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.

China/epidemiology* ; Cognition ; Cross-Sectional Studies

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 Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are major public health and social issues worldwide. The long-term follow-up of COVID-19 with pulmonary TB (PTB) survivors after discharge is unclear. This study aimed to comprehensively describe clinical outcomes, including sequela and recurrence at 3, 12, and 24 months after discharge, among COVID-19 with PTB survivors. Methods From January 22, 2020 to May 6, 2022, with a follow-up by August 26, 2022, a prospective, multicenter follow-up study was conducted on COVID-19 with PTB survivors after discharge in 13hospitals from four provinces in China. Clinical outcomes, including sequela, recurrence of COVID-19, and PTB survivors, were collected via telephone and face-to-face interviews at 3, 12, and 24 months after discharge. Results Thirty-two COVID-19 with PTB survivors were included. The median age was 52 (45, 59) years, and 23 (71.9％) were men. Among them, nearly two-thirds (62.5％) of the survivors were moderate, three (9.4％) were severe, and more than half (59.4％) had at least one comorbidity (PTB excluded). The proportion of COVID-19 survivors with at least one sequela symptom decreased from 40.6％ at 3 months to 15.8％ at 24 months, with anxiety having a higher proportion over a follow-up. Cough and amnesia recovered at the 12-month follow-up, while anxiety, fatigue, and trouble sleeping remained after 24 months. Additionally, one (3.1％) case presented two recurrences of PTB and no re-positive COVID-19 during the follow-up period. Conclusion The proportion of long symptoms in COVID-19 with PTB survivors decreased over time, while nearly one in six still experience persistent symptoms with a higher proportion of anxiety. The recurrence of PTB and the psychological support of COVID-19 with PTB after discharge require more attention.

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

Bone Neoplasms/complications* ; Humans ; Osteosarcoma/complications* ; Pulmonary Embolism/etiology*

Cerebral infarction is a clinical disease with corresponding neurological symptoms caused by cerebral ischemia and hypoxia caused by cerebral blood supply disorder. It is one of the most common cerebrovascular diseases and a serious threat to human health. The prevention and treatment of cerebral infarction has an important social significance. Angiogenesis is the key starting point for medical treatment of cerebral infarction, and signal transduction and transcriptional activators (STAT)/hypoxia inducing factor-1(HIF-1)/vascular endothelial growth factor (VEGF) pathway are important pathways to mediate angiogenesis after cerebral infarction. This paper took the angiogenesis as the starting point and the upstream molecules of STAT/HIF-1/VEGF signal pathway STAT3 and miRNA as the main study objects, and comprehensively discussed the results of chip sequencing, experimental research, traditional Chinese medicine (TCM) pathogenesis and TCM treatment. Based on the regulatory mode of "TF-miRNA" and the idea of "micro-whole", it is suggested that under the guidance of the basic theory of TCM, cubic compound prescriptions of TCM and its active components might activate the STAT/HIF-1/VEGF signal pathway through STAT3/miRNA feedback loop to promote angiogenesis after cerebral infarction, which puts forward a deep molecular mechanism and new direction for the treatment of cerebral infarction with TCM.