This article introduced clinical experience in treating narcolepsy from the perspective of Shaoyin disease.Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness,cataplexy and nocturnal sleep disturbances.The outline syndrome of Shaoyin disease with"constant desire to sleep"is highly similar to the manifestations of narcolepsy.Additionally,the core pathogenesis of narcolepsy involves Shaoyin heart-kidney yang deficiency,and the time when Shaoyin disease is about to be resolved coincides with the change time of narcolepsy.Based on the above,narcolepsy can be treated from Shaoyin disease.Mahuang Fuzi Gancao Decoction or Mahuang Xixin Fuzi Decoction can be selected to treat the disease.When treating clinical cases,it is necessary to adhere to the standards of original prescriptions:first,comply with the compatibility and dosage of the original prescriptions;second,Ephedrae Herba,Aconiti Lateralis Radix Praeparata and Asari Radix et Rhizoma need to be decocted first without the lid and remove the foam;the third is to take medicine after breakfast and lunch to avoid affecting sleep at night.

Objective:To analyze the epidemiological characteristics and influencing factors of single-cigarette use and dual cigarette-cigar use in China.Methods:This study was a cross-sectional study that selected 85 638 urban and rural residents who met the inclusion criteria from the 2018 China Health Literacy Survey as research subjects. An analysis was conducted on 21 849 users of cigarettes and cigars among them. Due to the small number of individuals who exclusively used cigars (247 cases), the research subjects were divided into two categories: exclusive cigarette users and dual users of cigarettes and cigars. The groups were categorized by age (18-34 years, 35-54 years, ≥55 years), gender (male, female), education level (primary school and below, junior high school and high school, university and above) and annual household income (<20 000 yuan, 20 000-<80 000 yuan, ≥80 000 yuan) to compare the tobacco usage rate and conduct subgroup analyses for each subgroup. Multivariate logistic regression analysis was employed, incorporating general demographic characteristic information to explore the influencing factors of exclusive cigarette use and dual use of cigarettes and cigars, respectively.Results:The rate of exclusive cigarette use in our country was 24.3%, while the dual use rate of cigarettes and cigars was 0.9%. The exclusive cigarette use rate and the dual use rate of cigarettes and cigars among males were significantly higher than those among females (48.25% vs 2.48%, and 1.84% vs 0.06%) (both P<0.001). For males, the high-risk factors for exclusive cigarette use included living in urban areas ( OR: 1.37, 95% CI: 1.23-1.54), being Han ethnicity ( OR: 1.73, 95% CI: 1.51-1.98), and having an annual household income ≥20 000 yuan ( OR: 1.54, 95% CI: 1.38-1.82) while having a junior high school education or higher was a protective factor ( OR: 0.68, 95% CI: 0.52-0.90). Age≥35 years ( OR: 3.36, 95% CI: 2.62-4.32) and having a junior high school education or higher ( OR: 1.30, 95% CI: 1.02-1.67) were risk factors for dual use of cigarettes and cigars in males. Among females, living in urban areas ( OR: 1.53, 95% CI: 1.19-1.97) and being Han ethnicity ( OR: 5.96, 95% CI: 4.47-7.96) were risk factors for exclusive cigarette use, while having a university education or higher was a protective factor ( OR: 0.28, 95% CI: 0.18-0.42). However, for female dual use of cigarettes and cigars, no significant effects were observed for any demographic characteristics. Conclusions:The use rate of cigarettes alone in China is significantly higher than that of cigarette-cigar dual use, and the rates of cigarette use alone and cigarette-cigar dual use in men are significantly higher than those in women. Tobacco use is being affected by sociodemographic factors, among which place of residence, ethnicity and education level are the main influencing factors of cigarette use alone, and gender, age and education level are the main influencing factors of cigarette-cigar dual use.

Atopic dermatitis and psoriasis are two chronic inflammatory skin diseases with distinct immune mechanisms, primarily driven by Th2-type inflammation and Th1/Th17 pathways, respectively. However, some patients may simultaneously or sequentially exhibit overlapping phenotypes of atopic dermatitis and psoriasis (psoriasis-atopic dermatitis overlap, PAO), characterized by the coexistence of scaly erythema and eczematous lesions. Currently, the nomenclature, diagnostic criteria, and pathogenesis of PAO remain unclear, and its incidence is increasing due to the widespread use of targeted therapies. The diagnosis of PAO requires an integrated assessment of clinical features, histopathological findings, and biomarker profiles, while treatment necessitates a balance between immune modulation and individualized strategies. This article summarizes the characteristic manifestations of and genetic-immune interactions involved in PAO based on clinical practice, and explores diagnostic challenges and therapeutic options to address this complex and increasingly prominent clinical issue.

Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans ; Orthodontics, Corrective/methods* ; Consensus ; Malocclusion/therapy* ; Patient Care Planning ; Cephalometry

Lumbar disc (LD) herniation and aging are prevalent conditions that can result in substantial morbidity. This study aimed to clarify the mechanisms connecting the LD aging and herniation, particularly focusing on cellular senescence and molecular alterations in the nucleus pulposus (NP). We performed a detailed analysis of NP samples from a diverse cohort, including individuals of varying ages and those with diagnosed LD herniation. Our methodology combined histological assessments with single-nucleus RNA sequencing to identify phenotypic and molecular changes related to NP aging and herniation. We discovered that cellular senescence and a decrease in nucleus pulposus progenitor cells (NPPCs) are central to both processes. Additionally, we found an age-related increase in NFAT1 expression that promotes NPPC senescence and contributes to both aging and herniation of LD. This research offers fresh insights into LD aging and its associated pathologies, potentially guiding the development of new therapeutic strategies to target the root causes of LD herniation and aging.
Intervertebral Disc Displacement/metabolism* ; Humans ; Aging/pathology* ; Nucleus Pulposus/pathology* ; Male ; Female ; Transcriptome ; Middle Aged ; Lumbar Vertebrae/pathology* ; Adult ; Cellular Senescence ; Stem Cells/pathology* ; Aged ; Intervertebral Disc Degeneration/metabolism*

Objective To explore the value of MR T2WI-spectral attenuated inversion recovery(T2WI-SPAIR)sequence and dif-fusion tensor imaging(DTI)in the recovery process of vertebral compression fractures over time.Methods Three patients aged 60-75 years with a clear time and mechanism of injury were selected.They underwent conventional MR sequences and DTI scans at eight time points.The morphological and signal changes of the fractured vertebrae on T2WI-SPAIR sequences were dynamically observed.Statistical analysis was performed on the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)of the fractured verte-brae and adjacent normal vertebrae.Results T2WI-SPAIR sequence showed that the vertebral morphology gradually worsened from the initial mild compression changes over time after vertebral fracture.Local bone collapse occurred at the upper edge of the verte-brae at>7-9 weeks,followed by stabilization.The initially diffuse and uniform high signal of the fractured vertebrae gradually changed a mixed signal,stabilizing around>9-12 weeks.Statistical analysis results revealed significant differences in ADC values between>1-2 weeks,>3-5 weeks,and>9-12 weeks post-fracture(P<0.05).Significant differences in FA values were also observed between≤1 week,>1-2 weeks,>3-5 weeks,>12 weeks,and>9-12 weeks post-fracture(P<0.05).Furthermore,ADC and FA values between the fractured and normal vertebrae also showed significant differences within the first 12 weeks post-fracture(P<0.05).Conclusion The T2WI-SPAIR sequence demonstrates specific patterns of morphological and signal changes dur-ing the recovery process of fractured vertebrae.Changes in DTI parameters,including ADC and FA values,in self-comparison within the fracture zone and comparison with normal regions,follow certain patterns.These findings can provide reliable imaging evidence for clinicians to make treatment decisions and estimate the time of vertebral injury.

Objective To explore the value of MR T2WI-spectral attenuated inversion recovery(T2WI-SPAIR)sequence and dif-fusion tensor imaging(DTI)in the recovery process of vertebral compression fractures over time.Methods Three patients aged 60-75 years with a clear time and mechanism of injury were selected.They underwent conventional MR sequences and DTI scans at eight time points.The morphological and signal changes of the fractured vertebrae on T2WI-SPAIR sequences were dynamically observed.Statistical analysis was performed on the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)of the fractured verte-brae and adjacent normal vertebrae.Results T2WI-SPAIR sequence showed that the vertebral morphology gradually worsened from the initial mild compression changes over time after vertebral fracture.Local bone collapse occurred at the upper edge of the verte-brae at>7-9 weeks,followed by stabilization.The initially diffuse and uniform high signal of the fractured vertebrae gradually changed a mixed signal,stabilizing around>9-12 weeks.Statistical analysis results revealed significant differences in ADC values between>1-2 weeks,>3-5 weeks,and>9-12 weeks post-fracture(P<0.05).Significant differences in FA values were also observed between≤1 week,>1-2 weeks,>3-5 weeks,>12 weeks,and>9-12 weeks post-fracture(P<0.05).Furthermore,ADC and FA values between the fractured and normal vertebrae also showed significant differences within the first 12 weeks post-fracture(P<0.05).Conclusion The T2WI-SPAIR sequence demonstrates specific patterns of morphological and signal changes dur-ing the recovery process of fractured vertebrae.Changes in DTI parameters,including ADC and FA values,in self-comparison within the fracture zone and comparison with normal regions,follow certain patterns.These findings can provide reliable imaging evidence for clinicians to make treatment decisions and estimate the time of vertebral injury.

Atopic dermatitis and psoriasis are two chronic inflammatory skin diseases with distinct immune mechanisms, primarily driven by Th2-type inflammation and Th1/Th17 pathways, respectively. However, some patients may simultaneously or sequentially exhibit overlapping phenotypes of atopic dermatitis and psoriasis (psoriasis-atopic dermatitis overlap, PAO), characterized by the coexistence of scaly erythema and eczematous lesions. Currently, the nomenclature, diagnostic criteria, and pathogenesis of PAO remain unclear, and its incidence is increasing due to the widespread use of targeted therapies. The diagnosis of PAO requires an integrated assessment of clinical features, histopathological findings, and biomarker profiles, while treatment necessitates a balance between immune modulation and individualized strategies. This article summarizes the characteristic manifestations of and genetic-immune interactions involved in PAO based on clinical practice, and explores diagnostic challenges and therapeutic options to address this complex and increasingly prominent clinical issue.

This article introduced clinical experience in treating narcolepsy from the perspective of Shaoyin disease.Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness,cataplexy and nocturnal sleep disturbances.The outline syndrome of Shaoyin disease with"constant desire to sleep"is highly similar to the manifestations of narcolepsy.Additionally,the core pathogenesis of narcolepsy involves Shaoyin heart-kidney yang deficiency,and the time when Shaoyin disease is about to be resolved coincides with the change time of narcolepsy.Based on the above,narcolepsy can be treated from Shaoyin disease.Mahuang Fuzi Gancao Decoction or Mahuang Xixin Fuzi Decoction can be selected to treat the disease.When treating clinical cases,it is necessary to adhere to the standards of original prescriptions:first,comply with the compatibility and dosage of the original prescriptions;second,Ephedrae Herba,Aconiti Lateralis Radix Praeparata and Asari Radix et Rhizoma need to be decocted first without the lid and remove the foam;the third is to take medicine after breakfast and lunch to avoid affecting sleep at night.

Objective:To analyze the epidemiological characteristics and influencing factors of single-cigarette use and dual cigarette-cigar use in China.Methods:This study was a cross-sectional study that selected 85 638 urban and rural residents who met the inclusion criteria from the 2018 China Health Literacy Survey as research subjects. An analysis was conducted on 21 849 users of cigarettes and cigars among them. Due to the small number of individuals who exclusively used cigars (247 cases), the research subjects were divided into two categories: exclusive cigarette users and dual users of cigarettes and cigars. The groups were categorized by age (18-34 years, 35-54 years, ≥55 years), gender (male, female), education level (primary school and below, junior high school and high school, university and above) and annual household income (<20 000 yuan, 20 000-<80 000 yuan, ≥80 000 yuan) to compare the tobacco usage rate and conduct subgroup analyses for each subgroup. Multivariate logistic regression analysis was employed, incorporating general demographic characteristic information to explore the influencing factors of exclusive cigarette use and dual use of cigarettes and cigars, respectively.Results:The rate of exclusive cigarette use in our country was 24.3%, while the dual use rate of cigarettes and cigars was 0.9%. The exclusive cigarette use rate and the dual use rate of cigarettes and cigars among males were significantly higher than those among females (48.25% vs 2.48%, and 1.84% vs 0.06%) (both P<0.001). For males, the high-risk factors for exclusive cigarette use included living in urban areas ( OR: 1.37, 95% CI: 1.23-1.54), being Han ethnicity ( OR: 1.73, 95% CI: 1.51-1.98), and having an annual household income ≥20 000 yuan ( OR: 1.54, 95% CI: 1.38-1.82) while having a junior high school education or higher was a protective factor ( OR: 0.68, 95% CI: 0.52-0.90). Age≥35 years ( OR: 3.36, 95% CI: 2.62-4.32) and having a junior high school education or higher ( OR: 1.30, 95% CI: 1.02-1.67) were risk factors for dual use of cigarettes and cigars in males. Among females, living in urban areas ( OR: 1.53, 95% CI: 1.19-1.97) and being Han ethnicity ( OR: 5.96, 95% CI: 4.47-7.96) were risk factors for exclusive cigarette use, while having a university education or higher was a protective factor ( OR: 0.28, 95% CI: 0.18-0.42). However, for female dual use of cigarettes and cigars, no significant effects were observed for any demographic characteristics. Conclusions:The use rate of cigarettes alone in China is significantly higher than that of cigarette-cigar dual use, and the rates of cigarette use alone and cigarette-cigar dual use in men are significantly higher than those in women. Tobacco use is being affected by sociodemographic factors, among which place of residence, ethnicity and education level are the main influencing factors of cigarette use alone, and gender, age and education level are the main influencing factors of cigarette-cigar dual use.