OBJECTIVE: To observe the efficacy and safety of Tiaowei Jiannao acupuncture (acupuncture for regulating defensive qi and nourishing brain) for post-ischemic stroke insomnia (PISI). METHODS: A total of 96 patients with PISI were randomized into an acupuncture group (32 cases, 1 case was excluded), a medication group (32 cases, 1 case dropped out, 1 case was excluded) and a sham-acupuncture group (32 cases, 1 case dropped out, 1 case was excluded). In the acupuncture group, Tiaowei Jiannao acupuncture was applied at bilateral Shenmai (BL62), Zhaohai (KI6), Hegu (LI4), Taichong (LR3), and Baihui (GV20), Sishencong (EX-HN1), Yintang (GV24⁺), Shenting (GV24), once a day, 1-day interval was taken after 6-day treatment, for 3 weeks totally. In the medication group, eszopiclone tablet was given orally, 1-3 mg a time, once a day for 3 weeks. In the sham-acupuncture group, non-invasive sham acupuncture was applied, the acupoint selection, frequency and course of treatment were the same as the acupuncture group. Before treatment, after 2,3 weeks of treatment, the scores of Pittsburgh sleep quality index (PSQI), self-rating sleep scale (SRSS), National Institutes of Health Stroke scale (NIHSS), Hamilton depression scale-17 (HAMD-17) were observed; before and after treatment, the sleep parameters were recorded using polysomnography (PSG); and the efficacy and safety were evaluated after treatment in the 3 groups. RESULTS: After 2,3 weeks of treatment, the scores of PSQI, HAMD-17 and SRSS in the acupuncture group and the medication group, as well as the SRSS scores in the sham-acupuncture group were decreased compared with those before treatment (P<0.05); after 2 weeks of treatment, the NIHSS score in the acupuncture group was decreased compared with that before treatment (P<0.05); after 3 weeks of treatment, the NIHSS scores in the acupuncture group, the medication group and the sham-acupuncture group were decreased compared with those before treatment (P<0.05). After 3 weeks of treatment, the scores of PSQI, SRSS, HAMD-17 and NIHSS in the acupuncture group and the medication group, as well as the NIHSS score in the sham-acupuncture group were decreased compared with those after 2 weeks of treatment (P<0.05). After 2,3 weeks of treatment, the scores of PSQI, SRSS and HAMD-17 in the acupuncture group and the medication group were lower than those in the sham-acupuncture group (P<0.05), the NIHSS scores in the acupuncture group were lower than those in the medication group and the sham-acupuncture group (P<0.05); after 3 weeks of treatment, HAMD-17 score in the acupuncture group was lower than that in the medication group (P<0.05), the NIHSS score in the medication group was lower than that in the sham-acupuncture group (P<0.05). Compared before treatment, after treatment, the total sleep time was prolonged (P<0.05), the wake after sleep onset, sleep latency, and non-rapid eye movement (NREM) sleep latency were shortened (P<0.05), the sleep efficiency was improved (P<0.05), the number of awakenings was reduced (P<0.05), the percentage of rapid eye movement (REM%) and the percentage of NREM stage 1 (N1%) were decreased (P<0.05), the percentage of NREM stage 2 (N2%) and the percentage of NREM stage 3 (N3%) were increased (P<0.05) in the acupuncture group and the medication group; the sleep latency was shortened in the sham-acupuncture group (P<0.05). After treatment, the PSG indexes in the acupuncture group and the medication group were superior to those in the sham-acupuncture group (P<0.05); in the acupuncture group, the number of awakenings was less than that in the medication group (P<0.05), the REM% and N1% were lower than those in the medication group (P<0.05), the N2% and N3% were higher than those in the medication group (P<0.05). The total effective rate were 93.5% (29/31) and 90.0% (27/30) in the acupuncture group and the medication group respectively, which were higher than 10.0% (3/30) in the sham-acupuncture group (P<0.05). There was no serious adverse events in any of the 3 groups. CONCLUSION Tiaowei Jiannao acupuncture improves the insomnia symptoms in patients with ischemic stroke, improves the quality of sleep, increases the deep sleep, promotes the recovery of neurological function, and relieves the depression. It is effective and safe for the treatment of PISI.
Humans ; Acupuncture Therapy ; Male ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Ischemic Stroke/complications* ; Stroke/complications* ; Sleep

Objective:To investigate the potential characteristic manifestations and application value of the Dynamic Visual Acuity Test（DVAT） in vestibular migraine（VM）. Methods:A total of 50 VM patients（case group） and 50 healthy subjects（control group） diagnosed at the Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University between November 1, 2023, and December 31, 2024, were enrolled. The case group underwent DVAT, video head impulse test（vHIT）, caloric test, and Dizziness Handicap Inventory（DHI） assessment, whereas the control group only received DVAT. Group-based analyses were conducted to examine the effect of age on Dynamic Visual Acuity Loss（DVALoss）, as well as the correlations of DVALoss with vestibular function tests and DHI scores. Results:DVALoss in the case group was significantly higher than that in the control group（P<0.001）. In both groups, age was significantly and positively correlated with DVALoss（P<0.001）. Within the case group, DVALoss was strongly and positively correlated with DHI scores（r=0.807, P<0.001）; it was negatively correlated with the vestibulo-ocular reflex（VOR） gain in vHIT, though without clinical significance, and showed no significant association with the caloric test. Age and DVALoss collectively accounted for 71.3% of the variance in DHI scores（R²=0.713）, with age exerting a relatively minor actual impact. Conclusion:DVAT can sensitively identify the core functional impairments of VM. DVALoss, as a direct functional reflection of the pathological mechanism of VM, is strongly correlated with DHI scores. Incorporating DVALoss into standardized assessments may provide an objective basis for the diagnosis and management of VM.
Humans ; Migraine Disorders/diagnosis* ; Visual Acuity ; Case-Control Studies ; Head Impulse Test ; Vestibular Function Tests ; Female ; Male ; Adult ; Vestibular Diseases/physiopathology* ; Middle Aged ; Caloric Tests

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Objective To evaluate the effects of physical exercise on liver function and size in adolescents.Methods A total of 361 adolescent subjects from Jining,Shandong Province were selected and divided into low,moderate,and high-intensity exercise groups according to the frequency of moderate intensity exercise.Physical ex-amination tests were conducted including morphological indicators,blood biochemical indicator measurements,liver size and the presence of non-alcoholic fatty liver disease.Independent sample t-tests and variance analysis were per-formed using SPSS 26.0,and correlation analysis was conducted using Spearman correlation analysis and multivari-ate linear regression analysis.Results Compared with the moderate and low-intensity exercise groups,the high-intensity exercise group had significantly lower diastolic blood pressure,homeostatic model assessment of insulin resistance(HOMA-IR),and triglycerides(TG),as well as significantly higher height,maximum oblique diameter of the right liver lobe,and direct bilirubin(DBIL).Correlation analysis showed that as exercise intensity in-creased,aspartate aminotransferase/alanine aminotransferase,DBIL,and the maximum oblique diameter of the right liver lobe increased significantly(P＜0.05).The results of the cumulative effect of exercise type and intensity indicate that exercise type does not influence the effect of exercise intensity on liver function and size.Conclusions Regular exercise in adolescents can not only shape body,but also improve glucose and lipid metabolism and en-hance liver function.

Objective:To evaluate the practical value of the up-converting phosphor technology (UPT) in the field fast detection of plague, and to provide scientific basis for its promotion and application in the field work of plague monitoring.Methods:In September 2020, a total of 116 samples (including 4 samples for epidemic determination) were collected at the plague epidemic site in Menghai County, Yunnan Province, including 24 human blood and lymphatic fluid samples, 83 rat liver and muscle samples, and 9 rat blood samples. In March 2023, a total of 12 rat liver and muscle samples were collected from Lijiang City for on-site monitoring of plague outbreak (all of them were outbreak determination samples). All of the above samples were tested for Yersinia pestis antibody and antigen using the up-converting phosphor technology. At the same time, haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture were conducted to compare the detection process and results of different experimental methods, the advantages and disadvantages of the up-converting phosphor technology for detecting Yersinia pestis were analyzed, and the feasibility of using this detection method in the field of plague epidemic monitoring was judged. Results:The plague epidemic samples site in Menghai County, Yunnan Province were tested by up-converting phosphor technology, and 19 samples were found to be positive for Yersinia pestis (1 antibody-positive and 18 antigen-positive). Among the samples determined, 4 samples with positive results of Yersinia pestis were detected by up-converting phosphor technology, and the results of their haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture were all positive. All samples from Lijiang City were tested by up-converting luminescence technology, two samples were positive for Yersinia pestis(antigen-positive). The results of haemagglutination test and real-time fluorescence quantitative PCR were positive, and one sample was positive for bacterial culture. The time required for up-converting phosphor technology, haemagglutination test, real-time fluorescence quantitative PCR, and bacterial culture were 0.5, 4.0, 2.5 and 72.0 h, respectively. Conclusions:The results of Yersinia pestis detection by up-converting phosphor technology are basically consistent with the results of haemagglutination test, real-time fluorescence quantitative PCR and bacterial culture, but the time used is relatively short. When the number of samples is large, this method can be used preferentially in the field work of plague outbreak monitoring, which can quickly complete the preliminary judgement of plague outbreak, and save a lot of time and economic resources for the next step of plague prevention and control work.

Plague is a virulent infectious disease caused by Yersinia pestis. There have been three plague pandemics in the world history, of which the third plague pandemic started in Yunnan, China in 1772, and became a global pandemic in 1894, affecting many countries in Asia, Europe, America, Oceania and Africa. It has been reported that the third plague pandemic was caused by the branch of Yersinia pestis 1.ORI. This paper summarizes the origin, transmission route, distribution area and ecological environment of 1.ORI clade and the relationship with the third plague pandemic, which has guiding significance for further understanding and studying the epidemiological pattern of plague, formulating appropriate surveillance programmes and prevention and control measures.

Tingli Dazao Xiefeitang is a classic formula for treating lung abscesses and thoracic fluid retention， recognized throughout history and included in the Catalogue of Ancient Classic Formulas （Second Batch）. This article employs bibliometric methods to investigate and analyze the source， origin， and key information of Tingli Dazao Xiefeitang， providing a theoretical basis for the development and application of this renowned formula. The results show that Tingli Dazao Xiefeitang first appears in Synopsis of the Golden Chamber （Jin Kui Yao Lue）， where three clinical applications are recorded. The original text clearly states that this formula is used to treat lung abscesses and thoracic fluid retention， with symptoms such as inability to lie down due to wheezing， chest and rib fullness， facial edema， inability to rest due to thoracic fluid retention， and cough inversion. This aligns with findings from ancient application research. In later generations， the methods proposed by ZHANG Zhongjing were predominantly used for medication and formulation. Modern applications of Tingli Dazao Xiefeitang focus primarily on the respiratory system， with pleural effusion being the most common condition. For the preparation and decoction， a single dose of 5 g of Descurainiae Semen Lepidii Semen （dried and mature seeds of Lepidium apetalum） processed as stir-fried seeds and 36 g of Jujubae Fructus （dried and mature fruit of Ziziphus jujuba） prepared as raw materials were recommended. Then 600 mL of water was added and Jujubae Fructus was first boiled until the volume reduced to 400 mL. After filtering out the residue， the supernatant was retained and mixed with stir-fried Descurainiae Semen Lepidii Semen， followed by boiling to 200 mL， which should be consumed all at once. This research provides a theoretical basis for the development and application of this formula.

Objective:To analyze and compare the pathological data characteristics of patients with simple papillary thyroid carcinoma (PTC) and PTC combined with Hashimoto’s thyroiditis (HT), so as to provide clinical treatment ideas.Methods:A retrospective analysis was performed on the medical records of 326 PTC patients who met the requirements and underwent surgical treatment in the Department of Thyroid and Breast Surgery, Nanjing Hospital of Traditional Chinese Medicine from Jan. 2020 to May. 2022. There were 81 males and 245 females. They were divided into PTC group and HT-PTC group, according to whether they were combined with HT. Clinical data were collected and organized. The collection indicators included patient gender, age, body mass index (BMI), five preoperative thyroid function items including free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), BRAF gene mutation, single or bilateral lesions, single or multiple lesions, largest postoperative pathological tumor lesions diameter, cervical lymph node metastasis (LNM) status, etc. At the same time, all patients were divided into CLNM group and no CLNM group according to CLNM status. The two groups were compared in terms of gender, age ≥55 years old, whether combined with HT, number of lesions, unilateral and bilateral, extraglandular invasion, microcarcinoma, and BRAF gene. Statistical software was used to analyze the results. t test, χ2 test, and logistic regression analysis were adopted. P<0.05 indicates that the difference is statistically significant. Results:The proportion of female patients in both groups was higher, and the proportion of female patients in the HT-PTC group (90/100, 90%) was higher than that in the PTC group (155/226, 69.59%). HT-PTC patients were younger than patients in the PTC group (43.03±12.72 vs. 43.70±12.63) years old, and their TSH (2.71±1.69 vs. 2.02±1.46) uIU/mL was higher. The differences were statistically significant (all P<0.05). There were no statistically significant differences in BMI, FT3, FT4, T3, or T4 (all P>0.05). The HT-PTC group had a lower proportion of BRAF gene mutations [87/100 (87%) vs. 212/226 (93.8%) ], a smaller maximum tumor diameter (1.06±0.73 vs. 1.32±0.97 cm), and a lower proportion of CLNM [37 /100 (37%) vs. 118/226 (52.2%) ]. The number of LNMs with metastasis is less (3.33±2.21 vs. 4.76±4.00), and it was more likely to be multifocal [44/100 (44%) vs. 73/226 (32.74%) ]. All differences were statistically significant (all P<0.05), and the differences in bilateral gland lobes involvement and extra-glandular invasion were not statistically significant. When accompanied by CLNM, gender (male vs. female) [55/100 (35.45%/64.52%) vs. 26/145 (15.2%/84.85%) ], age ≥ 55 years (yes vs. no) [21/134 (13.55) %/86.45%) vs. 50/121 (29.24%/70.76%) ], HT (yes vs. no) [37/118 (23.87%/76.13%) vs. 63/108 (36.84%/63.16%), number of lesions (single focus vs. multiple focus) [90/65 (41.94%/50.06%) vs. 119/52 (69.59%/30.41%) ], microcarcinoma (yes vs. no) [83/72 (53.55%/45.45%) vs. 139/32 (81.29%/18.71%) ] and extraglandular invasion (with vs. without) [38/117 (24.52%/75.48%) vs. 27/144 (17.42%/84.21%) ] had statistics significance (both P<0.05). There was no statistical significance in bilateral lesion involvement or BRAF gene mutation (all P>0.05). Multivariate logistic regression analysis showed that age, microcarcinoma, HT, gender, and number of lesions were independent risk factors for CLNM, and male gender and multifocal cancer were risk factors for CLNM. Age ≥55 years, microcarcinoma, and combined HT were negatively associated with CLNM. Conclusions:HT may promote the occurrence of PTC, but can inhibit its development. In the short term, patients with HT can have a better prognosis than those with simple PTC.

Objective The purpose of this article is to summarize and review the current status of the construction of clinical research evaluation systems in domestic public hospitals,identify existing problems in the evaluation system,and propose development strategies and suggestions.Methods Retrieved relevant articles,dissertations and policies from the past five years(2018-2022),screened the titles,viewed the full texts of 52 selected papers and their references,and summarized them.Results The"five-only"indicators have long been an important indicator for evaluating clinical research in public hospitals,but in today's scientific research environment and policy environment,the"five-only"evaluation system has revealed its utilitarian draw-backs and gradually evolved into a hindrance to scientific research.It is urgent to break through the"five-only"orientation and establish a clinical research evaluation system oriented towards"transforming and applying transformation of scientific research achievements".Conclusion The evaluation system for clinical research should break the previous"five-only"evaluation model based on quantity-oriented scientific research evaluation.We can draw on the framework of the research output,influence,and environment indicators in the UK's REF Excellence Framework model,combine the American APT system and the Chinese STEM indicator dimensions,explore multi-outcome evaluation,integrate developmental indicators,and continuously improve the indica-tor system and application methods in practice to promote the development of clinical research in public hospitals.

Sesquiterpenoids are natural compounds composed of 15 carbon atoms， which can be divided into sesquiterpene alcohols， ketones， lactones， aldehydes， and carboxylic acids according to oxygen groups. These compounds are widely distributed in nature， and their physiological activities are diverse. For example， many sesquiterpenes with potential anticancer effects have been found for anti-tumor effects， including cytotoxicity， antioxidant， immune regulation， cell proliferation， and so on. In addition， some sesquiterpenoids have good application prospects in antibacterial， anti-inflammatory， and anti-cardiovascular diseases. Malignant tumors， inflammation， bacterial diseases， and cardiovascular diseases are the main diseases that cause human death， and natural products have unique advantages in the treatment of these diseases. Therefore， the development of new drugs that are easy to promote has become a new research hotspot. In this paper， the sesquiterpenes extracted from the natural components of Chinese herbs and plants with anti-tumor， anti-inflammatory， antibacterial， and anti-cardiovascular activities， such as Xanthium， Atractylodes， Convolvulus， Acanthium， Ligularia， Artemisia， Ligularia， Ligularia， Labiaceae Mint， Acanthophyllum， Turmeria， Ginger， and other Chinese herbs and plants， were discussed. The biological activities and related mechanisms of this compound were reviewed， which provided a reference for further research and clinical application of sesquiterpenes.