epsis is a systemic inflammatory response syndrome triggered by infection， and its high mortality rate is closely associated with immune imbalance， particularly the imbalance in the differentiation of helper T cell （Th） cell subsets [Th1， Th2， Th17， regulatory T cell （Treg） ] . In recent years， traditional Chinese medicine （TCM）， with its characteristics of multi-component and multi-target actions， has demonstrated unique advantages in regulating Th cell differentiation and function， as well as correcting immune imbalances in sepsis， offering new perspectives for immunotherapy of sepsis. This review summarizes relevant studies on the regulation of Th cell differentiation for sepsis treatment by TCM monomers and active ingredients （such as Astragalus membranaceus ， Scutellaria baicalensis ， Coptis chinensis ， Rheum palmatum ， Ganoderma lucidum ， Ginkgo biloba ， and Cistanche deserticola ）， the alcohol extract of Dai Baijie， and TCM formulas and preparations categorized as blood-activating and stasis-removing， purgative and laxative， warming and tonifying yang， and tonifying qi and nourishing yin. The results indicate that these TCM monomers， active ingredients， extracts， formulas， and preparations can regulate the Th1/Th2 and Th17/Treg balance， target the differentiation balance of Th cell subsets， alleviate inflammatory responses， or improve immune suppression， thereby exerting therapeutic effects on sepsis.

BACKGROUND: Circadian syndrome (CircS) may be closely linked to lifestyle, psychological, and occupational factors, but evidence is lacking. This study aimed to explore complex associations between lifestyle, psychological and occupational factors and CircS among employed people in southwestern China. METHODS: In this study, network analysis was used to identify complex associations between lifestyle, psychological and occupational factors and CircS in employed people from the Chinese Cohort of Working Adults (CCWA). The centrality of each variable was estimated by strength centrality index, which was calculated by the sum of edge weights connected to the variable. Bridge in the network was identified as the variables in the top 80 th percentile of overall bridge strength, which was defined as the most strongly connected variables across lifestyle, psychological and occupational factors and CircS. The differences were assessed in network structures between subgroups divided by the median score of the variable with the strongest bridge strengthen. RESULTS: Among 31,105 participants from CCWA, 5213 (16.76%) had CircS. In the constructed network, anxiety (edge weights: 0.28), smoking (edge weights: 0.15), drinking (edge weights: 0.10), perceived noise at work (edge weights: 0.08), and implicit health attitude (edge weights: -0.02) were directly related to CircS, with 83.31% of the variance for CircS explained by these neighboring factors. Anxiety was the most central variable (strength centrality: 1.20) in the network and the strongest bridge (bridge strength: 0.84) connecting all domains of variables. A stronger association between anxiety and CircS was observed in the network of participants with more severe anxiety (edge weight: 0.23) than those with less severe anxiety (edge weight: 0.03). CONCLUSION Anxiety had the strongest association with CircS and was the central factor with the highest strength centrality, also the bridge with the highest bridge strength in the network.
Humans ; Male ; Female ; Adult ; China ; Middle Aged ; Life Style ; Chronobiology Disorders/epidemiology*

Objective:To establish a quality control method for the standard decoction of Polygoni Avicularis Herba.Methods:Totally 12 batches of decoction pieces from different origins were collected, the standard decoction was prepared and the quality evaluation method was established, the content of index components in the decoction pieces and the standard decoction was determined with HPLC, the index components, solution pH and other parameters were calculated, and the similarity analysis was carried out against the fingerprints.Results:The total content of myricetin in 12 batches of decoction pieces was >0.12%, and the content of myricetin in the standard decoction was >0.03%, which met the standard of the 2020 edition of the Chinese Pharmacopoeia. The pH value was 5.1-5.5, the transfer rate of myricetin components ranged from 50.0%-106.3%, and the fingerprint study showed that there were 7 common peaks. The similarity analysis results indicated that the standard decoction of 12 batches of decoction pieces of Polygoni Avicularis Herba had good consistency.Conclusion:The preparation process is stable and feasible in line with the traditional decoction preparation method, and can be used for the research and quality evaluation of the standard decoction.

This paper explained the etiology and mechanism of atrial fibrillation based on the theory of "deficiency qi stagnation" for directing the treatment. It is believed that “deficiency qi” is the root of atrial fibrillation， which can be divided into deficiency of pectoral qi in heart and lungs of the upper jiao， deficiency of center qi in spleen and stomach of the middle jiao， and deficiency of original qi in kidney of the lower jiao， and stagnation of stasis， phlegm dampness， cold dampness and other pathogenic qi as the pathological basis of atrial fibrillation， which lead to the development of atrial fibrillation by constraint to heat， or stagnation of cold and dampness， or pathogens stagnation in heart and lung. The therapeutic principles is to supplement deficiency and remove stagnation， and Qingliang Buqi Tiaomai Decoction （清凉补气调脉汤） is often used to supplement the center and boost qi， rectify qi and unblock vessels； Qingliang Huashi Tiaomai Decoction （清凉化湿调脉汤） is often used to strengthen the middle and remove phlegm， dry dampness and unblock vessels； Ziyang Wenhua Tiaomai Decoction （滋养温化调脉汤） is often used to bank up original qi， supplement yin and tonify yang， dissipate cold and unblock vessels.

Myocardial fibrosis is characterized by pathological remodeling of extracellular matrix,which is a common pathological change during the development of various cardiovascular diseases.Qi transformation dysfunction in the zang-fu organs,subtle substance accumulation,and endogenous turbid evil production lead to the occurrence of diseases.The theory of turbid blood is widely used to elucidate the pathological changes of diseases and guide the prevention and treatment.Turbid blood,as a special pathogenic factor and pathological product,plays a crucial role in the oxidative stress process of myocardial fibrosis.Qi deficiency of the heart and spleen,stagnation of turbid blood,impaired blood circulation in the heart,and the inability to maintain the oxidative-reductive system balance of myocardial cells are the root causes of disease onset.Accumulation of turbid blood,intermingled phlegm and blood stasis,blockage of heart vessels,and accumulation of metabolic waste products contribute to disease progression.Prolonged turbidity accumulation leads to cardiac enlargement,scattered mental state,and pathological remodeling of the extracellular matrix,indicating a severe disease stage.Early treatment focuses on strengthening the vital qi and spleen,reducing turbidity and recovering clarity.In the middle stage,the key is to resolve phlegm,eliminate stasis,and promote clarity while removing turbidity.In the late stage,detoxification,turbidity elimination,and restoring clarity are emphasized.By adhering to the characteristics of the pathological mechanism and using traditional Chinese medicine intervention,it is possible to suppress oxidative stress,prevent pathological remodeling of the extracellular matrix,and improve myocardial fibrosis.

ObjectiveTo explore the effects of graded motor imagery (GMI) combined with repetitive transcranial magnetic stimulation (rTMS) on upper limb function and activities of daily living of stroke patients. MethodsFrom June, 2022 to February, 2023, 45 stroke patients from Xuzhou Rehabilitation Hospital and Xuzhou Central Hospital were recruited and divided into control group (n = 15), GMI group (n = 15) and combined group (n = 15) randomly. All the groups received conventional rehabilitation, in addition, GMI group received GMI and the combined group received GMI and rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), modified Barthel Index (MBI) and Hong Kong version of Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) before and after treatment. ResultsThe scores of FMA-UE, ARAT and MBI, and grades of FTHUE-HK improved in all the groups after treatment (|t| > 9.681, P < 0.001), and all these indexes were the best in the combined group (F > 13.241, P < 0.001). ConclusionGMI combined with rTMS can further improve the motor function of upper limbs and activities of daily living of stroke patients.

OBJECTIVETo compare the pain thresholds of acupoints in the meridians related to irritable bowel syndrome(IBS) between IBS patients and healthy people.

METHODSThirty-four healthy adults were collected into a normal group,and 60 patients with IBS were arranged into an IBS group. Pain thresholds were detected on the acupoints of large intestinal,small intestinal,stomach,spleen,gallbladder meridians and some commone use acupoints for IBS by pain measuring apparatus three times. Bilateral-well,-spring,-stream,-river,-sea,front-alarm,lower-sea,-primary,-connecting and back-transport points of each meridian were selected as the main acupoints. And pain thresholds of acupoints common used in clinic were compared between the two groups.

RESULTSThe thresholds of five-transport points and-connecting point of the large intestinal meridian in the IBS group were apparently lower than those in the normal group(all<0.05),with Hegu(LI 4),Tianshu(ST 25),Shangjuxu(ST 37) and Dachangshu(BL 25) more decreasing(all<0.01). The thresholds of five-transport points,front-alarm point and-primary point of the small intestinal meridian in the IBS group were obviously lower than those in the normal group(all<0.05),with Zhizheng(SI 7),Xiajuxu(ST 39) and Xiaochangshu(BL 27) more decreasing(all<0.01). The thresholds of Zusanli(ST 36),Weishu(BL 21),Yanglingquan(GB 34),Danshu(BL 19),Pishu(BL 20),Neiguan(PC 6),Taichong(LR 3),Taixi(KI 3),Sanyinjiao(SP 6) and Qihai(CV 6) in the IBS group were markedly lower than those in the normal group(all<0.05).

CONCLUSIONSThe pathological changes of IBS often appeared in the stomach,large intestinal,small intestinal,bladder meridians,and some acupoints in the liver,spleen and kidney meridians. When the functions of viscera are abnormal,the pain thresholds of related acupoints tend to decrease,and meridians and acupoints become sensitized from quiet state.

Objective:To explore the mental health statues of patients with HIV worried well.Methods:①To record the personal data of 72 patients and information they knew about AIDS.②Symptom check-list 90(SCL-90) were assessed to the patients with HIV worried well.③To treat the patients with psychological consultation and treatment mainly,partly with medicines,observe changes during the treatment.Results:Most patients with HIV worried well had middle school culture level(94.4%) ,70(97.2%) patients had or their sex partners had high risk sex,39(54.2%) patients got the information about AIDS from Internet;Symptom of the disease were complex,the main complains were worry of infected HIV and similar symptoms with AIDS;The factor scores of somatization,force,relationship,depression,anxiety,hostility,worry,crankiness and psychosis in 72 patients were significantly higher than those in Chinese norms(P