Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective By analyzing the characteristics of hidden poisoning homicide cases,provide scientific references for grass-roots forensic examination and toxicological screening and provide direction for the efficient discovery of hidden or missed cases of poisoning homicide in non-natural death cases.Methods Poisoning incidents in Hunan Province from 2018 to 2023 were retrospectively analyzed and compiled using Origin and EXCEL software.Results There were a total of 149 poisoning homicide cases,with 15 occurring in urban areas(accounting for 10.1%)and 134 in rural areas(accounting for 89.9%).Out of the 46 cases that led to casualties,rodenticide poisoning was the most prevalent(accounting for 52.2%),followed by cyanide(4.3%),nitrite(4.3%),thallium(2.2%),and other forms of poisoning.These incidents were primarily concentrated in urban areas.The main way of poisoning was to mix poisons into drinking water(accounting for 28.3%),meals(26.1%),and dark or heavy seasoning(8.7%).There was no significant disparity in the gender distribution of suspects,although the number of male victims was notably higher than that of female victims.The suspects were predominantly between the ages of 19 and 45,while the victims were mostly between the ages of 46 and 60.Among the 103 cases that did not result in injury or death,99%occurred in rural areas,with more than 95%of the involved poisons included pungent pesticides or herbicides,while rodenticides accounted for the least(1.9%).Conclusion There are obvious urban-rural differences in the case occurrence areas and types of involved poisons in poisoning homicide cases.Therefore,it is imperative to focus on both urban and rural areas during the investigation and evidence collection process in suspected poisoning cases.

Objective:To analyze the relationship of hepatic transit time and portal vein pressure in the patients with portal hypertension and esophagogastric varices, and to clarify its clinical significance.Methods:A total of50hospitalized patients underwent esophagogastric venous embolization due to portal hypertension and esophagogastric varices were selected as observation group, and 50patients without history of liver disease and clinical manifestations of liver disease (hospitalized or out-patient) were selected as control group, All patients underwent liver contrast enhanced ultrasound.The free portal pressure (FPP) was measured by ultrasound guided portal vein puncture for operating pathways in the patients in observation group.The hepatic artery-hepatic vein transit time (HA-HVTT) , the hepatic portal vein-hepatic vein transit time (PV-HVTT) , the liver parenchymahepatic vein transit time (PA-HVTT) of the patients were compared between two groups.The correlations between HA-HVTT, PV-HVTT, PA-HVTT and FPP of the patients in observation group were analyzed.Results:The HA-HVTT, PV-HVTT and PA-HVTT of the patients in observation group were significantly shorter than those in control group (t=5.078, P＜0.01;t=12.163, P＜0.01;t=2.649, P＜0.01) .The HA-HVTT, PV-HVTT and PA-HVTT had negative correlations with FPP in observation group (r=-0.799, P＜0.01;r=-0.554, P＜0.01;r=-0.735, P＜0.01) .The linear relationship between HA-HVTT and FPP was Y=-0.410X+7.254;the linear relationship between PV-HVTT and FPP was Y=-0.355X+4.983;the linear relationship between PA-HVTT and FPP was Y=-0.566X+4.997.Conclusion:Liver transit time can be used as an effective index to judge the portal vein pressure, and it can provide the theroretical basis for the diagnosis and treatment of portal hypertension in the patients.

Objective To investigate and evaluate the feasibility and analgesic effect of ultrasound guided intercostobrachial nerve (ICBN) blockade in patients with persistent pain after radical mastectomy with ICBN preservation.Methods In a total of 53 following-up female cases,aged 18-55 years,ASA Ⅰ or Ⅱ,receiving radical mastectomy with ICBN preservation during January,2014 to February,2016,19 patients complained persistent pain in the lateral chest,axilla and/or upper arm more than 3 months after the surgery were enrolled.ICBN blockade was performed using 0.5% ropivacine 10 mL injected in the potential space between the superior of pectoralis minor muscle and the inferior of serratus anterior muscle in the second intercostal space guided by ultrasound.Visual analogue scale (VAS) was applied to assess the pain intensity at rest,on movement,and with 100 kPa pressure before blockage and 30 min thereafter,and then the pain intensity (SPI) was calculated.All nerve blockade-related adverse events including local anesthetic-related allergy,central nervous system and cardiovascular toxicity were recorded.Seven-day follow-ups were required in all patients to assess the pain intensity.Results All 19 cases completed ICBN blockade guided by ultrasound,of which 17 cases completed the seven-day follow-ups.The mean difference in SPI was-9.19 VAS points (95%CI-11.24--7.14,P<0.01).Compared with each mean VAS and SPI before block,all that after block at day 1-6 were significantly decreased (P<0.01 or P<0.05).There were 14(82.4%),13(76.5%),7(41.2%) and 3(17.6%)cases that SPI was decreased over 5 points after block at day 1-4.No nerve blockade-related adverse event was observed.Conclusion Ultrasound guided ICBN blockade can relieve persistent post-mastectomy pain safely and effectively.

OBJECTIVETo investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.

METHODSSixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.

RESULTSPatients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.

CONCLUSIONIn the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Biopsy ; Case-Control Studies ; Complement C3 ; analysis ; Glomerulonephritis, IGA ; blood ; diagnosis ; Humans ; Immunoglobulin A ; blood ; Kidney ; pathology

Objective To investigate the prevalence of PLA2R1 in renal biopsy specimens of patients with idiopathic membranous nephropathy (IMN) and explore the relationship between PLA2R1 and IMN. Methods A total of 108 adult patients with biopsy-proved glomerular diseases were enrolled in this study, including 41 with IMN, 2 with hepatitis B-associated membranous nephropathy, 8 with V lupus nephritis, 27 with IgA nephropathy, 19 with minimal change nephropathy, 5 with mild mesangial proliferative glomerulonephritis, and 6 with focal segmental glomeruloselerosis (FSGS). Indirect immunofluorescence assay was used to detect PLA2R1 in the biopsy specimens and the clinical variables of the IMN patients were analyzed. Results In 35 of the 41 (85.37%) patients with IMN, PLA2R1 was detected with a fine granular pattern in the subepithelial deposits along the glomerular capillary loops. PLA2R1 antigen was not detected in patients with other glomerulopathies. No significant differences were found in age, serum creatinine, serum albumin, or 24-h urinary protein level between PLA2R1-positive and negative patients with IMN (P>0.05). Conclusion According to our results, 85.37% of adult patients with biopsy-proven IMN are positive for PLA2R1 antigen, which, however, does not contribute to variations of the patients' clinical manifestations.