The theory of " Sui Qi Suo De" originates from Zhang Zhongjing's Jin Gui Yao Lue and has been further developed by later generations of practitioners, offering significant guidance for clinical practice. Myelodysplastic syndromes (MDS) are common malignant disorders of the hematopoietic system, characterized by high heterogeneity and progressive mutational changes. In Traditional Chinese Medicine (TCM), MDS falls under the category of "marrow toxin exhaustion". This article applies the theory of " Sui Qi Suo De" in TCM to analyze the pathophysiological changes during different stages of MDS. Specifically, it explores the precursor stage (focusing on health maintenance and prevention before illness, addressing the " Suo De" of "gradual decline of vital qi"), the low-risk stage (strengthening the spleen and kidneys, clearing toxic pathogens, addressing the " Suo De" of "weakened vital qi invaded by pathogens"), and the medium-to-high-risk stage (detoxifying and reinforcing the body, harmonizing physical and mental health, addressing the " Suo De" of "dominant pathogens and declining vital qi"). The goal is to provide new directions and theoretical insights for the TCM treatment of MDS.

The method of decocting and taking medicine can directly influence the efficacy of the Chinese herbal medicine,and is the key to enhancing efficacy and reducing toxicity.As the originator of classic books for traditional Chinese medicine(TCM)prescriptions,Treatise on Exogenous Febrile Diseases has recorded various specific methods of decocting and taking medicine in details.This paper summarized and sorted out various methods of decocting the same Chinese herbal medicine,re-decocting method with the removal of dregs(for concentrating medicinal solution),method of decocting pills,dosage of medicine,time for taking medicine,and notices and healthcare after medication recorded in Treatise on Exogenous Febrile Diseases.Moreover,the dialectical view in the method of decocting medicine recorded in Treatise on Exogenous Febrile Diseases.was explored.The special method of decocting and taking medicine in Treatise on Exogenous Febrile Diseases included the TCM dialectical view of using the same Chinese herbal medicine for the treatment of different diseases,consideration of both Chinese herbal medicine and syndromes,drastic purgatives for chasing long-term efficacy.The method of taking medicine contained the TCM dialectical view of modification of the medicine dosage according to syndrome differentiation,adapting to the general trend,and suspension after medicine starting an effect.It is believed that the method of decocting and taking medicine for the prescriptions in Treatise on Exogenous Febrile Diseases is established according to syndrome differentiation,and the utilization of various methods of decocting and taking medicine as well as notices and healthcare after medication in accordance with the characteristics of diseases and syndromes ensures the prescriptions meeting the pathogenesis,and then enhance the clinical efficacy.

ObjectiveTo explore the association between short-term exposure to atmospheric fine particulate matter （PM_2.5） and ozone （O₃） and systemic inflammatory indicators in patients with pneumonia， and to identify the susceptible populations. MethodsFrom September 2018 to April 2020， data of 1 480 patients admitted for pneumonia was collected from a tertiary hospital in Taiyuan City. Generalized additive models （GAMs） were used to explore the associations between PM_2.5 and O₃ exposure and inflammatory indicators of patients with pneumonia； and to explore the susceptibility factors and susceptible populations to PM_2.5 and O₃ exposures through stratified analyses. ResultsThe short-term exposure to PM_2.5 was associated with changes in peripheral blood C-reation protein （CRP）， erythrocyte sedimentation （ESR）， easinophil （EOS）， neutrophil （NEU） and neutrophil-lymphocyte ratio （NLR） in patients with pneumonia， and there were different degrees of hysteresis effects， with the effect values reaching a maximum at lag03， lag03， lag0， lag03， lag03， respectively， which were 4.13% （95%CI： 0.43%‒7.84%）， 3.10% （95%CI： 0.24%‒5.97%）， 5.27% （95%CI： 3.12%‒7.42%）， 1.85% （95%CI： 0.36%‒3.34%）， and 2.53% （95%CI： 0.53%‒4.74%） for every 10 μg·m^-3 of PM_2.5. The changes in O₃ concentration were associated with the elevation of peripheral blood PCT and ESR in patients with pneumonia， and their effect values all reached the maximum at lag01 d， every 1 μg·m^-3 of O₃ elevation increased by 0.38% （95%CI： 0.04%‒0.73%） and 0.47% （95%CI： 0.19%‒0.76%）， respectively. Stratified analyses showed that the associations of PM_2.5 with peripheral blood CRP， ESR， NEU， and NLR in pneumonia patients were more significant in males， the elderly， and those with onset in the cold season； the associations of O₃ with peripheral blood PCT and ESR in pneumonia patients were more significant in the elderly and those with onset in the warm season， and the peripheral blood CRP and PCT in female patients with pneumonia were more susceptible to the changes of O₃. ConclusionShort-term exposure to atmospheric PM_2.5 and O₃ are positively associated with changes in inflammatory indicators in patients with pneumonia， and the effects of PM_2.5 on patients with pneumonia are more extensive than those of O₃， with a longer lag effect. In addition， elderly patients with pneumonia are more sensitive to air pollution， male patients with pneumonia are more sensitive to PM_2.5， and female patients with pneumonia are more sensitive to O₃. Cold and warm seasons can exacerbate the effects of PM_2.5 and O₃ on inflammatory indicators in patients with pneumonia， respectively， and the patients must be protected well.

Objective:To evaluate the role of mitochondria-associated endoplasmic reticulum membranes (MAMs) regulated by protein tyrosine phosphatase interacting protein 51 (PTPIP51) in sevoflurane-induced necroptosis in hippocampal neurons of rats using the in vitro experiment.Methods:Primary cultured hippocampal neurons from fetal rats of Sprague-Dawley rats were inoculated in culture wells (100 μl/well ) or culture flasks (3 ml/bottle) at a density of 5×10 5 cells/ml at 7 days of culture and divided into 4 groups ( n=19 each) using a random number table method: control group (C group), sevoflurane group (Sev group), sevoflurane+ siRNA-PTPIP51 transfection group (Sev+ siPTPIP51 group), and sevoflurane+ nonsense siRNA transfection group (Sev+ siNC group). The neurons were placed in a culture incubator containing 2% sevoflurane and incubated at 37 ℃ for 5 h in Sev, Sev+ siPTPIP51 and Sev+ siNC groups. Then neurons were collected for determination of the cell survival rate (by MTT method), cytoplasmic calcium concentration ([Ca 2+ ] i) and necroptosis rate (by flow cytometry), expression of PTPIP51, receptor-interacting protein kinase 1 (RIPK1), RIPK3, and phosphorylated mixed lineage kinase domain-like protein (p-MLKL) (by Western blot) and for microscopic examination of the partial length, endoplasmic reticulum circumference, and mitochondrial circumference of MAMs (with a transmission electron microscope). Results:Compared with group C, the activity of neurons was significantly decreased, the [Ca 2+ ] i and necroptosis rate were increased, the expression of PTPIP51, RIPK1, RIPK3 and p-MLKL was up-regulated, and the ratio of partial length of MAMs to endoplasmic reticulum perimeter and partial length of MAMs to mitochondrial perimeter were increased in group Sev ( P<0.05). Compared with group Sev, the activity of neurons was significantly increased, the [Ca 2+ ] i and necroptosis rate were decreased, the expression of PTPIP51, RIPK1, RIPK3 and p-MLKL was down-regulated, and the ratio of partial length of MAMs to endoplasmic reticulum perimeter and partial length of MAMs to mitochondrial perimeter were decreased in group Sev+ siPTPIP51 ( P<0.05), and no statistically significant changes were found in the above parameters in group Sev+ siNC ( P>0.05). Conclusions:Up-regulation of PTPIP51 expression mediates structural changes in MAMs and is involved in the process of sevoflurane-induced necroptosis in hippocampal neurons of rats.

Objective:To investigate the changes of hippocampal gray matter volume and expression of candidate immune related genes in a rat model of schizophrenia established by repeated administration of dizocilpine(MK-801).Methods:Thirty SPF grade Sprague-Dawley male rats at postnatal day 28 were randomly divided into MK-801 medium-dose (0.25 mg/kg) group, MK-801 high-dose(0.50 mg/kg) group and normal saline (5 mL/kg) group according to random number table method, with 10 in each group.Rats were given continuous intraperitoneal administration according to grouping once a day for 14 days.Open field test, novel object recognition test and Y-maze test were used at postnatal day 60 to detect spontaneous activity, exploration ability, anxiety level, object recognition memory ability and spatial working memory of rats, respectively.At postnatal day 67, structural magnetic resonance imaging was used to detect the changes of hippocampal gray matter volume in rat.And at postnatal day 70, qRT-PCR was used to detect the expression of candidate immune-related genes in rat hippocampus.SPSS 25.0 was used for statistical analysis, one-way ANOVA was used for comparison among multiple groups, and Tukey test was used for further pairwise comparisons.Results:(1)The behavioral results showed that there were significant differences in the total movement distance, central area activity time, novel object recognition index, and spontaneous correct alternation rate among the three groups ( F=11.15, 10.11, 13.62, 11.99, all P<0.05). The total movement distances in MK-801 medium-dose group and MK-801 high-dose group ((21.44±2.17) m, (22.87±1.96)m) were higher than that in the normal saline group ((18.70±1.88) m) (both P<0.05). The activity time of the central area in the MK-801 medium-dose group and MK-801 high-dose group((3.24±1.58) s, (2.50±1.32) s) were lower than that of the normal saline group ((6.05±2.48)s) (both P<0.01). Novel object recognition indexes in the MK-801 medium-dose group and MK-801 high-dose group((56.10±3.99)%, (54.00±6.41)%) were both lower than that in the normal saline group ((65.90±5.65)%)(both P<0.01), and the rates of spontaneous correct alternation ((54.60±7.03)%, (51.60±8.84)%) in the two groups were lower than that of the normal saline group ((68.40±8.57)%) (both P<0.01). (2) The results of structural magnetic resonance imaging showed that there were significant differences in the volume of hippocampal gray matter among the three groups ( F=9.24, P<0.001). The volumes of hippocampal gray matter in MK-801 medium-dose group and MK-801 high-dose group were lower than that in normal saline group(both P<0.001). (3)By constructing protein-protein interaction network, four candidate immune related genes were screened out: neuropeptide Y (NPY), somatostatin (SST), cholecystokinin (CCK) and tachykinin 1 (TAC1). The results showed that the mRNA expression levels of NPY, SST and CCK in the hippocampus of the three groups were significantly different ( F=11.41, 10.43, 5.85, all P<0.05), but there was no statistical difference in the TAC1 mRNA expression level ( F=0.08, P>0.05). The mRNA levels of NPY, SST and CCK in the hippocampus of rats in the MK-801 high-dose group were lower than those in the normal saline group (all P<0.05). Conclusion:Both medium dose and high dose MK-801 administration can reduce the volume of hippocampal gray matter in schizophrenia model rats, but they have different effects on the expression of hippocampal immune related genes, of which high dose administration has a greater effect.

OBJECTIVE: To explore the genetic etiology of a child with Hypomagnesemia, epilepsy and mental retardation syndrome (HSMR). METHODS: A child who was admitted to the Children's Hospital of Shandong University on July 9, 2021 due to repeated convulsions for 2 months was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and his pedigree members were collected for the extraction of genomic DNA. Whole exome sequencing was carried out, and candidate variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: The child, a 1-year-and-7-month-old male, had presented with epilepsy and global developmental delay. Serological testing revealed that he has low serum magnesium. Genetic testing showed that the child has harbored a heterozygous c.1448delT (p.Val483GlyfsTer29) variant of the CNNM2 gene, which was de novo in origin. The variant has caused substitution of the Valine at position 483 by Glycine and formation of a termination codon after 29 amino acids at downstream. As predicted by Swiss-Model online software, the variant may alter the protein structure, resulting in a truncation. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.1448delT (p.Val483GlyfsTer29) was predicted as a pathogenic variant (PVS1+PS2+PM2_Supporting+PP4). CONCLUSION The heterozygous c.1448delT variant of the CNNM2 gene probably underlay the HSMR in this child. Above finding has enriched the phenotype-genotype spectrum of the CNNM2 gene.
Humans ; Male ; Cation Transport Proteins ; Computational Biology ; Ethnicity ; Intellectual Disability/genetics* ; Magnesium ; Mutation ; Seizures/genetics* ; Infant

【Objective】 To investigate the death time of patients with coronavirus disease 2019 (COVID-19). 【Methods】 The death time was calculated and analyzed using individual data and aggregated data through the daily notification of the epidemic situation and the death cases published on the website of the Heath Commission of China and provinces. 【Results】 In the 153 patients who died of COVID-19, the shortest time from onset to death was 4 days and the longest time was 50 days with the mean±standard deviation of (16.7±9.2) days. The median was 14 days and the 95% confidence interval was 4.6-42.9. The shortest time from admission to death was 1 day and the longest time was 50 days with the mean ± standard deviation of (12.1±7.8) days. The median was 11 days and the 95% confidence interval was 2-32.8. The time curve from diagnosis to death was skewed. The death time from diagnosis to death was 0 to 48 days with the mean ± standard deviation of (11.1±8.9) days. The median was 9 days, the interquartile interval was 10.5 days, and the 95% confidence interval was 0-35.4. It took 3 days from onset to admission and 1 day from admission to diagnosis. Aggregated data showed that the time from diagnosis to death of COVID-19 patients in China, China (except Hubei Province), Hubei Province and Wuhan City was 8, 9, 6 and 6 days, respectively. 【Conclusion】 The time from diagnosis to death of COVID-19 patients varied significantly, with the median time of 6-9 days in different regions.

Objective:To observe the effect of electro-acupuncture (EA) on learning, memory and the differentiation of neural stem cells in the hippocampus in the presence of chronic cerebral ischemia.Methods:A total of 120 male Sprague-Dawley rats had chronic cerebral ischemia induced by bilateral ligation of the common carotid arteries. The model was successfully established in 104 of them, and they were randomly divided into a model group and an EA group, each of 52. The EA group was given 20 minutes of EA at acpoints Baihui and Dahui every day for 7 days, followed by an interval of 2 days. The current output was 1mA and the frequency was 15Hz. The model group was not given any intervention. One, 2, 4 and 6 weeks after the modelling, 6 rats from each group were injected with BrdU, and any proliferation and differentiation of neural stem cells was observed. The rats′ learning and memory were also evaluated using the Morris water maze, and neurogenesis of in the dentate gyrus was observed using BrdU+ NeuN and BrdU+ GFAP double-labelled immunofluorescence.Results:The learning and memory of the EA group were significantly better than those of the model group 2, 4 and 6 weeks after the modelling. After two weeks BrdU+ NeuN and BrdU+ GFAP-positive cells were found in the granule cell layer of the hippocampus, and compared with the model group, there were siginificantly more such neurons in the EA group. The gliocyte levels were not significantly different.Conclusion:Electro-acupuncture can improve learning and memory in the face of chronic cerebral ischemia by promoting the differentiation of neural stem cells.

Objective: To observe the effects of continuous nursing(CN) on rehabilitation of patients with hypertensive intracerebral hemorrhage (HICH) and to explore the effective interventive measures for CN. Methods: Totally 129 admitted HICH patients from January to December 2017 were selected and randomly divided into study group (63 cases) and control group (66 cases), the control group was handed with Handbook of stroke prevention and control before discharge, the study group received CN intervention, which included pre-discharge health education, family visits, patient management and video interview via WeChat App, group lecture and psychological support, self-nursing ability, motor function and ability of daily life and emotional condition were evaluated before and post discharge, and the disabled ratio 6 months after discharge between the 2 groups were compared. Results: The 2 groups with the scores of exercise of self-care agency scale (ESCA) were increased significantly compared with before discharge (all P<0.05) ; the study group with the ESCA scores 3 months and 6 months after discharge were significantly higher than the control group [3months:118.5±8.2 vs. 112.3±7.5; 6 months: 127.7±8.7 vs. 119.3±9.1] (all P<0.05) . Fugl Meyer score and Barthel index of the 2 group after discharge were both lower than the pre-discharge levels (all P<0.05); Fugl Meyer score and Barthel index of the study group 3 months and 6 months after discharge were significantly higher than the control group [3 months: Fugl Meyer score 73.3±7.3 vs. 69.4±6.9; Barthel index 56.5±8.0 vs. 51.8±7.3; 6 months: Fugl Meyer score77.6±8.0 vs. 74.5±7.2; Barthel index 67.5±8.7 vs. 63.0±7.4] (all t=2.291-3.454, P<0.05). Two groups with HAD score after discharge were significantly decreased compared with before discharge (P<0.05); the study group with the HAD-A and HAD-D scores 3 and 6 months after discharge were significantly lower than the control group[3 months: HAD-A 6.75±2.23 vs. 8.02±2.85; HAD-D 6.07±1.75 vs. 7.23±1.94; 6 months: HAD-A 5.93±2.04 vs. 6.84±2.37; HAD-D 5.86±1.47vs. 6.75±1.76] (all P<0.05) . The study group with the re-admission rate and disabled ratio within 6 months after discharge were both lower than the control group, but the differences without statistical significance (all P>0.05). Conclusion The HICH patients added with CN can significantly improve self-care ability, improve prognosis; patient management via WeChat App and group lecture & psychological support are effective measures to carry out CN.

The purpose of this paper was to investigate the effects of wearable lower limb exoskeletons on the kinematics and kinetic parameters of the lower extremity joints and muscles during normal walking, aiming to provide scientific basis for optimizing its structural design and improving its system performance. We collected the walking data of subjects without lower limb exoskeleton and selected the joint angles in sagittal plane of human lower limbs as driving data for lower limb exoskeleton simulation analysis. Anybody (the human biomechanical analysis software) was used to establish the human body model (the human body model without lower limb exoskeleton) and the man-machine system model (the lower limb exoskeleton model). The kinematics parameters (joint force and joint moment) and muscle parameters (muscle strength, muscle activation, muscle contraction velocity and muscle length) under two situations were compared. The experimental result shows that walking gait after wearing the lower limb exoskeleton meets the normal gait, but there would be an occasional and sudden increase in muscle strength. The max activation level of main lower limb muscles were all not exceeding 1, in another word the muscles did not appear fatigue and injury. The highest increase activation level occurred in rectus femoris (0.456), and the lowest increase activation level occurred in semitendinosus (0.013), which means the lower limb exoskeletons could lead to the fatigue and injury of semitendinosus. The results of this study illustrate that to avoid the phenomenon of sudden increase of individual muscle force, the consistency between the length of body segment and the length of exoskeleton rod should be considered in the design of lower limb exoskeleton extremity.
Biomechanical Phenomena ; Exoskeleton Device ; Gait ; Humans ; Lower Extremity ; physiology