Objective To observe the clinical efficacy of fire needling in treating lumbar disc herniation(LDH)of cold-damp type under the guidance of meridian sinew theory.Methods A total of 70 cases of patients with LDH of cold-damp type were randomly divided into observation group and control group,35 cases in each group,the control group was given conventional acupuncture treatment,and the observation group was treated with fire needling under the guidance of meridian sinew theory on the basis of the treatment of the control group,and the course of treatment covered three courses,one week as a course.After three courses of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Visual Analogue Scale(VAS)scores of pain,the Japanese Orthopedic Association(JOA)scores,and traditional Chinese medicine(TCM)syndrome scores of patients in the two groups before and after treatment were observed.Results(1)During the study,there were three cases in the observation group and five cases in the control group were failed to follow-up.Finally,32 cases in the observation group and 30 cases in the control group were included in the efficacy statistics.(2)The total effective rate was 93.75%(30/32)in the observation group and 86.67%(26/30)in the control group.The clinical efficacy of the observation group was superior to that of the control group,and the difference being statistically significant(P<0.05).(3)After treatment,the VAS and JOA scores of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the TCM scores of the two groups of patients improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).Conclusion Under the guidance of the meridian sinew theory,fire needling in treating LDH of cold-damp type can significantly reduce the degree of pain,improve the lumbar function,alleviate LDH-related symptoms,so as to improve the patients'quality of life.

Objective To study the dynamic regulatory role of early growth response 4(EGR4)in mouse neurodevelopment.Methods Data on single-cell chromatin accessibility(single-cell assay for transposase-accessible chromatin by sequencing,scATAC-seq)and transcriptome(single-cell RNA sequencing,scRNA-seq)from seven key stages spanning from the embryonic period to adulthood was collected and analyzed.The transcription factor binding site network was inferred,a quantitative analysis from a temporal perspective was conducted,its functional modules were parsed,and the results were visualized.Results egr4 was significantly highly expressed from the late embryonic stage to adulthood,and specifically activated during the maturation of inhibitory neurons[parvalbumin(PV)and somatostatin(SST)subtypes].Moreover,its transcription was not directly regulated by changes in chromatin accessibility.Temporal network analysis indicated that EGR4 became a regulatory hub in the late embryonic stage and drove neuron differentiation and subtype specification.Functional enrichment analysis showed that EGR4 regulated the"cell differentiation"pathway through dynamic interacting factors,and there were subtype-specific interaction modules in PV/SST neurons respectively.Conclusion EGR4 can participate in the late-stage maturation of cortical neurons through a stage-specific regulatory network.This study provides a new perspective on mechanisms underlying the temporal logic of neural development.

OBJECTIVE To investigate the effect mechanism of Gualou guizhi granule on neurological function and synaptic plasticity in rats with cerebral ischemia-reperfusion injury. METHODS The rats were randomly divided into sham operation group， model group and Gualou guizhi granule group （3.6 g/kg）， with 6 rats in each group. The cerebral ischemia-reperfusion injury model was established by the suture occlusion method. Two hours after modeling， the model rats were given relevant medicine or normal saline intragastrically， once a day， for 7 consecutive days. After the last medication， the neurological function of rats was evaluated [calculated by modified neurological severity scores （mNSS） and corner turning percentage]； the neuronal apoptosis rate of brain histiocyte in the ischemic side of rats was detected in each group； the positive expressions of growth associated protein 43 （GAP43） and microtubule associated protein 2 （MAP2） were detected； protein expressions of neuron-specific nuclear protein （NeuN）， synaptophysin-1 （Syn-1）， postsynaptic density protein-95 （PSD-95）， peroxisome proliferators-activated receptor γ （PPARγ）， brain-derived neurotrophic factor （BDNF） and tropomyosin receptor kinase B （TrkB）， as well as mRNA expressions of NeuN， Syn-1 and PSD-95 were detected. RESULTS Compared with the model group， mNSS， corner turning percentage and neuronal apoptotic rate were decreased significantly in Gualou guizhi granule group （P＜0.01）； GAP43 represented weak immunoreactivity， and MAP2 represented moderate immunoreactivity； protein expressions of NeuN， Syn-1， PSD-95， PPARγ， BDNF， TrkB and mRNA expressions of Syn-1， NeuN， PSD-95 were all increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Gualou guizhi granule can promote synaptic plasticity by activating BDNF/TrkB signaling pathway， thus playing a protective role in cerebral ischemia-reperfusion injury in rats.

As the search for effective treatments for COVID-19 continues, the high mortality rate among critically ill patients in Intensive Care Units (ICU) presents a profound challenge. This study explores the potential benefits of traditional Chinese medicine (TCM) as a supplementary treatment for severe COVID-19. A total of 110 critically ill COVID-19 patients at the Intensive Care Unit (ICU) of Vulcan Hill Hospital between Feb., 2020, and April, 2020 (Wuhan, China) participated in this observational study. All patients received standard supportive care protocols, with a subset of 81 also receiving TCM as an adjunct treatment. Clinical characteristics during the treatment period and the clinical outcome of each patient were closely monitored and analysed. Our findings indicated that the TCM group exhibited a significantly lower mortality rate compared with the non-TCM group (16 of 81 vs 24 of 29; 0.3 vs 2.3 person/month). In the adjusted Cox proportional hazards models, TCM treatment was associated with improved survival odds (P < 0.001). Furthermore, the analysis also revealed that TCM treatment could partially mitigate inflammatory responses, as evidenced by the reduced levels of proinflammatory cytokines, and contribute to the recovery of multiple organic functions, thereby potentially increasing the survival rate of critically ill COVID-19 patients.
Humans ; COVID-19 ; Medicine, Chinese Traditional ; SARS-CoV-2 ; Critical Illness ; Treatment Outcome

Objective:To summarize the clinical and genetic characteristics of early-onset spinocerebellar ataxia type 5 (SCA5) caused by SPTBN2 gene mutation. Methods:The clinical and genetic data of a child with early-onset SCA5 diagnosed in the Department of Children′s Rehabilitation, Women and Children′s Hospital Affiliated to Qingdao University in February 2022 were retrospectively analyzed. The literatures related to early-onset SCA5 in major databases at home and abroad were retrieved and summarized.Results:The patient, a 4 years and 1 month old girl, was admitted to hospital because of "unable to stand independently at 2 years and 3 months", primarily presented with developmental delay, ataxia, hypotonia, and tendon hyperreflexia during infancy. Progressive cerebellar atrophy was observed on brain magnetic resonance imaging. A de novo heterozygous mutation of the SPTBN2 c.793G>C(p.Asp265His) was identified in the patient. Following hospitalization, the child received comprehensive rehabilitation therapy encompassing physical, occupational, language, educational interventions as well as bicycle ergometer training and transcranial magnetic stimulation. The patient was followed-up for more than 1 year to 4 years and 1 month old, whose motor function, cognitive abilities, and language skills were improved to some extent. A total of 13 English articles and 1 Chinese article were retrieved from the databases. A total of 20 early-onset SCA5 patients have been reported, with onset ages all within 12 months. Infants exhibited decreased muscle tone and delayed motor milestones, with the main clinical manifestations of ataxia, generalized developmental delay, and cerebellar atrophy. The previously reported cases involved 11 mutation sites in the SPTBN2 gene, and the main types of mutations were de novo missense mutations. The mutation site in this case has not been reported in the previous literature. Conclusions:Early-onset SCA5 is a rare autosomal dominant disorder caused by heterozygous mutations in the SPTBN2 gene. The main clinical manifestations include ataxia from infancy, developmental retardation and cerebellar atrophy. Early rehabilitation intervention can improve the degree of the dysfunction.

Objective:To translate and culturally adjust Decisional Fatigue Scale (DFS) , and test its reliability and validity.Methods:The Chinese version of DFS was formed through the method of double translation, back translation and expert consultation. Using the convenient sampling method, 247 medical staffs from 16 departments in 76 wards of Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine were selected as the research objects. Content validity, criterion validity and structure validity were used for validity evaluation, and internal consistency reliability, split half reliability and retest reliability were used for reliability evaluation. A total of 247 questionnaires were sent out in this study and 247 were effectively received, with effective recovery of 100.00%.Results:The total Cronbach's α coefficient of Chinese DFS was 0.933, the half-reliability coefficient was 0.849 and the retest reliability coefficient was 0.838 ( P<0.01) . Both the item content validity index and scale content validity index were 1.00, and the correlation coefficient with the total score of SRF-S was 0.729 ( P<0.01) . One common factor was extracted by exploratory factor analysis and 65.64% of the variation was explained cumulatively, which was consistent with the dimensions of the original scale. Confirmatory factor analysis showed that all fitting indexes were up to standard and the fitting degree was good. Conclusions:The reliability and validity of the Chinese version of DFS in medical staffs is good, which can be used to evaluate the degree of decision-making fatigue of Chinese medical staffs.

Objective:To explore the application effect of blended learning on the teaching of nursing research course for undergraduate nursing students.Methods:From March to July 2019, a total of 118 undergraduate nursing students from Batch 2016 of a university in Xinjiang were collected in this study and divided into two groups randomly: the experimental group ( n = 60) and the control group ( n = 58). At the end of the course, the final examination scores of the nursing students were compared, and questionnaires were used to evaluate the critical thinking, self-directed learning ability and satisfaction of nursing students. SPSS 21.0 was used for independent-sample t-test and chi-square test. Results:After the implementation of the course, the scores of nursing research theory and practice of nursing students in the experimental group were (78.97±6.57) points and (83.02±3.50) points respectively, which were better than those of nursing students in the control group (75.48±7.76) points and (81.48±3.86) points. The total scores of critical thinking ability and self-directed learning ability of nursing students in the experimental group (294.67±25.15) and self-directed learning ability (277.67±30.84) were higher than those in the control group (222.03±18.77) and (203.81±33.19). The satisfaction degree of nursing students in the experimental group (93.33%) was better than that in the control group (60.34%), with statistical significance ( P<0.05). Conclusion:The application of blended learning in nursing research teaching can improve the final examination results of nursing students, and contribute to the improvement of nursing students' critical thinking ability, self-directed learning ability and course satisfaction.

Objective To explore the effect of Naikan cognitive-music reminiscence therapy on coping style in female patients with chronic schizophrenia.Methods In May, 2020, 72 female patients with chronic schizophrenia from Beijing Huilongguan Hospital were assigned into control group (n = 48) and music group (n = 24) after trait matching. Both groups accepted routine medicine, while the control group accepted Naikan cognitive therapy, and the music group accepted Naikan cognitive therapy combined music reminiscence, for twelve weeks. They were blind assessed with Simplified Coping Style Questionnaire, Self-rating Depression Scale and Self-rating Anxiety Scale before and after intervention.Results There were five cases in the control group removed for erroneous response. The main effects of group were not significant for all the assessments (F < 0.567, P > 0.05). The main effect of time was significant for negative coping style score (F = 6.968, P = 0.01), and the interaction effects were significant for positive coping style score and Self-rating Depression Scale score (F > 4.227, P < 0.05).Conclusion Combining with music reminiscence, Naikan cognitive therapy may be advantageous for the coping style of female patients with chronic schizophrenia.

School-age children are in a specific development stage corresponding to juvenility, when the white matter of the brain experiences ongoing maturation. Diffusion-weighted magnetic resonance imaging (DWI), especially diffusion tensor imaging (DTI), is extensively used to characterize the maturation by assessing white matter properties in vivo. In the analysis of DWI data, spatial normalization is crucial for conducting inter-subject analyses or linking the individual space with the reference space. Using tensor-based registration with an appropriate diffusion tensor template presents high accuracy regarding spatial normalization. However, there is a lack of a standardized diffusion tensor template dedicated to school-age children with ongoing brain development. Here, we established the school-age children diffusion tensor (SACT) template by optimizing tensor reorientation on high-quality DTI data from a large sample of cognitively normal participants aged 6-12 years. With an age-balanced design, the SACT template represented the entire age range well by showing high similarity to the age-specific templates. Compared with the tensor template of adults, the SACT template revealed significantly higher spatial normalization accuracy and inter-subject coherence upon evaluation of subjects in two different datasets of school-age children. A practical application regarding the age associations with the normalized DTI-derived data was conducted to further compare the SACT template and the adult template. Although similar spatial patterns were found, the SACT template showed significant effects on the distributions of the statistical results, which may be related to the performance of spatial normalization. Looking forward, the SACT template could contribute to future studies of white matter development in both healthy and clinical populations. The SACT template is publicly available now ( https://figshare.com/articles/dataset/SACT_template/14071283 ).