Objective:To compare the pregnancy outcomes of surviving fetuses in monochorionic diam-niotic(MCDA)twin pregnancies after selective feticide or spontaneous single intrauterine fetal demise(sIUFD),and to explore the influencing factors of prognosis.Methods:A total of 219 cases of intra-uterine death of one fetus in MCDA twin pregnancies admitted to Peking University Third Hospital from September 2010 to August 2021 were collected.According to the mode of fetal death,they were divided into the spontaneous sIUFD group(120 cases)and the selective feticide group(99 cases).Data on the maternal conditions during pregnancy,the situation of the intrauterine-dead fetus,and pregnancy out-comes were collected for retrospective case-analysis.Results:The live-birth rates of surviving fetuses in the spontaneous sIUFD group and the selective feticide group were 85.0％and 81.8％respectively,and the total perinatal survival rates of surviving fetuses were 73.3％and 81.8％respectively,and there were no statistically significant differences.Compared with the spontaneous sIUFD group,the selective feticide group had a greater gestational week at delivery,and lower rate of preterm birth before 37 weeks,neonatal asphyxia,and early neonatal mortality.Using the gestational week at delivery as the outcome variable,Cox regression analysis showed that the mode of fetal death was not a risk factor affecting the gestational week at delivery of the surviving fetus,while gestational hypertension and the gestational week of fetal death were independent risk factors affecting the gestational week at delivery of the surviving fetus.Using preterm birth before 37 weeks,intrauterine death of the surviving fetus,and abnormal neonatal cranial ultrasound as outcome variables respectively,unconditional logistic regression analysis showed that the mode of fetal death,the gestational week of fetal death,the position of the dead fetus,and fetal complications were independent risk factors affecting the outcomes of the above-mentioned survi-ving fetuses.According to the results of the univariate analysis,the above risk factors were included in the multivariate regression analysis,and the results were the same as those of the univariate analysis.Conclusion:For MCDA twin pregnancy patients with severe twin-related complications,the prognosis of surviving fetuses after selective feticide is better.The proactive intrauterine intervention and treatment are of great significance for improving the prognosis of surviving fetuses.

With the development of manned space technology,long-term space missions have gradually become a reality,but the problem of sleep disorders faced by astronauts has become increasingly prominent.The combined effects of microgravity,abnormal circadian rhythm,confined space pressure and psychological stress in space environment lead to the significant decline of sleep quality of astronauts,which is manifested as difficulty falling asleep,sleep fragmentation and reduction of deep sleep.Based on the theory of traditional Chinese medicine,this paper systematically analyzes the etiology and pathogenesis of astronaut sleep disorders,and reveals the unique advantages of transcutaneous electrical acupoint stimulation in space medicine,which provides a new idea for the construction of non-pharmacological sleep intervention system.Although there are technical difficulties,non-pharmacological therapy such as transcutaneous electrical acupoint stimulation is still a key breakthrough to solve sleep disorders in astronauts.It is expected to become an important part of space medicine and provide safe and efficient health protection for long-term space missions.

Objective:To compare the pregnancy outcomes of surviving fetuses in monochorionic diam-niotic(MCDA)twin pregnancies after selective feticide or spontaneous single intrauterine fetal demise(sIUFD),and to explore the influencing factors of prognosis.Methods:A total of 219 cases of intra-uterine death of one fetus in MCDA twin pregnancies admitted to Peking University Third Hospital from September 2010 to August 2021 were collected.According to the mode of fetal death,they were divided into the spontaneous sIUFD group(120 cases)and the selective feticide group(99 cases).Data on the maternal conditions during pregnancy,the situation of the intrauterine-dead fetus,and pregnancy out-comes were collected for retrospective case-analysis.Results:The live-birth rates of surviving fetuses in the spontaneous sIUFD group and the selective feticide group were 85.0％and 81.8％respectively,and the total perinatal survival rates of surviving fetuses were 73.3％and 81.8％respectively,and there were no statistically significant differences.Compared with the spontaneous sIUFD group,the selective feticide group had a greater gestational week at delivery,and lower rate of preterm birth before 37 weeks,neonatal asphyxia,and early neonatal mortality.Using the gestational week at delivery as the outcome variable,Cox regression analysis showed that the mode of fetal death was not a risk factor affecting the gestational week at delivery of the surviving fetus,while gestational hypertension and the gestational week of fetal death were independent risk factors affecting the gestational week at delivery of the surviving fetus.Using preterm birth before 37 weeks,intrauterine death of the surviving fetus,and abnormal neonatal cranial ultrasound as outcome variables respectively,unconditional logistic regression analysis showed that the mode of fetal death,the gestational week of fetal death,the position of the dead fetus,and fetal complications were independent risk factors affecting the outcomes of the above-mentioned survi-ving fetuses.According to the results of the univariate analysis,the above risk factors were included in the multivariate regression analysis,and the results were the same as those of the univariate analysis.Conclusion:For MCDA twin pregnancy patients with severe twin-related complications,the prognosis of surviving fetuses after selective feticide is better.The proactive intrauterine intervention and treatment are of great significance for improving the prognosis of surviving fetuses.

OBJECTIVE To establish a rapid method for determining of acid yellow 36 in moxibustion. METHODS Based on the principle of acid yellow 36 as an acid-base indicator and discoloration in the pH range of 1.2(red) to 2.3(yellow), 15% sulfuric acid solution was used as the color developing agent to screen the ethanol extract of the sample, and then HPLC method was used to verify the suspicious positive samples in the initial screening, and finally LC-MS method was used to confirm the accuracy of the established rapid physicochemical detection method. RESULTS The established method was applied to 67 batches of samples, and 3 positive samples were detected. The results were consistent with those of HPLC and LC-MS. CONCLUSION The method is accurate and sensitive, which can be used for rapid detection of acid yellow 36 in moxibustion.

In recent years, the incidence of obesity has been rapidly increasing, greatly elevating the incidence of hypertension, heart disease, non-alcoholic fatty liver disease, and other diseases. Reducing the incidence of obesity has become the focus of global concern. There is an urgent need to find effective and safe treatment method. More and more evidence support the efficacy of auricular acupoint therapy for obesity. It has the advantages of safety, effectiveness, convenience, and cheap. This article intends to discuss the research status of auricular acupoint therapy for obesity based on theoretical development, mechanism exploration, and technical innovation in order to promote the clinical application of auricular acupoint therapy for obesity. At present, with the help of multiple disciplines, inheriting and enriching the theoretical connotation of auricular point therapy for obesity, confirming its clinical effectiveness and safety, clarifying its effect mechanism in the treatment of obesity, and improving the traditional auricular acupoint therapy are feasible directions to promote auricular point therapy in the treatment of obesity, and it can make auricular point therapy have a broader application prospect.

Objective:To summarize the pregnancy outcome of monochorionic triamniotic (MCTA) triplet pregnancy and its relationship with multifetal pregnancy reduction.Methods:This study retrospectively recruited 23 women with MCTA pregnancy who delivered at Peking University Third Hospital from January 1, 2012, to January 1, 2020. All 23 cases received regular prenatal examination at our hospital from the first trimester, who were divided into two groups: selective fetal reduction group (randomly reduced one fetus, n=8) and expectant group ( n=15). Pregnancy outcome was described in all participants, differences in maternal age, gestational weeks and outcomes were compared between the two groups. The selective fetal reduction group was further divided into two subgroups: first-trimester vacuum aspiration group ( n=3) and second-trimester radiofrequency ablation group ( n=5), to evaluate the differences in pregnancy outcomes. Two independent samples- t test and Fisher's exact test were used as statistical methods. Results:(1) There was no significant difference in the gestational weeks at the end of the pregnancy [(31.7±4.1) vs (28.8±8.8) weeks], preterm delivery after 32 weeks (9/15 vs 4/8), at least two surviving children (12/15 vs 4/8) and at least one surviving child (13/15 vs 5/8) between the expectant group and the selective fetal reduction group (all P>0.05). One case with twin-twin transfusion syndrome in the expectant group underwent fetoscopic surgery at 19 weeks of gestation and delivered three live infants through cesarean section at 33 +2 weeks due to premature rupture of membranes. One case with twin reversed arterial perfusion sequence at 17 weeks of gestation refused fetal reduction and gave birth to a child at 33 weeks when one fetus's heart stopped beating and one was acardia. (2) The first-trimester vacuum aspiration group and the second-trimester radiofrequency ablation group showed no significant differences in the average gestational weeks at the end of the pregnancy [(28.5±7.6) vs (28.9±10.4) weeks, t=1.145, P>0.05], or the rate of at least one (2/3 vs 3/5, Fisher's exact test, P>0.05) or two surviving children (2/3 vs 2/5, Fisher's exact test, P>0.05). No postoperative infection or amniotic fluid leakage was reported in the subgroups. Conclusions:The pregnancy outcome of MCTA triplet with fetal reduction is not different with expectant group.

Syndromes of coronary heart disease with angina pectoris were analyzed to provide guidance for clinical practice and to improve accuracy of traditional Chinese medicine (TCM) diagnoses and efficacy of TCM treatment. A total of 860 cases with coronary heart disease with angina pectoris were selected from TCM Clinical Research Information Sharing System for TCM clinics and research. Syndromes were automatically extracted with the cluster method and were analyzed to provide objective evidence for clinical studies. Final syndrome classifications were recognized and confirmed by clinical experts. Popular syndromes included Qi and blood deficiency, blood stasis and obstruction collaterals, liver depression and spleen deficiency, and Qi stagnation and blood stasis. Syndromes Qi and blood deficiency and blood stasis and obstruction collaterals accounted for 28.61% of total syndromes, whereas liver depression and spleen deficiency and Qi stagnation and blood stasis accounted for 26.44%. The main syndrome elements comprised Qi deficiency, blood deficiency, blood stasis, and Qi stagnation.
Aged ; Angina Pectoris ; diagnosis ; therapy ; Cluster Analysis ; Coronary Disease ; diagnosis ; therapy ; Diagnosis, Differential ; Female ; Hemostasis ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Syndrome

OBJECTIVETo observe and evaluate the clinical efficacy of transcutaneous vagus nerve stimulation (taVNS) at auricular concha for primary insomnia (PI) and affective disorder.

METHODSA total of 35 patients who met the diagnosis standard of PI in(5th edition) were included. The self-developed auricular vagus nerve stimulator (TENS-200A) was applied at auricular concha, 30 min per treatment, twice a day, 5 days a week for consecutive 4 weeks. The follow-up visit was conducted at the end of 6th week. The Pittsburg sleep quality index scale (PSQI), 17-items Hamilton depression scale (17HAMD) and Hamilton anxiety scale (HAMA) were applied for evaluation. The PSQI, HAMA and 17HAMD were observed before and after treatment; the safety was also observed.

RESULTSCompared before treatment, the PSQI was significantly decreased to (13.20±3.61) at the end of 2nd week (<0.05); compared before treatment, the 17HAMD and HAMA were significantly decreased at the end of 4th week and 6th week (all<0.05). No adverse reaction was observed.

CONCLUSIONSThe taVNS could not only relieve PI symptoms, but also improve the depressive and anxiety symptoms, in addition, it may have positive long-term efficacy and safety.

Objective: To investigate the feasibility and efficacy of the establishment of regional cooperative acute ST-segment elevation myocardial infarction (STEMI) rescue network among the prefectural-level city hospitals in China. Methods: Based on real-time remote electrocardiogram transmission and "120" emergency systems, we established a regional collaborative STEMI treatment network with our hospital as the network unclears including 8 second-class affiliated hospitals of Jiangsu University in 2013. STEMI treatment time, therapeutic effects and economic indexes were compared before (from January 2010 to December 2012, 180 cases, pre-network) and after (From January 2013 to December 2015, 374 cases, post-network) the establishment of the regional collaborative STEMI treatment network. Results: Post establishment of the rescue network, mean first medical contact (FMC) to balloon (FMC-to-B) time, referral time and obtaining informed consent time were all significantly decreased from (191±41), (94±18), (25±9) minutes to (93±19), (53±18), (7±5) minutes, respectively, in comparison with the pre-network era(all P<0.05). There was a trend of prolonged FMC-to-B time in proportion to aging of STEMI patients(trend P<0.05). Three months post discharge, LVEF was higher (55.3%±10.7% vs. 48.8%±12.1%, P<0.05) and LVEDd was lower ((49.1±10.8)mm vs.(51.8±9.2)mm, P<0.05) in the post-network group compared to pre-network group.In-hospital mortality was also significantly reduced post the establishment of the rescue network (2.14%(8/374) vs. 3.89%(7/180), P<0.05). The results also showed that the total costs (42 017(25 069, 75 148)yuan vs.51 030(28 137, 105 861)yuan), days of hospitalization ((9.1±4.5) days vs. (15.3±4.8)days) and percentage of medicine and consumables were all significantly decreased in the post-network group compared to pre-network group(all P<0.05). Conclusion Establishment of the regional cooperative rescue network is feasible among the prefectural-level city hospitals in China. Establishment of such network can improve the prognosis and decrease the FMC-to-B time, the rate of in-hospital mortality and financial burden of patients with STEMI, and serves as an effective strategy to improve the rescue ability for STEMI patients.

Traditional Chinese patent medicines are widely used to treat stroke because it has good efficacy in the clinical environment.However,because of the lack of knowledge on traditional Chinese patent medicines,many Western physicians,who are accountable for the majority of clinical prescriptions for such medicine,are confused with the use of traditional Chinese patent medicines.Therefore,the aid-decision method is critical and necessary to help Western physicians rationally use traditional Chinese patent medicines.In this paper,Manifold Ranking is employed to develop the aid-decision model of traditional Chinese patent medicines for stroke treatment.First,115 stroke patients from three hospitals are recruited in the cross-sectional survey.Simultaneously,traditional Chinese physicians determine the traditional Chinese patent medicines appropriate for each patient.Second,particular indicators are explored to characterize the population feature of traditional Chinese patent medicines for stroke treatment.Moreover,these particular indicators can be easily obtained by Western physicians and are feasible for widespread clinical application in the future.Third,the aid-decision model of traditional Chinese patent medicines for stroke treatment is constructed based on Manifold Ranking.Experimental results reveal that traditional Chinese patent medicines can be differentiated.Moreover,the proposed model can obtain high accuracy of aid decision.