Objective To observe the clinical efficacy of acupuncture in treating chronic insomnia disorder based on Huang Yuanyu's theory of"central qi ascending and descending,harmony of the four dimensions"regarding visceral qi movement.Methods Sixty patients diagnosed with chronic insomnia disorder at the Preventive Treatment Department of Yangjiang Hospital of Traditional Chinese Medicine from March 2022 to February 2023.The patients were randomly divided into an observation group and a control group according to a random number table,with 30 cases in each group.The observation group received acupuncture therapy,while the control group received oral administration of Alprazolam Tablets.The treatment duration spanned 4 weeks with 1 course per week.Clinical efficacy was evaluated after 1 month,and the changes in the Pittsburgh Sleep Quality Index(PSQI)scores and Hamilton Anxiety Rating Scale(HAMA)scores were observed.The Hamilton Depression Rating Scale(HAMD)scores were compared between groups before and after treatment.Results(1)After treatment,the PSQI scores of the two groups of patients were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the PSQI scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the HAMA scores and HAMD scores in the two groups of patients were significantly improved(P＜0.05),an the observation group in improvement of HAMA and HAMD was significantly superior to the control group,with statistically statistical significance(P＜0.05).(3)The total effective rate was 83.33%(25/30)in the observation group and 70.00%(21/30)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Acupuncture based on the ascending and descending of visceral qi movement theory significantly alleviates anxiety and depressive states while improving sleep quality in patients with chronic insomnia disorder,demonstrating notable clinical efficacy.

A 36-year-old male patient was hospitalized due to persistent chest tightness and dyspnea last-ing over 10 days.An echocardiogram revealed significant aortic valve regurgitation,the presence of vegetation on the aortic valve,severe mitral valve regurgitation,and enlargement of both the left atrium and left ventricle.Follow-ing a comprehensive multidisciplinary consultation,the focus was directed towards the aortic valve vegetation as the primary concern,with particular attention given to the potential diagnosis of blood culture-negative infective endocarditis(IE)and non-bacterial thrombotic endocarditis,while differentiating it from rheumatic heart disease.Ultimately,the vegetation was excised during a surgical aortic valve replacement procedure,which facilitated histopathological examination,biological culture,and high-throughput metagenomic sequencing of pathogenic mi-croorganisms.The definitive diagnosis was established as aortic valve infective endocarditis(Q fever IE)leading by infection of Coxiella burnetii.

Objective To investigate the therapeutic effects and mechanisms of curcumin derivatives C66 treatment on hepatic fibrosis .Methods Thirty three C57BL/6J mice were randomly divided into 3 groups:normal control group ,model control group and curcumin derivatives C66 treatment group .Nine mice in normal control group were fed with water and food .Hepatic fibrosis model was induced in 24 mice by intraperitoneal injection of 40% carbon tetrachloride at a dose of 4 mL/kg for the first time ,followed by 2 mL/kg twice a week for 6 weeks . At week 6 ,6 mice were randomly selected to perform pathological examination to evaluate whether the hepatic fibrosis were successfully induced .Mice with hepatic fibrosis were randomized into model control group and curcumin derivatives C66 treatment group with 9 mice in each group .From week 6 on ,mice in the treatment group were lavaged with curcumin derivatives C66 at a dosage of 10 mg ·/(kg · d) .The rest mice were administered with equivalent dosage of 0 .5% carboxymethylcellulose sodium .Serum alanine aminotransferase (ALT) ,aspartate aminotransferase (AST ) and liver hydroxyproline ( Hyp ) contents were detected , and the semi‐quantitative analysis of liver fibrosis was performed by pathological examination in hepatic tissue by hematoxylin and eosin (HE) and Masson staining .The expressions of collagen Ⅰ ,α‐smooth muscle actin (α‐SMA) mRNA and collagen Ⅰ ,α‐SMA ,nuclear factor‐kappa B p65 (NF‐κB p65) ,inhibitor kappa B alpha (IκBα) protein in each group were detected by quantitative real‐time polymerase chain reaction (RT‐PCR) and Western blot .Data were analyzed with one‐way ANOVA analysis .Results The serum levels of ALT and AST in model control group ,C66 treatment group and normal control group were (202 .71 ± 19 .66 ) U/L , (233 .42 ± 23 .97 ) U/L ;(102 .00 ± 11 .04 ) U/L , (120 .87 ± 13 .83 ) U/L ;(36 .66 ± 6 .37) U/L and (43 .33 ± 8 .08)U/L ,respectively .The differences between model and normal control group were both significant (t=23 .96 and 22 .39 ,respectively ;both P<0 .05) .The C66 treatment group showed significantly lower levels of serum ALT and AST in contrast with model control group (t =11 .56 and 10 .52 ,respectively ;both P<0 .05) .Compared to the model control group ,hepatic Hyp contents in normal control group and C66 treatment group were significantly different (t= 17 .50 , P< 0 .05;t=11 .45 ,P<0 .05) .Collagen Ⅰand α‐SMA mRNA expressions in C66 treatment group were remarkably lower in contrast with that in model control group (t= 7 .23 and 7 .95 ,respectively ;both P< 0 .05) . Protein levels of Collagen Ⅰ ,α‐SMA and NF‐κB p65 decreased in C66 treatment group ,while IκBαincreased significantly (all P<0 .05) .Conclusion The application of C66 can contribute to the regression of liver fibrosis and the mechanism may rely on the regulation of NF‐κB expression .