Mental state is an important part of the normal life activities of the human body, and it is also the most external expression and the most easily obtained information of the physical condition. The normal activities of the mind depend on the normal operation of the viscera, qi, and blood, and are a unified whole that prospers together and suffers together. The theory of the five-spirit-viscera in the Yellow Emperor’s Inner Classic revealed that the normal mental activities of the human body were dominated by the five internal organs, that is, the five internal organs were the body and the five spirits were the function. And it highlighted the viewpoint that the five internal organs store the spirits and are actually one. The heart governs the spirit and belongs to the four internal organs. On this basis, Synopsis of Golden Chamber used the internal organs to diagnose and treat mental diseases, integrating the theory of the five spirits into it, forming a unique method of diagnosis and treatment with the heart as the leading factor and regulating the qi and blood of the four internal organs. It identified the pathogenesis of diseases such as pathogenic crying, lily disease, and hysteria from five levels: heart deficiency and weak qi, heart-lung disharmony, heart-liver disharmony, the heart of the loss of the spleen nourishment, and disharmony between heart and kidney. The treatment was mainly to replenish the deficiency of the viscera and eliminate the pathogens, reflecting the characteristics of regulating the mind and calming the four internal organs. This unique view on diagnosis and treatment has profoundly influenced the diagnosis and treatment theories of mental illnesses by later doctors, and is of great significance to the current clinical treatment of such illnesses.

Surgical methods for varicocele remain controversial. This study intends to evaluate the efficacy and safety of different surgical approaches for treating varicocele through a network meta-analysis (NMA). PubMed, Embase, Cochrane, and Web of Science databases were thoroughly searched. In total, 13 randomized controlled trials (RCTs) and 24 cohort studies were included, covering 9 different surgical methods. Pairwise meta-analysis and NMA were performed by means of random-effects models, and interventions were ranked based on the surface under the cumulative ranking curve (SUCRA). According to the SUCRA, microsurgical subinguinal varicocelectomy (MSV; 91.6%), microsurgical retroperitoneal varicocelectomy (MRV; 78.2%), and microsurgical inguinal varicocelectomy (MIV; 76.7%) demonstrated the highest effectiveness in reducing postoperative recurrence rates. In this study, sclerotherapy embolization (SE; 87.2%), MSV (77.9%), and MIV (67.7%) showed the best results in lowering the risk of hydrocele occurrence. MIV (82.9%), MSV (75.9%), and coil embolization (CE; 58.7%) were notably effective in increasing sperm motility. Moreover, CE (76.7%), subinguinal approach varicocelectomy (SV; 69.2%), and SE (55.7%) were the most effective in increasing sperm count. SE (82.5%), transabdominal laparoscopic varicocelectomy (TLV; 76.5%), and MRV (52.7%) were superior in shortening the length of hospital stay. The incidence rates of adverse events for MRV (0), SE (3.3%), and MIV (4.1%) were notably low. Cluster analyses indicated that MSV was the most effective in the treatment of varicocele. Based on the existing evidence, MSV may represent the optimal choice for varicocele surgery. However, selecting clinical surgical strategies requires consideration of various factors, including patient needs, surgeon experience, and the learning curve.
Humans ; Male ; Embolization, Therapeutic/methods* ; Microsurgery/methods* ; Randomized Controlled Trials as Topic ; Sclerotherapy/methods* ; Treatment Outcome ; Urologic Surgical Procedures, Male/methods* ; Varicocele/surgery*

Non-small cell lung cancer(NSCLC)is one of the most prevalent and deadly malignant tumors in the world.In recent years,artificial intelligence(AI)in computed tomography(CT)has harnessed the power of big data to automatically extract and learn imaging features,thereby assisting radiologists in reducing the workload and missed diagnosis rate of pulmonary nodules.An ELISA kit for detecting seven lung cancer autoantibodies(p53,SOX2,PGP9.5,CAGE,MAGE-A1,GAGE7,and GBU4-5)has been clinically implemented in China,showing high specificity in the early screening of NSCLC.Additionally,other liquid biopsy techniques such as circulating tumor DNA(ctDNA)methylation markers are also continually being explored.However,existing methods for the early diagnosis of lung cancer all have their limitations,and optimizing their combination or establishing diagnostic models has become a trend.This review summarizes the research progress and value of the seven lung cancer autoantibodies and CT AI in the early diagnosis of NSCLC,with the aim of providing a reference for their combined use in the early diagnosis of lung cancer in Chinese population.

Objectives: To construct a nomogram for prediction of intrahepatic cholangiocarcinoma (ICC) lymph node metastasis based on inflammation-related markers,and to conduct its clinical verification. Methods: Clinical and pathological data of 858 ICC patients who underwent radical resection were retrospectively collected at 10 domestic tertiary hospitals in China from January 2010 to December 2018. Among the 508 patients who underwent lymph node dissection,207 cases had complete variable clinical data for constructing the nomogram,including 84 males,123 females,109 patients≥60 years old,98 patients<60 years old and 69 patients were pathologically diagnosed with positive lymph nodes after surgery. Receiver operating characteristic curve was drawn to calculate the accuracy of preoperative imaging examinations to determine lymph node status,and the difference in overall survival time was compared by Log-rank test. Partial regression squares and statistically significant preoperative variables were screened by backward stepwise regression analysis. R software was applied to construct a nomogram,clinical decision curve and clinical influence curve,and Bootstrap method was used for internal verification. Moreover,retrospectively collecting clinical information of 107 ICC patients with intraoperative lymph node dissection admitted to 9 tertiary hospitals in China from January 2019 to June 2021 was for external verification to verify the accuracy of the nomogram. 80 patients with complete clinical data but without lymph node dissection were divided into lymph node metastasis high-risk group and low-risk group according to the score of the nomogram among the 858 patients. Log-rank test was used to compare the overall survival of patients with or without lymph node metastasis diagnosed by pathology. Results: The area under the curve of preoperative imaging examinations for lymph node status assessment of 440 patients was 0.615,with a false negative rate of 62.8% (113/180) and a false positive rate of 14.2% (37/260). The median survival time of 207 patients used to construct a nomogram with positive or negative postoperative pathological lymph node metastases was 18.5 months and 27.1 months,respectively (P<0.05). Five variables related to lymph node metastasis were screened out by backward stepwise regression analysis,which were combined calculi,neutrophil/lymphocyte ratio,albumin,liver capsule invasion and systemic immune inflammation index,according to which a nomogram was constructed with concordance index(C-index) of 0.737 (95%CI: 0.667 to 0.806). The C-index of external verification was 0.674 (95%CI:0.569 to 0.779). The calibration prediction curve was in good agreement with the reference curve. The results of the clinical decision curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set to about 0.32,the maximum net benefit could be obtained by 0.11,and the cost/benefit ratio was 1∶2. The results of clinical influence curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set to about 0.6,the probability of correctly predicting lymph node metastasis could reach more than 90%. There was no significant difference in overall survival time between patients with high/low risk of lymph node metastasis assessed by the nomogram and those with pathologically confirmed lymph node metastasis or without lymph node metastasis (Log-rank test:P=0.082 and 0.510,respectively). Conclusion: The prediction accuracy of preoperative nomogram for ICC lymph node metastasis based on inflammation-related markers is satisfactory,which can be used as a supplementary method for preoperative diagnosis of lymph node metastasis and is helpful for clinicians to make personalized decision of lymph node dissection for patients with ICC.

SARS-CoV-2 has infected more than 600 million people worldwide and caused more than 6 million deaths. The emerging novel variants have made the epidemic rebound in many places. Meteorological factors can affect the epidemic spread by changing virus activity, transmission dynamic parameters and host susceptibility. This paper systematically analyzed the currently available laboratory and epidemiological studies on the association between the meteorological factors and COVID-19 incidence, in order to provide scientific evidence for future epidemic control and prevention, as well as developing early warning system.
Humans ; SARS-CoV-2 ; COVID-19 ; Meteorological Concepts ; Laboratories ; Epidemiologic Studies

In this study, we investigated the genetics, clinical features, and therapeutic approach of 14 patients with 5α-reductase deficiency in China. Genotyping analysis was performed by direct sequencing of PCR products of the steroid 5α-reductase type 2 gene (SRD5A2). The 5α-reductase activities of three novel mutations were investigated by mutagenesis and an in vitro transfection assay. Most patients presented with a microphallus, variable degrees of hypospadias, and cryptorchidism. Eight of 14 patients (57.1%) were initially reared as females and changed their social gender from female to male after puberty. Nine mutations were identified in the 14 patients. p.G203S, p.Q6X, and p.R227Q were the most prevalent mutations. Three mutations (p.K35N, p.H162P, and p.Y136X) have not been reported previously. The nonsense mutation p.Y136X abolished enzymatic activity, whereas p.K35N and p.H162P retained partial enzymatic activity. Topical administration of dihydrotestosterone during infancy or early childhood combined with hypospadia repair surgery had good therapeutic results. In conclusion, we expand the mutation profile of SRD5A2 in the Chinese population. A rational clinical approach to this disorder requires early and accurate diagnosis, especially genetic diagnosis.
3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics* ; Adolescent ; Adult ; Asian People/genetics* ; Child ; Child, Preschool ; China ; Disorder of Sex Development, 46,XY/genetics* ; Follicle Stimulating Hormone/blood* ; Genitalia, Male/abnormalities* ; Humans ; Hypospadias/genetics* ; Luteinizing Hormone/blood* ; Male ; Membrane Proteins/genetics* ; Mutation/genetics* ; Sequence Alignment ; Steroid Metabolism, Inborn Errors/genetics* ; Testosterone/blood* ; Young Adult

Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) are considered as the lower He-sea points, which are located along the leg lines of stomach meridian of foot Yangming from top to bottom. According to the corresponding zang-fu of lower He-sea points, the distribution order from top to bottom is stomach, large intestine and small intestine. This is significantly different from digestive physiology function sequence of stomach, small intestine and large intestine in modern medicine. However, it conforms to their anatomical position from top to bottom. In order to make a further confirmation that the indication specificity of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is closely associated with anatomical location, a great number of ancient and modern literature is reviewed. It is found that the functions of the three acupoints are obviously related to stomach, large intestine and small intestine, respectively, indicating that the sequence of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is related to anatomical position of corresponding zang-fu. This study conclusion could play an important role for exploring the significance of anatomical location in indication specificity of acupoints.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Intestine, Large ; physiopathology ; Medicine in Literature ; Meridians ; Stomach ; physiopathology

Objective To investigate the outcome of endovascular treatment of large or giant intracranial aneu?rysm by long-term angiographic follow-up. Methods Clinical data of 72 patients with large or giant intracranial aneu?rysms receiving endovascular treatment were analyzed retrospectively. Thirty aneurysms were treated with coil emboliza?tion alone, 14 with stent-assisted coiling, 15 with covered stent-deployment and 13 with parent artery occlusion. Results complete occlusion was achieved in 10 cases of pure coil embolization, 7 cases of stent assisted coil embolization,11 cas?es of completely covered stent-deployment and,13 cases of parent artery occlusion. The postoperative immediate com?plete embolism rate was 56.9%. Nearly completely occlusion was achieved in 17 cases of pure coil embolization, in 6 cas?es of stent auxiliary coil embolization, 4 cases of covered stent-deloyment and zero case of parent artery occlusion. The total postoperative immediate nearly completely embolism rate was 37.5%. Incomplete occlusion was achieved in 3 cases of pure coil thrombosis, 1 case of stent assisted coil, zero case of ,covered stent-deloyment and zero case of parent artery occlusion. The total immediate postoperative incomplete embolization rate was 5.6%. Patients were followed up for 6 to 72 months, with an average follow-up of 24.2 months . All patients had no bleeding. The total periprocedural complica?tion rate was 9.7%and there were no death cases. The recurrence of aneurysm in pure spring coil embolization treatment was higher compared with other treatments. The overall recurrence rate was 23.6%. The recurrent 14 aneurysms were suc?cessfully treated endovascularly. Conclusions Endovascular embolization treatment of intracranial large or giant aneu?rysm is safe and effective but its long-term recurrence rate is high. Thus a close follow-up is needed. Endovascular inter?ventional therapy based on the location of aneurysm and shape characteristics can improve treatment effectiveness and re?duce recurrence rate.

OBJECTIVETo explore the influence of compound whole grain complex antioxidant chain on oxidative stress to the hyperlipidemia population.

METHODSFrom March 2008 to March 2009, 418 hyperlipemia residents (45 to 75 years of age) of Han group were screened from 3 main districts in Nanjing, according to the community, blood lipids and oxidative indicators, stratified into intervention and control group by quasi-experimental design. The intervention group (212 individuals) were provided with compound whole grain and health education while only health education was provided for the control group (206 individuals). Body mass index (BMI), waist-to-hip ratio (WHR), total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) and oxidative indicators (including T-AOC, MDA, SOD, GSH-Px) were measured before and after the one-year intervention period. Analyses of the correlation between posture, biochemical markers and oxidative stress indicators before and after intervention were carried out.

RESULTSAfter intervention, BMI ((25.53 ± 2.77) kg/m(2)), WHR (0.82 ± 0.03), TC ((4.60 ± 0.98) mmol/L), TG ((1.26 ± 0.88) mmol/L) in the intervention group were decreased significantly compared to the levels of BMI ((26.60 ± 3.18) kg/m(2)), WHR (0.93 ± 0.05), TC ((4.97 ± 1.02) mmol/L), TG ((1.98 ± 1.11) mmol/L) in the control group (all P values < 0.05); while HDL-C ((1.34 ± 0.26) mmol/L) in the intervention group was increased significantly compared to the level of HDL-C ((1.18 ± 0.17) mmol/L) in the control group (P < 0.05); After intervention, levels of T-AOC (19.52 ± 0.81), SOD ((85.42 ± 21.65) U/ml) and GSH-Px ((128.26 ± 33.65) µmol/L) were increased significantly compared to the levels of T-AOC (11.11 ± 1.30), SOD ((78.68 ± 30.48) U/ml) and GSH-Px ((118.48 ± 24.19) µmol/L) in the control group (all P values < 0.05); while MDA ((1.78 ± 1.16) nmol/ml) decreased significantly compared to the level of MDA ((2.12 ± 1.37) nmol/ml in the control group (P < 0.05); Pearson product moment correlation analysis showed that: T-AOC with TC, TG, BMI showed a negative correlation (r values were -0.258, -0.266, -0.230, respectively, all P values < 0.05), while with HDL-C was a positive correlation (r values was 0.194, P < 0.05); SOD with TC, TG, BMI showed a negative correlation (r values were -0.282, -0.311, -0.217, respectively, all P values < 0.05), while with HDL-C was a positive correlation (r values was 0.169, P < 0.05).

CONCLUSIONCompound whole grain could improve lipid metabolism to the hyperlipidemia population. There was a correlation between common human metabolism and the levels of oxidative stress.

Aged ; Aged, 80 and over ; Antioxidants ; China ; epidemiology ; Diet ; Diet Surveys ; Edible Grain ; Female ; Health Education ; Humans ; Hyperlipidemias ; epidemiology ; metabolism ; prevention & control ; Lipid Metabolism ; Male ; Middle Aged ; Oxidative Stress

OBJECTIVETo find out the effects of peroxisome proliferator-activated receptor gamma 2 (PPARgamma2) genetic polymorphism and nutrition intervention to blood lipid abnormal population.

METHODS412 hyperlipemia residents of Han group were screened from 3 main districts in Nanjing by multistage stratified cluster random sampling, and separated into nutritional intervention and control group by simple random method. The intervention group (221 individuals) were provided with coarse good grain and health education while only health education was provided for the control group (191 individuals). Medical examinations (including body mass index (BMI), waist-to-hip ratio (WHR); total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and fasting blood glucose (FBG)) were taken every 6 months between March 2007 and March 2008, and PPARgamma2 genetic polymorphism was also detected later.

RESULTSAfter intervention, TC levels of intervention group and control group were (4.90 +/- 0.86) and (5.16 +/- 0.94) mmol/L respectively; TG levels were (1.68 +/- 0.97) and (2.29 +/- 1.10) mmol/L respectively; HDL-C levels were (1.35 +/- 0.36) and (1.16 +/- 0.33) mmol/L respectively, all of the differences were significant in statistics (t values were -2.95, -6.01, 5.55 respectively, P < 0.01). The levels of BMI ((24.81 +/- 3.21) kg/m(2)), WHR (0.88 +/- 0.07), FBG ((5.40 +/- 1.17) mmol/L), TC ((4.92 +/- 0.87) mmol/L) and TG ((1.68 +/- 1.01) mmol/L) decreased significantly (t values were 19.06, 16.43, 1.98, 8.86, -14.32 respectively, P < 0.01) compared to the levels before intervention (BMI (25.39 +/- 3.30) kg/m(2), WHR (0.92 +/- 0.07), FBG (6.07 +/- 2.17) mmol/L, TC (5.28 +/- 0.94) mmol/L and TG (2.70 +/- 1.86) mmol/L), while HDL-C (1.37 +/- 0.36) mmol/L increased significantly compared to the level before intervention (1.13 +/- 0.42) mmol/L (t = -7.68, P < 0.01) in the individuals with Pro/Pro of intervention group. WHR (0.90 +/- 0.06) and TG ((1.71 +/- 0.59) mmol/L) decreased significantly compared to the levels before intervention (WHR (0.95 +/- 0.06) and TG (2.58 +/- 1.12) mmol/L) (t values were -3.53 and -8.05 respectively, P < 0.01) in the ones with Pro/Ala. Moreover, susceptibility of change for BMI in Pro/Pro genotype carriers ((-1.21 +/- 1.02) kg/m(2)) was significantly greater than that in Pro/Ala genotype carriers ((-0.58 +/- 1.85) kg/m(2), t = -6.29, P < 0.01).

CONCLUSIONSeveral indices of individuals with Pro/Pro improved obviously after nutrition intervention, which showed that effects of intervention to these people were better than those with Pro/Ala and Ala/Ala.

Case-Control Studies ; China ; Dyslipidemias ; diet therapy ; prevention & control ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; PPAR gamma ; genetics ; Polymorphism, Genetic