Yi and Gui,its physiological characteristics and pathological manifestations are closely related to the lumbar spine.The intervertebral disc,chamber of arthrosis,requires nourishment from qi and blood circulation,as well as support from liver and kidney functions to maintain its health.Chinese medicine master Shi Qi has based on the pathological manifestations of discogenic low back pain patients at different stages and followed the guidelines of the Visceral manifestation theory.Combining more than 60 years of experience in traditional Chinese medicine diagnosis and treatment,he has used external observations to infer internal conditions and examined causes to find solutions.By entering the body from the outside and focusing on the"Homology of Yi and Gui"as a benchmark,he emphasizes the distinctive characteristic of traditional Chinese medicine in medical treatment.He states that"visceral pattern is fundamental"and"qi-blood is first,"emphasizing the importance of treating liver and kidney together.This article aims to draw on the wisdom of Taishan to provide a bridge for colleagues.

Background: Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. Methods: From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. Results: Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. Conclusion This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities.

ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

Objective To investigate the therapeutic effect of Formononetin on mice with Mycoplasma pneumoniae pneumonia(MPP)by regulating the mitogen-activated protein kinase(MAPK)/nuclear factor κB(NF-κB)signaling pathway.Methods Six-week-old SPF-grade male BALB/c mice were selected.The MPP mouse model was established as the model group by instillating Mycoplasma pneumoniae bacterial solution through the nose.On the second day after successful modeling,mice were intraperitoneally injected with 15,30,and 60 mg/kg of Formononetin and 60 mg/kg of Formononetin+20 mg/kg of Anisomycin respectively as the low-dose,medium-dose,and high-dose Formononetin groups and the high-dose Formononetin+Anisomycin group,with 12 mice in each group.Another 12 mice were intraperitoneally injected with the same amount of 0.9％sodium chloride injection as the control group.The cough frequency of mice in each group was detected through the cough induction test.The partial pressure of carbon dioxide(PCO2)and partial pressure of oxygen(PO2)in each group of mice were detected by a blood gas analyzer,and the oxygenation index(OI)was calculated.The levels of inflammatory factors in each group were detected by ELISA,and the apoptosis of lung tissue cells in each group of mice was detected by TUNEL.HE staining was performed to observe the pathological changes of lung tissues in each group.The expression of MAPK/NF-κB pathway-related proteins in the lung tissues of mice in each group was detected by Western blot method.Results The lung tissue morphology of the mice in the control group was normal.The alveolar ducts and alveolar structures of mice in the model group were damaged,the alveolar septa thickened,and there was a large amount of inflammatory cell infiltration.Compared with the model group,the lung tissue morphology was improved in the low-dose,medium-dose and high-dose Formononetin groups.The lung tissue injury in the high-dose Formononetin+Anisamycin group was more severe compared with the high-dose Formononetin group.Compared with the control group,the cough latency period in the model group was shortened,and PO2,OI,and interleukin-10(IL-10)were decreased,while the frequency of coughing,PCO2,interleukin-18(IL-18),tumor necrosis factor-α(TNF-α),apoptosis rate,and the ratios of p-P38 MAPK/P38 MAPK,p-NF-κB p65/NF-κB p65,p-extracellular signal-regulated kinase 1/2(ERK1/2)/ERK1/2,and p-C-jun N-terminal kinase(p-JNK)/JNK increased(P＜0.05).Compared with the model group,the low-,medium-and high-dose Formononetin groups had improved lung tissue morphology,prolonged cough latency,increased PO2,OI and IL-10,and reduced cough frequency.The PCO2,IL-18,TNF-α,apoptosis rate,and the ratios of p-p38 MAPK/P38 MAPK,p-NF-κB p65/NF-κB p65,ERK1/2/ERK1/2,and p-JNK/JNK decreased(P＜0.05).In the low-,medium-,and high-dose Formononetin groups,with the increase of Formononetin dose,the cough latency gradually prolonged,the cough frequency gradually decreased,and the PO2,oxygenation index,and IL-10 gradually increased.The PCO2,IL-18,TNF-α,apoptosis rate and the ratios of p-p38 MAPK/P38 MAPK,p-NF-κB p65/NF-κB p65,p-ERK1/2/ERK1/2,and p-JNK/JNK gradually decreased(P＜0.05).Compared with the high-dose Formononetin group,the high-dose Formononetin+Anisamycin group had shorter cough latency,lower PO2,OI and IL-10.The frequency of coughing,PCO2,IL-18,TNF-α,apoptosis rate,and the ratios of p-p38 MAPK/P38 MAPK,p-NF-κB p65/NF-κB p65,p-ERK1/2/ERK1/2,and p-JNK/JNK increased(P＜0.05).Conclusion Formononetin may improve lung injury in MPP mice by inhibiting the MAPK/NF-κB signaling pathway.

Aim To perform high-throughput screen-ing of immunomodulatory traditional Chinese medicine(TCMs)based on an in vitro B cell differentiation-antibody secretion model,identifying active herbal candidates with immune-enhancing properties to pro-vide novel therapeutic options and theoretical support for influenza virus treatment in immunocompromised in-dividuals.Methods B cells were stimulated with dif-ferent concentrations of cytosine-phosphate-guanine oli-godeoxynucleotide 2006(CpG)and nterleukin-2(IL-2)to promote proliferation,differentiation,and anti-body secretion,and the effects of varying concentra-tions of the solvent DMSO were also evaluated.The op-timal conditions for the B cell differentiation-anti-body secretion model were determined based on the se-cretion levels of three antibody isotypes.The feasibility of the model was further validated using rapamycin,a known B cell function inhibitor.On this basis,a high-throughput screening platform for immunomodulatory a-gents was optimized and established.Subsequently,the immune-enhancing activity of 465 polarity extract from TCMs was evaluated.Results The optimal con-ditions for the model were determined as 2 mg·L-1 CpG,1.67 × 106 nkat·L-1 IL-2,and DMSO with a volume fraction of 0.1％.Rapamycin effectively inhib-ited B cell differentiation into plasmablast and signifi-cantly reduced antibody production,indicating the reli-ability of the model.Multiple rounds of screening re-vealed that the dichloromethane extract of licorice,the dichloromethane extract of Vinegar-processed Curcumae Rhizoma,the cyclohexane extract of Honey-prepared Radix Asteris,and the aqueous extract of Siphonostegia chinensis Benth were identified to significantly promote both B cell proliferation and differentiation and anti-body secretion at a concentration of 600 μg·L-1.Conclusion This study successfully optimizes an in vitro B cell differentiation-antibody secretion model and identifies several TCM extracts,including licorice,with potential immune-enhancing activity.

Objective To explore the prognostic value of serum glutathione reductase(GR),superoxide dismutase(SOD),cystatin C(Cys-C),homocysteine(Hcy)and lipoprotein a[Lp(a)]levels in patients with cerebral ischemic stroke(CIS),and to provide a reference for improving the prognosis of CIS patients.Methods 126 patients with CIS admitted to the 980th Hospital of Joint Logistics Support Force from June 2022 to April 2023 were selected as the observation group,another 126 healthy individuals were selected as the control group at a ratio of 1:1.The expression levels of GR,SOD,Cys-C,Hcy and Lp(a)in the two groups were detected and compared after admission and during physical examination.The degree of neurological deficit in patients with CIS was classified into mild(NIHSS:2～4 points,n=35),moderate(NIHSS:5～15 points,n=47),moderate-severe(NIHSS:16～20 points,n=26)and severe(NIHSS:21～42 points,n=18)according to the National Institutes of Health Stroke Scale(NIHSS).The expression of serum GR,SOD,Cys-C,Hcy and Lp(a)in patients with different degrees of neurological deficit was compared,and the correlation between each indicator and the degree of neurological deficit was analyzed.The observation group received intravenous thrombolytic therapy after admission and was re-examined one day after thrombolysis.After treatment,follow-up visits were conducted for 28 days.According to the patient's condition(modified Rankin scale),patients were divided into good prognosis(n=94)and poor prognosis groups(n=32).The levels of each indicator in patients with different prognoses were compared,and the predictive value of GR,SOD,Cys-C,Hcy and Lp(a)expression for poor prognosis and early warning were analyzed.Results The expression levels of serum GR(48.54±3.07U/L)and SOD(157.17±25.47U/ml)in the observation group were lower than those in the control group(61.68±3.15U/L,203.63±18.31U/ml),while the expression levels of Cys-C(1.24±0.28mg/L),Hcy(15.21±1.62μmol/L)and Lp(a)(386.53±52.16mg/L)were higher than those in the control group(0.82±0.23mg/L,9.58±0.60μmol/L,257.83±45.34mg/L),with statistically significant differences(t=13.011～36.582,all P<0.05).As the disease progressed,the expression levels of GR and SOD gradually decreased,while the expression levels of Cys-C,Hcy and Lp(a)gradually increased,with statistically significant differences(F=14.685～197.041,all P<0.05).Spearman analysis,GR and SOD were negatively correlated with the degree of neurological deficit in patients with CIS(r=-0.814,-0.753,all P<0.05),while Cys-C,Hcy and Lp(a)were positively correlated with the degree of neurological deficit in patients with CIS(r=0.647,0.782,0.724,all P<0.05).The expression of GR and SOD in patients with good prognosis at admission and 1 day after thrombolysis was higher than that in patients with poor prognosis(t=9.109,6.338;2.934,4.358,all P<0.05),while the expression of Cys-C,Hcy and Lp(a)was lower than that in patients with poor prognosis(t=5.246,5.118,8.561;4.636,5.298,7.461,all P<0.05).The AUC(95%CI)of combined prediction of GR,SOD,Cys-C,Hcy and Lp(a)at admission was 0.898(0.832～0.945),and the AUC(95%CI)of combined prediction of GR,SOD,Cys-C,Hcy and Lp(a)at 1 day after thrombolysis was 0.931(0.871～0.968).The RR(95%CI)values caused by the expression of GR,SOD,Cys-C,Hcy and Lp(a)at 1 day after thrombolysis were 2.868(1.594～5.161),3.194(1.807～5.645),0.155(0.082～0.291),0.150(0.071～0.319)and 0.227(0.119～0.435).Conclusion Abnormal changes in the levels of GR,SOD,Cys-C,Hcy and Lp(a)are closely related to the degree of neurological deficit and prognosis in patients with CIS.Early combined detection of GR,SOD,Cys-C,Hcy and Lp(a)levels has high predictive value and early warning for evaluating the poor prognosis of patients with CIS.

Objective To explore the factors that influence major adverse cardiovascular events(MACE)in atrial fibrillation(AF)patients undergoing radiofrequency ablation(RFA),as well as to compare the prognosis of patients with advanced AF to that of the general population.Methods We prospectively recruited AF patients who underwent RFA treatment at Peking University Third Hospital between January 2021 and March 2023.General patient data were collected through the hospital's inpatient system,and MACE were tracked through outpatient visits and telephone follow-ups.Patients were categorized into three age groups:Group 1(under 65 years),Group 2(65 to 75 years),and Group 3(over 75 years).In this study,MACE was defined as include cardiovascular death,all-cause death,readmission for heart failure,acute coronary syndrome(ACS),grade 2 or higher bleeding and stroke.Results A total of 431 patients were included in this study,with an average age of(66.17±12.22)years.Among these patients,259 were male(60.09％),and the mean of CHA2DS2-VASc score was(1.79±1.30).The median follow-up period was 16.0(11.3,21.3)months,during which 28(6.50％)patients experienced MACE,with ACS and stroke being the most common events.Variables were selected using LASSO regression,and a LASSO-Cox regression model was constructed.Age(HR 1.06,95％CI 1.02-1.10,P=0.006)and hypertrophic cardiomyopathy(HR 3.70,95％CI 1.27-8.68,P=0.008)were identified as independent predictors of MACE after RFA for AF.Subgroup analysis revealed that patients under 65 had significantly better prognoses compared to older AF patients(P=0.030 compared with group 2;P=0.021 compared with group 3).Conclusions Age and hypertrophic cardiomyopathy are independent risk factors for MACE in AF patients undergoing RFA.The prognosis for younger patients is better than that for older patients,while the prognosis for advanced patients is comparable to that of patients aged 65-75 years.

Objective To compare the effects of different detector combinations of 320-row CT on the image quality and radiation dose of head CT to explore the feasibility of using a wide detector for head CT scanning.Methods Totally 100 patients underwent head CT scanning due to trauma or cerebrovascular disease at some hospital from June to August 2023 were collected prospectively and divided into group A and group B by using block randomization grouping method,with the length of the block group being 2 and 50 patients in each group.In group A,all the detectors had the widths at z-axis direction being 40×0.5 mm and head scanning was completed after multiple exposures;in group B,detector combinations with widths of 280×0.5 mm or 320×0.5 mm were chosen based on the patient's head size in the head-foot direction(z-axis direction),and head scanning was performed with a single-turn exposure.The remaining scanning and image reconstruction parameters in the two groups were kept completely consistent.The head image quality of the 2 groups was evaluated objectively and scored subjectively by 2 radiologists.The volume CT dose index(CTDIvol),dose length product(DLP)and exposure time of the 2 groups were recorded,and the effective dose(ED)was calculated.SPSS 22.0 software was used for statistical analysis.Results In terms of objective evaluation of image quality,at the level of the parietal skull group B had the CT value of gray matter,image noise and contrast to noise ratio(CNR)of the images higher than those of group A,and the differences were statistically significant(all P<0.05);at the level of the posterior skull group B had the CT values of gray and white matter,image noise and air noise lower while CNR higher than those of group A,and the differences were statistically significant(all P<0.05).In terms of subjective scoring of image quality,at the levels of parietal and posterior skull group A behaved better than group B,and the differences were statistically significant(all P<0.05).In group A 5 patients had obvious motion artifacts affecting the diagnosis and the image quality scores not higher than 2,and secondary scanning had to be carried out;In group B all the patients had no obvious motion artifacts and met the diagnosis requirements.When compared with group A Group B had the CTDIvol,DLP,ED and exposure time decreased by 17.44%,17.24%,17.48%and 85.53%,respectively,and the differences were statistically significant(all P<0.05).Conclusion A wide detector gains advantages over a 20 mm detector in image quality when 320-row CT is used for head CT scanning,with the diagnosis requirements satisfied.[Chinese Medical Equipment Journal,2025,46(4):57-62]

Objective:This study aims to explore the job preferences of county-level Centers for Disease Control and Prevention(CDC)personnel and to provide a basis for the development of effective incentive mechanisms.Methods:This study used a combination of stratified sampling and latent class sampling to investigate 1 809 respondents from 56 county-level CDCs in Shandong Province,Hubei Province,and Guizhou Province.Data were analysed using a mixed logit model and a latent class model,and willingness to pay was calculated.Results:The results of the mixed logit model showed that,all attributes and their levels had a significant influence(P<0.05),with establishment being the most important motivating factor(β=2.249).In the latent class model,respondents were divided into three categories.The main differences between the three classes were the choice of exit options and differences in preferences for job attributes.Conclusion:County-level CDC personnel preferred jobs with higher incomes,very good benefit levels,establishment,low workload,better recognition and respect from the public,more opportunities for career advancement,and abundant training opportunities.It is recommended that the total number of establishment should be rationally controlled and dynamically adjusted to balance the differences between working conditions within and outside the establishment;that a comprehensive approach should be adopted to improve both hygiene and motivation factors;and that different incentives should be adopted for different categories of CDC staff. Those who are willing to make a change should be provided with more opportunities for training and career advancement.

Aim To perform high-throughput screen-ing of immunomodulatory traditional Chinese medicine(TCMs)based on an in vitro B cell differentiation-antibody secretion model,identifying active herbal candidates with immune-enhancing properties to pro-vide novel therapeutic options and theoretical support for influenza virus treatment in immunocompromised in-dividuals.Methods B cells were stimulated with dif-ferent concentrations of cytosine-phosphate-guanine oli-godeoxynucleotide 2006(CpG)and nterleukin-2(IL-2)to promote proliferation,differentiation,and anti-body secretion,and the effects of varying concentra-tions of the solvent DMSO were also evaluated.The op-timal conditions for the B cell differentiation-anti-body secretion model were determined based on the se-cretion levels of three antibody isotypes.The feasibility of the model was further validated using rapamycin,a known B cell function inhibitor.On this basis,a high-throughput screening platform for immunomodulatory a-gents was optimized and established.Subsequently,the immune-enhancing activity of 465 polarity extract from TCMs was evaluated.Results The optimal con-ditions for the model were determined as 2 mg·L-1 CpG,1.67 × 106 nkat·L-1 IL-2,and DMSO with a volume fraction of 0.1％.Rapamycin effectively inhib-ited B cell differentiation into plasmablast and signifi-cantly reduced antibody production,indicating the reli-ability of the model.Multiple rounds of screening re-vealed that the dichloromethane extract of licorice,the dichloromethane extract of Vinegar-processed Curcumae Rhizoma,the cyclohexane extract of Honey-prepared Radix Asteris,and the aqueous extract of Siphonostegia chinensis Benth were identified to significantly promote both B cell proliferation and differentiation and anti-body secretion at a concentration of 600 μg·L-1.Conclusion This study successfully optimizes an in vitro B cell differentiation-antibody secretion model and identifies several TCM extracts,including licorice,with potential immune-enhancing activity.