This paper aimed to explain the clinical thinking of using the method of unblocking the bowels and harmonizing viscera. Based on theory of "viscera-bowels extraordinary connection" of The Gateway to Medicine （《医学入门》）， combined with the theoretical research， clinical practice and individual experience of ancient physicians， modern scholars， it is believed that viscera qi disorder caused by bowels qi blocking is the basic mechanism of insomnia. In clinic， it is common that gallbladder phlegm-heat harassing the heart spirit， stagnant blood and qi in stomach blocking the pericardium， turbid heat in large intestine causing fire and affecting liver， dampness insmall intestine trapping the spleen， water retention in the bladder drying up lungs， and the inhibited original qi of sanjiao damaging the kidney， which could be treated with Wendan Decoction （温胆汤）， Taohe Chengqi Decoction （桃核承气汤）， Chengqi-series Decoction （承气汤类方）， Linggui Zhugan Decoction （苓桂术甘汤）， Wuling Powder （五苓散）， Xiaochaihu Decoction （小柴胡汤）， respectively.

Objective To observe the body surface calorific value characteristics of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs chronic insomnia patients with heart-spleen deficiency syndrome through infrared thermal imaging technology.Methods Totally 150 patients with chronic insomnia with heart-spleen deficiency syndrome who were treated in the outpatient department of Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang)from December 2021 to December 2022 were selected as the observation group.Another 50 healthy subjects were recruited as the normal control group.Infrared thermal imaging technology was used to collect and measure the temperature of surface areas of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs,and the calorific values were analyzed and compared.Results Compared with healthy subjects,chronic insomnia patients with heart-spleen deficiency syndrome had a statistically significant decrease in the temperature of the Governor Vessel(P<0.05);there were statistically significant decreased in the temperature of upper energizer and middle energizer(P<0.05);there were statistically significant decreased in the temperature of chest,apex,right chest,epigastric region,big abdomen,and the temperature of left and right flank increased(P<0.05).Conclusion There were significant differences in infrared thermography distribution characteristics of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs between patients with chronic insomnia with heart-spleen deficiency syndrome and healthy subjects,which can provide some reference for the clinical diagnosis and syndrome differentiation of chronic insomnia with heart-spleen deficiency syndrome.

Objective: A predictive model of WHO/ISUP grading of renal clear cell carcinoma was constructed based on CT radiomics. Methods: The clinical data of 104 patients with ccRCC confirmed by operation or biopsy from March 2014 to December 2018 in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were retrospectively analyzed. There were 70 males and 34 females, and the age was 61.2±11.7 years. The patients were randomly divided into development cohort (73 cases) and validation cohort (31 cases) by stratified sampling according to 7∶3 ratio. According to the WHO/ISUP pathological grading criteria of renal cancer in 2016, Ⅰ and Ⅱ were defined as low-grade group, Ⅲ and Ⅳ were defined as high-grade group. The radiomics features of ccRCC were calculated in cortical phase images of CT enhanced scanning. LASSO regression was used to reduce the radiomics feature dimensionality in the training group, and to establish radiomics risk scores. The binary logistic regression was used to build the prediction model, which was used in the validation group. Bootstrap method was used to validate the model of training and validation group. AUC, sensitivity and specificity were calculated respectively. Hosmer-Lemeshow goodness-of-fit test was used to evaluate model calibration degree. Results: After dimensionality reduction, the radiomics risk score of ccRCC was established. The low and high-level risk scores of the training group were -2.49±1.73 and 1.23±2.17, with significant difference (t=-7.785, P < 0.01). The binary logistic regression multivariate analysis showed that the radiomics risk score was an independent risk factor in identifying low or high-grade ccRCC with odds ratio of (OR=3.576, 95%CI 1.964~6.513). The predictive model was Y=1/[1+ exp(-Z)], Z=1.274×radiomics risk score+ 0.072. The AUC of radiomics risk score in training group was 0.940 (95%CI 0.883-0.998) with 95.5% sensitivity and 88.2% specificity after internal verification by Bootstrap method, and good Hosmer-Lemeshow goodness-of-fit test (χ²=4.463, P>0.05). The low and high-level risk scores of the Validation group were -2.27±2.02 and 0.82±2.08, with significant difference (t=-3.832, P<0.01). The AUC in validation group was 0.859(95%CI 0.723-0.995) with 77.8% sensitivity and 81.8% specificity, and with good Hosmer-Lemeshow goodness-of-fit test (χ²=14.554, P=0.068) as well. Conclusions The prediction model based on CT radiomics has high accuracy in predicting high or low grade of ccRCC.

BACKGROUND: Clinical observation has been proved that acupuncture has effect on antiinflammation and immunoloregulation, which is the basis for preventing and curing immune disturbance and active chronic inflammation. OBJECTIVE: To observe the effect of electropumcture on antiinflammation, analgesia and subgroup of T cells of adjuvant-arthrosis rats at Jiaji acupoint.DESIGN: Completely randomized grouping and controlled study.SETTING: Basic Laboratory of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine. MATERIALS: A total of 30 Wistar rats were selected in this study. Five days after feeding, all rats were randomly divided into 3 groups: normal control group, model group and electropumcture group with 10 in each group. METHODS: ① The experiment was completed at Basic Laboratory of Acupuncture and Moxibustion of Shandong University of Traditional Chinese Medicine from January to May 2005. Freund's complete adjuvant (FCA) was used to establish adjuvant-arthrosis models in model group and electropumcture group. On the modeling day, the 3rd and the 5th Jiaji acupoints of bilateral lumbar vertebrae of rats in electropumcture group were acupunctured with 28-sized stainless-steel milli-needle of 0.5 inch.The needle was stimulated 0.3 cm from the 3rd and the 5th spinous process of lumbar vertebra which was counected to G6805-2A multiple functional electropumcture meter for sparse-tight waves (frequency of sparse wave: 4 Hz, frequency of tight wave: 60 Hz, intensity: t mA) 30 minutes each time,once a day for 7 days. Rats in normal group and model group were fixed with the same way for 7 days. (Rats were fixed with cloth-rope at fixing apparatus.) ② Pain threshold was measured before modelling, 1 and 7 days after modelling. Foot pad was exposured with strong light by hot-pain stimulation meter, and paw withdrawal latency was regarded as pain threshold. ③ Right hindfoot bulk of rats was assayed with foot bulk determinator (bulk draining method) before modelling, 1 and 7 days after modelling to calculate swelling rate (％) [(foot bulk after modelling-foot bulk before modelling)/ foot bulk before modelling × 100％ ]. ④ Expressional rates of serum CD4+ and CD8+ were assayed with FACSCalibur flow cytometer and the ratio between CD4+ and CD8+ was calculated 8 days after modelling. ⑤ Average value of multiple samples were compared with single-factor analysis of variance and t test.MAIN OUTCOME MEASURES: Effect of electropumcture at Jiaji acupoint on pain threshold, swelling rate and subgroup of serum T cells of adjuvant-arthrosis rats.RESULTS: A total of 30 rats were involved in the final analysis. ① One day after modeling, bulk of right hindfoot in model group and electropumcture group was bigger than that in normal control group and that before modeling (P ＜ 0.01), and swelling rate was higher than that in normal control group (P ＜ 0.01); 7 days after modeling, bulk and swelling of right hindfoot in model group were higher than those in normal control group (P ＜ 0.01), and bulk was bigger than that before modeling (P ＜ 0.01);bulk and swelling of right hindfoot in electropumcture group were lower than those in model group (P ＜ 0.05). ② Pain threshold of both rear feet of normal rats were not changed after modelling. One day after modelling,pain threshold at inflammatory side was decreased in model group and electropumcture group (P ＜ 0.01) and it was lower than that in normal control group (P ＜ 0.01); 7 days after modeling, pain threshold at inflammatory side was still lower than that before inflammation (P ＜ 0.05),and it in electropumcture group was higher than that in model group (P＜ 0.05). ③ Percentages of CD4+ T lymphocyte and CD8+ T lymphocyte in model group were lower than those in normal control group (P ＜ 0.01), and ratio of CD4+/CD8+ was also higher than that in normal control group (P＜ 0.05). Percentage of CD4+ in electropumcture group was higher than that in model group, but there was no significant difference. Percentage of CD8+ in electropumcture group was higher than that in model group (P ＜ 0.01),but ratio of CD4+/CD8+ was lower than that in model group (P ＜ 0.05).CONCLUSION: Electropumcture at Jiaji acupoint has obvious effect on anti-inflammation and analgesia, and can also regulate cellular immunity of adjuvant-arthrosis rats.

AIM: To identify the differences of gene expression between human age-related cataract and clear lenses. METHODS: The RNA were extracted from human age related cataract and clear lens epithelial cells, labeled with cy3/cy5 as probes, then were hybridized to cDNA chip containing 8 064 genes. The differential expressions of the genes were screened. Furthermore, a primary classification of these genes function was given. The expression levels of the identified genes were further evaluated by real time polymerase chain reaction. RESULTS: 286 genes expression were observed to increase and 438 genes expression were observed to decrease in cataractous lens epithelial cells as compared with normal lens. According to functional analysis, the changed genes in cataract lens are associated with lens structural components, cytoskeleton, cell cycle, apoptosis and stress responses. CONCLUSION: These data suggest that there are differences in gene expression between cataract and clear human lens epithelial cells. The majority of genes changed in cataract exhibited decreased expression. Processes associated with the down-regulated genes may reflect the inability of the lens to maintain its homeostasis and transparency.