Objective: o develop an onset risk prediction nomogram for patients with homocysteine-type (H-type) hypertension (HTH) based on pulse diagram parameters to assist early clinical prediction and diagnosis of HTH. Methods: Patients diagnosed with essential hypertension and admitted to Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai Hospital of Traditional Chinese Medicine, and Shanghai Hospital of Integrated Traditional Chinese and Western Medicine from July 6th 2020 to June 16th 2021, and from August 11th 2023 to January 22nd 2024, were enrolled in this retrospective research. The baselines and clinical biochemical indicators of patients were collected. The SMART-I TCM pulse instrument was applied to gather pulse diagram parameters. Multivariate logistic regression was adopted to analyze the risk factors for HTH. RStudio was employed to construct the nomogram model, receiver operating characteristic (ROC) curve, and calibration curve (bootstrap self-sampling 200 times), and clinical decision curve were drawn to evaluate the model’s discrimination and clinical effectiveness. Results: A total of 168 hospitalized patients with essential hypertension were selected and divided into non-HTH group (n = 29) and HTH group (n = 139). Compared with non-HTH group, HTH group had a lower body mass index (BMI), and higher proportions of male patients and drinkers (P < 0.05). The ventricular wall thickening (VWT) could not be determined. The proportions of left common carotid intima-media wall thickness (LCCIMWT) and serum creatinine (SCR) were higher in HTH group (P < 0.05). The pulse diagram parameter As was significantly higher, and H4/H1 and T1/T were lower in HTH group (P < 0.05). Gender, alcohol consumption, serum creatinine, and the pulse diagram parameter H4/H1 were identified as independent risk factors for HTH (P < 0.05). The nomogram’s area under the ROC curve (AUC) was 0.795 [95% confidence interval (CI): (0.706 6, 0.882 8)], with a specificity of 0.724 and sensitivity of 0.799. After 200 times repeated bootstrap self-samplings, the calibration curve showed that the simulated curve fits well with the actual curve (x2 = 9.5002, P = 0.301 9). The clinical decision curve indicated that the nomogram’s applicability was optimal when the threshold for predicting HTH was between 0.38 and 1.00. Conclusion The nomogram model could be valuable for predicting the onset risk of HTH and pulse diagram parameters can facilitate early screening and prevention of HTH.

Objective To construct a model for predicting the risk of essential hypertension accompanied by left ventricular hypertrophy using machine learning algorithms based on pulse diagram parameters;To explore its clinical application value.Methods A total of 295 patients with essential hypertension who were hospitalized in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai Hospital of Traditional Chinese Medicine and Shanghai Hospital of Integrated Traditional Chinese and Western Medicine were selected from July 2020 to May 2021 and July 2023 to July 2024.According to the echocardiographic results,the selected research subjects were divided into the essential hypertension with left ventricular hypertrophy group(referred to as the"LVH group")and the essential hypertension without left ventricular hypertrophy group(referred to as the"non-LVH group").The general data and clinical biochemical indicators were collected,and the pulse diagram parameters of the patients were detected using the SMART-I type TCM digital pulse analyzer.A clinical prediction model was constructed based on decision tree,support vector machine and extreme gradient boosting model algorithms.The predictive performance of the model was evaluated in terms of discrimination,calibration and clinical prediction ability by using the receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis respectively.The influence of each predictive factor on the risk of LVH in essential hypertension was explained based on the SHAP algorithm.Results Compared with the non-LVH group,the BMI,the proportion of males,drinkers and smokers was lower in the LVH group,with statistical significance(P<0.05);the thickened ventricular wall,left ventricular internal dimension enlargement,left common carotid artery intima-media thickness and high density lipoprotein cholesterol were higher in the LVH group than in the non-LVH group(P<0.05);the left common carotid peak systolic velocity,left common carotid resistance index,serum uric acid and serum creatinine were lower in the LVH group than in the non-LVH group(P<0.05).The pulse diagram parameters T4,T,W1,W2,H3/H1 and H4/H1 were higher in the LVH group than in the non-LVH group(P<0.05).The areas of the ROC curves of the models constructed by the three types of machine learning algorithms were 0.887,0.962 and 0.873 respectively,indicating that the model had good discrimination and certain diagnostic efficacy.The calibration curve suggested that the prediction accuracy of the model was average;the clinical decision curve showed that XGBoost model has a higher net benefit.Conclusion The interpretable model constructed based on pulse diagram parameters and machine learning algorithms can be used as a reliable tool for predicting the risk of essential hypertension with LVH.

Objective To construct a model for predicting the risk of essential hypertension accompanied by left ventricular hypertrophy using machine learning algorithms based on pulse diagram parameters;To explore its clinical application value.Methods A total of 295 patients with essential hypertension who were hospitalized in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai Hospital of Traditional Chinese Medicine and Shanghai Hospital of Integrated Traditional Chinese and Western Medicine were selected from July 2020 to May 2021 and July 2023 to July 2024.According to the echocardiographic results,the selected research subjects were divided into the essential hypertension with left ventricular hypertrophy group(referred to as the"LVH group")and the essential hypertension without left ventricular hypertrophy group(referred to as the"non-LVH group").The general data and clinical biochemical indicators were collected,and the pulse diagram parameters of the patients were detected using the SMART-I type TCM digital pulse analyzer.A clinical prediction model was constructed based on decision tree,support vector machine and extreme gradient boosting model algorithms.The predictive performance of the model was evaluated in terms of discrimination,calibration and clinical prediction ability by using the receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis respectively.The influence of each predictive factor on the risk of LVH in essential hypertension was explained based on the SHAP algorithm.Results Compared with the non-LVH group,the BMI,the proportion of males,drinkers and smokers was lower in the LVH group,with statistical significance(P<0.05);the thickened ventricular wall,left ventricular internal dimension enlargement,left common carotid artery intima-media thickness and high density lipoprotein cholesterol were higher in the LVH group than in the non-LVH group(P<0.05);the left common carotid peak systolic velocity,left common carotid resistance index,serum uric acid and serum creatinine were lower in the LVH group than in the non-LVH group(P<0.05).The pulse diagram parameters T4,T,W1,W2,H3/H1 and H4/H1 were higher in the LVH group than in the non-LVH group(P<0.05).The areas of the ROC curves of the models constructed by the three types of machine learning algorithms were 0.887,0.962 and 0.873 respectively,indicating that the model had good discrimination and certain diagnostic efficacy.The calibration curve suggested that the prediction accuracy of the model was average;the clinical decision curve showed that XGBoost model has a higher net benefit.Conclusion The interpretable model constructed based on pulse diagram parameters and machine learning algorithms can be used as a reliable tool for predicting the risk of essential hypertension with LVH.

[Objective]To provide insights into the clinical diagnosis and treatment of infectious diseases in summer through probing into the theory of heat epidemic and its characteristics formulated by famous doctors in the past dynasties.[Methods]The etiology,pathogenesis and treatment of heat epidemic were analyzed by summarizing the discussions of various doctors from different angles and at different levels,and the differentiation and treatment rules of several common summer infectious diseases were explored on the basis of the application of heat epidemic theory.[Results]The etiology and pathogenesis of heat epidemic can be classified as excessive main Qi,evil abundance and Yin deficiency,transpiration of summer heat and diffuse ptomaine.Its treatment can be roughly divided into interior-clearing and exterior-harmonizing,blood-cooling and orifice-unblocking.On the basis,the article explored the etiology,pathogenesis and treatment of summer infectious diseases,such as hand-foot-and-mouth disease,dengue and Corona Virus Disease 2019(COVID-19),which have certain similarities with heat epidemic.[Conclusion]The theory of heat epidemic,closely related to the syndrome and treatment rules of three types of summer infectious diseases,can be the tentative basis for clinical diagnosis and treatment of summer infectious diseases with traditional Chinese medicine.

Objective:To observe any effects of repetitive high-frequency transcranial magnetic stimulation (rTMS) on the upper limb motor function of stroke survivors with right hemiplegia.Methods:Forty stroke survivors with right hemiplegia were divided at random into a high-frequency rTMS group and a sham stimulation group, each of 20. In addition to routine rehabilitation, the high-frequency rTMS group was given daily high-frequency rTMS 5d per week for 2 weeks, while the sham stimulation group was provided with sham rTMS. Before and after the treatment, both groups were evaluated using the Fugl-Meyer Upper Extremity motor function evaluation scale (FMA-UE), surface electromyography (sEMG), and electroencephalographic microstatus testing. Any adverse reactions in the course of the treatment were recorded.Results:After the treatment, the average FMA-UE scores of both groups had improved significantly, with the average of the high-frequency rTMS group significantly higher than the other group′s average. After the treatment the peak-to-peak sEMG value of the radial long extensor carpi radialis longus muscle in the high-frequency rTMS group was significantly higher than before the treatment and significantly higher than that of the other group. The temporal coverage of microstate B, the average duration and temporal coverage of microstate C, and the temporal coverage and frequency of occurrence of microstate D after treatment of both groups were also significantly improved. The mean duration of electroencephalographic (EEG) microstate A was negatively correlated with the FMA-UE scale scores ( r=-0.57) and its temporal coverage was positively correlated with the peak-to-peak sEMG value of the ulnar lateral wrist flexor. The mean duration of EEG microstate B was positively correlated with the peak-to-peak sEMG value of the triceps brachii and deltoid, and the mean duration of EEG microstate C was also positively correlated with the peak-to-peak sEMG value of the deltoid muscle. Conclusions:High-frequency rTMS can effectively improve the upper limb motor functioning of stroke survivors with right hemiparesis. After high-frequency rTMS, the functional network activity related to EEG microstate B increases significantly, while that related to microstates C and D decreases significantly.

High normal blood pressure is a crucial period for preventing cardiovascular and cerebrovascular events in our country.Target organs such as blood vessels,heart,kidney and brain may already be damaged even at the stage of high normal blood pressure.Early diagnosis and treatment can reduce the risk of cardiovascular and cerebrovascular events in patients with high normal blood pressure.Modern research methods for TCM pulse-taking are increasingly mature and have been widely used in screening,diagnosing,predicting,and intervening in cardiovascular and cerebrovascular risk events,such as hypertension,coronary heart disease,and stroke,with remarkable results.By detecting the pressure pulse map corresponding to the pulse of traditional Chinese medicine,it is possible to obtain information on the blood vessel function and elasticity in patients with high normal blood pressure.This can aid in the management of cardiovascular and cerebrovascular risks in such patients.This paper discusses the management of cardiovascular and cerebrovascular risk events in patients with high normal blood pressure.It reviews the application of traditional Chinese medicine pulse diagnosis and considers its value in risk event management.The paper proposes corresponding risk management strategies.

Background: Pleuropterus multiflorum Thunb. cv. “Heshouwu”(HSW) has been used as a classical material for both medicine and food in China for millennia. Recently, the cultivation region of HSW has shifted from Guangdong to Sichuan, Guizhou, and other regions. The investigation of geographic variation in bioactive metabolite contents and their relationship with soil mineral elements holds academic significance. Objective: This study aimed to investigate the variations in the distribution of active components in HSW across diverse planting regions and their relationship with soil mineral elements. Methods: A reliable quantitative analysis based on ultrahigh-performance liquid chromatography with triple-quadrupole mass spectrometry (UPLC-QQQ-MS) was developed to assess the levels of 15 bioactive metabolites in 60 HSW samples collected from 4 distinct regions. A total of 43 soil mineral elements in corresponding 60 soil samples were quantified by inductively coupled plasma mass spectrometry (ICP-MS). Orthogonal partial least squares-discriminant analysis (OPLS-DA), heatmap analysis, Pearson correlation analysis, and random forest (RF) regression were conducted based on the above quantitative data. Results: The content of stilbene glycosides displayed a wider range of variation compared with emodin and physcion among different regions. Eight compounds were screened as the differential metabolites in HSW samples from various sources using the supervised OPLS-DA analysis. Among these, 2 important functional compounds including physcion and 2, 3, 5, 4′-tetrahydroxystilbene-2-O-(6″-O-ace-tyl)-glucoside (THSG-5) are the most abundant in HSW samples from Deqing, a geographical indicative production region. Pearson correlation analysis indicated that the impact of soil mineral elements on the levels of stilbene glycosides is greater compared to that on anthraquinones. A negative correlation was observed between the levels of elements Na, Zn, Ba, Ti, and 2, 3, 5, 4′-tetrahydroxysilbene 2-O-glucoside (THSG-1). Conversely, a positive correlation was found between the contents of elements Na, Ce, Ti, and physcion and THSG-5, 2 components that exhibited higher levels in Deqing. Furthermore, an RF algorithm was employed to establish an interrelationship model, effectively forecasting the abundance of the majority of differential metabolites in HSW samples based on the content data of soil mineral elements. Conclusions: The variation of stilbene glycosides is wider than emodin and physcion in HSW. The levels of metabolites in HSW samples are influenced by soil mineral elements, with stilbene glycosides being more susceptible to such influences compared to anthraquinones. Specifically, THSG-1 shows a negative association withmost soil mineral elements, notably Na, Zn, Ba, and Ti, whereas the content of physcion displays a positive correlation.

High normal blood pressure is a crucial period for preventing cardiovascular and cerebrovascular events in our country.Target organs such as blood vessels,heart,kidney and brain may already be damaged even at the stage of high normal blood pressure.Early diagnosis and treatment can reduce the risk of cardiovascular and cerebrovascular events in patients with high normal blood pressure.Modern research methods for TCM pulse-taking are increasingly mature and have been widely used in screening,diagnosing,predicting,and intervening in cardiovascular and cerebrovascular risk events,such as hypertension,coronary heart disease,and stroke,with remarkable results.By detecting the pressure pulse map corresponding to the pulse of traditional Chinese medicine,it is possible to obtain information on the blood vessel function and elasticity in patients with high normal blood pressure.This can aid in the management of cardiovascular and cerebrovascular risks in such patients.This paper discusses the management of cardiovascular and cerebrovascular risk events in patients with high normal blood pressure.It reviews the application of traditional Chinese medicine pulse diagnosis and considers its value in risk event management.The paper proposes corresponding risk management strategies.

ObjectiveTo explore the brain mechanism of repetitive transcranial magnetic stimulation (rTMS) on dysfunction after stroke using functional magnetic resonance imaging (fMRI). MethodsLiteratures about the functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke were retrieved in PubMed, Web of Science, CNKI and Wanfang data from establishment to June 1st, 2021. The quality of the literature was evaluated with Physiotherapy Evidence Database (PEDro) scale. Literature screening, and data extraction were performed by two researchers. ResultsA total of 14 randomized controlled trials were finally enrolled. They were of high or very high quality. They mainly involved the therapeutic effect and imaging mechanisms of rTMS on dysfunction after stroke. ConclusionrTMS could change the excitability of the cerebral cortex and the effective connections between brain regions after stroke, promote the reorganization of brain function, and achieve the recovery of post-stroke dysfunction.

OBJECTIVE: To analyze the clinical features and genetic basis for a Chinese pedigree affected with hereditary dyschromatosis symmetrica hereditaria (DSH). METHODS: Peripheral blood samples of the proband and his mother were collected and subjected to PCR and Sanger sequencing. RESULTS: The patient has conformed to the typical pattern of DSH and manifested with hyperpigmentation, hypo- and hyperpigmentation spots on the back of hands, feet and face. Sanger sequencing confirmed that the proband and his mother have both harbored heterozygous splicing variant c.2762+1G>T in exon 9 of the ADAR gene, which was unreported previously. The same variant was not detected among 100 healthy controls. According to the guidelines of the American College of Medical Genetics and Genomics, the variant was predicted to be pathogenic (PVS1+PM2+PP4). CONCLUSION The c.2762+1G>T variant of the ADAR gene probably underlay the DSH in this pedigree. Above finding has enriched the spectrum of ADAR gene mutations.
Adenosine Deaminase/genetics* ; China ; Humans ; Mutation ; Pedigree ; Pigmentation Disorders/congenital* ; RNA-Binding Proteins/genetics*