ObjectiveTo construct a risk prediction model for frequent acute exacerbations of chronic obstructive pulmonary disease （COPD） under disease-syndrome combination， thus providing decision support for precise clinical intervention. MethodsA total of 2 029 patients with acute exacerbations of COPD admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2020 to August 2024 were retrospectively included. These patients were classified into groups of frequent acute exacerbations （≥2 times/year） and infrequent acute exacerbations （<2 times/year） according to the hospitalization times per year. Risk factors were screened by LASSO regression combined with logistic regression， and a nomogram model was constructed. The model performance was assessed based on the area under the curve （AUC）， calibration curves， and decision curve analysis （DCA）. ResultsThe differences in baseline characteristics between the frequent acute exacerbations group （1 196 cases） and infrequent acute exacerbations group （833 cases） were not statistically significant. LASSO regression combined with multivariate logistic regression screened the following independent risk factors： body mass index （BMI）， hospitalization days， number of smoking years， place of residence， use of noninvasive ventilators， oxygen-demanding therapy， liver cirrhosis， use of systemic glucocorticosteroids， and traditional Chinese medicine syndrome （phlegm and stasis obstructing the lung）. The nomogram model showed good discrimination and calibration in both the training set （AUC=0.748） and validation set （AUC=0.774）. ConclusionThe risk prediction model for frequent acute exacerbations of COPD， integrating traditional Chinese medicine syndrome， constructed in this study has high accuracy. It can provide a scientific basis for early clinical identification of high-risk patients and individualized intervention.

Through collecting the existing clinical evidences on acupuncture and moxibustion for urticaria, the distribution of evidence in this field was mapped. A systematic search of Chinese and English literature was conducted in CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library for treatment of urticaria with acupuncture and moxibustion, published up to December 31, 2023 since inception of each database. The research status in this field was summarized using an evidence mapping approach, and methodological quality was assessed. A total of 323 randomized controlled trials (RCTs) and 22 systematic reviews were included. The number of studies on acupuncture and moxibustion for urticaria has been increasing, with a significant rise in recent years. In most RCTs, the study scale was small, and the subjects focused on chronic spontaneous urticaria in adolescents and middle-aged adults, aged 14 to 60 years. Regarding the intervention measures, the single therapy of acupuncture and moxibustion was predominant such as acupoint injection, acupoint embedding thread, and filiform needling. In acupuncture with filiform needles, the commonly used acupoints were Quchi (LI11), Xuehai (SP10), Sanyinjiao (SP6), Zusanli (ST36) and Hegu (LI4). The main outcome measures referred to effectiveness rate, score of disease severity, recurrence rate, laboratory indexes, and score of quality of life; and the short-term effect was evaluated specifically. The overall methodological quality of the included studies was relatively low. It is suggested that the future research should focus on large-scale, multi-center, high-quality clinical trials, optimize the protocols for acupuncture and moxibustion intervention, standardize the outcomes, and draw the attention to the evaluation of long-term efficacy, so as to provide clinical evidences of high certainty for urticaria treated with acupuncture and moxibustion.
Humans ; Moxibustion ; Acupuncture Therapy ; Urticaria/therapy* ; Acupuncture Points ; Randomized Controlled Trials as Topic ; Adolescent ; Adult ; Young Adult

OBJECTIVE: To reveal the gap between the evidence of systematic reviews (SRs) and clinical concerns by systematically summarizing the evidence on acupuncture and moxibustion for frozen shoulder and investigating the concerns and needs of clinicians in treatment with acupuncture and moxibustion for this disease. METHODS: The articles of SR and Meta-analysis on acupuncture and moxibustion for frozen shoulder were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library, starting from the inception of each database up to December 31st, 2022. Two researchers screened the articles and extracted data independently. Using AMSTAR-2, the methodological quality of the included studies was evaluated. Based on systematic reviews and expert discussion, a questionnaire on clinical concerns of acupuncture and moxibustion for frozen shoulder was developed and distributed to clinicians. The discrepancies between the evidence and clinical concerns were compared from 5 dimensions, including population, interventions, control measures, outcome indicators and review time points. RESULTS: The evidence gaps existed between SRs and clinical concerns. In the existing studies, the needs of personalized treatment were not fully considered in terms of different syndromes/patterns of frozen shoulder and stages of illness, the outcome indicators were not employed properly, the time for outcome measurement was vague, the control groups were set up outside of standardization, and the methodological quality was lower. CONCLUSION It is suggested that future studies should improve the quality of methodology, lay more consideration to different patient groups, optimize outcome indicators and standardize the setting of control groups, so as to better meet the needs of patients and achieve the best match between evidence and clinicians' needs.
Humans ; Acupuncture Therapy ; Bursitis/therapy* ; Evidence Gaps ; Moxibustion ; Systematic Reviews as Topic ; Meta-Analysis as Topic

Objective:To seek any correlation between hypoesthesia and sensory disturbance to motor function among stroke survivors.Methods:One hundred and two stroke survivors with hyperalgesia were treated with sinusoidal alternating current at 2000Hz, 250Hz or 5Hz to stimulate the fingers and toes on their healthy and hemiplegic sides. Current perception thresholds (CPTs) and pain tolerance thresholds (PTTs) were recorded. The correlation between the degree of sensory disturbance in the hemiplegic limb and muscle strength was explored.Results:①The degree of sensory impairment in those who had suffered a cerebral hemorrhage was significantly greater than among those with cerebral infarction, without significant difference in pain tolerance between different genders and affected sides. ②All of the patients with sensory impairment showed significantly higher CPT and PTT values at the different frequencies, with a positive correlation between them. ③The CPT values of the affected hand and foot at the different frequencies were negatively correlated with muscle strength on the affected side.Conclusions:Both CPT and PTT can usefully represent the degree of sensory disturbance after a stroke. The CPT values of patients with different types of stroke are significantly different, and the degree of sensory disturbance is correlated with the muscle strength of the affected side. Therefore, it is helpful for prognostic judgment and individualized rehabilitation treatment planning by quantifying the degree of sensory disturbance.

High myopia is a refractive abnormality characterized by excessive elongation of the eye axis.The sclera,as an important part of the eye axis regulation,plays a key role in the occurrence and development of high myopia.In this pa-per,based on the domestic and international articles,the pathological changes and related regulatory molecules of the scle-ra in high myopia were systematically summarized from the features of scleral lesions in high myopia and the gene regula-tion and signaling pathways affecting the ultrastructure and mechanical properties of the sclera,thus providing a theoretical basis for the study of the pathological mechanism of high myopia.

Objective:To compare the efficacy of linaclotide and procalcitide in the treatment of adult constipation IBS-C.Methods:A retrospective study was conducted on 80 IBS-C patients admitted from May 2021 to May 2024.All patients were treated with novel secretagogues,and were divided into four groups according to the different treatment methods:linarotinib group and Pucanapide group,with 40 patients in each group.The clinical efficacy of oral administration of 290 μg of Nallotide capsules and 3 mg of Pucanapeptide in the Linalotide group and Pucanapeptide group was compared after one month of continuous treatment.The scores of IBS-C symptoms related to stool frequency,stool characteristics,upper abdominal pain,early satiety,and bloating were evaluated before and Post-treatment.Enzyme linked immunosorbent assay(ELISA)was used to detect the levels of vasoactive intestinal peptide(VIP),substance P(SP),5-hydroxytryptamine(5-HT),motilin,and gastrin IBS-C related serum markers in feces.The 16s rDNA fluorescence quantitative polymerase chain reaction method was used to detect Escherichia coli and lactate in feces.Compare the incidence of adverse reactions between the two groups based on the levels of Bacillus and Bifidobacterium.Results:There was no difference in the total effective rate between linagliptin group and Pucanotide group(P＞0.05);Post-treatment,the fecal frequency scores of the linaclotide group and the procalcitonin group were higher than pretherapy,while the fecal characteristics,upper abdominal pain,early satiety,and fullness scores were lower than pretherapy(P＜0.05).There was no difference in the fecal frequency,fecal characteristics,early satiety,and fullness scores between the linaclotide group and the procalcitonin group(P＞0.05),and the upper abdominal pain score of the linaclotide group was lower than that of the procalcitonin group(P＜0.05);Post-treatment,VIP,SP,5-HT,motilin and gastrin levels in linagliptin group and Pucanotide group were all lower than that pretherapy(P＜0.05),and there was no significant difference between linagliptin group and Pucanotide group(P＞0.05);Post-treatment,the levels of Escherichia coli in the linaclotide group and the procaine group were lower than pretherapy,while the numbers of Lactobacilli and Bifidobacteria were higher than pretherapy(P＜0.05).There was no difference between the linaclotide group and the procaine group(P＞0.05);There was no difference in the incidence of headache,bloating/abdominal pain between the linaclotide group and the procaine group(P＞0.05),and the incidence of diarrhea in the procaine group was lower than that in the linaclotide group(P＜0.05).Conclusion:Linalotide and Pucanatide have similar therapeutic effects in treating adult IBS-C,both of which can improve patients' clinical symptoms,serum biomarker levels,and intestinal microbiota structure.However,Linalotide has a better effect on improving abdominal pain,while Pucanatide can reduce the risk of diarrhea.Therefore,the clinical application of different new secretagogue drugs can be determined based on individualized symptoms and diarrhea risk of patients.

Over 40%of critically ill patients will develop coagulopathy.Once critically ill patients are complicated with coagulopathy,the incidence of bleeding and mortality can increase by more than 4 times.Early identification of coagulopathy and accurate evaluation of coagulation function are essential for correcting coagulopathy as soon as possible.Therefore,Chinese Society of Thrombosis,Hemostasis and Critical Care,Chinese Medicine Education Association,together with Chinese People's Liberation Army Professional Committee of Critical Care Medicine updated the"Chinese expert consensus on standardized assessment of severe coagulopathy(2025 Edition)"on the basis of the"Consensus of Chinese experts on standardized evaluation of coagulation dysfunction in severe patients"formulated in 2022.This consensus includes four parts:classification and typing,etiology and mechanism,assessment methods,and diagnostic criteria of severe coagulopathy,with a total of 14 recommendations,aiming to provide corresponding guidance for clinical practice.

Objective:To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Weinan City, Shaanxi Province, and study the predictive effect of the seasonal autoregressive integrated moving average (SARIMA) model.Methods:Relevant information on HFRS cases reported by the China Disease Prevention and Control Information System from January 2010 to August 2024 in Weinan City, as well as the epidemiological investigation data on clinical diagnosis and confirmed HFRS cases in Weinan City were collected. Epidemiological characteristics of HFRS were analyzed by descriptive epidemiological methods. At the same time, a SARIMA model was constructed based on the monthly incidence of HFRS from 2010 to 2023, the incidence of HFRS from January to August 2024 was used to test the simulation prediction effect, and the optimal model was used to predict the incidence of HFRS from September to December 2024.Results:A total of 4 373 HFRS cases were reported in Weinan City from 2010 to 2023, with an average annual incidence of 6.39/100 000. The incidence rate showed a cyclical fluctuation trend, reaching two peaks in 2012 (10.25/100 000) and 2021 (12.26/100 000), respectively. The incidence of HFRS presented a seasonal bimodal distribution, with the peak predominantly in autumn and winter (from October to January of the following year), accounting for 67.83% (2 966/4 373), and the peak in spring and summer (form May to July) accounting for 17.27% (755/4 373). HFRS cases were reported in all counties (cities and districts) of Weinan City, and the top 3 annual incidence rates were Huazhou District (17.84/100 000), Linwei District (16.10/100 000) and Huayin City (9.15/100 000). The age of onset was mainly concentrated in the age group of 15 - 59 years old, accounting for 68.31% (2 987/4 373). The male to female ratio was 2.96∶1.00 (3 268∶1 105). The main occupation was farmers, accounting for 82.07% (3 589/4 373). SARIMA (1, 0, 1) (2, 1, 1) 12 model was the optimal model for short-term prediction of HFRS incidence rate in Weinan City, and the residual difference was listed as white noise ( Q = 7.45, P = 0.878), the model could be used for disease prediction. The model was used to predict the incidence of HFRS from September to December 2024, and the predicted values of each month were 0.17/100 000, 0.59/100 000, 1.85/100 000 and 1.61/100 000, respectively. Conclusions:The epidemic range of HFRS in Weinan City is wide, and the incidence has obvious seasonality. The population are mainly males, young and middle-aged adults and farmers. The SARIMA (1, 0, 1) (2, 1, 1) 12 model constructed can be used for predicting the short-term incidence trend of HFRS in Weinan City.

Objective:To investigate the clinical efficacy of acupuncture aimed at awakening the mind and opening the orifices, when combined with a qi-tonifying and blood-circulating decoction, in the treatment of post-stroke dysphagia due to qi deficiency and blood stasis. Methods:A randomized controlled study was conducted involving 86 patients with post-stroke dysphagia due to qi deficiency and blood stasis who were admitted to the Department of Acupuncture and Moxibustion at Yan'an Hospital of Traditional Chinese Medicine from January 2020 to March 2023. The patients were randomly divided into a control group and a treatment group, with 43 cases in each group, using a random number table method. The control group received conventional treatment, while the treatment group received acupuncture aimed at awakening the mind and opening the orifices combined with a qi-tonifying and blood-circulating decoction. Both groups were treated for 1 month. Clinical efficacy, swallowing function, serological indicators, floating index, and quality of life were compared between the two groups. Results:After treatment, the Standardized Swallowing Assessment score in the treatment group was (18.23 ± 2.04) points, which was significantly lower than that in the control group [(22.52 ± 4.38) points, t = 5.82, P < 0.05]. The Water-Swallowing test score in the treatment group was (2.77 ± 0.55) points, which was significantly higher than that in the control group [(2.00 ± 0.42) points, t = 7.30, P < 0.05]. The level of superoxide dismutase in the treatment group was (147.54 ± 21.03) kU/L, which was significantly higher than that in the control group [(128.31 ± 18.54) kU/L, t = 4.50, P < 0.05]. The Pulsatility Index in the treatment group was (0.72 ± 0.25), which was significantly lower than that in the control group [(0.83 ± 0.24), t = 0.74, P < 0.05]. The cerebral vascular reserve in the treatment group was (42.28 ± 5.69)%, which was significantly higher than that in the control group [(35.45 ± 4.31)%, t = 2.03, P < 0.05]. The Swallowing Quality-of-Life Questionnaire score in the treatment group was (76.33 ± 11.54) points, which was significantly higher than that in the control group [(68.02 ± 12.16) points, t = 3.25, P < 0.05]. The response rate in the treatment group was 97.67% (42/43), which was significantly higher than that in the control group [86.05% (37/43), χ2 = 3.89, P < 0.05]. Conclusions:The use of acupuncture for awakening the mind and opening the orifices, combined with a qi-tonifying and blood-circulating decoction, can significantly enhance clinical efficacy and improve the quality of life for patients with post-stroke dysphagia due to qi deficiency and blood stasis syndrome compared with conventional treatment.

Objective:To summarise the main points of operation during thyroid surgery using bilateral axillo-breast approach (BABA) with a domestic robot and to analyse the learning curve.Methods:From May. 2023 to Oct. 2023, we retrospectively analysed the clinical data of 38 patients who underwent thyroid surgery with domestically manufactured robot via BABA attending the Department of Thyroid and Breast Surgery of the 960th Hospital of PLA Joint Logistics Support Force, proposed and constructed learning curves using cumulative and analytical methods to study the minimum number of learning cases required for the loading time of assistants and surgeon-in-charge with da Vinci surgical experience to transition from the initial learning stage to the proficiency stage. The age, BMI, surgical time (loading time, operating time), postoperative drainage time, and number of lymph nodes dissected were compared among patients at different stages of the learning curve.Results:A total of 38 thyroidectomy patients successfully underwent surgery, with an average surgical time of (176.61 ± 47.98) minutes. After 18 cases, the assistant's loading time shortened and stabilized at (42.20 ± 3.44) minutes. The operator reached peak proficiency at the 18th case (loading time, operating time), which was considered the dividing point between the learning phase and the proficiency phase. During the learning phase, the average surgical time was (209.72 ± 49.28) minutes, operation time: (165.44 ± 49.93) minutes, while in the proficiency phase, the average surgical time decreased to 146.80 ± 18.34 minutes, operation time: (104.60 ± 19.01) minutes. There were no statistically significant differences in baseline characteristics such as age, BMI, postoperative drainage time, or the number of central compartment lymph nodes dissected between the two phases ( P > 0.05) . Conclusion:Over the results of this study, it was shown that for robosurgeons with experience in da Vinci robotic surgery, the transition from the learning stage to the proficiency stage could be considered after crossing the learning curve for 18 cases, and that assistants could become proficient in loading techniques after 18 procedures.