The connotation of the "four-dimensional pivot-earth" qi transformation mode is a dialectical system of the ascending and descending of yin-yang qi movement， which presented as "the middle Jiao showing earth qi mediating， the left wheel showing water and wood ascending， and the right wheel showing fire and metal converting and descending". Based on this dialectical thinking， it is believed that the core pathogenesis of myasthenia gravis is deficiency of center qi and transportation failure to pivot-earth； the middle-stage characteristics of the disease progression are the loss of mediation of the central qi， resulting in water coldness and wood constraint， and clear yang failing to ascend； the final outcome of this disease is the loss of astringeing of lung metal and qi sinking. The treatment should be based on the rule of qi movement， so for the start-stage， Buzhong Yiqi Decoction （补中益气汤） should be used as the basis to nourish the earth and consolidate the root， and restrengthen the middle qi； for the middle-stage， herbs like Yingyanghuo （Epimedium brevicornu Maxim.）， Bajitian （Morinda officinalis How） could be combined to warm the water and soothe the wood， raise yang and boost qi； for the final stage， plus Sini Decoction （四逆汤） to astringe metal to stop collapse， and powerfully supplement original qi. All these medicinals can promote pivot-earth re-transportation， four-dimensional transformation， and regular circulation of qi movement， so as to provide thoughts for improving the clinical effectiveness of myasthenia gravis.

Aim To investigate the effect of interdialytic serum potassium levels on thrombosis of autologous ar-teriovenous fistula(AVF)in patients with chronic kidney disease(CKD)on maintenance haemodialysis(MHD).Methods 159 CKD patients who underwent MHD in our hospital from October 2021 to October 2022 were retrospectively analyzed.They were divided into hyperkalemia group(n=53),normal serum potassium group(n=61)and hypokalemia group(n=45)according to the mean serum potassium level of patients with different dialysis intervals,and all patients were followed up for 1 year or followed up until AVF thrombosis.General datas were collected and the following indicators were detected at the time of patient enrolment,including biochemical indicators,inflammatory factors,ultrasound indicators of AVF and oxidative stress factors levels.Multifactorial Logistic regression equations were used to analyze the effects of clinical indicators on AVF thrombosis in MHD patients,receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of clinical indicators on AVF thrombosis;And interval likelihood ratio was used to stratify interdialyt-ic serum potassium levels,and further observe whether the relationship was stability between AVF thrombosis and interdia-lytic serum potassium levels in MHD patients.Results Compared with the normal serum potassium group,the levels of C-reactive protein(CRP),intact parathyroid hormone(iPTH),procalcitonin(PCT),triglyceride(TG),malondial-dehyde(MDA),myeloperoxidase(MPO),brachial artery resistance index(RI),brachial artery pulsatility index(PI)and radial artery PI were significantly elevated in hyperkalemia group and hypokalemia group,while the levels of albumin(Alb),total cholesterol(TC),superoxide dismutase(SOD)and fistula blood flow were significantly reduced(P＜0.05).Systolic blood pressure,diastolic blood pressure,fistula blood flow,Alb and SOD levels were significantly lower in patients with AVF thrombosis than those in patients with AVF unthrombosis(P＜0.05);Interdialytic mean serum potassium level,CRP,iPTH,PCT,brachial artery RI,brachial artery PI,radial artery PI,radial artery RI,MDA and MPO levels were significantly higher in patients with AVF thrombosis(P＜0.05).The ROC curve was used to analyse the model estab-lished by the multifactorial Logistic regression equation,and it was found that model 1 and model 2 had good predictive effi-cacy,and model 2 had the best predictive efficacy.The results of the interval likelihood ratio showed that:when the patient's interdialytic serum potassium level was 3.5～4.5 mmol/L,the possibility of the patient's AVF thrombosis was the lowest,and when the patient's interdialytic serum potassium level was＞5.5 mmol/L or＜3.5 mmol/L,the possibility of the patient's AVF thrombosis was higher,and when the patient's serum potassium level was＞5.5 mmol/L,the probability of AVF thrombosis was the highest in patients,which was 3.925 times higher than that of patients without AVF thrombosis.Conclusion Abnormal interdialytic serum potassium levels may induce AVF thrombosis in CKD patients.Serum potassium levels can be monitored during MHD treatment to enable timely intervention and improve clinical treatment outcomes for patients.

Aim To investigate the effect of interdialytic serum potassium levels on thrombosis of autologous ar-teriovenous fistula(AVF)in patients with chronic kidney disease(CKD)on maintenance haemodialysis(MHD).Methods 159 CKD patients who underwent MHD in our hospital from October 2021 to October 2022 were retrospectively analyzed.They were divided into hyperkalemia group(n=53),normal serum potassium group(n=61)and hypokalemia group(n=45)according to the mean serum potassium level of patients with different dialysis intervals,and all patients were followed up for 1 year or followed up until AVF thrombosis.General datas were collected and the following indicators were detected at the time of patient enrolment,including biochemical indicators,inflammatory factors,ultrasound indicators of AVF and oxidative stress factors levels.Multifactorial Logistic regression equations were used to analyze the effects of clinical indicators on AVF thrombosis in MHD patients,receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of clinical indicators on AVF thrombosis;And interval likelihood ratio was used to stratify interdialyt-ic serum potassium levels,and further observe whether the relationship was stability between AVF thrombosis and interdia-lytic serum potassium levels in MHD patients.Results Compared with the normal serum potassium group,the levels of C-reactive protein(CRP),intact parathyroid hormone(iPTH),procalcitonin(PCT),triglyceride(TG),malondial-dehyde(MDA),myeloperoxidase(MPO),brachial artery resistance index(RI),brachial artery pulsatility index(PI)and radial artery PI were significantly elevated in hyperkalemia group and hypokalemia group,while the levels of albumin(Alb),total cholesterol(TC),superoxide dismutase(SOD)and fistula blood flow were significantly reduced(P＜0.05).Systolic blood pressure,diastolic blood pressure,fistula blood flow,Alb and SOD levels were significantly lower in patients with AVF thrombosis than those in patients with AVF unthrombosis(P＜0.05);Interdialytic mean serum potassium level,CRP,iPTH,PCT,brachial artery RI,brachial artery PI,radial artery PI,radial artery RI,MDA and MPO levels were significantly higher in patients with AVF thrombosis(P＜0.05).The ROC curve was used to analyse the model estab-lished by the multifactorial Logistic regression equation,and it was found that model 1 and model 2 had good predictive effi-cacy,and model 2 had the best predictive efficacy.The results of the interval likelihood ratio showed that:when the patient's interdialytic serum potassium level was 3.5～4.5 mmol/L,the possibility of the patient's AVF thrombosis was the lowest,and when the patient's interdialytic serum potassium level was＞5.5 mmol/L or＜3.5 mmol/L,the possibility of the patient's AVF thrombosis was higher,and when the patient's serum potassium level was＞5.5 mmol/L,the probability of AVF thrombosis was the highest in patients,which was 3.925 times higher than that of patients without AVF thrombosis.Conclusion Abnormal interdialytic serum potassium levels may induce AVF thrombosis in CKD patients.Serum potassium levels can be monitored during MHD treatment to enable timely intervention and improve clinical treatment outcomes for patients.

[Objective]To explore the clinical experience of Professor QIU Changlin in treating Parkinson's disease(PD) from the perspective of "tremor and rigidity".[Methods]By reviewing the relevant Chinese medical literature,following the teacher's clinical work and compiling medical cases,it investigated Professor QIU Changlin's understanding of the Chinese medical names of PD,summarized his academic thought and clinical experience from the following five aspects:"deficiency of treatment from tremor theory","basis for tremor and rigidity" "discrimination hardness and softness" "characteristics of joint treatment of tremor and rigidity" and "cases of joint treatment of tremor and rigidity". Then it enumerated his experimental cases to support his view.[Results]Professor QIU Changlin believes that if PD is treated only from the "tremor",there are still some shortcomings. According to the diagnosis,main symptoms,etiology and pathogenesis and disease location of PD,Professor QIU proposes that PD can also be treated from the "spasm syndrome". It is established that PD is the same disease as spasm and tremor. In terms of treatment,the therapy is based on the joint treatment of spasm and tremor,and the treatment method of nourishing Yin and softening the liver,relieving spasm and suppressing wind is proposed. The symptoms of "spasm syndrome" have achieved satisfactory clinical results. The medical cases cited fully support the above academic experience.[Conclusion]Professor QIU Changlin's treatment of PD from the perspective of "tremor and rigidity" is unique,justified and effective,and worthy of study and promotion.

[Objective]To explore the clinical experience of Professor QIU Changlin in treating Parkinson's disease(PD) from the perspective of "tremor and rigidity".[Methods]By reviewing the relevant Chinese medical literature,following the teacher's clinical work and compiling medical cases,it investigated Professor QIU Changlin's understanding of the Chinese medical names of PD,summarized his academic thought and clinical experience from the following five aspects:"deficiency of treatment from tremor theory","basis for tremor and rigidity" "discrimination hardness and softness" "characteristics of joint treatment of tremor and rigidity" and "cases of joint treatment of tremor and rigidity". Then it enumerated his experimental cases to support his view.[Results]Professor QIU Changlin believes that if PD is treated only from the "tremor",there are still some shortcomings. According to the diagnosis,main symptoms,etiology and pathogenesis and disease location of PD,Professor QIU proposes that PD can also be treated from the "spasm syndrome". It is established that PD is the same disease as spasm and tremor. In terms of treatment,the therapy is based on the joint treatment of spasm and tremor,and the treatment method of nourishing Yin and softening the liver,relieving spasm and suppressing wind is proposed. The symptoms of "spasm syndrome" have achieved satisfactory clinical results. The medical cases cited fully support the above academic experience.[Conclusion]Professor QIU Changlin's treatment of PD from the perspective of "tremor and rigidity" is unique,justified and effective,and worthy of study and promotion.

Abundant clinical and basic studies in recent years reported the high association of Wnt/β-catenin signaling pathway with the incidence and development of multiple neurological disorders. In order to improve the attention about the relationship between Wnt/β-catenin signaling pathway and neurological disorders, and to provide new therapy target, this article reviews the research progress on the relationship between wnt/β-catenin signaling pathway and Parkinson′s disease, Alzheimer′s disease, epilepsy, multiple sclerosis and myasthenia gravis.

In this study, the distribution of five Alzheimer's disease (AD)-related single nucleotide polymorphisms (SNPs) in the Han population was examined in combination with the evaluation of clinical cognition and brain pathological analysis. The associations among SNPs, clinical daily cognitive states, and postmortem neuropathological changes were analyzed in 110 human brains from the Chinese Academy of Medical Sciences/Peking Union Medical College (CAMS/PUMC) Human Brain Bank. APOE ε4 (OR = 4.482, P = 0.004), the RS2305421 GG genotype (adjusted OR = 4.397, P = 0.015), and the RS10498633 GT genotype (adjusted OR = 2.375, P = 0.028) were associated with a higher score on the ABC (Aβ plaque score, Braak NFT stage, and CERAD neuritic plaque score) dementia scale. These results advance our understanding of the pathogenesis of AD, the relationship between pathological diagnosis and clinical diagnosis, and the SNPs in the Han population for future research.
ADAM10 Protein ; genetics ; Adult ; Aged ; Aged, 80 and over ; Alzheimer Disease ; genetics ; pathology ; Amyloid Precursor Protein Secretases ; genetics ; Antiporters ; genetics ; Apolipoprotein E4 ; genetics ; Asian Continental Ancestry Group ; genetics ; Brain ; pathology ; Cognitive Dysfunction ; genetics ; pathology ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Membrane Proteins ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide

Brain ; pathology ; China ; Humans ; Organ Preservation ; standards ; Tissue Banks ; ethics ; standards

Objective] To sum up Qiu Changlin's clinical experience and academic views of treatment of multiple sclerosis remission stage. [Methods] Through the way of reviewing the related literature of traditional Chinese medicine, clinical practice with teacher, arranging medical records, systematically arranging Qiu Changlin's clinical experience and academic perspective in the aspects of etiology and pathogenesis, syndrome differentiation ,treatment ideas, drug integration of TCM and western medicine. [Results] Qiu Changlin believes that the MS remission stage is of deficiency syndrome or deficiency complicated with excess syndrome. The main pathogenesis is insufficiency of kidney yin and kidney yang, deficiency of governor vessel. The subject is wind and phlegm attacking into collateral, stagnation of phlegm and blood stasis. Put forward that the treatment based on the differentiation between the main syndrome and minor syndrome. In clinic, divided the main syndrome into three types, like insufficiency of kidney yin, insufficiency of kidney yang, insufficiency of kidney essence. Establish the therapeutic principles like nourishing yin and kidney, warming yang and nourishing kidney, the complementing of yin and yang, dispelling wind and dredging collaterals. The kidney yin deficiency type can modify Six Ingredient Rehmannia pill, Zhibaidihuang pill, Zuogui pill, Dabuyin pill, Huqian pill. The kidney yang deficiency type can modify Jingui Shenqi pill, Yougui pill. The kidney essence deficiency type can modify Dihuangyinzi. Regard that nourishing kidney and governing vessel to the fundamental treatment, ants going into collaterals to dispel the blood stasis and wind for treatment of the symptoms, and believe that nourishing kidney and extinguish wind should always run through the whole treatment process. When treatment based on the main syndrome, we should emphasize personalized features that can reflect the characteristics of this disease, in order to improve the clinical curative effect. [Conclusion] Qiu Changlin has rich clinical experience in the treatment of MS remission stage;patients are satisfactory to the curative effect and have fewer side effects. It's fully explained that TCM has certain advantages in the treatment of MS remission stage, and is worth popularizing inheritance.

Objective To evaluate the short-term efficacy and safety of sevelamer hydrochloride in treating maintenance hemodialysis (MHD) patients with hyperphosphemia.Methods A multicenter,open-labeled,self-control study was performed.Phosphate binders were discontinued during a two-week washout period.Patients with more than 1.78 mmol/L serum phosphorus after two-week washout period were eligible for the trial.The dose was adjusted every two weeks as necessary to achieve serum phosphorus control. Sevelamer hydrochloride was administered to 138 MHD patients for 10 weeks and a second two-week washout period followed.Results A total of 111 from 138 patients fulfilled the whole 14-week study. Mean serum phosphorus and calcium-phosphate products starte to decline after two-week sevelamer hydrochloride treatment. By the end of 10-week sevelamer hydrochloride treatment, mean serum level of phosphorus [(1.85±0.50) vs (2.57±0.54) mmol/L,P＜0.01],calcium-phosphate product [(4.16± 1.72) vs (5.79 ± 1.50) mmol2/L2,P＜0.01 ] and low density lipoprotein [(1.64±0.76) vs (2.31 ±0.87) mmol/L,P＜0.01] were significantly decreased,while the adjusted serum level of calcium and serum intact parathyroid hormone kept steady.Both serum phosphorus and calcium-phosphrus product increased after the second washout period, but the levels were still lower as compared to pre-treatment [(2.26±0.71) vs (2.57±0.54) mmol/L; (5.12±1.63) vs (5.79±1.50) mmol2/L2,P＜0.01].Of the 138 patients involved,214 episodes in 106 patients and 121 episodes in 89 patients were reported as adverse events and adverse drug reaction respectively. Gastrointestinal symptoms,of which most were mild or moderate,happened to 68.1％ (94/138) patients. Conclusions Sevelamer hydrochloride can control serum phosphorus and reduce the levels of calcium-phosphorus product and cholesterol.Slight gastrointestinal symptoms like constipation are common during the treatment.