Chronic fatigue syndrome(CFS)has emerged as a debilitating condition significantly impacting both physical health and psychological well-being,imposing substantial burdens on society and families.This article systematically summarizes Professor Chen Xinghua's clinical experience in acupuncture treatment for CFS,illustrated with representative case studies.Professor Chen postulates that the disease primarily results from visceral deficiency,with insufficiency of the"central earth"(spleen-stomach system)as its core pathogenesis,leading to concurrent impairment of both body constitution and mental state.Based on the"central earth"theory,he proposes the therapeutic principle of"prioritizing central earth while concurrently regulating the five zang-organs"to achieve comprehensive body-spirit regulation.In clinical practice,his treatment protocol combines acupuncture with traditional external therapies,emphasizing the application of Zusanli(ST36)and Neiguan(PC6)to reinforce earth and regulate the middle jiao,complemented by scalp acupuncture to nourish the spirit,benefit the heart,and regulate mental state to treat physical symptoms.The integrated acupuncture approach synergistically achieves fatigue relief and tonic effects,while external therapies serve to consolidate the fundamental treatment.

This paper introduces Professor WANG Jihong's clinical experience in treating refractory lateral epicondylitis using the Wang's crescent technique of blade needle. Based on the classical theories of Huangdi Neijing (the Yellow Emperor's Inner Classic) such as the "twelve sinew meridians" "short needling" and "shu needling", Professor WANG applies a self-designed blade needle with crescent needling method. This approach forms a distinctive treatment philosophy characterized by "sinew meridians as the foundation, selecting points at the pain site; using chicken-claw needling technique deliverd at both internal and external; integration of heaven, earth, and man, using both short and shu needling; treating tendon injuries and inflammation with the crescent technique of blade needle". It embodies the therapeutic concept of "treating tendons and bones simultaneously, harmonizing yin and yang", and shows unique advantages in the treatment of this condition.
Acupuncture Therapy/methods* ; Humans ; Tennis Elbow/therapy* ; Male ; Middle Aged ; Adult ; Needles ; Female ; Acupuncture Points

This article introduces the clinical experience of Professor WANG Jihong in treatment of post-stroke hypermyotonia with Lai's tongyuan therapy (therapy for removing obstruction and consolidating vital essence). Regarding the pathogenesis of this disease, Professor WANG Jihong emphasizes a "trinity" approach, "the mind disturbed, qi and blood unbalanced, and yuan (vital essence) not consolidated". In treatment, "the unblocking, conducting and nourishing are taken as the fundamental" to "prevent from over-dredging, balancing yin and yang, and avoiding over-replenishing". In clinical practice, the combined measure is adopted with acupuncture, tuina and herbal medicine. In acupuncture, the acupoints are selected according to the front-back combination of the points of the conception vessel and the governor vessel (basic prescription: Yintang [GV24⁺], Baihui [GV20] and Niesanzhen; prescription for promoting the governor vessel: Dazhui (GV14), Jinsuo [GV8], Xinshu [BL15], Pishu [BL20] and etc.; and the prescription for consolidating the vital essence: Danzhong (CV17), Zhongwan [CV12], Tianshu [ST25], Qihai [CV6]) and etc., as well as those on the four limbs for "opening, closing and pivoting of yin and yang" (on the upper limbs of the affected side: Jiquan [HT1], Jianyu [LI15], Quchi [LI11], Quze [PC3] and etc.; on the lower limbs of the affected side: Huantiao [GB30], Liangqiu [ST34], Xuehai [SP10], Yanglingquan [GB34]) and etc. The above points co-act on regulating the conception vessel and the governor vessel, and balancing yin and yang. Tuina is delivered on the governor vessel, the bladder meridian of foot-taiyang and wind points on the area between the head and nape, so as to promote the governor vessel, benefit the orifices, strengthen the spine and relax tendons. Herbal medicine works on nourishing the liver to soften tendons, nourishing blood to remove wind, regulating qi to replenish the spleen, consolidating the root to cultivate the vital essence, activating blood circulation to unblock meridians, and removing stasis to resolve phlegm. Tongyuan therapy provides a certain instruction in treatment of post-stroke hypermyotonia.
Humans ; Acupuncture Therapy ; Acupuncture Points ; Stroke/complications* ; Male ; Female ; Middle Aged ; Aged ; Drugs, Chinese Herbal ; Adult

Objective:This study aimed to analyze cytomegalovirus (CMV) reactivation and its influencing factors in patients with B-lymphocyte malignancy who received chimeric antigen receptor T (CAR-T) cell therapy.Methods:This study retrospectively reviewed patients with B-lymphocyte malignancy who received CAR-T cell therapy in the First Affiliated Hospital of Soochow University from January 2021 to December 2023. The data of patients who underwent CMV-DNA detection and/or pathogen metagenomic sequencing twice or more within 100 days after CAR-T cell therapy were analyzed. The clinical characteristics of the CMV reactivation and non-activation groups were compared. The factors related to CMV reactivation were analyzed with the Chi-square test and nonparametric rank sum test, and the risk factors were examined with Logistic regression.Results:This study included 86 patients, among whom 18 (20.9%) had CMV reactivation, and the median time of reactivation was 20 (1-95) days. All of the 18 patients had CMV viremia, and no CMV disease was observed. Seven patients turned to the latent state after continuing acyclovir antiviral therapy, and 11 patients returned to the latent state after upgrading the antiviral therapy to first-line drugs, including ganciclovir and foscarnet sodium. Six or more courses of anti-tumor treatment before CAR-T cell therapy, allogeneic hematopoietic stem cell transplantation within 2 years before CAR-T cell therapy, non-remission before treatment, and the use of high-dose glucocorticoids and/or tocilizumab were related to CMV reactivation, among which allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and the use of high-dose glucocorticoids and/or tocilizumab treatment were independent risk factors for CMV reactivation.Conclusion:Patients with B-lymphocyte malignancy who received CAR-T cell therapy have the risk of CMV reactivation, especially for those who received allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and those who received high-dose glucocorticoids and/or tocilizumab treatment.

Objective:This study aimed to analyze cytomegalovirus (CMV) reactivation and its influencing factors in patients with B-lymphocyte malignancy who received chimeric antigen receptor T (CAR-T) cell therapy.Methods:This study retrospectively reviewed patients with B-lymphocyte malignancy who received CAR-T cell therapy in the First Affiliated Hospital of Soochow University from January 2021 to December 2023. The data of patients who underwent CMV-DNA detection and/or pathogen metagenomic sequencing twice or more within 100 days after CAR-T cell therapy were analyzed. The clinical characteristics of the CMV reactivation and non-activation groups were compared. The factors related to CMV reactivation were analyzed with the Chi-square test and nonparametric rank sum test, and the risk factors were examined with Logistic regression.Results:This study included 86 patients, among whom 18 (20.9%) had CMV reactivation, and the median time of reactivation was 20 (1-95) days. All of the 18 patients had CMV viremia, and no CMV disease was observed. Seven patients turned to the latent state after continuing acyclovir antiviral therapy, and 11 patients returned to the latent state after upgrading the antiviral therapy to first-line drugs, including ganciclovir and foscarnet sodium. Six or more courses of anti-tumor treatment before CAR-T cell therapy, allogeneic hematopoietic stem cell transplantation within 2 years before CAR-T cell therapy, non-remission before treatment, and the use of high-dose glucocorticoids and/or tocilizumab were related to CMV reactivation, among which allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and the use of high-dose glucocorticoids and/or tocilizumab treatment were independent risk factors for CMV reactivation.Conclusion:Patients with B-lymphocyte malignancy who received CAR-T cell therapy have the risk of CMV reactivation, especially for those who received allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and those who received high-dose glucocorticoids and/or tocilizumab treatment.

Objective:To compare the medium-term clinical effects of arthroscopic double row repair between traumatic and degenerative medium supraspinatus tear.Methods:A retrospective study was conducted to analyze the clinical data of 23 patients who had been treated for traumatic or degenerative medium supraspinatus tear by the same arthroscopic double row repair and postoperative rehabilitation at Sports Medicine Center, The First Hospital Affiliated to Army Medical University between January 2015 and August 2020. They were assigned into 2 groups according to different tears. In the traumatic group of 8 cases of traumatic medium supraspinatus tear, there were 5 males and 3 females with an age of (46.1±4.3) years and a tear size of (1.3±1.0) cm 2. In the degenerative group of 15 cases of degenerative medium supraspinatus tear, there were 4 males and 11 females with an age of (59.9±8.1) years and a tear size of (4.1±1.1) cm 2. At preoperation and the last follow-up, the shoulder pain was evaluated by visual analogue scale (VAS), and the shoulder function by American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and Simple Shoulder Test (SST); the improvements in active range of motion (ROM) of the shoulder were recorded at the last follow-up. Results:The 2 groups were comparable because there was no significant difference between them in the general clinical data ( P>0.05). The traumatic and degenerative groups were followed up for (40.3±11.2) and (36.4±12.4) months, respectively. At the last follow-up, the improvements in range of anterior flexion and internal rotation vertebral rank in the degenerative group [55.3°±33.6° and (4.1±1.3) ranks] were significantly greater than those in the traumatic group [27.5°±22.5° and (2.3±1.9) ranks] ( P<0.05). At the last follow-up, the VAS, ASES, Constant-Murley, and SST scores in the degenerative group were improved respectively by (3.7±0.8), (40.9±14.0), (38.4±9.4), and (6.5±1.4) points compared with their preoperative values, significantly greater than those in the traumatic group [(2.3±0.7), (19.6±14.6), (19.2±7.9), and (3.8±0.7) points] ( P<0.05). Conclusion:Arthroscopic double row repair can achieve significant medium-term improvements in shoulder function for both traumatic and degenerative medium supraspinatus tears, but the improvements may be grater for the degenerative ones.

Objective:To understand the characteristics of scientific research cooperation network, research hotspots, evolution paths and development trends of advance care planning (ACP) , so as to provide reference for follow-up related research.Methods:With the theme of "advance care planning", the retrieval results based on Web of Science core collection database were respectively imported into VOS viewer and CiteSpace for visual analysis, and the retrieval time was from database construction to February 3, 2021.Results:A total of 2 456 articles meet the selection criteria. The annual publications were all less than 50 from 1993 to 2009, which showed a rapid upward trend from 2010 to now. The distribution trend of citation frequency was basically the same as that of publications. Most of the authors and institutions are European and American. Chan Helen Yue-lai of the Chinese University of Hong Kong ranked first in China and 19th in the world in terms of publicationsand Chinese scholars' research in this field is still in its infancy. Research hotspots included ACP alternative decision-making skills training, and the research frontiers and evolutionary paths included ACP, severe mental illness, alternative decision-making, life planning, end-stage renal disease, doctor's orders, ACP model, advanced dementia, chronic heart failure, etc.Conclusions:Since 2010, the number of articles published in this field and the frequency of citations have shown a rapid upward trend. The United States, Belgium, Canada and other countries have developed well in this field and Scholars of China have a wide space for development in this field. The advanced research experience reported in the foreign ACP literature can be used for reference to deepen and speed up the clinical practice research in the field of ACP in China.

Objective:To summarize the clinical characteristics of an early death in patients with de novo acute promyelocytic leukemia (APL) , analyze the risk factors and direct causes of early death, and perform survival analysis.Methods:The clinical data of 368 patients with de novo APL in three centers (First Affiliated Hospital of Soochow University, Soochow Guangci Hospital, and Soochow Hopes Hospital of Hematology) during January 2011-December 2017 were retrospectively analyzed. The clinical characteristics of patients who suffered hemorrhagic early death and non-hemorrhagic early death were compared. The risk factors for early death, survival, and prognosis of patients with APL were analyzed.Results:Among the 368 de novo APL patients, 31 died early with an early mortality rate of 8.4%. The median time from diagnosis to death was 7 (0-29) d. On comparison of the clinical characteristics of patients with early death and non-early death and subsequent multivariate analysis using a logistic regression model, it was observed that age ≥50 years and WBC ≥10×10 9/L were independent risk factors for early death ( P<0.01) . A total of 27 (87.1%) of the 31 early deaths was directly attributed to hemorrhage as the immediate cause of early death. Hemorrhage was the only cause of death in patients <50 years old and the major cause of death in patients ≥50 years old. A comparison of the clinical characteristics of patients with hemorrhagic early death and patients with non-hemorrhagic early death suggested that the median age and indirect bilirubin concentration of patients with hemorrhagic early death were lower than those with non-hemorrhagic early death ( P<0.05) . The median follow-up time for all patients was 41.0 (0.3-101.4) months. The 2-year overall survival (OS) rate was (93.5±1.3) %, and the 5-year OS rate was (91.0±1.5) %. The 2-year disease-free survival (DFS) rate was (98.8±0.6) %, and the 5-year DFS rate was (97.1±0.9) %. The 2-year OS rate of patients ≥50 years old and patients <50 years old was 79.3% vs 94.2%, P=0.000; the 2-year DFS rate was 92.3% vs 98.1%, P=0.023. The respective 2-year OS rates of high-risk and non-high-risk patients were 77.3% and 96.7% ( P=0.000) and the respective 2-year DFS rates were 94.0% and 98.4% ( P=0.139) . Conclusion:Age and WBC are independent prognostic factors for early death. We observed a difference in early mortality between high-risk and low-risk APL, but no difference in DFS rate.

Objective: To explore the clinical therapeutic method and effect of the thumb-tack needle for subcutaneous embedding therapy on treating insomnia with insufficiency of heart and spleen among breast cancer patients. Methods: Totally 80 breast cancer patients with insomnia with insufficiency of heart and spleen treated in department of oncology, the Second Affiliated Hospital of Xi′an Jiao Tong University from March 2018 till November 2018 were selected and assigned into an experiment group and a control group by random number table, 40 cases in each one. The experiment group applied thumb-tack needle for subcutaneous embedding therapy, selecting Shenmen, Sanyinjiao, Zusanli, Anmian as major acupoint and Taibai as assistant acupoint. The control group used fake needles at the same places. After four-week treatment, we evaluated the therapeutic effect using the Pittsburgh Sleep Quality Index (PSQI) and observed side effects. Results: Before treatment, no significantly statistical differences were observed between the two groups on global and each dimension′s PSQI scores (P>0.05). After treatment, the PSQI scores and PSQI global score of the experiment group on sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, and daytime dysfunction were (1.58±0.53), (1.72±0.33), (1.57±0.64), (1.61±0.68), (1.05±0.42), (1.27±0.53), (8.91±2.73) points respectively, which were (1.86±0.71), (1.90±0.41), (1.85±0.47), (1.97±0.83), (1.42±0.91), (1.56±0.45), (10.86±4.53) points respectively in the control group. There was significant difference between the two groups on PSQI global scores (t=1.998-2.637, P<0.05). The number of patients in the experiment group assessed as clinical cure, obviously effective, effective and noneffective were 8, 13, 9, 10 respectively, which were 1, 5, 12, 22 in the control group respectively. The clinical efficacy showed significant difference between the two groups (χ²=27.68, P<0.01). No side effects, such as infection, needle drop-off and etc. were observed. Conclusions The thumb-tack needle for subcutaneous embedding therapy could improve sleep quality of breast cancer patients with insomnia with insufficiency of heart and spleen, and it′s easy to operate, safe with little side effects.

MarR family transcription regulators are ubiquitous among bacteria and archaea. They extensively control multiple cellular processes and elaborately regulate the expression of genes involved in virulence, stress response and antibiotics at translational level. In Xanthomonas campestris pv. campestris, insertional inactivation of MarR family transcription regulator HpaR (XC2827) resulted in significantly decrease in virulence and increase in the production of the extracellular proteases. Here, we reported that the genome of Xcc 8004 encodes nine MarR family transcription regulators. The MarR family transcription regulators, HpaR (XC2827) and XC0449, were heterologous expressed and purified. In vitro MST and Pull-down assay confirmed the physical interaction between HpaR and XC0449. Phenotypical assay determined that deletion of XC0449 resulted in substantial virulence attenuation. In vitro EMSA, in vivo qRT-PCR and GUS activity assay identified that HpaR and XC0449 coordinately act as the transcriptional activator to regulate the expression of the virulence-associated gene XC0705, and eventually control the bacterial virulence and the production of extracellular proteases.
Bacterial Proteins ; Gene Expression Regulation, Bacterial ; Transcription Factors ; Virulence ; Xanthomonas campestris