[Objective]Based on the holistic view of"correspondence between nature and humans"in Huangdi Neijing,which is central to traditional Chinese time medicine theory,to explore a new diagnostic and therapeutic approach to insomnia from the perspective of"time".[Methods]By grounding in ancient and modern literature,this study elucidates the connotations of traditional Chinese time medicine and systematically reviews the temporal rhythms and derived theories related to insomnia in Huangdi Neijing,summarizing the approach to treating insomnia through time medicine.[Results]The disruption of the wake-sleep rhythm is a primary pathological mechanism of insomnia.The circadian rhythm,the four seasons rhythm,the exceeding the age rhythm and the meridians rhythm discussed in Huangdi Neijing are closely related to insomnia.They could be encapsulated into four major theories:the waxing and waning of Yin and Yang,the viscera and bowels managing time,the five movements and six climates,and the midnight-midday ebb flow theory.This study advocates a four-level strategy for insomnia,closely aligned with time medicine theory and the pathogenesis of insomnia,namely"regulating Yin and Yang""adapting to the four seasons""responding to annual Qi"and"reinforcement and elimination of Nazhi".[Conclusion]The time medicine concept in Huangdi Neijing has objectively effects in the prevention and treatment of insomnia,providing a new breakthrough and integration point for clinical diagnosis and treatment of insomnia.In clinical diagnosis and treatment of insomnia,the consideration of time rhythms should be fully integrated to achieve optimal therapeutic outcomes.

The neonatal mammalian heart has a remarkable regenerative capacity, while the adult heart has difficulty to regenerate. A metabolic reprogramming from glycolysis to fatty acid oxidation occurs along with the loss of cardiomyocyte proliferative capacity shortly after birth. In this study, we sought to determine if and how metabolic reprogramming regulates cardiomyocyte proliferation. Reversing metabolic reprogramming by carnitine palmitoyltransferase 1 (CPT1) inhibition, using cardiac-specific Cpt1a and Cpt1b knockout mice promoted cardiomyocyte proliferation and improved cardiac function post-myocardial infarction. The inhibition of CPT1 is of pharmacological significance because those protective effects were replicated by etomoxir, a CPT1 inhibitor. CPT1 inhibition, by decreasing poly(ADP-ribose) polymerase 1 expression, reduced ADP-ribosylation of dual-specificity phosphatase 1 in cardiomyocytes, leading to decreased p38 MAPK phosphorylation, and stimulation of cardiomyocyte proliferation. Our present study indicates that reversing metabolic reprogramming is an effective strategy to stimulate adult cardiomyocyte proliferation. CPT1 is a potential therapeutic target for promoting heart regeneration and myocardial infarction treatment.

[Objective]Based on the holistic view of"correspondence between nature and humans"in Huangdi Neijing,which is central to traditional Chinese time medicine theory,to explore a new diagnostic and therapeutic approach to insomnia from the perspective of"time".[Methods]By grounding in ancient and modern literature,this study elucidates the connotations of traditional Chinese time medicine and systematically reviews the temporal rhythms and derived theories related to insomnia in Huangdi Neijing,summarizing the approach to treating insomnia through time medicine.[Results]The disruption of the wake-sleep rhythm is a primary pathological mechanism of insomnia.The circadian rhythm,the four seasons rhythm,the exceeding the age rhythm and the meridians rhythm discussed in Huangdi Neijing are closely related to insomnia.They could be encapsulated into four major theories:the waxing and waning of Yin and Yang,the viscera and bowels managing time,the five movements and six climates,and the midnight-midday ebb flow theory.This study advocates a four-level strategy for insomnia,closely aligned with time medicine theory and the pathogenesis of insomnia,namely"regulating Yin and Yang""adapting to the four seasons""responding to annual Qi"and"reinforcement and elimination of Nazhi".[Conclusion]The time medicine concept in Huangdi Neijing has objectively effects in the prevention and treatment of insomnia,providing a new breakthrough and integration point for clinical diagnosis and treatment of insomnia.In clinical diagnosis and treatment of insomnia,the consideration of time rhythms should be fully integrated to achieve optimal therapeutic outcomes.

This study aims to evaluate the accuracy of portable hemoglobinometer (Hemocue Hb 201+ hemoglobin analyzer) in patients with maintenance hemodialysis (MHD) and its diagnostic value for anemia. The data of venous hemoglobulin (Hb) and fingertip capillary hemoglobulin (DHb) in MHD patients from Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed, and the correlation and difference between DHb and Hb and the accuracy of DHb in the diagnosis of anemia were evaluated. A total of 105 patients were included in the study. There was no significant difference between the paired DHb and Hb [(109±21) g/L vs. (108±20) g/L, t=-1.284, P=0.202]. Pearson correlation analysis showed that DHb was positively correlated with Hb ( r=0.929, P<0.001). Linear regression analysis showed that DHb and Hb met the regression equation Hb=0.88×DHb+12.23, and P<0.001. Bland-Altman analysis showed that the differences between the paired DHb and Hb was (1.0±7.8) g/L with the limit of agreement as (-14.2, 16.2) g/L. The mean percentage of the differences in Hb was 1% with limit of agreement as (-13.7%, 15.7%). A DHb of >110 g/L was 0.90 sensitive and 0.83 specific to identify patients with an Hb >110 g/L and its positive and negative predictive values were 0.84 and 0.90, respectively. It suggests that, in MHD patients, Hemocue Hb 201+ analyzer shows good accuracy, and can be used to monitor the Hb trend and serve as a screen method for those reaching target Hb.

Objective To investigate the distribution and antimicrobial resistance of the bacterial strains isolated from blood samples of inpatients in Longgang Hospital,Beijing University of Chinese Medicine.Methods The bacterial identification and antimicrobial susceptibility test results for the strains isolated from 2018 to 2022 were retrospectively analyzed.Results A total of 910 strains of bacteria were isolated from blood samples,of which 63.2％(575/910)were gram-negative bacteria and 36.8％(335/910)were gram-positive bacteria.Escherichia coli,coagulase-negative Staphylococcus,Klebsiella pneumoniae,Staphylococcus aureus,and Enterococcus spp.were the top 5 pathogens.In the past 5 years,no carbapenem-resistant strains of E.coli or K.pneumoniae were found in the blood samples of the inpatients.A.baumannii had a resistance rate of 11.8％to carbapenems.The prevalence of methicillin-resistant strains in S.aureus,S.epidermidis and other Staphylococcus species was 16.7％,75.0％and 55.5％,respectively.No vancomycin-or linezolid-resistant staphylococcual isolates were found.No strains of Enterococcus faecalis or Enterococcus faecium were found resistant to high concentrations of gentamicin,linezolid,or vancomycin.Conclusions The bacteria isolated from blood samples in Longgang Hospital were mainly gram-negative bacteria.Carbapenem-resistant strain was identified in the strains of A.baumannii.Bacterial resistance surveillance should be strengthened for the isolates from blood samples and other specimens from the site of infection.Antimicrobial agents should be used rationally to prevent the spread of drug-resistant bacteria.

AIM:To investigate the protective effect of decylubiquinone(DUb)against medium-wave ultravio-let(UVB)-induced photodamage in HaCaT cells and its molecular mechanism.METHODS:The photodamage model was established by irradiating HaCaT cells with UVB.The experiment was divided into 6 groups:control group,UVB model group(30 mJ/cm2),UVB+low-,medium-and high-concentration(2.5,5 and 10 μmol/L)DUb groups,and DUb(10 μmol/L)group.Cell viability was detected using the CCK-8 assay.The morphological changes of the HaCaT cells were observed under a light microscope.The production of reactive oxygen species(ROS)content in the HaCaT cells was analyzed by fluorescence probe of DCFH-DA,and the superoxide dismutase(SOD)activity,intracellular glutathione(GSH)and malondialdehyde(MDA)levels were detected using biochemical reagents.The apoptosis rate was detected through flow cytometry.The protein expression levels of Bax、Bcl-2、caspase-3 and p53 were detected by Western blot.RESULTS:Compared with the control group,the cell viability of UVB model group was significantly decreased(P＜0.01),and obvious morphological changes,ROS and MDA were significantly increased(P＜0.01),GSH and SOD were significantly decreased(P＜0.01),the apoptosis rate was increased(P＜0.01).DUb pretreatment significantly increased the viability of UVB-induced photodamage HaCaT cells(P＜0.01),decreased intracellular ROS and MDA production(P＜0.05,P＜0.01),increased GSH content and SOD activity(P＜0.05,P＜0.01),and reduced apoptosis(P＜0.01).Addi-tionally,the protein expression levels of Bax,caspase-3 and p53 in medium-and high-dose DUb groups were significantly decreased(P＜0.01),while the anti-apoptotic protein Bcl-2 was significantly increased(P＜0.01).CONCLUSION:Dec-ylubiquinone can alleviate UVB-induced photodamage to HaCaT cells,reduce apoptosis and enhance the antioxidant ca-pacity of cells,and protect HaCaT cells against UVB radiation.

AIM:To investigate the protective effect of decylubiquinone(DUb)against medium-wave ultravio-let(UVB)-induced photodamage in HaCaT cells and its molecular mechanism.METHODS:The photodamage model was established by irradiating HaCaT cells with UVB.The experiment was divided into 6 groups:control group,UVB model group(30 mJ/cm2),UVB+low-,medium-and high-concentration(2.5,5 and 10 μmol/L)DUb groups,and DUb(10 μmol/L)group.Cell viability was detected using the CCK-8 assay.The morphological changes of the HaCaT cells were observed under a light microscope.The production of reactive oxygen species(ROS)content in the HaCaT cells was analyzed by fluorescence probe of DCFH-DA,and the superoxide dismutase(SOD)activity,intracellular glutathione(GSH)and malondialdehyde(MDA)levels were detected using biochemical reagents.The apoptosis rate was detected through flow cytometry.The protein expression levels of Bax、Bcl-2、caspase-3 and p53 were detected by Western blot.RESULTS:Compared with the control group,the cell viability of UVB model group was significantly decreased(P＜0.01),and obvious morphological changes,ROS and MDA were significantly increased(P＜0.01),GSH and SOD were significantly decreased(P＜0.01),the apoptosis rate was increased(P＜0.01).DUb pretreatment significantly increased the viability of UVB-induced photodamage HaCaT cells(P＜0.01),decreased intracellular ROS and MDA production(P＜0.05,P＜0.01),increased GSH content and SOD activity(P＜0.05,P＜0.01),and reduced apoptosis(P＜0.01).Addi-tionally,the protein expression levels of Bax,caspase-3 and p53 in medium-and high-dose DUb groups were significantly decreased(P＜0.01),while the anti-apoptotic protein Bcl-2 was significantly increased(P＜0.01).CONCLUSION:Dec-ylubiquinone can alleviate UVB-induced photodamage to HaCaT cells,reduce apoptosis and enhance the antioxidant ca-pacity of cells,and protect HaCaT cells against UVB radiation.

Objective:To investigate the application and effect of frontal flap combined with tarsalconjunctiva flap in the repair of widely full-thickness defects of the lower eyelid.Methods:From January 2016 to March 2018, 9 patients with extensive full-thickness lower eyelid defect were admitted to the Plastic Surgery Department of Changhai Hospital Affiliated to the Naval Military Medical University. All the lengths of lower eyelid defects were greater than a half of the full length. Then we designed forehead flaps combined with tarsalconjunctival flaps to cover the wounds. The second stage operation was done after 4-6 weeks to cut the pedicle and dress the eyelid.Results:All the frontal flaps of 9 patients survived. One patient had lower eyelid retraction and the lid position returned to normal half a year later. One underwent thinning surgery because of lower eyelid flap hypertrophy and one were because of pedicle hypertrophy. The appearance and function of other patients were greatly improved after surgery, and they were satisfied with the operation effect. No repair operation was performed in the future.Conclusions:The frontal flap with good quality of blood supply has a high survival rate and can be used to repair the wide defect of the lower eyelid with tarsalconjunctival flaps.

Objective:To investigate the application and effect of frontal flap combined with tarsalconjunctiva flap in the repair of widely full-thickness defects of the lower eyelid.Methods:From January 2016 to March 2018, 9 patients with extensive full-thickness lower eyelid defect were admitted to the Plastic Surgery Department of Changhai Hospital Affiliated to the Naval Military Medical University. All the lengths of lower eyelid defects were greater than a half of the full length. Then we designed forehead flaps combined with tarsalconjunctival flaps to cover the wounds. The second stage operation was done after 4-6 weeks to cut the pedicle and dress the eyelid.Results:All the frontal flaps of 9 patients survived. One patient had lower eyelid retraction and the lid position returned to normal half a year later. One underwent thinning surgery because of lower eyelid flap hypertrophy and one were because of pedicle hypertrophy. The appearance and function of other patients were greatly improved after surgery, and they were satisfied with the operation effect. No repair operation was performed in the future.Conclusions:The frontal flap with good quality of blood supply has a high survival rate and can be used to repair the wide defect of the lower eyelid with tarsalconjunctival flaps.

Objective: To investigate the lateral canthoplasty and canthopexy with bone drilling to correct lower eyelid malposition and its benefit. Methods: From January 2014 to January 2019, lateral canthopexy with bone drilling technique was used to repair 56 patients with lower eyelid malposition in Department of Plastic and Reconstructive Surgery of Changhai Hospital. Forty-four patients with lower eyelid ectopic had multiple previous surgeries, and 12 patients had congenital lower eyelid retraction. For patients without lower palpebral margin extension, lateral canthopexy with bone drilling technique was applied. For patients with lower palpebral margin extension, the lateral canthus angle was exposed to shorten the lower eyelid margin. For congenital lower eyelid retraction, the lateral canthus tendon was completely cut off, and then fixed with double armed sutures. Results: Operations were successfully performed on all 56 patients, and the patients were followed up for 1-38 months. Forty-nine patients achieved good eyelid shape and satisfied with the operative effects (87.5%). Malposition was ameliorated in 6 patients (10.7%). One remained uncorrected (1.8%). Conclusions Lateral canthopexy with bone drilling technique could obtain firm suspension force. For lower eyelid malposition, especially for patients with recurrent malposition or congenital lower eyelid retraction, satisfied function and appearance could be achieved.