Objective To investigate the characteristics of traditional Chinese medicine(TCM)syndrome elements and the distribution patterns of TCM syndromes in senile osteoporosis(SOP),providing a reference for TCM treatment of SOP.Methods A cross-sectional study was conducted on 200 SOP patients aged over 70 years treated at Wuxi Huishan Chinese Medicine Hospital from January 2022 to June 2023.General information and TCM diagnostic data were collected.The syndrome element differentiation scoring method was employed for analysis.Results(1)Among the 200 SOP patients,the most prevalent disease-location syndrome element was kidney(61.50％),followed by liver(48.50％),bones and tendons(45.50％),spleen(37.00％),meridians(25.50％),heart(12.50％),and lung(10.50％).Statistical analysis showed significantly higher syndrome element scores for kidney,liver,bones and tendons,spleen,and meridians compared to heart and lung(P＜0.01).(2)Regarding disease-nature syndrome elements,deficiency-type elements predominated,with yang deficiency(52.50％)being most common,followed by blood deficiency(46.00％),essence depletion(45.50％),qi deficiency(45.50％),yin deficiency(37.00％),unconsolidation(25.50％),and qi sinking(15.50％).Yang deficiency,blood deficiency,essence depletion,qi deficiency,and yin deficiency scores were significantly higher than those of insecurity and qi sinking,the difference being statistically significant(P＜0.01).Among excess-type elements,cold(47.00％)was most prevalent,followed by blood stasis(45.00％),qi stagnation(43.50％),dampness(34.50％),phlegm(27.50％),and heat(25.00％).Cold and blood stasis scores were significantly higher than phlegm,while cold,blood stasis,qi stagnation,dampness,and phlegm scores were significantly higher than heat,the difference being statistically significant(P＜0.05).(3)Eighteen TCM syndrome patterns were identified.Spleen-kidney yang deficiency(40.00％)was most frequent,followed by liver blood deficiency(37.50％),kidney essence insufficiency(35.00％),qi stagnation and blood stasis(31.00％),cold congelation and obstruction(25.50％),phlegm-damp obstruction(27.50％),and qi-yin deficiency with qi insecurity(11.00％).Based on syndrome element scores,the primary syndromes were defiined as spleen-kidney yang deficiency(35.60％),liver blood deficiency(25.13％),kidney essence insufficiency(18.32％),and qi stagnation and blood stasis(13.09％),etc.Conclusion The characteristic TCM syndrome elements of SOP patients involve qi-blood-yin-yang deficiency of kidney,spleen,and liver,combined with cold congelation,blood stasis,and qi stagnation.The main TCM syndromes are spleen-kidney yang deficiency,liver blood deficiency,kidney essence insufficiency,and qi stagnation with blood stasis.

Objective To explore the diagnostic value of mediastinal lymph nodes CT image features in pulmonary sarcoidosis.Methods The imageologic data of the patients with pulmonary sarcoidosis(pulmonary sarcoidosis group)and lung cancer complicating mediastinal lymph node metastasis(lung cancer group)con-firmed by EBUS-TBNA in this hospital from June 2015 to November 2023 were analyzed retrospectively.The chest plain scan CT and enhanced scan CT were performed in all cases,and the imaging characteristics were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated.The diagnostic value of CT imaging characteristics in pulmonary sar-coidosis was analyzed.Results The proportion of female patients in the lung sarcoidosis group was signifi-cantly higher than that in the lung cancer group,while the age was smaller than that in the lung cancer group,and the differences were statistically significant(P＜0.05).The number of mediastinal lymph nodes,location,short diameter and CT enhancement value in the pulmonary sarcoidosis group had statistical difference(P＜0.05).The ROC curve analysis showed that AUC of lymph node short diameter reciprocal,CT enhancement value and position in detection alone were 0.586,0.785 and 0.505 respectively,and AUC of the three combined reciprocal was the highest(0.789).Conclusion The lymph node short diameter,CT enhancement value and po-sition have certain value in clinical diagnosis of pulmonary sarcoidosis and the 3-indicator combination could increase the diagnostic efficiency of pulmonary sarcoidosis.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To analyze the electromyography(EMG)characteristics of high-level male speed climbers using Tomoa skip technique,and provide a theoretical basis for the determination of special strength training methods and means.Methods Ten male speed climbers at national first level or above were recruited,and their kinematics and surface EMG signal data using Tomoa skip technique during climbing the official route were collected.Results For using Tomoa skip technique,the order of the main muscle contribution rate for high-level male speed climbers was biceps brachii,triceps brachii,flexor digitorum superficialis,latissimus dorsi,anterior tibial,vastus lateralis,gluteus maximus,medial head of gastrocnemius muscle.The sum of all muscle contribution rates of the left side,the contribution rate of biceps brachii and triceps brachii were significantly lower than that of the right side(P＜0 05).The contribution rate of medial head of left gastrocnemius muscle was significantly higher than that of right side(P＜0.05).The level of activation of the left biceps brachii was significantly lower than that of the right side(P＜0.05).The co-contraction indexes of left elbow joint and ankle joint,right elbow joint and ankle joint were 0.93±0.21,1.33±0.14,0.72±0.10,2.08±0.59,respectively.The co-contraction level of the left elbow joint and ankle joint was significantly higher than that of the right side(P＜0.05).Conclusions High-level male speed climbers using Tomoa skip technique showed obvious EMG characteristics,and the contribution rate of the upper limb muscles and latissimus dorsi were higher than that of the lower limb.The activation mode of elbow joint was dominated by biceps brachii,and that of ankle joint was dominated by anterior tibial muscle.There exsited differences between the left and right limbs in coordinated movement modes.The difference of contribution rate and activation level of the upper limb between the left and right side was more than that of the lower limb.

Objective To analyze the electromyography(EMG)characteristics of high-level male speed climbers using Tomoa skip technique,and provide a theoretical basis for the determination of special strength training methods and means.Methods Ten male speed climbers at national first level or above were recruited,and their kinematics and surface EMG signal data using Tomoa skip technique during climbing the official route were collected.Results For using Tomoa skip technique,the order of the main muscle contribution rate for high-level male speed climbers was biceps brachii,triceps brachii,flexor digitorum superficialis,latissimus dorsi,anterior tibial,vastus lateralis,gluteus maximus,medial head of gastrocnemius muscle.The sum of all muscle contribution rates of the left side,the contribution rate of biceps brachii and triceps brachii were significantly lower than that of the right side(P＜0 05).The contribution rate of medial head of left gastrocnemius muscle was significantly higher than that of right side(P＜0.05).The level of activation of the left biceps brachii was significantly lower than that of the right side(P＜0.05).The co-contraction indexes of left elbow joint and ankle joint,right elbow joint and ankle joint were 0.93±0.21,1.33±0.14,0.72±0.10,2.08±0.59,respectively.The co-contraction level of the left elbow joint and ankle joint was significantly higher than that of the right side(P＜0.05).Conclusions High-level male speed climbers using Tomoa skip technique showed obvious EMG characteristics,and the contribution rate of the upper limb muscles and latissimus dorsi were higher than that of the lower limb.The activation mode of elbow joint was dominated by biceps brachii,and that of ankle joint was dominated by anterior tibial muscle.There exsited differences between the left and right limbs in coordinated movement modes.The difference of contribution rate and activation level of the upper limb between the left and right side was more than that of the lower limb.

BACKGROUND:Establishing a nomogram prediction model for postoperative pulmonary infection in hip fractures and taking early intervention measures is crucial for improving patients'quality of life and reducing medical costs. OBJECTIVE:To construct a nomogram risk prediction model of postoperative pulmonary infection in elderly patients with hip fracture,and provide theoretical basis for feasible prevention and early intervention. METHODS:Case data of 305 elderly patients with hip fractures who underwent surgical treatment at Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine between January and October 2020(training set)were retrospectively analyzed.Using univariate and multivariate logistic regression analysis and Hosmer-Lemeshow goodness of fit test,receiver operating characteristic curve was utilized to analyze the diagnostic predictive efficacy of independent risk factors and joint models for postoperative pulmonary infections.Tools glmnet,pROC,and rms in R Studio software were applied to construct a nomogram model for predicting the risk of postoperative pulmonary infection in elderly patients with hip fractures,and calibration curves were further drawn to verify the predictive ability of the nomogram model.Receiver operating characteristic curves,calibration curves,and decision curves were analyzed for 133 elderly patients with hip fractures(validation set)receiving surgery at the same hospital from November 2022 to March 2023 to further predict the predictive ability of the nomogram model. RESULTS AND CONCLUSION:(1)The postoperative pulmonary infection rate in elderly patients with hip fractures in this group was 9.18%(28/305).(2)Single factor and multivariate analysis,as well as forest plots,showed that preoperative hospitalization days,leukocyte count,hypersensitive C-reactive protein,and serum sodium levels were independent risk factors(P<0.05).The Hosmer-Lemeshow goodness of fit test showed good fit(χ2=4.57,P=0.803).Receiver operating characteristic curve analysis was conducted on the independent risk factors and their joint models mentioned above,and the differentiation of each independent risk factor and joint model was good,with statistical significance(P<0.05).(3)The graphical calibration method,C-index,and decision curve were used to validate the nomogram prediction model.The predicted calibration curve was located between the standard curve and the acceptable line,and the predicted risk of the nomogram model was consistent with the actual risk.(4)The validation set used receiver operating characteristic curve,graphic calibration method,and decision curve to validate the prediction model.The results showed good consistency with clinical practice,indicating that the model had a good fit.The nomogram risk prediction model constructed for postoperative pulmonary infection in elderly patients with hip fractures has good predictive performance.The use of the nomogram risk prediction model can screen high-risk populations and provide a theoretical basis for early intervention.

ObjectiveTo identify the prototypical components and metabolites absorbed into blood and cerebrospinal fluid of Schisandrae Chinensis Fructus（SCF） based on sequential metabolism combined with liquid chromatography-mass spectrometry. MethodBlood and cerebrospinal fluid samples of integrated metabolism， intestinal metabolism and hepatic metabolism were collected from male SD rats after gavage and in situ intestinal perfusion administration， and ultra-performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC Q-Exactive Orbitrap MS） was used to analyze and compare the differences in the spectra of SCF extract， blank plasma， administered plasma， blank cerebrospinal fluid and administered cerebrospinal fluid with ACQUITY UPLC BEH Shield RP18 column（2.1 mm×100 mm， 1.7 µm）， the mobile phase was acetonitrile（A）-0.1% formic acid aqueous solution（B） for gradient elution（0-7 min， 95%B； 7-12 min， 95%-35%B； 12-17 min， 35%-15%B； 17-20 min， 15%-12%B； 20-22 min， 12%-5%B； 22-23 min， 5%B； 23-25 min， 5%-95%B； 25-28 min， 95%B）. And heated electrospray ionization（HESI） was used with positive and negative ion modes， the scanning range was m/z 100-1 500. The prototypical constituents and their metabolites absorbed into blood and cerebrospinal fluid of SCF were identified according to the retention time， characteristic fragments， molecular formulae and the information of reference substances. ResultA total of 42 chemical components were identified in the extract of SCF， including lignans， flavonoids， amino acids， tannins， and others， of which lignans were the main ones. A total of 27 prototypical components and 14 metabolites were identified in plasma samples from different sites. A total of 15 prototypical components and 9 metabolites were identified in cerebrospinal fluid. The main metabolic reactions involved in the formation of metabolites were mainly demethylation， methylation， demethoxylation and hydroxylation. ConclusionThrough the systematic identification of the prototypical components and metabolites of SCF in rats， it provides data support for further better exploring the material basis of SCF in the treatment of central nervous system diseases.

BACKGROUND:The alteration of miR-146a-3p level is a common event in the pathogenesis of most neurological diseases,and the specific mechanism of miR-146a-3p regulation of astrocytes has not been studied. OBJECTIVE:To verify that miR-146a-3p regulates astrocyte proliferation,migration and apoptosis through insulin-like growth factor 1. METHODS:12 SD rats were divided into a sham operation group and a spinal cord injury group,with six rats in each group.RNA sequencing analysis was performed on the spinal cord tissues of all groups 2 weeks after surgery to screen out the differential genes(log2FC>2),and to select spinal cord injury-related genes(Score>20)in the Genecards database,and then to predict the target genes of miR-146a-3p by Targetscan.The intersection of three gene sets was obtained to screen out insulin-like growth factor 1 as one of the important target genes.qPCR,western blot assay and immunohistochemistry were performed to analyze the expression level of insulin-like growth factor 1 in spinal cord tissues.The primary astrocytes were divided into NC group,NC-mimics group and miR-146a-3p mimics group.Annexin-V/PI staining was used to detect cell apoptosis.CCK-8 assay was used to detect cell proliferation.Transwell assay was used to detect cell migration ability. RESULTS AND CONCLUSION:The expression of miR-146a-3p in the spinal cord tissue of the spinal cord injury group was lower than that of the sham operation group(P<0.05).The expression of insulin-like growth factor 1 in the spinal cord tissue of the spinal cord injury group was higher than that of the sham operation group(P<0.05).Compared with the NC group and NC-mimics group,the apoptotic rate of astrocytes was increased(P<0.01);the proliferation of astrocytes was decreased(P<0.01)and the number of migration was decreased(P<0.01)in the miR-146a-3p mimics group.To conclude,the expression of miR-146a-3p decreased and the expression of insulin-like growth factor 1 increased in spinal cord tissue after spinal cord injury.miR-146a-3p targeted regulation of insulin-like growth factor 1 in astrocytes,inhibited the proliferation and migration of astrocytes and promoted their apoptosis.

Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine （TCM） mainly involves peripheral vestibular diseases of Western medicine， such as Meniere's disease， benign paroxysmal positional vertigo， vestibular neuritis， and vestibular migraine， being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo， aural vertigo affecting the quality of life， aural vertigo not relieved after surgery， aural vertigo with complex causes， and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM： Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo， the control and mitigation of the symptoms， and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.

Objective:To investigate the hemodynamic characteristics of transverse sinus with sigmoid sinus wall dehiscence (SSWD) of pulsatile tinnitus (PT) based on 4D flow MRI.Methods:Retrospective analysis was performed on all patients admitted to Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2021 for dehiscent sigmoid plate pulsatile tinnitus. A total of 26 patients (sides) who met the criteria and underwent 4D flow MRI were included. A total of 26 subjects (46 sides), matched 1∶1 according to gender and age, were included in the normal healthy control group. Nonparametric rank sum test, Student′s t test, and ANOVA were performed by SPSS 19.0 software. Binary Logistic regression was applied to the data with statistical significance. Results:There were more patients with dominant drainage on the affected side in PT group than in control group (73.1% vs. 42.3%). The incidence of transverse with a focal intraluminal filling defect and tapered stenosis was higher than that in control group (21.7% vs. 69.2%; 17.4% vs. 42.3%). Average through-plane velocity and maximum through-plane velocity in PT group were higher than those in control group [(33.75±13.88) cm/s vs. (15.84±7.21) cm/s; (93.19±33.55) cm/s vs. (40.40±14.40) cm/s]. The middle part and proximal end of Flow avg (ml/s) in PT group were larger than those in control group [4.69 (2.87; 5.62) ml/s vs. 2.76 (1.67; 4.99) ml/s; 3.41 (2.16; 5.47) ml/s vs. 2.67 (1.68; 4.41) ml/s]. In control group, the velocity of transverse sinus changed relatively gently, while in PT group, the velocity of proximal sinus increased significantly. Binary Logistic regression showed that SSWD PT was independently correlated with proximal maximum flow velocity [ OR=1.086(1.029-1.146), P=0.003]. Conclusion:4D flow MRI showed that the dominant drainage and higher velocity at the proximal end of the transverse sinus might be an important hemodynamic characteristics of dehiscent sigmoid plate pulsatile tinnitus.