Breast cancer has become the malignant tumor with the highest incidence rate among women， seriously threatening the life and health of women all over the world. The pathogenic factors and development mechanisms of breast cancer are complex and diverse. The development of breast cells from ordinary hyperplasia to atypical hyperplasia， and from pre-cancerous lesions to cancerous lesions， is a long-term progressive process. Therefore， early screening and prevention of breast cancer is particularly important. Western medicine has a relatively mature treatment program for breast cancer， which is mainly based on surgery and systemic treatment， whereas the ensuing complications and adverse reactions often bring a heavy burden to patients. For the precancerous lesions of breast cancer， surgery is also the mainstay of treatment. In recent years， traditional Chinese medicine （TCM） has increasingly highlighted its advantages in the prevention and treatment of breast cancer. Increasing studies have shown that in the prevention and treatment of breast cancer and pre-cancerous lesions， TCM compound prescriptions， single herbs or herb pairs， and active components are able to regulate a variety of intracellular signaling pathways through multi-targets to inhibit the proliferation and invasion， promote the apoptosis and autophagy of tumor cells， and regulate the cell cycle and the immune microenvironment， thus exerting anti-tumor effects. At the same time， they can significantly attenuate the toxic side effects of radiotherapy and drug resistance of patients. However， the specific mechanisms of TCM in the prevention and treatment of breast cancer and precancerous lesions have not been fully clarified. The available studies are tanglesome regarding the TCM inhibition of tumor development through the regulation of classical signaling pathways such as phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， Wnt/β-catenin， and Notch， which still need to be verified by a large number of clinical and experimental studies. Therefore， this paper reviews the research progress in the prevention and treatment of breast cancer and precancerous lesions by TCM through interfering with the relevant signaling pathways in recent years， aiming to summarize the possible mechanisms of TCM in the prevention and treatment of breast cancer and provide references for subsequent studies.

Through analyzing the every textual research literature on the origin of the location method of ashi points, it is pointed out that the location method of ashi points has been generalized. It is known through systematic research and theoretical identification that this method refers to the simple way to locate the points, originated from the folk, and it is widely used to find the sites for pain relief when compared to the official education of meridians and acupoints, as well as treatment. At the time with the shortage of medical services and supplies, the poor people had no alternative, which results in a certain limitation. Modern acupuncture practitioners must associate ashi points with the acupoints of fourteen meridians and the extraordinary points in clinical practice, and deepen the exploration with modern medical knowledge and technology adopted.
Humans ; Acupuncture Points ; Acupuncture Therapy/methods* ; Meridians ; History, Ancient ; Medicine in Literature ; China

Consensus method is not only a common technical approach to the formulation of the acupuncture-moxibustion guidelines, but also an important way to form the recommended treatment protocols of acupuncture-moxibustion guidelines. Based on the theory of implementation science, the paper explores the influencing factors of consensus-reaching to acupuncture-moxibustion guidelines, and puts forward methodological suggestions on the consensus method performed in the formulation of acupuncture-moxibustion guidelines, so as to advance the rational application of consensus method and enhance the scientificity and transparency of acupuncture-moxibustion guidelines.
Moxibustion/standards* ; Humans ; Acupuncture Therapy/standards* ; Consensus ; Practice Guidelines as Topic

From the perspective of evidence integration and utilization in guidelines, based on the carrier variety, medical experience is composed of the literature on the practical experience of medical scholars recorded in the ancient and modern time, and the individual opinions in the expert consensus. These two types of carrier for medical experience play the different roles in the key steps during formulating the acupuncture-moxibustion guidelines. Three values are summarized, named being conductive to centering the key clinical questions and strongly representing these questions; being used as a basis to judge the clinical applicability of the recommended regimens; and facilitating the recommendation.
Humans ; Moxibustion/standards* ; Acupuncture Therapy/standards* ; Practice Guidelines as Topic

Acupuncture-moxibustion technical specifications are a crucial component of the acupuncture-moxibustion standardization system. This study reviews the current development status of acupuncture-moxibustion technical specifications in China, and analyzes their classifications and characteristics. It is found that the scope and classification of acupuncture technical specifications remain unclear in academic circles, and the development process faces numerous difficulties and challenges. Therefore, this study proposes the need for a systematic approach to the planning and management of acupuncture technical specifications based on a clear definition of acupuncture techniques and categories. Additionally, it suggests conducting methodological research on the development of acupuncture technical specifications and promoting the rational application of the consensus method in this process.
China ; Moxibustion/methods* ; Acupuncture Therapy/instrumentation* ; Humans ; Acupuncture/standards*

Objective:To explore the clinical characteristics and genetic variants in three children with late-onset Multiple acyl-Coenzyme A dehydrogenase deficiency (MADD type Ⅲ).Methods:Clinical data of three children diagnosed with late-onset MADD at the Children′s Hospital Affiliated to Zhengzhou University between March 2020 and March 2022 were retrospectively analyzed. All children were subjected to whole exome sequencing (WES), and candidate variants were verified by Sanger sequencing. All children had received improved metabolic therapy and followed up for 1 ~ 3 years.Results:The children had included 2 males and 1 female, and aged from 2 months to 11 years and 7 months. Child 1 had intermittent vomiting, child 2 had weakness in lower limbs, while child 3 had no symptom except abnormal neonatal screening. Tandem mass spectrometry of the three children showed elevation of multiple acylcarnitines with short, medium and long chains. Children 1 and 2 showed increased glutaric acid and multiple dicarboxylic acids by urine Gas chromatography-mass spectrometry (GC-MS) analysis. All children were found to harbor compound heterozygous variants of the ETFDH gene, including a paternal c. 1211T>C (p.M404T) and a maternal c. 488-22T>G variant in child 1, a paternal c. 1717C>T (p.Q573X) and a maternal c. 250G>A (p.A84T) variant in child 2, and a paternal c. 1285+ 1G>A and maternal c. 629A>G (p.S210N) variant in child 3. As for the treatment, high-dose vitamin B2, levocarnitine and coenzyme Q 10 were given to improve the metabolism, in addition with a low fat, hypoproteinic and high carbohydrate diet. All children showed a stable condition with normal growth and development during the follow-up. Conclusion:The compound heterozygous variants of the ETFDH gene probably underlay the muscle weakness, remittent vomiting, elevated short, medium, and long chain acylcarnitine, as well as elevated glutaric acid and various dicarboxylic acids in the three children with type Ⅲ MADD.

Objective:To explore the differences in bacterial community structure between proximal colon cancer (PC), distal colon cancer (DC), and rectal cancer (RC), and the values of featured microbiota in differentiating PC with tumor markers.Methods:This case-control study enrolled 85 newly diagnosed colorectal cancer patients, including 22 PC, 15 DC and 48 RC patients, and 8 colorectal adenoma patients from May 2019 to July 2022 at the Department of General Surgery, Anyang Oncology Hospital. The blood and fecal samples were collected before surgery and then subjected to biochemical tests for tumor markers and 16S rDNA tests, respectively. SPSS (27.0.1) was applied to perform the t-test, one-way ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, and Chi-Squared Test. Also, the receiver operating characteristic curve (ROC) was plotted on tumor markers and/or f_Bacteroidaceae with SPSS software .Results:All groups had significant differences in the CA125 ( F=3.543, P<0.05), CA72-4 ( F=3.596, P<0.05), and serum tumor-associated materials (TAM) levels ( F=5.787, P<0.01). In PC group, the levels of CA125 [PC vs RC, (36.84±6.30) kU/L vs (12.73±4.21) kU/L, P<0.01] and CA72-4 [PC vs RC, (45.56±10.86) kU/L vs (3.30±7.63) kU/L, P<0.01] were significantly higher than that of the RC group, while the level of TAM was remarkably elevated in PC group than in RC group [PC vs RC, (124.84±5.19) U/ml vs (102.44±3.63) U/ml, P<0.001] and CRA group [PC vs CRA, (124.84±5.19) U/ml vs (95.39±8.42) U/ml, P<0.01]. The LEfSe analysis showed that the featured microbiota in the PC group included f_Bacteroidaceae, f_Neisseriaceae, f_Clostridiaceae_1, f_Spirochaetaceae, and so on. The largest area under the ROC belonged to the combination of TAM and f_Bacteroidaceae, which reached 0.845 (95% CI 0.747-0.944), with sensitivity being 0.857 and specificity being 0.815. Conclusions:There is heterogeneity in gut microbiota composition among PC, DC, RC, and CRA. The combination of gut microbiota and tumor biomarkers demonstrated good differentiating effects in proximal colon cancers.

Objective　To analyze the antibiotic resistance of clinical isolates from Western China in 2021, providing a reference for guiding the rational use of antibiotics in clinical practices and controlling nosocomial infections. 　　　　Methods　Bacterial samples were collected from nine hospitals in 5 autonomous regions and provinces in Northwest China (690 strains in Ningxia, 141 strains in Gansu, 133 strains in Xinjiang, 179 strains in Qinghai, and 151 strains in Shaanxi) in 2021. MALDI-TOF mass spectrometry was used to confirm bacterial identification, and bacterial susceptibility testing was performed using automated susceptibility testing systems. The results of the susceptibility tests were interpreted according to the 2021 CLSI standards. Results　A total of 1 294 clinical strains (non-duplicates) were collected, primarily sourced from sputum specimens 312 strains (24.11%), urine specimens 235 strains (18.16%), pus specimens 147 strains (11.36%), and blood specimens 128 strains (9.89%). Among the 1 294 pathogenic strains, Gram-negative bacteria accounted for 69.47%, whereas Gram-positive bacteria accounted for 30.53%. From the Gram-negative organisms, the most common Enterobacterales strains included E.coli 258 strains (19.94%), K.pneumoniae 166 strains (12.83%), E.cloacae 39 strains (3.01%), and K.oxytoca 36 strains (2.78%). Non-fermentative Gram-negative bacilli constituted 20.63% of all isolates, mainly including P.aeruginosa 129 strains (9.97%) and A.baumannii 87 strains (6.72%). Among Gram-positive bacteria, S.aureus 267 strains (20.63%), E. faecium 68 strains (5.26%), and E.faecalis 48 strains (3.71%) were predominant. Enterobacteriaceae remained highly sensitive to carbapenem antibiotics; however, K.oxytoca had a resistance rate exceeding 15%. P.aeruginosa showed resistance rates of 29.5% and 14% to imipenem and meropenem, respectively; A.baumannii showed resistance rates of 63.2% to both drugs. The detection rate of MRSA was 36.7%, with MRSA showing significantly higher resistance rates than MSSA to most tested drugs. No S.aureus isolates were found resistant to vancomycin, teicoplanin, or linezolid. E.faecium strains demonstrated much higher resistance rates to most of the tested drugs compared to E.faecalis, with a few vancomycin-resistant strains found in both. Conclusions　Bacterial resistance to commonly used antibiotics was still severe in Western China. Therefore, medical institutions should continue to enhance the monitoring of bacterial resistance, standardize the management and use of antibiotics, and reduce the transmission and spread of resistant bacteria within hospitals.

OBJECTIVE: To develop the clinical questions and outcomes of Clinical Practice Guideline of Fire Needling Therapy for Herpes Zosters based on Norms of Formulation and Evaluation for the Clinical Guideline on Acupuncture and Moxibustion released by World Federation of Acupuncture and Moxibustion Societies. METHODS: Combined the investigation with expert consultation and consensus method, and taken clinicians (members) of Chinese Association of Acupuncture and Moxibustion as the subjects, the clinical questions concerned were collected and the two-round consultation was conducted among expert group by letter. In the first round questionnaire, using the voting method, the relevant clinical questions in intervention measures were collected; and in the second round, with the Delphi method adopted, the importance of clinical questions and outcomes in the investigation was scored. RESULTS: A total of 200 structured clinical questions proposed by 153 clinicians and the clinical experience with 13 kinds of combined therapies involved and fire needling as the key measure were collected. The authority coefficient (Cr) of the Delphi questionnaire was >0.70, and the coefficient of variation for the importance scores of alternative clinical questions and outcomes was 0.06-0.26 and 0.12-0.47, respectively. The top 10 clinical questions and 12 outcomes (6 outcomes referred to the patients either in the acute stage or the post-neuralgia stage) were included, with the importance score of clinical questions>4, the importance score of outcomes>6, and the coefficient of variation ≤0.25. CONCLUSION The clinical questions and outcomes of Clinical Practice Guideline of Fire Needling Therapy for Herpes Zosters are formulated, which provides the research basis for the recommendation development of the guideline.
Acupuncture Therapy/methods* ; Treatment Outcome ; Practice Guidelines as Topic ; Herpes Zoster/therapy* ; Humans ; Delphi Technique

Objective:To evaluate the efficacy and safety of intravitreal ranibizumab combined with laser (IVR+ Laser) and the intravitreal ranibizumab (IVR) monotherapy for the treatment of diabetic macular edema (DME).Methods:A meta-analysis was conducted on randomized controlled trial (RCT) literature related to IVR+ Laser therapy and IVR alone for DME.Databases including Cochrane Library, PubMed, EMbase, Web of Science, SinoMed, CNKI, VIP and WanFang Data were searched from their inception to April 2022.Literature screening, data extraction, quality evaluation and cross-checking were conducted independently by two researchers according to inclusion and exclusion criteria.Then a meta-analysis was conducted using RevMan 5.4.1 software.The two therapies were compared in terms of best corrected visual acuity (BCVA), central macular thickness (CMT), mean number of injections and adverse events.Results:Twelve RCTs involving 1 695 eyes were included in the study.Meta-analysis showed that at the end of follow-up, IVR+ Laser demonstrated better improvement in BCVA and CMT than IVR alone, and there were significant differences in the changes in BCVA and CMT between the two groups (weighted mean difference[WMD]=-0.66, 95% confidence interval[ CI]: -1.11--0.21, P<0.01; WMD=-5.05, 95% CI: -9.21--0.89, P=0.02).IVR+ Laser required significantly fewer injections than IVR alone (WMD=-1.16, 95% CI: -2.07--0.25, P=0.01).There were no significant differences in the adverse events incidence between the two therapies (all at P>0.05). Conclusions:The safety of IVR+ Laser is comparable to IVR alone, and it requires fewer injections for the treatment of DME.