Objective:To observe the clinical efficacy of transcranial direct current stimulation(tDCS)and tDCS com-bined with mirror therapy in the treatment of shoulder-hand syndrome after stroke.Method:Forty-five patients with post-stroke shoulder-hand syndrome were divided into the combined group,tDCS group and the conventional group,with 15 cases in each group.In the combined group,tDCS combined with mirror therapy was added on the basis of routine rehabilitation.The tDCS group added tDCS treatment on the ba-sis of routine rehabilitation treatment.The conventional group received routine rehabilitation treatment.The treat-ment lasted for 10 days.Before and after treatment,shoulder-numerical rating scale(S-RNS),hand-numerical rating scale(H-RNS),edema degree of affected hand,Fugl-Meyer assessment of upper extremity(FMA-UE),modified bar-thel index(MBI)and shoulder-hand syndrome scale(SHSS)were used to evaluate patients in the three groups.Result:Compared with before treatment,the S-NRS,H-NRS score,hand edema degree,FMA-UE,MBI and SHSS score in the combined group and tDCS group were significantly improved(P<0.05)after treat-ment,while the H-NRS score in conventional group was significantly improved(P<0.05).After the treatment,the shoulder-NRS score of the combined group was significantly decreased and the SHSS and MBI score were also significantly increased,compared with that of the tDCS and conventional group(P<0.05).The MBI score of the tDCS group was significantly increased compared with the conventional group(P<0.05).Conclusion:tDCS can improve the clinical symptoms of post-stroke SHS,the combination of mirror therapy is more effective.

ObjectiveTo evaluate the methodological quality and reporting quality of published guidelines/consensuses on traditional Chinese medicine （TCM）/integrated traditional Chinese and Western medicine diagnosis and treatment of nonalcoholic fatty liver disease （NAFLD）， and to provide a basis for formulating guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD in the future. MethodsDatabases including PubMed， Embase， Web of Science， CNKI， Wanfang Data， and CBM and the websites of China Association of Chinese Medicine and China Association of Integrative Medicine were searched for related articles published up to September 1， 2024. Two clinical researchers independently assessed the methodological quality and reporting quality of the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD by using Appraisal of Guidelines for Research and Evaluation Ⅱ （AGREE Ⅱ） and Reporting Items for Practice Guidelines in Healthcare （RIGHT）. ResultsA total of nine guidelines/consensuses were included after literature screening， with four guidelines and five expert consensuses. The scores of different domains assessed by AGREE Ⅱ for the nine guidelines/consensuses were as follows： scope and purpose （47.1%）， stakeholder involvement （41.0%）， rigor of development （21.6%）， clarity of presentation （40.2%）， applicability （19.0%）， and editorial independence （19.6%）. The recommendation level of the articles was B level （recommended after revision） for four articles and C level （not recommended） for five articles. The RIGHT assessment showed high reporting rates for “Basic Information” and “Background”， while other areas needed to be improved. Currently， there was no international standard for the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and the quality of these guidelines/consensuses needed to be enhanced to ensure comprehensiveness and credibility. ConclusionThere is still potential for improving the quality of guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD， and AGREE Ⅱ and RIGHT checklists should be strictly followed to ensure the fairness， scientific rigor， and transparency of these guidelines/consensuses.

Chronic hepatitis B-associated liver fibrosis is the key pathological stage in disease progression to liver cirrhosis and even hepatocellular carcinoma. Although antiviral therapy can effectively inhibit HBV replication， reversal of liver fibrosis remains a significant challenge in contemporary clinical practice， and some patients still face the risk of disease progression. With the distinctive advantages of “multiple targets and holistic regulation”， traditional Chinese medicine （TCM） has gradually formed a comprehensive prevention and treatment strategy integrating traditional theories and modern scientific research evidence. “Weakened body resistance and blood stasis” are the core pathogenesis of liver fibrosis and exist throughout the course of the disease， and therefore， the treatment of this disease should focus on stage-specific differentiation and address both the symptoms and root causes. In recent years， significant progress has been achieved in both clinical and basic research. This article systematically reviews the clinical effect and mechanism of action of classic TCM prescriptions （such as Biejia Decoction Pill， Dahuang Zhechong Pill， and Xiaochaihu Decoction）， modern Chinese patent drugs， and core TCM drugs （such as Salvia miltiorrhiza， Astragalus membranaceus， and Bupleurum chinense） in the treatment of liver fibrosis. It also analyzes the current challenges in evidence quality and precise medication and proposes future research directions. It is recommended to enhance the role of TCM in the prevention and treatment of liver diseases by deepening research on the “disease-syndrome-prescription-effect-target” association and conducting high-level clinical trials and real-world studies.

Liver disease is a major global health issue, severely impacting patients' quality of life and life expectancy. Integrated Traditional Chinese and Western Medicine demonstrates unique advantages in the field of liver disease treatment. Therefore, this article elaborates on the research progress of integrated traditional Chinese and Western medicine in viral hepatitis, metabolic dysfunction-associated steatotic liver disease, cirrhosis, and liver cancer.

Objective:To observe the clinical efficacy of transcranial direct current stimulation(tDCS)and tDCS com-bined with mirror therapy in the treatment of shoulder-hand syndrome after stroke.Method:Forty-five patients with post-stroke shoulder-hand syndrome were divided into the combined group,tDCS group and the conventional group,with 15 cases in each group.In the combined group,tDCS combined with mirror therapy was added on the basis of routine rehabilitation.The tDCS group added tDCS treatment on the ba-sis of routine rehabilitation treatment.The conventional group received routine rehabilitation treatment.The treat-ment lasted for 10 days.Before and after treatment,shoulder-numerical rating scale(S-RNS),hand-numerical rating scale(H-RNS),edema degree of affected hand,Fugl-Meyer assessment of upper extremity(FMA-UE),modified bar-thel index(MBI)and shoulder-hand syndrome scale(SHSS)were used to evaluate patients in the three groups.Result:Compared with before treatment,the S-NRS,H-NRS score,hand edema degree,FMA-UE,MBI and SHSS score in the combined group and tDCS group were significantly improved(P<0.05)after treat-ment,while the H-NRS score in conventional group was significantly improved(P<0.05).After the treatment,the shoulder-NRS score of the combined group was significantly decreased and the SHSS and MBI score were also significantly increased,compared with that of the tDCS and conventional group(P<0.05).The MBI score of the tDCS group was significantly increased compared with the conventional group(P<0.05).Conclusion:tDCS can improve the clinical symptoms of post-stroke SHS,the combination of mirror therapy is more effective.

Liver disease is a major global health issue, severely impacting patients' quality of life and life expectancy. Integrated Traditional Chinese and Western Medicine demonstrates unique advantages in the field of liver disease treatment. Therefore, this article elaborates on the research progress of integrated traditional Chinese and Western medicine in viral hepatitis, metabolic dysfunction-associated steatotic liver disease, cirrhosis, and liver cancer.

Breast augmentation using polyacrylamide hydrogel (PAHG) was widely used in China. We present the first case of delayed breast inflammation after 2019 novel coronavirus(2019-nCoV) infection in a patient who recieved breast augmentation with PAHG 20 years ago, without any other predispositions. The 45-year-old female patient complained of severe breast swelling and pain three weeks after 2019-nCoV infection. The swelling extended from the upper clavicle to the upper abdomen. Delayed inflammation reaction was diagnosed, followed by emergency surgery. During the surgery, the injected material was observed to gush out in a form of greenish and thin paste, with a foul odor. The wound had extensive diffuse oozing and hemoglobin decreased significantly. The patient was discharged one week after surgery. During a three-month follow-up, she experienced weakness and fatigue with no complications. There are still many unknown areas of the impact of 2019-nCoV on human foreign bodies and immune system, which is diverse and complex. Reporting various possible symptoms and mechanisms is conducive to improving the level of awareness and intervention of plastic surgeons.

Pneumococcal vaccine plays a key role in preventing diseases such as pneumonia and meningitis caused by Streptococcus pneumoniae(S.pneumoniae).Capsular polysaccharide,C-polysaccharide and phosphorus content are important indicators for quality control of polysaccharide antigens in vaccine development and production.In this study,a quantitative 1H NMR and 31P NMR method based on a single internal standard hexamethylphosphoramide(HMPA)was developed to achieve simultaneous determination of capsular polysaccharide,C-polysaccharide and phosphorus content in 6A,6B,18C,19A,19F and 23F S.pneumoniae polysaccharide antigens.Using the internal reference comparison method,the effect of solubility of polysaccharide on quantitative 1H NMR determination was investigated.It was found that the determination results of quantitative 1H NMR were affected by the viscosity and concentration of polysaccharide solution.It was found that high viscosity polysaccharides at 3-15 mg/mL and low viscosity polysaccharides at 5-25 mg/mL were the optimal detection solution concentration range.This"one internal standard three quantitative"NMR method has good precision,specificity and accuracy,and provides a valuable new strategy for the quality control of pneumococcal vaccine.

Breast augmentation using polyacrylamide hydrogel (PAHG) was widely used in China. We present the first case of delayed breast inflammation after 2019 novel coronavirus(2019-nCoV) infection in a patient who recieved breast augmentation with PAHG 20 years ago, without any other predispositions. The 45-year-old female patient complained of severe breast swelling and pain three weeks after 2019-nCoV infection. The swelling extended from the upper clavicle to the upper abdomen. Delayed inflammation reaction was diagnosed, followed by emergency surgery. During the surgery, the injected material was observed to gush out in a form of greenish and thin paste, with a foul odor. The wound had extensive diffuse oozing and hemoglobin decreased significantly. The patient was discharged one week after surgery. During a three-month follow-up, she experienced weakness and fatigue with no complications. There are still many unknown areas of the impact of 2019-nCoV on human foreign bodies and immune system, which is diverse and complex. Reporting various possible symptoms and mechanisms is conducive to improving the level of awareness and intervention of plastic surgeons.

Objective:To investigate the effect of vitamin D supplementation on weight loss efficacy and insulin resistance (IR) in obese patients.Methods:It was a randomized controlled trial. A total of 190 obese patients with vitamin D deficiency were selected from the obesity clinic of Tianjin Union Medical Center from March to December in 2023. The patients were divided into control group (95 cases) and vitamin D group (95 cases) according to random number table. The control group was given energy-limited high-protein diet combined with moderate intensity exercise, and the vitamin D group was supplemented with vitamin D on the basis of the control group, 14 000 U/week for 24 weeks. A total of 25 dropped out of the study from the two groups for various reasons. Finally, 79 cases in the control group and 86 cases in the vitamin D group were included in the analysis. Independent sample t test and rank sum test were used to compare serum 25 hydroxyvitamin D [25 (OH) D] level, body weight, body mass index, fat mass, visceral fat area, fasting blood glucose, fasting insulin and glycated hemoglobin (HbA 1c) between the two groups at baseline and after intervention. Homeostasis model insulin resistance index (HOMA-IR) was used to evaluate the degree of insulin resistance (IR), and the effects of vitamin D supplementation on weight loss efficiency and IR in those patients were analyzed. Results:There was no significant differences in serum 25(OH)D level between the two groups before intervention ( P>0.05); the serum 25(OH)D level in the vitamin D group was significantly higher than that in the control group after intervention [(30.90±7.55) vs (16.00±4.34) μg/L] ( t=-15.35, P<0.001). The body weight, body mass index, fat mass, visceral fat area, fasting blood glucose, fasting insulin, HbA 1c, and HOMA-IR were all significantly lower after the intervention than those before the intervention in both groups [control group: (93.32±13.47) vs (98.95±14.31) kg, (33.74±5.09) vs (35.80±5.52) kg/m 2, (39.77±11.87) vs (44.12±12.79) kg, (183.76±40.95) vs (204.01±32.18) m 2, 5.00 (4.55, 5.67) vs 5.24 (4.68, 6.42) mmol/L, 16.78 (13.94, 24.30) vs 22.56 (15.95, 31.2) mU/L, 5.55%±0.53% vs 6.05%±0.99%, 4.11 (3.14, 5.57) vs 5.51 (3.61, 8.49); vitamin D group: (88.14±17.66) vs (104.43±22.02) kg, (31.02±5.10) vs (36.66±5.98) kg/m 2, (35.51±12.87) vs (46.67±13.33) kg, (166.50±49.50) vs (213.64±40.14) m 2, 4.70 (4.35, 5.07) vs 5.17 (4.77, 6.30) mmol/L, 13.18 (9.87, 18.84) vs 21.67 (15.78. 32.74) mU/L, 5.43%±0.48% vs 6.21%±1.22%, 2.88 (1.99, 4.21) vs 5.19 (3.82, 9.27)], and the body weight, body mass index, adiposity, visceral fat area, fasting blood glucose, fasting insulin, and HOMA-IR were all significantly lower in vitamin D group than those in the control group [(88.14±17.66) vs (93.32±13.47) kg, (31.02±5.10) vs (33.74±5.09) kg/m 2, (35.51±12.87) vs (39.77±11.87) kg, (166.50±49.50) vs (183.76±40.95) m 2, 4.70 (4.35, 5.07) vs 5.00 (4.55, 5.67) mmol/L, 13.18 (9.87, 18.84) vs 16.78 (13.94, 24.30) mU/L, and 2.88 (1.99, 4.21) vs 4.11 (3.14, 5.57), respectivley] (all P<0.05). The IR remission rate was significantly higher in the vitamin D group than that in the control group after the intervention (37.3% vs 15.3%) ( χ2=8.071, P=0.002). Conclusion:Supplementation of vitamin D on the basis of energy-limited high-protein diet combined with moderate intensity exercise can significantly improve the efficacy of weight loss and IR in obese patients with vitamin D deficiency.