The theory of " heart governing the exterior" derives from Prohibition of Pricking in Suwen, which has an important position in the clinical practice of traditional Chinese medicine. This article sorts out the interpretation of " heart governing the exterior" of physicians in the past dynasties, and summarizes the clinical application of " heart governing the exterior" in chest painful impediment, warm disease, dermatosis, allergic rhinitis, tic disorder, and diabetic neuropathy. It is found that the theory of " heart governing the exterior" is widely used in clinical practice and has good effects. This paper further expands and enhances its theoretical connotation, that is, the physiological and pathological connection and clinical application of the three dimensions of heart yang, heart blood, and heart spirit with the life and mental activities dominated by it, as well as the overall external performance. In addition, by exploring the relationship between " heart governing the exterior" and " brain-heart axis" , " brain-skin axis" in Western medicine, it indirectly confirms the rationality of " heart governing the exterior" in Western medicine, and lays the foundation for the further development and application of the theory of " heart governing the exterior" .

OBJECTIVE: To evaluate the clinical efficacy of clear aligner therapy in patients with severe periodontitis accompanied by pathological tooth displacement in the anterior region. METHODS: This retrospective study analyzed patients diagnosed with severe periodontitis and pathological displacement in the anterior region, who visited both the Periodontics and Orthodontics Departments at Peking University School and Hospital of Stomatology between 2019 and 2022. A total of 26 eligible cases were included in this study. All the patients underwent regular periodontal maintenance throughout the treatment process, and clear aligners were used for orthodontic treatment. Intraoral scans were analyzed by dedicated software to measure and compare occlusal distribution and proximal contact scores before and after orthodontic treatment. Periodontal clinical indicators were assessed at three key time points: before periodontal treatment (T0), before orthodontic treatment (T1), and after orthodontic treatment (T2). All the cases were treated with clear aligner. RESULTS: A total of 217 pathologically displaced anterior teeth from 26 patients were analyzed. Among these, 105 teeth exhibited periodontal pockets [probing depth (PD) ≥5 mm] before periodontal treatment. After clear aligner therapy, the occlusal score improved significantly from 10.35±8.61 to 23.62±9.73 (P < 0.001), and the proximal contact score increased from 13.62±4.73 to 31.62±10.37 (P < 0.001). The median PD decreased significantly from 3.33 mm [interquartile range (IQR)=0.92] at T0 to 2.50 mm (IQR=0.67, P < 0.001) at T1 and remained stable at 2.50 mm (IQR=0.50) after treatment (T2). A significant reduction in PD was observed between T0 and T2 (P < 0.001), but no significant difference was found between T1 and T2 (P=0.948). CONCLUSION Clear aligner therapy demonstrates favorable clinical efficacy in patients with severe periodontitis and pathological anterior tooth displacement. It effectively improves occlusal distribution and proximal contact while maintaining periodontal health in these patients. However, further large-scale prospective controlled studies are needed to verify its long-term clinical outcomes.
Humans ; Retrospective Studies ; Periodontitis/therapy* ; Female ; Male ; Adult ; Tooth Migration/therapy* ; Tooth Movement Techniques/methods* ; Treatment Outcome ; Middle Aged ; Young Adult ; Orthodontic Appliances, Removable

Objective:To explore effect of homogeneous medical concept nursing mode combined with focused solution mode on self-efficacy and immunity function and nursing satisfaction analysis of patients with postoperative enterostomy of colorectal cancer.Methods:A total of 102 patients with colorectal cancer undergoing postoperative enterostomy admitted to Suining Central Hospital from December 2019 to December 2020 were selected and divided into control group and observation group according to random number table method, with 52 cases in observation group and 50 cases in control group. The control group received homogeneous medical concept nursing mode, and the observation group combined with the focused solution mode nursing intervention on this basis. The self-efficacy, immune function and nursing satisfaction of the two groups were compared.Results:The general self-efficacy of the observation group was higher than that of the control group ( χ2=2.61, P<0.05). After nursing, the stomato-related self-efficacy score of the observation group was 102.69 ± 12.37, which was higher than that of the control group (90.13±11.22). There was significant difference between the two groups ( t= 5.37, P<0.05). There was no significant difference in peripheral blood CD3+, CD4+ and CD4+/CD8+ and NK levels between 2 groups one day after surgery ( P>0.05). The levels of CD3+, CD4+ and CD4+/CD8+ and NK in peripheral blood of the observation group after nursing care were (67.21 ± 6.21)%, (67.22 ± 8.76)%, (2.65 ± 0.45)% and (19.50 ± 2.05)%, respectively, which were higher than those of the control group (60.32 ± 5.45)%, (60.21 ± 8.25)%, (2.41 ± 0.32)% and (15.62 ± 1.81)%. The differences were statistically significant ( t=5.95, 4.21, 3.11, all P<0.05). The total satisfaction rate of nursing in the observation group was 98.08% (51/52), which was higher than 84.00% (42/50) in the control group, and the difference was statistically significant ( χ2= 2.63, P<0.05). Conclusions:The application of homogenous medical concept nursing mode combined with focused solution mode in colorectal cancer postoperative enterostomy patients is helpful to improve patients' self-efficacy, enhance patients ′ immune function, and improve nursing satisfaction degree, which is worthy of further promotion in clinical practice.

Objective:To investigate the expression of iron-regulating erythroid factors in different types of erythropoiesis disorders.Methods:From January 2016 to November 2019, the plasma concentrations of iron-regulating erythroid factors were measured by ELISA methods in 47 patients with different types of erythropoiesis disorders. The adaptation orientation of iron-regulating erythroid factor expression with bone marrow erythropoiesis activities (represented by bone marrow-nucleated erythrocytes ratio) was analyzed.Results:The median plasma growth differentiation factor (GDF) 15 levels in patients with polycythemia vera (PV) , pure red cell aplasia (PRCA) , autoimmune hemolytic anemia (AIHA) , and myelodysplastic syndrome (MDS) were 266.01 ng/L (112.40, 452.37) , 110.63 ng/L (81.41, 220.42) , 52.11 ng/L (32.61, 171.66) , and 276.53 (132.16, 525.70) ng/L, respectively, which were significantly higher than those in normal patients with 37.45 (19.65, 57.72) ng/L (all P < 0.01) . The plasma TWSG1 expression levels were not significantly different in patients with PV, PRCA, AIHA, and MDS from those of normal patients (P>0.05) . The median plasma GDF11 level in PV was 74.75 (10.95, 121.32) ng/L, which was significantly higher than 36.90 (3.38, 98.34) ng/L in normal control subjects ( P<0.01) . However, no statistical differences were observed in the other three subjects ( P>0.05) . The median plasma erythroferrone (ERFE) levels in AIHA and PV were 121.76 ng/L (68.12, 343.11) and 129.63 (47.02, 170.03) ng/L, respectively, with the highest level in AIHA in all the studied types of erythropoiesis disorders. The bone marrow-nucleated erythrocytes ratio was significantly and positively correlated with ERFE ( r=0.458, P=0.001) but not with GDF15 ( r=-0.163, P=0.274) , GDF11 ( r=0.120, P=0.421) , and TWSG1 ( r=-0.166, P=0.269) . Conclusion:The expression profile of iron-regulating erythroid factors is not exactly the same in different types of erythropoiesis disorders. ERFE demonstrated the highest correlation with erythropoiesis activities.

Objective:To study the effect of iron deficiency level for oral iron absorption in iron deficient patients.Methods:37 non-pregnant female patients who were diagnosed with iron deficiency and 13 healthy females who completed their physical examination at the outpatient department of the Anemia Center of the Institute of Hematology & Blood Diseases Hospital from July 2018 to June 2020 were included. Hepcidin and C2-C0 of oral iron absorption test were analyzed in different iron deficiency and serum ferritin level.Results:The median of Hepcidin in IDA, ID/IDE and healthy control group were 4.9 (2.17-32.86) , 26.98 (11.02-49.71) and 69.89 (42.23-138.96) μg/L ( P<0.001) , respectively. Hepcidin level of IDA group was lower than that of ID/IDE group (adjusted P=0.005) and healthy control (adjusted P<0.001) . Hepcidin level of ID/IDE group had no significant difference compared with healthy control (adjusted P=0.22) . The mean of C2-C0 in IDA, ID/IDE and healthy control group were (35.30±21.68) , (37.90±14.06) and (23.57±10.14) μmol/L ( P=0.130) , respectively. Multilinear regression analysis showed C0, SF, sTFR and HGB were independent factors for Hepcidin in iron deficient patients, with an equation of Hepcidin=-31.842-0.642*C0+2.239*SF+1.778*sTFR+0.365*HGB-0.274*RET-HB. We didn't find independent factor of C2-C0. Conclusion:The degree of iron deficiency had an effect on oral iron absorption. Patients of ID/IDE group absorbed iron more slowly than patients of IDA group. Iron deficient patients with normal gastrointestinal function absorbed more iron by oral administration when they were in a more serious iron deficient stage. Hepcidin was a better parameter to distinguish iron absorption level among different iron deficient patients than C2-C0 of oral iron absorption test.

OBJECTIVE：To establish a method for the simultan eous determination of the contents of 12 flavonoids in Quzhiqiao. METHODS ：HPLC method was adopted. The determination was performed on Agilent Extend C 18 column with mobile phase consisted of 0.1％ formic acid-acetonitrile （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was set at 35 ℃. The detection wavelength was set at 330 nm，and sample size was 10 μL. The contents of 12 components（such as eriocitrin，narirutin，naringin，naringenin，hesperidin，neohesperidin，hesperide hydrate ，luteolin，hesperide，nobiletin，hesperetin and hesperidolactone ）in 10 batches of Quzhiqiao from different collection places were determined. RESULTS ：The linear range of eriocitrin，narirutin，naringin，naringenin，hesperidin，neohesperidin，hesperide hydrate ，luteolin，hesperide，nobiletin，hesperetin and hesperidolactone were 1.65-16.51，4.50-45.02，35.41-354.12，4.11-41.12，2.29-22.86，34.96-349.56，1.42-14.15，1.50-15.04， 1.83-18.28，1.51-15.08，1.61-16.12，1.28-12.84 μg/mL，respectively（all r＞0.999 7）. The detection limits were 0.165 1，0.450 2， 3.541 2，0.411 2，0.228 6，3.495 6，0.141 5，0.150 4，0.182 8，0.150 8，0.161 2，0.128 4 μg/mL，respectively. The limits of quantitation were 0.547 8，1.487 4，11.663 3，1.360 3，0.758 3，11.594 9，0.466 3，0.497 1，0.601 2，0.499 9，0.532 3，0.424 6 μg/mL，respectively. RSDs of precision （n＝6），reproducibility（n＝6）and stability （24 h，n＝7）tests were all lower than 3％. The average recoveries were 99.50％，99.61％，98.18％，98.85％，98.48％，98.50％，98.25％，99.91％，103.13％，98.82％， 98.44％ ， 100.29％ （RSD＝1.49％ -2.38％ ， n＝6）. The contents of the above 12 components in 10 batches of samples from different collection places were 1.995 5-2.648 8，4.317 7- 5.005 1，33.215 5-34.054 6，3.140 4-3.471 5，3.221 2-3.748 8， 42.746 6-44.026 6，0.202 7-0.239 4，0.191 2-0.208 8，0.080 3- 0.097 9，0.291 9-0.307 1，0.119 9-0.149 1，0.082 7-0.089 8 mg/g. CONC LUSIONS：The method is accurate ，reliable，simple and efficient，which can be used to simultaneous determination of the contents of 12 flavonoids in Quzhiqiao ，and to provide reference for the establishment of quality control standards of Quzhiqiao.

Objective To investigate the expression of membrane CD14 (mCD14), Toll-like receptor (TLR4) and nuclear factor-kappa B (NF-kB) in peripheral blood ieukocytes from patients with psoriasis vulgaris (PV). Methods Blood samples were obtained from 29 normal controls and 32 patients with PV. Patient cohort consisted of 19 males and 13 females, with an average age of 30.28 ±13.11 years, disease duration of 8.21±10.21 years, and PASI score of 21.19±5.85. Flow cytometry was used to measure the expression of mCD14, TLR4 and activated NF-kB in peripheral blood leukocytes in these subjects. Results The expressions of mCD14 and TLR4 in peripheral blood leukocytes were significantly higher in patients than in the normal controls (5.454±2.78 vs 3.937±1.964, P < 0.05; 17.641±18.120 vs 7.527±8.574, P <0.01 ). Although the expression of activated NF-kB in total blood leukocytes in patients was higher than that in normal controls, no statistical difference was noticed (63.538±8.650 vs 62.236±6.72, P > 0.05). Conclusion There is an abnormal expression of mCD14 and TLR4 in patients with PV, suggesting that the abnormal activation of endotoxin signal transduction pathway may exert a role in the induction of psoriasis.

Objective To evaluate guglidnai detachable ceil(GDC)embolization therapy in treatment of acnte stage ruptured aneurysms.Methods 86 patients were involved in our study,we treat aneurysms with different intravascular therapy techniques,anti-artery-spasm treatment and lumber centesis were performed after therapy.Resuits 72 patients received 100% embolization,10 patients received 95% embolization,4 patients received 90% embolization,no patient died due to therapy in follow-up,further function recover was found.Conclusion Acute stage intravascular therapy combined with comprehensive measures can effectively improve the outcome of patients with ruptured aneurysms.

Objective To observe the effectiveness and expenses of the AMI patients with facilitated PCI,and to search for a new pattern for them.Methods 81 AMI patients were divided into 2 groups.One group accepted facilitated PCI(n=42) and the other group took routine PCI(n= 39).We compared the successful rate,death rate,left ventricular function between the two groups in infusing the infarction related artery(IRA).Results The successful rate of facilitated PCI group is 41/42,while routine PCI group is 31/39.There was no dead patient in facilitated PCI group,but six patients died in the routine PCI group.The EF in facilitated PCI group was(53.8?6.7)% and in routine PCI group it was(50.2?5.2)%.Conclusion Facilitated PCI is a safer and more efficient method than routine PCI,which will be worthy of further research to treat AMI.