From the perspective of the physiological basis of liver and kidney sharing the common source in traditional Chinese medicine(TCM),and by integrating the theory of kidney dominating bone,liver dominating tendon,and meridian sinew of TCM as well as the bone resorption and collapse theory,and non-uniform settlement theory and lower-limb musculoskeletal bowstring structure theory of modern orthopedics,the pathogenesis of osteonecrosis of the femoral head(ONFH)under the system of non-uniform settlement during bone resorption and multidimensional composite bowstring working in coordination with the theory of liver-kidney and muscle-bone was explored.The key to the TCM pathogenesis of ONFH lies in the deficiency of the liver and kidney,and then the imbalance of kidney yin-yang leads to the disruption of the dynamic balance of bone formation and bone resorption mediated by osteoblasts-osteoclasts,which manifests as the elevated level of bone metabolism and the enhancement of focal bone resorption in the femoral head,and then leads to the necrosis and collapse of the femoral head.It is considered that the kidney dominates bone,liver dominates tendon,and the tendon and bone together constitute the muscle-bone-joint dynamic and static system of the hip joint.The appearance of collapse destroys the originally balanced muscle-bone-joint system.Moreover,the failure of liver blood in the nourishment of muscles and tendons further exacerbates the imbalance of the soft tissues around the hip joint,accelerates the collapse of the muscle-bone-joint dynamic and static system,speeds up the process of femoral head collapse,and ultimately results in irreversible outcomes.Based on the above pathogenesis,the systematic integrative treatment of ONFH should be based on the TCM holistic concept,focuses on the focal improvement of internal and external blood circulation of the femoral head by various approaches,so as to rebuild the coordination of joint function.Moreover,attention should be paid to the physical constitution of the patients,and therapy of tonifying the kidney and regulating the liver can be used to restore the balance between osteogenesis and osteoblastogenesis,and to reconstruct the muscle-bone-joint system,so as to effectively delay or even prevent the occurrence of ONFH.

The aim of this study was to investigate the serogroups,ST types,virulence genes,and resistance characteris-tics of Listeria monocytogenes(Lm)isolates from fresh edible mushrooms in Fujian Province.The whole genomes of Lm isola-ted from fresh edible mushrooms in Fujian province were sequenced.BioNumeric7.6 software was used to assemble the sequen-cing data,and the serogroups,ST types,virulence genes,and drug resistance characteristics were further analyzed.Ten Lm strains were classified into three serogroups(six Ⅱb strains,three Ⅱa strains,and one Ⅱc strain),five ST types(four ST5 strains;three ST8 strains;and one strain each for ST87,ST9,and ST429).CC5 and CC8 were the dominant clone groups.All Lm carried six virulence genes(actA,hly,mpl,plcA,plcB,and prfA)on LIPI-1,as well as internal genes(inlA,inlB,inlC,inlE,inlF,inlH,inlJ,and inlK).Some strains carried inlD,inlG,and inlL.Neither strain carried the gene on LI-PI-3,and two strains carried some genes on LIPI-4.The resistance rate of Lm to cefoxitin was 100％,and the resistance rates to oxacillin and clindamycin were both 30％.Five strains were resistant to two or more antibiotics,one ST87 strain had a resistance spectrum of OXA-CLI-CIP-FOX,two ST8 strains had a resistance spectrum of CLI-FOX,and two ST5 strains had a re-sistance spectrum of OXA-FOX.Prediction of antibiotic resistance genes revealed that all ten Lm carried fosX,mprF,norB,sul,and Lmo0919 antibiotic resistance genes.According to cgMLST a-nalysis,strains of Lm clustered on five separate evolutionary branches,each containing one ST type.No allelic differences were identified among the three ST8 strains and the four ST5 strains of Lm,thus indicating that they belonged to the same clone and could sustainably exist in fresh edible mushrooms.Lm strains isolated from retail fresh edible mushrooms in Fujian Province pose a potential risk human infection,and the drug re-sistance status is concerning.In particular,a highly virulent multi-drug resistant strain found in flammulina velutipes may pose a potential threat to public health and should be alerted.

The aim of this study was to investigate the serogroups,ST types,virulence genes,and resistance characteris-tics of Listeria monocytogenes(Lm)isolates from fresh edible mushrooms in Fujian Province.The whole genomes of Lm isola-ted from fresh edible mushrooms in Fujian province were sequenced.BioNumeric7.6 software was used to assemble the sequen-cing data,and the serogroups,ST types,virulence genes,and drug resistance characteristics were further analyzed.Ten Lm strains were classified into three serogroups(six Ⅱb strains,three Ⅱa strains,and one Ⅱc strain),five ST types(four ST5 strains;three ST8 strains;and one strain each for ST87,ST9,and ST429).CC5 and CC8 were the dominant clone groups.All Lm carried six virulence genes(actA,hly,mpl,plcA,plcB,and prfA)on LIPI-1,as well as internal genes(inlA,inlB,inlC,inlE,inlF,inlH,inlJ,and inlK).Some strains carried inlD,inlG,and inlL.Neither strain carried the gene on LI-PI-3,and two strains carried some genes on LIPI-4.The resistance rate of Lm to cefoxitin was 100％,and the resistance rates to oxacillin and clindamycin were both 30％.Five strains were resistant to two or more antibiotics,one ST87 strain had a resistance spectrum of OXA-CLI-CIP-FOX,two ST8 strains had a resistance spectrum of CLI-FOX,and two ST5 strains had a re-sistance spectrum of OXA-FOX.Prediction of antibiotic resistance genes revealed that all ten Lm carried fosX,mprF,norB,sul,and Lmo0919 antibiotic resistance genes.According to cgMLST a-nalysis,strains of Lm clustered on five separate evolutionary branches,each containing one ST type.No allelic differences were identified among the three ST8 strains and the four ST5 strains of Lm,thus indicating that they belonged to the same clone and could sustainably exist in fresh edible mushrooms.Lm strains isolated from retail fresh edible mushrooms in Fujian Province pose a potential risk human infection,and the drug re-sistance status is concerning.In particular,a highly virulent multi-drug resistant strain found in flammulina velutipes may pose a potential threat to public health and should be alerted.

Objective To investigate the EMG characteristics and clinical application value of surface EMG in cervical muscle group of children with congenital muscular torticollis(CMT).Methods A retrospective analysis was performed on 478 children diagnosed as CMT from January 2018 to August 2022 in Rehabilitation Center of the Children's Hospital Affiliated to Chongqing Medical University.The torticollis side of the same case was included in observation group and the healthy side was included in control group.Surface EMG was used to record the electromyography root-mean-square values of bilateral sternocleidomastoid muscles,platysma muscles and upper trapezius muscles in the rest and different exercise states.The difference of root-mean-square values between the affected side and the healthy side muscle groups at rest and under different exercise states and the diagnostic value were compared.Spearman correlation analysis was used to evaluate the relationship between the severity of congenital muscular torticollis on the affected side and the root mean square value of each cervical muscle group.Results The root-mean-square value of sternocleidomastoid muscle on the affected side of CMT children was higher than that on the healthy side during relaxation and lower than that on the healthy side during contraction,and the differences were statistically significant(P<0.05),the abnormal root-mean-square value of the affected side in the resting position and in all motion state has higher diagnostic value.The root-mean-square value of platysma muscle on the affected side was higher than that on the healthy side when it was in the resting position and the reverse neck rotation relaxed state(P<0.05),and lower than that on the healthy side when it was in the same neck rotation contraction state(P<0.05),abnormal values detected in resting sitting position and elevation of head have higher value.Root-mean-square value of upper trapezius muscle on the affected side was higher than that on the healthy side in the relaxed state(P<0.05).The abnormal values in sitting position,turning neck and bending head have high diagnostic value.The severity of CMT was positively correlated with the root-mean-square values of sternocleidomastoid muscle,platysma muscle,and upper trapezius muscle(r was 0.721,0.612,0.655,P<0.001).Conclusion sEMG could be used as a good method for the clinical diagnosis and evaluation of congenital muscular torticollis in children.

The purpose of this study was to systematically analyze the antidepressant mechanism of Chaigui granules from the perspective of biological metabolic network by using integrated metabolomics and biological network analysis tools. The model of chronic unpredictable mild stress (CUMS) depression rat was established, and LC-MS-based plasma metabolomics was used to identify the key metabolites and analyze metabolic pathways underlying the antidepressant effects of Chaigui Granules. The key metabolites regulated by Chaigui granules was integrated with biological network analysis tools to further focus on the key metabolic pathways and explore the potential targets of the antidepressant effect of Chaigui granules. The results showed that there were significant differences in the plasma levels of 20 metabolites in the model group compared with the control group (P < 0.05), Chaigui granules significantly regulated 12 metabolites including docosatrienoic acid, 3-hydroxybutyric acid, 4-hydroxybenzaldehyde, chenodeoxycholic acid, cholic acid, L-glutamine, glycocholic acid, linoleyl carnitine, L-tyrosine, N-acetylvaline, palmitoylcarnitine, arachidonic acid. Further network analysis of the key metabolites regulated by Chaigui granules indicated that plasma arachidonic acid metabolism might be the core pathway for the antidepressant effect of Chaigui granules, with 10 proteins were potential targets for the antidepressant effect of Chaigui granules, including CYP2B6, CYP2E1, CYP2C9, CYP2C8, PLA2G6, PTGS2, ALOX15B, PTGS1, ALOX12 and ALOX5. The animal experimental operations involved in this paper was followed the regulations of the Animal Ethics Committee of Shanxi University and passed the animal experimental ethical review (Approval No. SXULL2020028).

OBJECTIVE: To examine whether the combination of Naoxintong Capsule with standard care could further reduce the recurrence of ischemic stroke without increasing the risk of severe bleeding. METHODS: A total of 23 Chinese medical centers participated in this trial. Adult patients with a history of ischemic stroke were randomly assigned in a 1:1 ratio using a block design to receive either Naoxintong Capsule (1.2 g orally, twice a day) or placebo in addition to standard care. The primary endpoint was recurrence of ischemic stroke within 2 years. Secondary outcomes included myocardial infarction, death due to recurrent ischemic stroke, and all-cause mortality. The safety of drugs was monitored. Results were analyzed using the intention-to-treat principle. RESULTS: A total of 2,200 patients were enrolled from March 2015 to March 2016, of whom 143 and 158 in the Naoxintong and placebo groups were lost to follow-up, respectively. Compared with the placebo group, the recurrence rate of ischemic stroke within 2 years was significantly lower in the Naoxintong group [6.5% vs. 9.5%, hazard ratio (HR): 0.665, 95% confidence interval (CI): 0.492-0.899, P=0.008]. The two groups showed no significant differences in the secondary outcomes and safety, including rates of severe hemorrhage, cerebral hemorrhage and subarachnoid hemorrhage (P>0.05). CONCLUSION The combination of Naoxintong Capsule with standard care reduced the 2-year stroke recurrence rate in patients with ischemic stroke without increasing the risk of severe hemorrhage in high-risk patients. (Trial registration No. NCT02334969).
Adult ; Humans ; Secondary Prevention/methods* ; Ischemic Stroke ; Stroke/prevention & control* ; Cerebral Hemorrhage/complications* ; Double-Blind Method ; Platelet Aggregation Inhibitors

Objective: To examine the prevalence and trend of tobacco and e-cigarettes uses and identify the influencing factors for smoking behavior in junior middle school students in Shanghai, and provide data support and scientific basis for the development of tobacco control intervention strategy in adolescents. Methods: Multi-stage stratified random sampling method was used to select junior middle school students in 8 districts and 10 districts in Shanghai in 2013 and in 2019 respectively. Information about tobacco and e-cigarettes uses in the students were collected by using self-administrated questionnaire. The prevalence of tobacco and e-cigarettes uses were calculated, the difference between two years was compared with χ² test. The influencing factors were identified by multivariate logistic regression analysis. Results: In 2019, the current smoking rate was 0.6% in junior middle school students in Shanghai, and the smoking attempt rate was 2.9%, both were lower than the levels in 2013 (0.7% and 6.9%). The current use rate of e-cigarettes was 0.6% in 2019,with no significant change compared with 2013 (0.6%). The proportion of the students who had heard of e-cigarettes in 2019 (78.4%) was higher than that in 2013 (47.2%). In 2019, the second-hand smoke (SHS) exposure rate at home, in both indoor and outdoor public places and on public transportations was 72.5%, which was slightly lower than the level in 2013 (73.0%), the differences were all significant (P<0.05). In 2019, the students seeing close friend smoking (OR=27.381, 95%CI: 12.037-62.287), seeing someone smoking in school (OR=2.477, 95%CI: 1.155-5.312), believing that SHS may not be harmful (OR=8.471, 95%CI: 1.464-49.005) had higher possibility of smoking. Being aged ≥15 years (compared with being aged ≤12 years, OR=8.688, 95%CI: 1.922-39.266), exposure to SHS in outdoor public place (OR=8.608, 95%CI: 1.048-70.692), close friend smoking (OR=8.115, 95%CI: 1.754-37.545) were positively associated with e-cigarettes use, and believing that smoking results in uncomfortable social contact [compared with believing that smoking results in comfortable social contact (OR=0.105,95%CI: 0.018-0.615)] were negatively associated with e-cigarettes use, the difference was significant (P<0.05). Conclusion: The prevalence of tobacco and e-cigarette uses in junior middle school students in Shanghai remained at a low level in recent years. The SHS exposure rate in junior middle school students is high. Smoking behavior of junior middle school students is closely related to personal attitude and awareness of tobacco, exposure to SHS, peer smoking and the situation of tobacco control in schools. Prevention and intervention should be carried out from multi-dimensions to effectively protect teenagers from tobacco hazards.
Adolescent ; China/epidemiology* ; Electronic Nicotine Delivery Systems ; Humans ; Prevalence ; Students ; Tobacco ; Tobacco Smoke Pollution

Consensus ; Critical Illness ; Humans ; Serum Albumin ; Serum Albumin, Human

Professor WU Bing-huang is one of the national famous TCM experts. He advocates painless acupuncture and uses acupuncture to regulate qi and needle knife to treat a variety of diseases about lumbar, with satisfying efficacy. This article introduced Professor WU's experience in treating lumbar disc herniation from the aspects of understanding etiology and pathogenesis, sequential treatment strategy, and clinical characteristic therapy.

Objective To observe effects of warming acupuncture therapy on expressions of IL-6 and SOCS3 in spinal cord in rats with neuropathic pain; To discuss its mechanism for treating neuropathic pain. Methods Experimental rats were randomly divided into: normal group, model group, warming acupuncture and IL-6 group, with 6 rats in each group. Sciatic nerve chronic constriction injury neuralgia model was established in the model group, without intervention. After modeling for 5 days in the warming acupuncture group, "Pishu" and "Shenshu" acupoints were chosen for warming acupuncture therapy for 10 times. After modeling for 5 days in the IL-6 group, IL-6 group was successfully intrathecally injected 3 times with recombinant IL-6. After finishing all experiments, the mechanical pain behavior was measured with electronic Frye fibers. The mRNA levels of IL-6 and SOCS3 and protein concentration of spinal Iba-1were detected with ELISA and RT-PCR analysis. Results Compared with model group, mechanical withdrawal thresholdsin the warm acupuncture group significantly increased, and the content of Iba-1 decreased significantly (P<0.01); The mRNA level of IL-6 decreased significantly (P<0.01), and the mRNA level of SOCS3 significantly increased (P<0.01). Conclusion Warming acupuncture therapy can reduce the pain response in rats with neuropathic pain through inhibiting spinal cord microglial activation, down-regulating the gene expression of lL-6 and up-regulating the gene expression of SOCS3.