Based on the pathogenesis of erectile dysfunction (ED) from the meridian-zangfu relationship and the "brain-heart-kidney-essence chamber" axis, it proposes that dysfunction of the "brain-heart-kidney-essence chamber" axis is closely related to the occurrence of ED. Among these, brain-heart disharmony is the key pathogenic factor, kidney deficiency and essence depletion constitute an important basis, and essence chamber stasis is a critical mechanism. The treatment approach emphasizes harmonizing the brain and heart, regulating the mind, tonifying the kidney and replenishing qi, unblocking qi and blood to harmonize the essence chamber. The primary acupoints include Baihui (GV20)-Neiguan (PC6)-Shenmen (HT7), Taixi (KI3)-Guanyuan (CV4)-Sanyinjiao (SP6), and Zhongji (CV3)-Dahe (KI12)-Gongsun (SP4), with additional acupoints selected based on syndrome differentiation. This approach aims to restore the clarity of the brain and heart, replenish kidney qi, and unblock the essence chamber, thereby facilitating the restoration of normal functions of the brain, heart, kidney, and essence chamber, and alleviating ED symptoms and improving overall clinical efficacy.
Humans ; Male ; Meridians ; Erectile Dysfunction/physiopathology* ; Kidney/physiopathology* ; Brain/physiopathology* ; Acupuncture Therapy ; Acupuncture Points ; Heart/physiopathology*

Objective With the development of manned space missions to the moon and space exploration,extravehicular activities become more frequent and extravehicular mission become more complex,which puts forward higher requirements for the extravehicular spacesuit.In order to ensure the ergonomics of spacesuit,the flexible joints are usually adopted in the limbs of spacesuit.The structural design of large angle of movement and low resistance joints is the basic for ensuring the ergonomics of spacesuit.Methods This study established a method of spacesuit joint structure to analysis the motion characteristic of typical joints.Firstly,the structure and activity characteristics of the spacesuit and lunar space suits were comprehensively analyzed,and the activity characteristics of different typical structure are qualitatively analyzed based on existing empirical method.Then,the dynamics of typical structure was analyzed by finite element model.By studying the change trend of motion of spacesuit joint with motion angle,and the motion characteristic curve was obtained.Finally,the model was studied according to different structural size parameters.The influence of structural parameters on the motion characteristics was analyzed,and the curves was obtained to provide a basis for design of spacesuit motion joint structure.Results Through the above analysis,the motion characteristics of different typical structure are obtained qualitatively.And the influence of different structure parameters on the motion characteristics was analyzed.This establishes the method basis for structure design.Conclusion The study was carried out a method based on finite element model for joint motion analysis,which is suitable for the design of typical joint structure of spacesuit.

Objective Maintain a sable differential pressure inside the Underwater Positive Pressure Protective Suit(UPPPS)to ensure normal breathing and safe underwater operations for the diver.Methods Utilize a pressure regulator as the UPPPS's pressure control valve to automatically maintain the differential pressure inside the suit.Results By establishing a physical model,the relationship between the steady-state differential pressure with the ventilation flow rate and the ambient pressure was obtained.(1)The ventilation flow rate is positively correlated with the steady-state differential pressure,the higher the ventilation flow rate,the greater the steady-state differential pressure.(2)At the same ventilation flow rate,the larger the ambient pressure is,the smaller the steady-state differential pressure is.Underwater unmanned and manned experiments using the UWT suit were conducted.The expermental results are in agreement with the theoretical analysis.Conclusion The performance of pressure regulator has been verified by the underwater experiments,it effectively stabilizes the differential pressure within the UPPPS.

Objective: To study the relationship between sugar sweetened beverages consumption characteristics and insomnia of college students in Yunnan Province, so as to provide evidence for sleep quality improvement of college students. Methods: A cluster random sampling method was used to select 2 515 college students from two universities (Kunming University and Dali Nursing Vocational College) in Kunming and Dali in Yunnan Province for a longitudinal study, including baseline survey (T1, November 2021) and three follow up surveys (T2: June 2022, T3: November 2022, T4: June 2023). Sugar sweetened beverages consumption of college students was collected by Semi quantitative Food Frequency Questionnaire and insomnia was assessed by Insomnia Severity Index Scale. Sugarsweetened beverages consumption was analyzed by Kruskal-Wallis test. The Mann-Whiter U test and Kruskal-Wallis test were used to compare the detection rate of insomnia in college students with different population characteristics, and the generalized estimating equations model was established to analyze the association between sugar sweetened beverages consumption and insomnia. Results: The reported rate of insomnia among college students from T1 to T4 was 21.2%, 23.6%, 30.5 % and 36.0%, respectively. The median of sugar sweetened beverages consumption per week was 5 (1,9) bottles per person, and there were significant differences in sugar sweetened beverages (carbonated beverages, fruit beverages, tea beverages, milk beverages, energy beverages) consumption among college students with different insomnia status ( χ 2=42.91, 23.67, 29.98, 61.70, 30.82, P <0.01). The analysis of the generalized estimating equation model revealed that the consumption of carbonated beverages ( β= 0.04, 95%CI =0.00-0.08) and the consumption of milk beverages among college students ( β=0.04, 95%CI =0.00-0.09) were correlated with insomnia ( P <0.05). The stratified analysis indicated that consumption of carbonated beverages by female college students was associated with insomnia [ β(95%CI )=0.06(0.01-0.11)]; consumption of milk beverages among college students from middle income family was associated with insomnia [ β (95% CI )=0.05(0.00-0.10)], and consumption of carbonated beverages and fruit beverages from college students with high household economic status were both associated with insomnia [ β (95% CI )=0.35(0.23-0.46), 0.12(0.00-0.24)] ( P <0.05). Conclusion Sugar sweetened beverages, especially carbonated beverages, are associated with insomnia among college students in Yunnan Province.

Objective:To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia.Methods:From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method.Results:Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% vs. 10.64%, χ2 value 12.304, P<0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% vs. 10.65%, χ2 value 6.296, P=0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% vs. 5.50%, χ2 value 10.497, P<0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, χ2 value 70.054, P<0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated ( R=0.7671, P<0.001). Conclusion:Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.

Objective:To clarify the characteristics of dynamic change of pelvic incidence (PI) in patients with adult spinal deformity in a longitudinal study, to explore the relationship of PI change and other sagittal parameters, and to investigate the role of PI change in the progression of global sagittal imbalance.Methods:The patients with adult spinal deformity (ASD) who were followed up at our clinic from December 2014 to December 2022 were retrospectively reviewed. All patients were older than 50 years and had a minimum of 2-year follow-up. Full-spine frontal and lateral X-ray films were taken at pre-operation, post-operation, and last follow-up. Radiographic parameters were measured, including Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), regional kyphosis (RK), sagittal vertical axis (SVA), T1 pelvic angle (TPA), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). Intraclass correlation coefficient (ICC) was used to evaluate intra- and inter-observers' reliability, of which ICC>0.75 indicated excellent; 0.5< ICC≤0.75 indicated good; ICC≤0.5 indicated poor. Independent t-test, paired t-test and Pearson coefficient correlation were performed for statistical analysis. Results:A total of 30 patients were included in this study with a mean age of 61.93±6.20 years (range 54-72 years). The mean follow-up duration was 37.47±8.57 months (range 25-46 months). ICC test showed an excellent intra- and inter-observer reliability of PI in ASD patients from baseline to last follow-up (inter-observer ICC: 0.917 at baseline and 0.923 at last follow-up; intra-observer ICC: 0.913 at baseline and 0.915 at last follow-up). From first-visit to the last follow-up, PI significantly increased from 44.47°±5.96° to 52.07°±7.42° ( t=13.375, P<0001), PT (22.33°±5.77° vs. 28.07°±8.16°, t=4.268, P=0.001), SVA (40.03±13.34 mm vs. 64.37±27.06 mm, t=5.303, P<0.001), TPA (16.20°±5.02° vs. 27.13°±6.45°, t=13.742, P<0.001) and PI-LL (15.07°±13.92° vs. 29.67°±13.54°, t=10.802, P<0.001) were significantly increased while LL was significantly decreased (29.40°±15.53° vs. 22.40°±16.47°, t=4.814, P<0.001) at last follow-up. Pearson correlation analysis showed that the change of PT ( r=0.659, P=0.008), the change of TPA ( r=0.629, P=0.012), pre-operation PI ( r=0.560, P=0.030), and the last follow-up PI ( r=0.746, P=0.001) were significantly correlated with last follow-up PI. Conclusion:This study suggested that PI could significantly increase during follow-up in ASD patients. The dynamic change of PI may be correlated with the deterioration of sagittal imbalance.

Objective:To investigate the correlation between pelvic compensatory capacity and proximal junctional kyphosis (PJK) in patients with adult spinal deformity undergoing spino-pelvic fixation utilizing second sacral alar iliac (S 2AI). Methods:A cohort of 55 patients diagnosed with adult spinal deformity and treated with spino-pelvic fixation utilizing S 2AI between January 2016 and January 2019 was included. The pelvic tilt to pelvic incidence ratio (PT to PI ratio, PTr) was used to categorize patients into high PTr group (PT/PI>0.4) and low PTr group (PT/PI<0.4). Subsequently, patients were further classified into PJK group and non-PJK group based on the occurrence of PJK during the last follow-up. Radiographic parameters such as Cobb angle, coronal balance distance (CBD), global kyphosis (GK), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), proximal junctional angle (PJA), T 1 pelvic angle (T 1PA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and PI-LL were measured preoperatively, postoperatively, and at final follow-up. The chi-square test was employed to compare the incidence of PJK between the high PTr and low PTr groups at the last follow-up. Additionally, multivariable logistic regression analysis was conducted to identify independent risk factors for PJK. Results:The incidence of PJK was significantly higher in the high PTr group compared to the low PTr group [high PTr group (38%) vs. low PTr group (8%), P<0.05]. Multivariable logistic regression analysis identified pre-operative PTr [ OR=3.274, 95% CI(1.100, 36.973), P=0.035], post-operative PTr [ OR=5.700, 95% CI(1.271, 65.272), P=0.029], and PJA at the last follow-up [ OR=1.274, 95% CI(0.998, 1.624), P=0.009] as independent risk factors for PJK. Conclusion:Patients with higher PTr exhibited poor pelvic compensatory ability, struggled to maintain optimal sagittal balance post-operation, and were at increased risk of developing PJK during follow-up.

Objective:To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia.Methods:From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method.Results:Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% vs. 10.64%, χ2 value 12.304, P<0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% vs. 10.65%, χ2 value 6.296, P=0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% vs. 5.50%, χ2 value 10.497, P<0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, χ2 value 70.054, P<0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated ( R=0.7671, P<0.001). Conclusion:Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.

Hepatocellular carcinoma is a kind of cancer with a strong invasion, a high incidence rate and mortality, and a poor prognosis. At the time of diagnosis, most patients are already in the advanced stages of a tumor and have lost the chance for radical surgical treatment. Advanced hepatocellular carcinoma treatment has a gradual transition from systemic chemotherapy to targeted therapy, immunotherapy, and combination therapy, especially immune checkpoint inhibitor-based immunotherapy combination therapy, such as combination with bevacizumab monoclonal antibodies and other drugs, or combination with TACE, HAIC, radiotherapy, ablation, and other treatment methods. Combination therapy has significant synergistic effects and thus has already become a future treatment trend for hepatocellular carcinoma. An immunotherapy-based combination therapy plan will run through the whole process of systemic therapy, which is expected to bring better survival benefits to patients with hepatocellular carcinoma. This article reviews the latest research progress in aspects of the first-line treatment of advanced hepatocellular carcinoma.

Objective:To investigate the value of neutrophil-to-lymphocyte ratio (NLR) in predicting the prognosis of patients with severe heat stroke.Methods:A retrospective analysis was performed on patients with severe heat stroke hospitalized in the ICU of Changzhou No. 2 People's Hospital from June 2013 to September 2019. The patients were divided into the survival group and death group according to their 30-day survival. The basic data of the patients were recorded. Blood routine, liver and kidney function parameters, troponin, brain natriuretic peptide, myocardial enzyme spectrum, blood coagulation routine, and acute physiology and chronic health evaluation (APACHE)Ⅱ were analyzed within 24 h after admission. Multivariate COX regression analysis was used to screen the risk factors of 30-day death. Spearman correlation test was used to analyze the correlation between NLR and APACHEII score. Receiver operating characteristic (ROC) curves were drawn to assess the predictive value of NLR for the 30-day death in patients with severe heat stroke. Kaplan-Meier survival curve was used to analyze 30-day cumulative survival of high-risk patients.Results:A total of 115 patients with severe heat stroke were included in this study, and they were divided into the survival group ( n=92) and the death group ( n=23) according to the prognosis. NLR in the death group was significantly higher than that in the survival group ( P<0.05). Multivariate COX regression analysis showed that NLR was an independent risk factor for death after adjusting confounders ( HR=1.091, 95% CI: 1.049-1.136, P<0.001). Spearman correlation test showed a correlation between NLR and APACHEII score ( r=0.655, P<0.001). ROC curve analysis showed that NLR had the greatest predictive value for 30-day death, with an area under ROC curve (AUC) of 0.787, a sensitivity of 82.6%, a specificity of 67.4%, and the cut-off value of 7.35. Kaplan-Meier survival analysis curve shows that patients in the below NLR cut-off value group had a significantly higher 30-day survival rate than those in the above NLR cut-off value group ( P<0.001). Conclusions:The increased NLR is a high risk factor for death in patients with severe heat stroke, and helps predict the prognosis of patients with severe heat stroke.