of the strains, and secretion-type virulence genes were present in 84.6% (11/13). Furthermore, 92.3% (12/13) of ESBLs-positive Acinetobacter strains carried plasmids, with one A. baumannii strain isolated from a non-diarrhea child carrying seven types of plasmids. The analysis of the phylogenetic relationship indicated that A. baumannii strains isolated in this study formed a clonal cluster, and also clustered with some strains from southern China during the same period. Conclusions　ESBLs-positive Acinetobacter strains isolated from children with and without diarrhea exhibited serious drug resistance, carrying multiple resistance and virulence genes, as well as multiple plasmids. Carrying multiple plasmids may facilitate the horizontal transmission risk of drug-resistance genes and virulence genes, indicating the need to pay attention to the characteristics of intestinal colonized ESBLs-positive Acinetobacter strains in children and strengthen the monitoring of drug-resistant bacteria colonized in the intestine in healthy children.

ObjectiveTo construct a traditional Chinese medicine （TCM） syndrome diagnosis and prescription model for coronary heart disease with the improved Transformer algorithm. MethodTaking the syndrome elements of coronary heart disease as key links， the model was constructed based on the clinical diagnosis and treatment principle of "symptoms-syndrome elements-syndrome-treatment method-prescription-medicine （dose）". The basic logic of improved Transformer algorithm was constructed with multi-head attention mechanism， compound term vector and dropout， in order to form the model with functions of TCM syndrome elements judgment， syndrome diagnosis， prescription recommendation. After the model was constructed， it was trained by 8 030 cases. And 100 cases with TCM prescriptions were randomly selected for testing， and the model output prescriptions were compared with those of clinicians for qualitative evaluation of the model. ResultThe improved Transformer with multi-head attention improved the accuracy of the model. The model was consistent with clinicians in the judgment of main syndromes and the selection of prescriptions. Whereas there was a certain room for improvement in the addition and subtraction of medicines. ConclusionThe improved Transformer model can improve the accuracy and stability of output， which is an embodiment of the intelligent development of TCM.

BACKGROUND: Clinical trial evidence is limited to identify better topical non-steroidal anti-inflammatory drugs (NSAIDs) for treating knee osteoarthritis (OA). We aimed to compare the clinical efficacy and safety of flurbiprofen cataplasms (FPC) with loxoprofen sodium cataplasms (LSC) in treating patients with knee OA. METHODS: This is an open-label, non-inferiority randomized controlled trial conducted at Peking University Shougang Hospital. Overall, 250 patients with knee OA admitted from October 2021 to April 2022 were randomly assigned to FPC and LSC treatment groups in a 1:1 ratio. Both medications were administered to patients for 28 days. The primary outcome was the change of pain measured by visual analog scale (VAS) score from baseline to day 28 (range, 0-10 points; higher score indicates worse pain; non-inferiority margin: 1 point; superiority margin: 0 point). There were four secondary outcomes, including the extent of pain relief, the change trends of VAS scores, joint function scores measured by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and adverse events. RESULTS: Among 250 randomized patients (One patient without complete baseline record in the flurbiprofen cataplasms was excluded; age, 62.8 ± 10.5 years; 61.4% [153/249] women), 234 (93.6%) finally completed the trial. In the intention-to-treat analysis, the decline of the VAS score for the 24-h most intense pain in the FPC group was non-inferior, and also superior to that in the LSC group (differences and 95% confidence interval, 0.414 (0.147-0.681); P <0.001 for non-inferiority; P = 0.001 for superiority). Similar results were observed of the VAS scores for the current pain and pain during exercise. WOMAC scores were also lower in the FPC group at week 4 (12.50 [8.00-22.50] vs . 16.00 [11.00-27.00], P = 0.010), mainly driven by the dimension of daily activity difficulty. In addition, the FPC group experienced a significantly lower incidence of adverse events (5.6% [7/124] vs . 33.6% [42/125], P <0.001), including irritation, rash and pain of the skin, and sticky hair uncovering pain. CONCLUSIONS This study suggested that FPC is superior to LSC for treating patients with knee OA in pain relief, joint function improvement, and safety profile.
Humans ; Female ; Middle Aged ; Aged ; Osteoarthritis, Knee/drug therapy* ; Flurbiprofen/therapeutic use* ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Pain/drug therapy* ; Treatment Outcome ; Double-Blind Method

Background:The musk glands of adult male Chinese forest musk deer(Moschus berezovskii Flerov,1929)(FMD),which are considered as special skin glands,secrete a mixture of sebum,lipids,and proteins into the musk pod.Together,these components form musk,which plays an important role in attracting females during the breeding season.However,the relationship between the musk glands and skin of Chinese FMD remains undiscovered.Here,the musk gland and skin of Chinese FMD were examined using histological analysis and RNA sequencing(RNA-seq),and the expression of key regulatory genes was evaluated to determine whether the musk gland is derived from the skin.Methods:A comparative analysis of musk gland anatomy between juvenile and adult Chinese FMD was conducted.Then,based on the anatomical structure of the musk gland,skin tissues from the abdomen and back as well as musk gland tissues were obtained from three juvenile FMD.These tissues were used for RNA-seq,hematoxylin-eosin(HE)staining,immunohistochemistry(IHC),western blot(WB),and quantitative real-time polymerase chain reaction(qRT-PCR)experiments.Results:Anatomical analysis showed that only adult male FMD had a complete glandular organ and musk pod,while juvenile FMD did not have any well-developed musk pods.Transcriptomic data revealed that 88.24%of genes were co-expressed in the skin and musk gland tissues.Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway analysis found that the genes co-expressed in the abdomen skin,back skin,and musk gland were enriched in biological development,endocrine system,lipid metabolism,and other pathways.Gene Ontology(GO)enrichment analysis indicated that the genes expressed in these tissues were enriched in biological processes such as multicellular development and cell division.Moreover,the Metascape predictive analysis tool demonstrated that genes expressed in musk glands were skin tissue-specific.qRT-PCR and WB revealed that sex-determining region Y-box protein 9(Sox9),Caveolin-1(Cav-1),and androgen receptor(AR)were expressed in all three tissues,although the expression levels differed among the tissues.According to the IHC results,Sox9 and AR were expressed in the nuclei of sebaceous gland,hair follicle,and musk gland cells,whereas Cav-1 was expressed in the cell membrane.Conclusions:The musk gland of Chinese FMD may be a derivative of skin tissue,and Sox9,Cav-1,and AR may play significant roles in musk gland development.

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.

Objective:To explore the value and significance of transcranial color-coded duplex (TCCD) parameters, serum insulin-like growth factor-1 (IGF-1), neuron-specific enolase (NSE) levels in the evaluation of the condition of cerebral infarction.Methods:One hundred and ten patients with cerebral infarction in Anhui Wanbei Coal-Electricity Group General Hosptial were selected from April 2018 to February 2020, and TCCD examination was performed after admission. Blood samples were taken to determine the levels of serum IGF-1 and NSE, and corresponding treatment was given. The TCCD parameters and serum IGF-1 and NSE levels were compared in patients with different disease severity, plaque nature and different prognosis after 3 months′ follow-up. The correlation between the above indicators and the condition and plaque nature and the predictive value of the prognosis of patients with cerebral infarction were analyzed.Results:The level of IGF-1 were negatively correlated with the severity of disease ( r=- 0.650) and the nature of plaques ( r=- 0.711); and the level of NSE and resistance index (RI), pulsatility index (PI) were positively correlated with the severity of the disease ( r=0.609, 0.613, 0.645) and the nature of plaques ( r=0.589, 0.579, 0.608), and the differences were statistically significant ( P<0.05). After 3 months′ follow-up, the level of IGF-1 in the favourable prognosispatients was higher than that in the unfavourable prognosis patients, the levels of NSE, RI and PI in the favourable prognosis patients were lower than those in the unfavourable prognosis patients: (9.01 ± 2.64) μg/L vs. (25.13 ± 3.82) μg/L, 1.05 ± 0.19 vs. 1.32 ± 0.22, 0.69 ± 0.06 vs. 0.89 ± 0.07, and the differences were statistically significant ( P<0.05). The area under the curve (AUC) of RI, PI, IGF-1 and NSE in predicting the prognosis of cerebral infarction was less than that of combined diagnosis. Conclusions:The early use of TCCD parameters, serum IGF-1 and NSE combined detection can provide evidence-based guidance for evaluating the condition and prognosis of cerebral infarction.

Objective:To observe the changes of biomarkers in patients with non-ST segment elevation myocardial infarction (NSTEMI) after intervention with Salvianolate.Methods:A total 81 patients with NSTEMI who met the inclusion criteria from January 2016 to December 2019 were randomly divided into two groups. The control group dropped 6 cases, the treatment group dropped 6 cases, and finally each group had 35 cases. The control group was treated with conventional medicine therapy, and the treatment group was treated by intravenous drip of 0.9% NS 250 ml + Salvianolate on the basis of the control group. Both groups were treated continuously for 10 days. The latex immunoturbidimetric method was used to detect hypersensitive-C-Reactive-Protein (hs-CRP), double antibodysandwich immune chemiluminescence method for procalcitonin (PCT), electrochemiluminescence method for N-Terminal pro-B-type Natriuretic Peptide (NT-proBNP), coagulation method for plasma fibrinogen (FIB), and immunoassay for D-dimer. The number of episodes of angina pectoris after infarction, recurring myocardial infarction, malignant arrhythmia, and death in the hospital were recorded and collected during the hospitalization period (0-10 d).Results:After treatment, hs-CRP (2.46 ± 1.76 mg/L vs. 3.45 ± 0.67 mg/L, t=2.324), PCT (0.52 ± 0.30 ng/L vs. 0.11 ± 0.08 ng/L, t=2.059), FIB (1.30 ± 0.63 g/L vs. 1.97 ± 0.67 g/L, t=2.168) in the treatment group were significantly lower than those in the control group ( P<0.05). After treatment, the level of NT-proBNP and D-dimer showed a downward trend, but there was no statistically significant difference within and between groups ( P>0.05). During hospitalization, the number of angina pectoris after infarction in the treatment group was significantly lower than that of the control group ( t=4.019, P=0.045), while the incidence of acute heart failure, recurring myocardial infarction, malignant arrhythmia and death in the hospital showed no significant difference ( P>0.05). Conclusion:Salvianolate can reduce the inflammatory response of NSTEMI patients on the basis of western medicine, relieve the hypercoagulable state, and reduce the number of angina pectoris after infarction.

OBJECTIVE：To study the effects of loganin on the prolife ration and apoptosis of liver cancer HepG 2 cells，and to explore its mechanism. METHODS ：CCK-8 assay was used to detect the effects of different concentrations （10，25，50，100， 150，200，300，400 µg/mL）of loganin on the proliferation activity of HepG 2 cells for 24 and 48 h. HepG 2 cells were divided into control group ，loganin low-concentration ，medium-concentration and high-concentration groups （50，100，150 μ g/mL）. After treated for 24 h，morphological changes of apoptosis of cells were detected by Hoechst 33342 fluorescence staining. The apoptosis and cycle distribution of cells were detected by flow cytometry. Western blotting was used to detect protein expression of Cyclin D1， PCNA， Bcl-2， Caspase-3， Cleaved-Caspase-3， Caspase-9 and Cleaved-Caspase- 9. RESULTS ： Loganin inhibited the proliferation of HepG 2 cells，in concentration-dependent trend. Compared with control group ，apoptosis as pyknosis and fragmentation occurred ，and the apoptosis rate increased significantly in loganin low-concentration ，medium-concentration and high-concentration groups （P＜0.01）；the cell were mainly blocked in S phase ；relative protein expression of Cyclin D 1，PCNA and Caspase- 3 were significantly decreased ，while that of Cleaved-Caspase- 3 were significantly increased in loganin low- concentration， medium-concentration and high-concentration groups （P＜0.05 or P＜0.01）； relative protein expression of Cleaved-Caspase-9 were increased significantly ，while that of Bcl- 2 and Caspase- 9 were decreased significantly in loganin medium-concentration and high-concentration groups （P＜0.05 or P＜0.01）. CONCLUSIONS ：Loganin can significantly inhibit the proliferation and induce apoptosis of HepG 2 cells，the mechanism of which may be associated with inhibiting Bcl- 2 protein expression and promoting Caspase- 3，Caspase-9 activation.