Wilson disease （WD） is an autosomal recessive disorder of copper metabolism， and decoppering therapy and symptomatic treatment are the main Western medicine therapies for WD. This article systematically reviews the understanding of the etiology and pathogenesis of WD in traditional Chinese medicine （TCM） and points out that abnormal natural endowment is the core etiology and pathogenesis of WD， with internal accumulation of copper toxicity as the manifestation， liver/spleen/kidney dysfunction as the root cause， and intermingled “toxin， stasis， phlegm， and deficiency” as the key pathogenesis. Literature research and clinical observation are conducted to summarize the common TCM syndromes of WD， including stagnation of liver Qi， internal retention of damp-heat， phlegm-stasis-heat accumulation syndrome， liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency， and syndrome of deficiency damage and phlegm stasis. This article proposes the corresponding therapies and representative prescriptions for each syndrome and discusses the advantages of treatment by stage and integrated traditional Chinese and Western medicine therapy. This article aims to provide a systematic reference for the syndrome differentiation-based treatment of WD in clinical practice of TCM， thereby giving full play to the advantages of TCM in the treatment of this disease.

Objective: To genotype 50 RhD variant samples from Guangzhou, China, using our previously established genotyping strategy, thereby providing guidance for transfusion management and antenatal monitoring in RhD-variant individuals. Methods: Between June and August 2024, fifty samples identified as RhD variants during RhD-negative confirmation testing at Guangzhou Blood Center were collected. Serological testing for the D antigen was performed with two different anti-D reagents, and the epitope profiles of the D antigen were determined using a commercial panel of monoclonal anti-D reagents containing nine kinds of monoclonal anti-D. Genomic DNA was extracted, and high-resolution melting (HRM) analysis was applied to detect the Asian-type DEL (RHD 1227A). Subsequently, RHD genotyping was carried out using Multiplex Ligation-dependent Probe Amplification (MLPA) and Sanger sequencing. Results: Among the 50 D variant samples, 17 (34.0%) Asian type DEL samples were detected by HRM, including 13 cases with RHD DEL1/01N.01 genotype and 4 cases with RHD DEL1/DEL1 genotype. Eleven (11/50, 22.0%) samples were typed as DVI by the epitope profiles of D antigen. The epitope profiles of D antigen combined with Sanger sequencing of exon 6 identified 5 (5/50, 10.0%) cases of RHD weak partial 15/01N.01. MLPA combined with Sanger sequencing identified two cases of RHD DVI.3/DEL1, representing 4.0% (2/50) of the samples. Additionally, the following RHD genotypes were each detected in one case: RHD weak D type 18/01N.04, RHD weak D type 72/01N.01, RHD weak D type 95/DEL1, RHD weak D type 114/DEL1, RHD weak D type 136/DEL1, RHD weak D type 147/01N.01, RHD 496G/496G, RHD 536C/01N.01, RHD 689A/689A, RHD 689A/DEL1, RHD DEL32/DEL1, RHD DV.1/01N.01, RHD DV.5/01N.01, RHD 01.01/01N.01, and RHD 01/01N.01. Conclusion: Fifty D variant individuals were typed using our previously established serological and molecular approach. These findings provide guidance for precision transfusion therapy in RhD variant patients and inform evidence-based decisions regarding anti-D immunoglobulin prophylaxis for RhD variant pregnant women.

Objective To investigate the current situation and existing problems regarding the diagnosis and treatment integrating traditional Chinese and western medicine in the emergency departments of various general hospitals in China to provide a reference for the development of integrated traditional Chinese and western medicine emergency medicine. Methods From November 18,2022 to February 28,2023,an online questionnaire survey was conducted among 291 hospitals in 21 provinces/municipalities directly under the Central Government across the country,which was based on the members of the Emergency Medicine Professional Committee of the Chinese Association of the Integration of Traditional Chinese and Western Medicine. The questionnaire covered 5 aspects:basic information of hospitals and emergency departments,personnel allocation,medical quality management,equipment allocation,and traditional Chinese medicine techniques and skills (including the application of traditional Chinese medicine and non-drug treatment of traditional Chinese medicine). A comparative study was carried out between the "hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine" and "western medicine hospitals" on the current situation of integrated traditional Chinese and western medicine diagnosis and treatment in the emergency department. Results A total of 291 valid questionnaires were collected,covering 291 hospitals in 21 provinces and municipalities directly under the Central Government across the country. Among them,142 were hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,and 149 were western medicine hospitals. The number of doctors in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were significantly less than that of western medicine hospitals[individuals:11.00 (7.00,18.75) vs. 20.00 (13.00,31.00),P<0.01]. Specifically,the numbers of traditional Chinese medicine doctors,integrated traditional Chinese and western medicine doctors,and "western medicine doctors learning traditional Chinese medicine" in these hospitals were significantly higher than those in western medicine hospitals[individuals:4.00 (2.00,9.00) vs. 0.00 (0.00,0.00),1.00 (0.00,4.00) vs. 0.00 (0.00,0.00),2.00 (0.00,5.00) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine doctors was significantly less than that in western medicine hospitals[individuals:4.00 (1.00,7.50) vs. 25.50 (16.00,37.00),P<0.01]. The number of nurses in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese was significantly less than that of western medicine hospitals[individuals:23.00 (16.00,38.75) vs. 42.00 (30.00,80.00),P<0.01]. The numbers of traditional Chinese medicine nurses,"western medicine nurses learning traditional Chinese medicine" in these hospitals were also significantly higher than those in western medicine hospitals[individuals:1.50 (0.00,5.75) vs. 0.00 (0.00,0.00),1.00 (0.00,7.75) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine nurses was significantly less than that in western medicine hospitals[individuals:15.00 (9.00,25.00) vs. 42.00 (27.00,79.00),P<0.01]. In the situation of medical quality management,the setting rates of emergency clinics,resuscitation rooms and observation rooms in western medicine hospitals were close to those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,but the setting rates of emergency department wards and emergency intensive care units (EICU) and the number of beds were significantly higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine[setting rate of emergency department wards:70.47％ vs. 53.52％,setting rate of EICU:67.11％ vs. 47.89％,number of beds (individuals):18.00 (0.00,30.00) vs. 2.00 (0.00,12.00) and 8.00 (0.00,12.00) vs. 0.50 (0.00,7.00),all P<0.01]. In terms of the number of visits in 2022,the annual total number of emergency visits (10000 person-times) in western medicine hospitals:6.60 (3.38,12.00) vs. 4.00 (1.25,7.00),the number of visits to the resuscitation room (10000 person-times):0.40 (0.12,1.00) vs. 0.17 (0.05,0.50) and the annual discharge volume of EICU (number of case):216.00 (0.00,550.00) vs. 0.00 (0.00,187.50) were all higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine (all P<0.01). In addition,the success rate of rescue in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine was similar to that in western medicine hospitals,and the participation rate of traditional Chinese medicine in the treatment of the resuscitation room was significantly higher than that in western medicine hospitals (P<0.01). In the situation of equipment allocation,hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine had fewer numbers of equipment than western medicine hospitals (all P<0.01). The proportion of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine equipped with non-drug treatment equipment of traditional Chinese medicine was significantly higher than that of western medicine hospitals (all P<0.01). In the application of traditional Chinese medicine techniques and skills,the proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in using Chinese patent medicines,agreed prescriptions,syndrome differentiation and treatment prescriptions,etc. were all higher than those of western medicine hospitals (application rate of Chinese patent medicines:81.69％ vs. 61.74％,application rate of agreed prescriptions:61.97％ vs. 16.78％,application rate of syndrome differentiation and treatment prescriptions:61.27％ vs. 19.46％,all P<0.01). The application rates of decoction pieces,non-decoction agreed with prescriptions,injections,hospital preparations and other dosage forms in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all significantly higher than those in western medicine hospitals (application rate of decoction pieces:29.58％ vs. 4.70％,the application rate of non-decoction agreed prescriptions:40.85％ vs. 7.38％,application rate of injections:80.28％ vs. 53.02％,application rate of hospital preparations:33.80％ vs. 12.75％,all P<0.01). The application proportions of oral administration,nasal feeding,enema,gastric lavage,external use,intravenous injection,etc. in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all higher than those in western medicine hospitals (oral application rate:71.13％ vs. 42.28％,nasal feeding application rate:47.18％ vs. 26.17％,enema application rate:48.59％ vs. 19.46％,gastric lavage application rate:21.13％ vs. 6.04％,external use application rate:53.52％ vs. 16.78％,intravenous injection application rate:71.83％ vs. 54.36％,all P<0.01). The application proportions of some drugs such as Shenmai/Shengmai injection,Tianma injection in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were higher than those in western medicine hospitals (application rate of Shenmai/Shengmai injection:59.15％ vs. 35.57％,application rate of Tianma injection:40.85％ vs. 10.07％,application rate of Danshen Honghua injection:30.99％ vs. 14.77％,application rate of Angong Niuhuang pill:26.76％ vs. 12.08％,P<0.01). The proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in carrying out traditional Chinese medicine non-drug treatment operations such as acupuncture,acupoint application,cupping,scraping,bone-setting,moxibustion,press needles,collateral pricking method,etc. were higher than those in western medicine hospitals (application rate of acupuncture:65.49％ vs. 11.41％,application rate of acupoint application:60.56％ vs. 10.07％,application rate of cupping:32.39％ vs. 4.70％,application rate of scraping:28.17％ vs. 2.01％,application rate of bone-setting:26.76％ vs. 10.74％,application rate of moxibustion:24.65％ vs. 5.37％,application rate of press needles:17.61％ vs. 1.34％,application rate of collateral pricking method:16.90％ vs. 0.67％,all P<0.01). Conclusion The proportion of integrated traditional Chinese and western medicine personnel in the emergency departments of hospitals in China is relatively low,and the utilization rate and equipment rate of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs are not high. It is necessary to strengthen the cultivation of integrated traditional Chinese and western medicine skills of emergency department doctors and the application of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs to improve the ability of integrated traditional Chinese and western medicine emergency treatment.

Objective To investigate the safety and feasibility of peripheral vascular intervention via the ipsilateral transulnar access(TUA)due to failure of transradial access(TRA)puncture.Methods The clinical data of 2546 peripheral vascular interventions via TRA,which were performed at authors'hospital between January 2019 and December 2021,were retrospectively analyzed.Among the 2546 interventions,TRA puncture failed in 37 procedures,and in 27 of these patients the ipsilateral TUA puncture had to be adopted.The puncture success rate,surgical success rate and puncture approach-related complications of TUA of the 27 patients receiving ipsilateral TUA puncture were analyzed.Results The success rate of ipsilateral TUA puncture after TRA puncture failed was 96.3％(26/27),and in one patient transfemoral access(TFA)puncture had to be substituted because of the ulnar artery spasm.The total success rate of interventional procedures was 96.3％(26/27).No serious complications occurred,and the incidence of minor complications was 19.2％(5/26).Conclusion Preliminary results indicate that for the experienced TRA operators,using ipsilateral TUA puncture due to failure of TRA puncture is a safe and feasible strategy choice.

ObjectiveTo explore the mechanism and pathway of Gandou Fumu decoction （GDFMD） in the development of liver fibrosis in Wilson's disease （WD）. MethodFirst， 30 TX-j mice were randomly divided into the model group， high-dose， medium-dose， and low-dose GDFMD groups， and penicillamine group， with six mice in each group， and another six wild-type mice were used as the normal group. The high-dose， medium-dose， and low-dose GDFMD groups were intragastrically administered drugs of 13.92， 6.96， 3.48 g·kg^-1. In the penicillamine group， 0.1 g·kg^-1 of penicillamine was given by intragastric administration. The model group and the normal group were given equal volume of normal saline， once a day， for four consecutive weeks. Samples were collected four weeks after gavage， and enzyme-linked immunosorbent assay （ELISA） was used to detect type Ⅲ procollagen peptide （PCⅢ）， collagen type Ⅳ （Col Ⅳ）， hyaluronic acid （HA）， and laminin （LN）. Hematoxylin-eosin （HE）， Masson， and picric acid-Sirus red collagen （Sirus Red） staining were used to observe the histopathological changes of liver fibrosis. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， immunohistochemistry， and Western blot were used to observe the expressions of α-smooth muscle actin （α-SMA） and collagen type Ⅰ （Col Ⅰ）， which were related to the activation of hepatic stellate cells （HSCs）. The expression of miR-29b-3p was observed by Real-time PCR. The expression of Unc-51-like kinase 1 （ULK1） and its downstream-related factors were observed by Western blot. The downstream genes of miR-29b-3p were verified by the dual luciferase reporter gene detection method. ResultCompared with the normal group， the four items of liver fibrosis （PCⅢ， Col Ⅳ， HA， and LN） in the model group were significantly abnormal （P<0.01）， and the pathology was significantly abnormal. The expression of HSC activation-related indicators including α-SMA and Col Ⅰ， as well as α-SMA mRNA and Col Ⅰ mRNA was up-regulated （P<0.05， P<0.01）， and miR-29b-3p expression was down-regulated （P<0.01）. ULK1， p-ULK1， autophagy-related gene 13 （Atg13）， p-Atg13， Beclin-1， FAK family kinase-interacting protein of 200 kDa （FIP200）， activating molecule in BECN1-regulated autophagy protein 1 （AMBKA1）， and microtubule-associated protein 1 light chain 3Ⅱ/Ⅰ（LC3Ⅱ/Ⅰ） were up-regulated （P<0.05， P<0.01）. p62 protein expression was down-regulated （P<0.01）. Compared with the model group， the four items of liver fibrosis in the high-dose， medium-dose， and low-dose GDFMD groups and the penicillamine group were significantly improve （P<0.01）， and the pathological conditions were improved. The expression of HSC activation-related indicators including α-SMA and Col Ⅰ， as well as α-SMA mRNA and Col Ⅰ mRNA was down-regulated （P<0.05， P<0.01）， and the expression of miR-29b-3p was up-regulated （P<0.01）. ULK1， p-ULK1， Atg13， p-Atg13， Beclin-1， FIP200， AMBKA1， and LC3Ⅱ/Ⅰ were down-regulated （P<0.05， P<0.01）， and p62 protein expression was up-regulated （P<0.01）. The prediction software predicted that there was a binding site between miR-29b-3p and ULK1. The dual-luciferase reporter gene detection method indicated that the luciferase activity of the ULK1-WT plasmid-transfected cell group was reduced when miR-29b-3p mimics were co-cultured （P<0.01）. ConclusionGDFMD can regulate ULK1-mediated autophagy by up-regulating miR-29b-3p and further exert its anti-hepatic fibrosis effect in Wilson's disease.

Wilson's disease （WD） is a copper metabolism disorder caused by mutations in the ATP7B gene， with diverse phenotypes and complex pathogenesis. It is one of the few rare diseases that can achieve good clinical efficacy through standardized treatment. Since there are few systematic reviews of this disease， we summarize the pathogenesis and treatment methods of WD from traditional Chinese and western medicine by reviewing the literature related to WD. In western medicine， ATP7B gene mutation is considered as the root cause of WD， which affects copper transport and causes copper metabolism disorders. The excessive copper deposited in the body will result in oxidative stress， defects in mitochondrial function， and cell death. Western medicine treatment of WD relies mainly on drugs， and copper antagonists are the first choice in clinical practice， which are often combined with hepatoprotective and antioxidant therapy. Surgery is a common therapy for the patients with end-stage WD， and gene therapy provides an option for WD patients. According to the traditional Chinese medicine （TCM） theory， WD is rooted in constitutional deficiency and copper accumulation and triggered by dampness-heat accumulation or phlegm combined with stasis. The patient syndrome varies in different stages of the disease， and thus the treatment should be based on syndrome differentiation. The TCM treatment method of nourishing the liver and kidneys and warming the spleen and kidneys can address the root cause. The methods of clearing heat and drying dampness， resolving phlegm and dispelling stasis， and soothing liver and regulating qi movement can be adopted to treat symptoms. On the basis of syndrome differentiation， special prescriptions for the treatment of WD have been formulated， such as Gandou decoction， Gandouling， and Gandou Fumu decoction， which have been widely used in clinical practice. TCM and western medicine have their own advantages and shortcomings. The integrated Chinese and western medicine complementing with each other demonstrates great therapeutic potential. This paper summarizes the pathogenesis and treatment of WD with integrated Chinese and western medicine， aiming to provide a reference for the clinical diagnosis and treatment of this disease.

Objective To investigate the current situation and existing problems regarding the diagnosis and treatment integrating traditional Chinese and western medicine in the emergency departments of various general hospitals in China to provide a reference for the development of integrated traditional Chinese and western medicine emergency medicine. Methods From November 18,2022 to February 28,2023,an online questionnaire survey was conducted among 291 hospitals in 21 provinces/municipalities directly under the Central Government across the country,which was based on the members of the Emergency Medicine Professional Committee of the Chinese Association of the Integration of Traditional Chinese and Western Medicine. The questionnaire covered 5 aspects:basic information of hospitals and emergency departments,personnel allocation,medical quality management,equipment allocation,and traditional Chinese medicine techniques and skills (including the application of traditional Chinese medicine and non-drug treatment of traditional Chinese medicine). A comparative study was carried out between the "hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine" and "western medicine hospitals" on the current situation of integrated traditional Chinese and western medicine diagnosis and treatment in the emergency department. Results A total of 291 valid questionnaires were collected,covering 291 hospitals in 21 provinces and municipalities directly under the Central Government across the country. Among them,142 were hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,and 149 were western medicine hospitals. The number of doctors in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were significantly less than that of western medicine hospitals[individuals:11.00 (7.00,18.75) vs. 20.00 (13.00,31.00),P<0.01]. Specifically,the numbers of traditional Chinese medicine doctors,integrated traditional Chinese and western medicine doctors,and "western medicine doctors learning traditional Chinese medicine" in these hospitals were significantly higher than those in western medicine hospitals[individuals:4.00 (2.00,9.00) vs. 0.00 (0.00,0.00),1.00 (0.00,4.00) vs. 0.00 (0.00,0.00),2.00 (0.00,5.00) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine doctors was significantly less than that in western medicine hospitals[individuals:4.00 (1.00,7.50) vs. 25.50 (16.00,37.00),P<0.01]. The number of nurses in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese was significantly less than that of western medicine hospitals[individuals:23.00 (16.00,38.75) vs. 42.00 (30.00,80.00),P<0.01]. The numbers of traditional Chinese medicine nurses,"western medicine nurses learning traditional Chinese medicine" in these hospitals were also significantly higher than those in western medicine hospitals[individuals:1.50 (0.00,5.75) vs. 0.00 (0.00,0.00),1.00 (0.00,7.75) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine nurses was significantly less than that in western medicine hospitals[individuals:15.00 (9.00,25.00) vs. 42.00 (27.00,79.00),P<0.01]. In the situation of medical quality management,the setting rates of emergency clinics,resuscitation rooms and observation rooms in western medicine hospitals were close to those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,but the setting rates of emergency department wards and emergency intensive care units (EICU) and the number of beds were significantly higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine[setting rate of emergency department wards:70.47％ vs. 53.52％,setting rate of EICU:67.11％ vs. 47.89％,number of beds (individuals):18.00 (0.00,30.00) vs. 2.00 (0.00,12.00) and 8.00 (0.00,12.00) vs. 0.50 (0.00,7.00),all P<0.01]. In terms of the number of visits in 2022,the annual total number of emergency visits (10000 person-times) in western medicine hospitals:6.60 (3.38,12.00) vs. 4.00 (1.25,7.00),the number of visits to the resuscitation room (10000 person-times):0.40 (0.12,1.00) vs. 0.17 (0.05,0.50) and the annual discharge volume of EICU (number of case):216.00 (0.00,550.00) vs. 0.00 (0.00,187.50) were all higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine (all P<0.01). In addition,the success rate of rescue in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine was similar to that in western medicine hospitals,and the participation rate of traditional Chinese medicine in the treatment of the resuscitation room was significantly higher than that in western medicine hospitals (P<0.01). In the situation of equipment allocation,hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine had fewer numbers of equipment than western medicine hospitals (all P<0.01). The proportion of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine equipped with non-drug treatment equipment of traditional Chinese medicine was significantly higher than that of western medicine hospitals (all P<0.01). In the application of traditional Chinese medicine techniques and skills,the proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in using Chinese patent medicines,agreed prescriptions,syndrome differentiation and treatment prescriptions,etc. were all higher than those of western medicine hospitals (application rate of Chinese patent medicines:81.69％ vs. 61.74％,application rate of agreed prescriptions:61.97％ vs. 16.78％,application rate of syndrome differentiation and treatment prescriptions:61.27％ vs. 19.46％,all P<0.01). The application rates of decoction pieces,non-decoction agreed with prescriptions,injections,hospital preparations and other dosage forms in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all significantly higher than those in western medicine hospitals (application rate of decoction pieces:29.58％ vs. 4.70％,the application rate of non-decoction agreed prescriptions:40.85％ vs. 7.38％,application rate of injections:80.28％ vs. 53.02％,application rate of hospital preparations:33.80％ vs. 12.75％,all P<0.01). The application proportions of oral administration,nasal feeding,enema,gastric lavage,external use,intravenous injection,etc. in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all higher than those in western medicine hospitals (oral application rate:71.13％ vs. 42.28％,nasal feeding application rate:47.18％ vs. 26.17％,enema application rate:48.59％ vs. 19.46％,gastric lavage application rate:21.13％ vs. 6.04％,external use application rate:53.52％ vs. 16.78％,intravenous injection application rate:71.83％ vs. 54.36％,all P<0.01). The application proportions of some drugs such as Shenmai/Shengmai injection,Tianma injection in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were higher than those in western medicine hospitals (application rate of Shenmai/Shengmai injection:59.15％ vs. 35.57％,application rate of Tianma injection:40.85％ vs. 10.07％,application rate of Danshen Honghua injection:30.99％ vs. 14.77％,application rate of Angong Niuhuang pill:26.76％ vs. 12.08％,P<0.01). The proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in carrying out traditional Chinese medicine non-drug treatment operations such as acupuncture,acupoint application,cupping,scraping,bone-setting,moxibustion,press needles,collateral pricking method,etc. were higher than those in western medicine hospitals (application rate of acupuncture:65.49％ vs. 11.41％,application rate of acupoint application:60.56％ vs. 10.07％,application rate of cupping:32.39％ vs. 4.70％,application rate of scraping:28.17％ vs. 2.01％,application rate of bone-setting:26.76％ vs. 10.74％,application rate of moxibustion:24.65％ vs. 5.37％,application rate of press needles:17.61％ vs. 1.34％,application rate of collateral pricking method:16.90％ vs. 0.67％,all P<0.01). Conclusion The proportion of integrated traditional Chinese and western medicine personnel in the emergency departments of hospitals in China is relatively low,and the utilization rate and equipment rate of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs are not high. It is necessary to strengthen the cultivation of integrated traditional Chinese and western medicine skills of emergency department doctors and the application of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs to improve the ability of integrated traditional Chinese and western medicine emergency treatment.

Objective:To analyze the application and regularity of acupoint selection of Sanyinjiao (SP 6) based on data mining.Methods:Search for literatures in CNKI, Wanfang, VIP, and Pubmed, the clinical researches of acupuncture on Sanyinjiao (SP 6) point were selected, according to the inclusion and exclusion criteria, and the retrieval period was from database construction to September 30th, 2021. Excel 2016, SPSS Statistics 25.0, SPSS Modeler 18.0 were used to perform descriptive analysis, association analysis and cluster analysis.Results:After literature screening, a total of 261 literatures were included, involving 73 kinds of diseases, mainly including mental and behavioral disorders, genitourinary diseases, endocrine and nutritional metabolism diseases and nervous system diseases. The most frequently used acupoints in Sanyinjiao (SP 6) compatibility are Zusanli (ST 36), Baihui (GV 20), Guanyuan (CV 4) and Taichong (LR 3), most of which focus on stomach meridian, conception channel, governor channel and bladder meridian. Seven categories were extracted among high-frequency acupoints by cluster analysis. The association rule analysis showed that the commonly used combination of Sanyinjiao (SP 6) were Zusanli (ST 36)-Sanyinjiao (SP 6), Baihui (GV 20)-Sanyinjiao (SP 6), and Guanyuan (CV 4)-Sanyinjiao (SP 6).Conclusions:Sanyinjiao (SP 6) is widely used in clinical application, and it is always compatible with stomach meridian, conception vessel, governor channel acupoints, especially those acupoints on the outer and inner meridians and the upper and lower parts. Sanyinjiao (SP 6) combined with other acupoints can treat diseases of multiple systems, such as insomnia, stroke, anxiety and depression, dysmenorrhea, infertility, etc. Clustering and association analysis found the core compatibility law of Sanyinjiao (SP 6), which can be used as a reference for clinical acupoint selection.

Objective To systematically integrate qualitative studies on health promoting behaviors of stroke patients and provide references for the development of relevant behavioral interventions.Methods Qualitative studies on health promotion behaviors of stroke patients were retrieved from CNKI,Wanfang,China Biomedical Database,VIP,PubMed,Web of Science,the Cochrane Library,and Embase from the inscription to February 2023.The JBI Model of Evidence-Based Healthcare was employed to assess the quality of the acquired literature,with the results treated with meta-integration.Results A total of 9 articles were included in the study.From the literature acquired 49 complete themes were abstracted and 3 novel types of literature were yielded.By meta-integration,11 factors affecting the health promoting behaviors of the stroke patients were concluded,including ability of patients such as physical dysfunction,disease cognition,disease risk management,motivation such as negative emotional distress,positive emotional experience,psychological self-regulation,and opportunity such as family caring degree,iatrogenic support,peer mutual support,access to information,and environmental restrictions.Conclusions The factors influencing health promoting behaviors of stroke patients consist of ability,motivation,and opportunity.Medical staff should care about their mental and physical experience,establishing a multi-social support system and working hard to promote the transformation of their health behaviors.

Hepatolenticular degeneration (HLD) is a rare genetic metabolic disorder of the nervous system with complex and diverse clinical phenotypes and is difficult to diagnose. The common lesions of HLD brain area are basal ganglia, thalamus, cerebellum and other anatomical structures, the classic manifestations of brain magnetic resonance imaging are symmetrical bilateral lenticular nucleus with low signal on T 1WI and high signal on T 2WI, and it is extremely rare for cases with high signal intensity on diffusion weighted imaging (DWI) of the brain stem, bilateral cerebral peduncles, thalamus, and basal ganglia. This article reported a case of HLD with high signal on DWI for clinical reference.