Needle removal is an essential component of the entire acupuncture treatment process， and its standardization is directly related to clinical safety and quality control in acupuncture practice. However， in actual clinical work， due to factors such as the accelerated pace of diagnosis and treatment， increased workload， and changes in personnel collaboration patterns， missed needle removel still occurs from time to time， gradually becoming one of the potential safety hazards in acupuncture clinical practice. Based on the clinical practice， this article analyzes the occurrence characteristics and risk factors of missed needle removal， and finds that it is closely associated with personnel collaboration， the spatial distribution and identifiability of acupoints， and changes in patients' body positioning. A risk stratification framework is developed according to acupoint location， patient positioning， and diagnosis and treatment mode， and prevention and control strategies， including standardized handover， stratified checking， and information support proposed for different risk levels， aiming to provide a reference for standardized acupuncture and moxibustion practice and quality and safety management.

Adolescent idiopathic scoliosis(AIS)is a complex three-dimensional deformity involving coronal,sagittal,and axial planes,with a prevalence that should not be overlooked.With advancements in technology and in-depth research,an increasing number of hospitals and physicians are exploring standardized diagnostic and treatment approaches for AIS.Comprehensive and in-depth understanding is required for AIS,including its etiology,screening and diagnosis,classification,assessment and examination,treatment options,exploration of current focus,and evaluation of quality of life.Such understanding ensures that the diagnostic and treatment are scientific,standardized,and timely.Based on the principles of evidence-based medicine,a consensus on the diagnosis and treatment of AIS is reached after multiple discussions among spinal surgery experts,aiming to provide reference and guidance for clinical practice.

Objectives:To evaluate the efficacy and safety of the self-fixing and self-detachable drainage stent in pancreaticojejunostomy and to provide supportive data for the follow clinical trials.Methods:This is an experimental research in animals which completed from February 2022 to September 2022. A self-fixing and self-detachable pancreaticojejunostomy drainage stent was designed for Hong′s pancreaticojejunostomy technique based on the theory of “fistula healing” in pancreaticojejunostomy. Ten biocompatibility tests were completed invitro before this study. Twenty-five Bama minipigs were selected and double-ligated in the neck of the pancreas to dilate the distal main pancreatic duct. Twenty-three of them were successfully modelled and divided into three groups by a stratified random method: pancreaticojejunostomy drainage stent group (referred to as stent group) with 11 pigs, pancreatic duct to jejunal mucosa anastomosis group (referred to as manual suture group) with 8 pigs, sham operation group with 4 pigs. The anastomic time,amylase content in postoperative abdominal drainage fluid and the tolerable pressure value of pancreaticojejunostomy were compared between the stent group and the manual suture group. An abdominal X-ray fluoroscopy examination was adopted to detect the detach time of the stent. A postoperative pathological examination was performed to verify the healing time,the type of treatment and the stricture rate of pancreaticojejunostomy. Quantitative data was analyzed by independent sample t-test. The classified data were analyzed by Fisher′s exact test. Results:There were no significant differences in the diameter of the pancreatic duct and pancreatic texture,the time of pancreaticojejunostomy,the amylase content in postoperative peritoneal drainage fluid,and the tolerable pressure value of the pancreaticojejunostomy between the stent group and the manual suture group(all P>0.05). Abdominal X-ray fluoroscopy showed that the stents gradually detached and were removed from the body 21 days after operation,and all stents were detached in the follow 3 months after operation. Pancreaticojejunostomy healed 7 days after operation based on fistula formation in the stent group,and 14 days in the manual suture group. The incidence of anastomotic stricture within 35 days after operation was 2/8 in the stent group and 6/8 in the manual suture group (Fisher′s exact test: P=0.132). Conclusion:The stent method is safer and simpler than the manual suture method in pancreaticojejunostomy of Bama minipigs, with shorter anastomotic healing time and lower stricture rate.

Objectives:To evaluate the efficacy and safety of the self-fixing and self-detachable drainage stent in pancreaticojejunostomy and to provide supportive data for the follow clinical trials.Methods:This is an experimental research in animals which completed from February 2022 to September 2022. A self-fixing and self-detachable pancreaticojejunostomy drainage stent was designed for Hong′s pancreaticojejunostomy technique based on the theory of “fistula healing” in pancreaticojejunostomy. Ten biocompatibility tests were completed invitro before this study. Twenty-five Bama minipigs were selected and double-ligated in the neck of the pancreas to dilate the distal main pancreatic duct. Twenty-three of them were successfully modelled and divided into three groups by a stratified random method: pancreaticojejunostomy drainage stent group (referred to as stent group) with 11 pigs, pancreatic duct to jejunal mucosa anastomosis group (referred to as manual suture group) with 8 pigs, sham operation group with 4 pigs. The anastomic time,amylase content in postoperative abdominal drainage fluid and the tolerable pressure value of pancreaticojejunostomy were compared between the stent group and the manual suture group. An abdominal X-ray fluoroscopy examination was adopted to detect the detach time of the stent. A postoperative pathological examination was performed to verify the healing time,the type of treatment and the stricture rate of pancreaticojejunostomy. Quantitative data was analyzed by independent sample t-test. The classified data were analyzed by Fisher′s exact test. Results:There were no significant differences in the diameter of the pancreatic duct and pancreatic texture,the time of pancreaticojejunostomy,the amylase content in postoperative peritoneal drainage fluid,and the tolerable pressure value of the pancreaticojejunostomy between the stent group and the manual suture group(all P>0.05). Abdominal X-ray fluoroscopy showed that the stents gradually detached and were removed from the body 21 days after operation,and all stents were detached in the follow 3 months after operation. Pancreaticojejunostomy healed 7 days after operation based on fistula formation in the stent group,and 14 days in the manual suture group. The incidence of anastomotic stricture within 35 days after operation was 2/8 in the stent group and 6/8 in the manual suture group (Fisher′s exact test: P=0.132). Conclusion:The stent method is safer and simpler than the manual suture method in pancreaticojejunostomy of Bama minipigs, with shorter anastomotic healing time and lower stricture rate.

The disorder of group 3 innate lymphoid cells(ILC3)subgroup,such as the predominance of NCR-ILC3 but the deple-tion of NCR+ILC3,is unfavorable to damaged intestinal barrier repair,which leads to the prolongations and obstinacy of ulcerative colitis(UC).Our previous studies had shown that luteolin promoted NCRILC3 differentitating into NCR+ILC3 to improving the de-pletion of NCR+ILC3 in UC mice,while the mechanism is unclear.This article aimed to explore the underlying mechanism of luteolin enhancing the proportion NCR+ILC3.UC mice model was established with 2％DSS and Notch signaling was blocked,then luteolin was used to intervene.The results showed that the effect of luteolin on ameliorating disease symptoms in UC mice,including inhibit-ing the weight loss,reducing the pathological damage of colon mucosa,etc.,was diminished with blocking Notch signaling pathway.In addition,luteolin increased the proportion of NCR+ILC3,NCR+MNK3 and IL-22+ILC3,decreased intestinal permeability,pro-moted mucin secretion,and promoted ZO-1 and Occludin expression,the above effect of luteolin was neutralized by Notch inhibitor LY-411575.Luteolin activated the abnormally blocked Notch signaling pathway in UC mice.And molecular docking predicted the af-finity of luteolin for RBPJ to be-7.5 kcal·mol-1 in mouse,respectively;the affinity of luteolin for Notchl and RBPJ was respectively scored to be-6.4 kcal·mol-1 and-7.7 kcal·mol-1 homo sapiens.These results proved that luteolin is positive for enhancing the propor-tion of NCR+ILC3 via Notch signaling,and it provides a basis for targeting NCR+ILC3 for restoring intestinal barrier function to alle-viating ulcerative colitis.

Objective:To explore the role of cytokines and glucocorticoid receptors (GR) in adolescent depression and childhood trauma.Methods:Using convenient sampling,80 adolescents with depression were recruited from the in-patient department of the Mental Health Center,First Hospital of Hebei Medical University from August 2021 to December 2022. Meanwhile,70 healthy adolescents were recruited to participate in the study. Life and learning stress,childhood trauma,anxiety and depression symptoms were evaluated using adolescent Life Events Scale,Childhood Trauma Questionnaire,Hamilton Depression Scale-17 (HAMD 17) and Hamilton Anxiety Scale(HAMA). Serum glucocorticoid receptor and plasma 12 cytokines were also detected. SPSS 25.0 and AMOS 26.0 was used for statistical analysis. The rank sum test or Chi-square test was used to compare the demographic data and blood indicators between adolescents with and without depression. Spearman method was used to examine the correlation between childhood trauma,GR,cytokines and depression. Maximum likelihood estimation method was performed to test the mediating effect,and the average path coefficient was obtained after testing the indirect path by Bootstrap method. If the 95% confidence interval ( CI) does not contain 0,the intermediary effect is significant. Results:There was significant difference in GR concentration between adolescents with and without depression ( Z=-10.50, P<0.001). IL-1β,IL-2,IL-5,IL-10,IL-12,IL-17 and IFN-α were also significantly different between the two groups. Spearman correlation analysis showed that HAMD 17 and HAMA scores were associated with emotional abuse,emotional neglect,physical abuse,CTQ total score and cytokine level IL-5,IFN-α were positively correlated. Physical neglect and IL-1β were only positively correlated with HAMD 17 score. GR was negatively associated with emotional abuse ( r=-0.523, P<0.001),emotional neglect ( r=-0.245, P=0.002),sexual abuse ( r=-0.172, P=0.035),physical abuse score ( r=-0.180, P=0.027),CTQ total score ( r=-0.562, P<0.001),HAMD 17 score ( r=-0.783--0.271, P<0.001),HAMA score( r=-0.741--0.602, P<0.001),IL-1β ( r=-0.217, P=0.008),IL-5 ( r=-0.334, P<0.001),and IFN-α ( r=-0.276, P=0.001). IL-5 level was positively correlated with emotional abuse score ( r=0.211, P=0.009) and CTQ total score ( r=0.201, P=0.014). IFN-α level was positively correlated with emotional abuse score ( r=0.207, P=0.011) and CTQ total score ( r=0.166, P=0.042). The mediating effect showed that GR played a partial mediating role between childhood trauma and depression (indirect effect: effect size 0.294, S.E. 0.043,95 %CI=0.236-0.398). GR and cytokine IL-5 play a chain mediating role between childhood trauma and depression (indirect effect: effect size 0.067, S.E. 0.040,95 %CI=0.023-0.147). Conclusion:GR,and cytokine IL-5 play a mediating role between adolescent depression and childhood trauma.

Objective:To explore the role of cytokines and glucocorticoid receptors (GR) in adolescent depression and childhood trauma.Methods:Using convenient sampling,80 adolescents with depression were recruited from the in-patient department of the Mental Health Center,First Hospital of Hebei Medical University from August 2021 to December 2022. Meanwhile,70 healthy adolescents were recruited to participate in the study. Life and learning stress,childhood trauma,anxiety and depression symptoms were evaluated using adolescent Life Events Scale,Childhood Trauma Questionnaire,Hamilton Depression Scale-17 (HAMD 17) and Hamilton Anxiety Scale(HAMA). Serum glucocorticoid receptor and plasma 12 cytokines were also detected. SPSS 25.0 and AMOS 26.0 was used for statistical analysis. The rank sum test or Chi-square test was used to compare the demographic data and blood indicators between adolescents with and without depression. Spearman method was used to examine the correlation between childhood trauma,GR,cytokines and depression. Maximum likelihood estimation method was performed to test the mediating effect,and the average path coefficient was obtained after testing the indirect path by Bootstrap method. If the 95% confidence interval ( CI) does not contain 0,the intermediary effect is significant. Results:There was significant difference in GR concentration between adolescents with and without depression ( Z=-10.50, P<0.001). IL-1β,IL-2,IL-5,IL-10,IL-12,IL-17 and IFN-α were also significantly different between the two groups. Spearman correlation analysis showed that HAMD 17 and HAMA scores were associated with emotional abuse,emotional neglect,physical abuse,CTQ total score and cytokine level IL-5,IFN-α were positively correlated. Physical neglect and IL-1β were only positively correlated with HAMD 17 score. GR was negatively associated with emotional abuse ( r=-0.523, P<0.001),emotional neglect ( r=-0.245, P=0.002),sexual abuse ( r=-0.172, P=0.035),physical abuse score ( r=-0.180, P=0.027),CTQ total score ( r=-0.562, P<0.001),HAMD 17 score ( r=-0.783--0.271, P<0.001),HAMA score( r=-0.741--0.602, P<0.001),IL-1β ( r=-0.217, P=0.008),IL-5 ( r=-0.334, P<0.001),and IFN-α ( r=-0.276, P=0.001). IL-5 level was positively correlated with emotional abuse score ( r=0.211, P=0.009) and CTQ total score ( r=0.201, P=0.014). IFN-α level was positively correlated with emotional abuse score ( r=0.207, P=0.011) and CTQ total score ( r=0.166, P=0.042). The mediating effect showed that GR played a partial mediating role between childhood trauma and depression (indirect effect: effect size 0.294, S.E. 0.043,95 %CI=0.236-0.398). GR and cytokine IL-5 play a chain mediating role between childhood trauma and depression (indirect effect: effect size 0.067, S.E. 0.040,95 %CI=0.023-0.147). Conclusion:GR,and cytokine IL-5 play a mediating role between adolescent depression and childhood trauma.

OBJECTIVE To clarify whether the thera-peutic effect of escitalopram on depression patients is cor-related with traditional Chinese medicine syndrome types,and to provide a basis for more accurate drug applica-tion.METHODS A total of 235 depression patients were recruited and classified according to traditional Chinese medicine syndrome differentiation into 5 types:liver and qi stagnation(45),liver stagnation and fire transformation(43),liver qi stagnation and spleen deficiency(79),heart and spleen deficiency(20),and liver and kidney deficiency(38).All patients were treated with escitalopram(10 mg·d-1)for eight weeks.The Montgomery Depression Rating Scale(MADRS)and the 17 Hamilton Depression Rating Scale(HAMD-17)were used to score before treatment and 2,4,and 8 weeks after treatment,respectively.RESULTS Compared with before treatment,the MADRS and HAMD-17 scores and remission rates of each syn-drome type significantly improved with increasing medica-tion duration.The MADRS score relief rate of liver and kidney deficiency type was the most significant(69.3%),significantly higher than the other four syndrome types(47.5%-52.6%,P<0.05);The remission rate of HAMD-17 score was significantly higher than that of heart and spleen deficiency(50.7%vs.28.5%,P＜0.05).The remis-sion rate of HAMD-17 score in liver and qi stagnation type(52.2%)was significantly higher than that in liver stagnation and spleen deficiency type(37.0%,P＜0.01)and heart spleen deficiency type(28.5%,P＜0.05).CON-CLUSION Escitalopram may have a more significant therapeutic effect on patients with liver and kidney defi-ciency and liver stagnation depression.This study pro-vides a new approach for the more effective and accu-rate application of traditional Chinese medicine syndrome differentiation in the selection of clinical antidepressants.

Deep phenotyping is a precise and comprehensive approach used for the precise analysis and comprehensive assessment of multi-system phenotypes of the patients. The approach uses symptoms, signs, various medical examination and laboratory results, and other relevant medical information. In the clinical diagnosis and medical research of rare bone diseases, deep phenotyping plays a pivotal role. The realization of precision medicine primarily comprises three key dimensions: deep phenotyping, stratified medicine, and targeted therapy. The deep phenotyping is the basis for the latter two. Deep phenotyping not only facilitates fine subtyping of diseases, but also allows for the in-depth understanding of genetic data. The use of deep phenotyping requires stand- ardized terminology and specific procedures. Moreover, deep phenotyping shows substantial potential using the application of artificial intelligence technology particularly when combining with multi-omics techniques.

Blau syndrome is a rare genetic disorder characterized by the a mix of granulomatous arthritis, uveitis, and dermatitis. Patients typically manifest multisystem involvement, including ocular, skin, and skeletal abnormalities. Blau syndrome is extremely rare, with a global incidence of less than one in a million among children. In this multidisciplinary consultation, we present a case of a 21-year-old young female patient having multisystemic involvement since early childhood. She was presented with multiple joint swelling, skin lesions, increased eye discharge, and accompanied by hypertension and arterial abnormalities, and received a diagnosis of uveitis. The patient had been receiving steroid treatment since the age of 6 and has tried various medications, with some improvement in joint swelling and ocular symptoms. Through this rare disease multidisciplinary consultation, we aim to provide guidance in the molecular diagnosis of the patient, multisystem assessment, and the selection and formulation of treatment plans. Additionally, we hope that by reporting this case, clinical physicians can gain a better understanding of the diagnosis and comprehensive treatment strategies for Blau syndrome, thereby improving the management and treatment of rare diseases.