Objective To investigate the clinical efficacy of Yiqi Huoxue Prescription(derived from Shengyu Decoction)in the treatment of mild cervical spondylotic myelopathy(CSM)with qi deficiency and blood stasis type.Methods A total of 128 patients with mild CSM of qi deficiency and blood stasis type who admitted to Guangdong Provincial Hospital of Chinese Medicine from January 2022 to January 2024 were randomly divided into the control group and the trial group according to the random number table method,with 64 cases in each group.The control group was treated with oral administration of Mecobalamin Tablets,and the trial group was treated with Yiqi Huoxue Prescription orally on the basis of treatment for the control group.The two groups were all treated for four weeks,and then were followed up for three months after the completion of treatment.The CSM scores of the Japanese Orthopedic Association(JOA)and the traditional Chinese medicine(TCM)syndrome scores in the two groups were observed before treatment,after two weeks of treatment,after four weeks of treatment,and three months after the completion of treatment.And then the clinical efficacy,progression of CSM and the incidence of adverse reactions of the two groups were evaluated.Results(1)During the trial,two cases in the control group and three cases in the trial group fell off,and eventually a total of 123 cases were included,62 cases in the control group and 61 cases in the trial group.(2)Three months after the completion of treatment,the total effective rate of the trial group was 93.44%(57/61)and that of the control group was 82.26%(51/62),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).(3)After two and four weeks of treatment as well as three months after the completion of treatment,JOA scores in the two groups were increased compared with those before treatment(P<0.05),and JOA scores of the trial group at various time points mentioned above were higher than those of the control group,the difference being statistically significant(P<0.05).(4)After two and four weeks of treatment as well as three months after the completion of treatment,TCM syndrome scores in the two groups were decreased compared with those before treatment(P<0.05),and TCM syndrome scores of the trial group at various time points mentioned above were lower than those of the control group,the difference being statistically significant(P<0.05).(5)During the follow-up period,there was none case of significant aggravation or progression to moderate-severe illness in the two groups,and there were no adverse events such as allergies and gastrointestinal reactions.Conclusion Yiqi Huoxue Prescription exerts certain efficacy in treating patients with mild CSM of the qi deficiency and blood stasis type,and the treatment method is effective on improving the spinal cord function and symptoms of qi deficiency and blood stasis type,and slowing down the progression of disease in the patients,with high safety.

Objective To investigate the comparative effect of different spinal traction therapy on the treat-ment of degenerative lumbar spondylolisthesis based on the change of lumbosacral and pelvic sagittal position parameters.Methods The clinical data of 108 patients with degenerative lumbar spondylolisthesis admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2022 to January 2024 were selected for retrospective analysis,and they were divided into the three-dimensional group(n=55)and the four-dimensional group(n=53)according to the difference in treatment methods.The four dimensional group received four dimen-sional traction combined with basic treatment,and the three dimensional group received three dimensional traction combined with basic treatment.Lumbosacral pelvis sagittal position parameters,vertebral glide reduction degree,lumbar curvature value,coronal Cobb Angle of lumbar spine,lumbar function,pain degree and clinical efficacy were compared between the two groups.Results At the end of treatment and 3 months after treatment,the levels of sacral inclination Angle(SS)and lumbar lordosis Angle(LL)in 3D and 4D groups were lower than before treat-ment,and at 3 months after treatment were lower than at the end of treatment(P＜0.05).At the end of treatment,SS and LL levels in 3D group were lower than those in 4D group(P＜0.05),while there was no difference in SS and LL levels between the two groups at 3 months after treatment(P＞0.05).The lumbar lordotic index and coro-nal Cobb Angle of both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,the lumbar lordotic index and coronal Cobb Angle of both groups were lower than at the end of treatment(P＜0.05).At the end of treatment,the lumbar protrusion index and coronal Cobb Angle in the three-dimensional group were lower than those in the four-dimensional group(P＜0.05).At the end of treatment and 3 months after treatment,the distance of lumbar arch top in both groups was higher than before treatment(P＜0.05),and at 3 months after treatment,the distance of lumbar arch top in both groups was higher than at the end of treatment(P＜0.05).At the end of treatment,the distance of lumbar arch in the three-dimensional group was higher than that in the four-dimensional group(P＜0.05).At 3 months after treatment,there were no significant differences in lumbar lordo-sis index,coronal Cobb Angle of lumbar spine and distance between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,visual analogue pain scale(VAS)scores in both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,VAS scores in both groups were lower than at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,the Japanese Orthopaedic Asso-ciation evaluated treatment score(JOA)in both groups was higher than that before treatment(P＜0.05),and at 3 months after treatment,the JOA score in both groups was higher than that at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,there was no significant difference in JOA score and VAS score between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,there was no difference in the reduction rate of vertebral slippage between the two groups(P＞0.05).There was no difference in total effec-tive rate between the two groups(P＞0.05).Conclusion Four dimensional traction and three dimensional traction combined with basic treatment of degenerative lumbar spondylolisthesis have the same efficacy,both can effectively reduce pain and improve lumbar function,but three dimensional traction is better in improving lumbar function and lumbosacral pelvic sagittal position parameters,and correcting lumbar curvature abnormalities.

Objective To investigate the comparative effect of different spinal traction therapy on the treat-ment of degenerative lumbar spondylolisthesis based on the change of lumbosacral and pelvic sagittal position parameters.Methods The clinical data of 108 patients with degenerative lumbar spondylolisthesis admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2022 to January 2024 were selected for retrospective analysis,and they were divided into the three-dimensional group(n=55)and the four-dimensional group(n=53)according to the difference in treatment methods.The four dimensional group received four dimen-sional traction combined with basic treatment,and the three dimensional group received three dimensional traction combined with basic treatment.Lumbosacral pelvis sagittal position parameters,vertebral glide reduction degree,lumbar curvature value,coronal Cobb Angle of lumbar spine,lumbar function,pain degree and clinical efficacy were compared between the two groups.Results At the end of treatment and 3 months after treatment,the levels of sacral inclination Angle(SS)and lumbar lordosis Angle(LL)in 3D and 4D groups were lower than before treat-ment,and at 3 months after treatment were lower than at the end of treatment(P＜0.05).At the end of treatment,SS and LL levels in 3D group were lower than those in 4D group(P＜0.05),while there was no difference in SS and LL levels between the two groups at 3 months after treatment(P＞0.05).The lumbar lordotic index and coro-nal Cobb Angle of both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,the lumbar lordotic index and coronal Cobb Angle of both groups were lower than at the end of treatment(P＜0.05).At the end of treatment,the lumbar protrusion index and coronal Cobb Angle in the three-dimensional group were lower than those in the four-dimensional group(P＜0.05).At the end of treatment and 3 months after treatment,the distance of lumbar arch top in both groups was higher than before treatment(P＜0.05),and at 3 months after treatment,the distance of lumbar arch top in both groups was higher than at the end of treatment(P＜0.05).At the end of treatment,the distance of lumbar arch in the three-dimensional group was higher than that in the four-dimensional group(P＜0.05).At 3 months after treatment,there were no significant differences in lumbar lordo-sis index,coronal Cobb Angle of lumbar spine and distance between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,visual analogue pain scale(VAS)scores in both groups were lower than before treatment(P＜0.05),and at 3 months after treatment,VAS scores in both groups were lower than at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,the Japanese Orthopaedic Asso-ciation evaluated treatment score(JOA)in both groups was higher than that before treatment(P＜0.05),and at 3 months after treatment,the JOA score in both groups was higher than that at the end of treatment(P＜0.05).At the end of treatment and 3 months after treatment,there was no significant difference in JOA score and VAS score between the two groups(P＞0.05).At the end of treatment and 3 months after treatment,there was no difference in the reduction rate of vertebral slippage between the two groups(P＞0.05).There was no difference in total effec-tive rate between the two groups(P＞0.05).Conclusion Four dimensional traction and three dimensional traction combined with basic treatment of degenerative lumbar spondylolisthesis have the same efficacy,both can effectively reduce pain and improve lumbar function,but three dimensional traction is better in improving lumbar function and lumbosacral pelvic sagittal position parameters,and correcting lumbar curvature abnormalities.

Background::Understanding the characteristics of newly diagnosed primary human deficiency virus-1 (HIV-1) infection in the context of the post-antiretroviral therapy era and HIV drug prophylaxis is essential for achieving the new target of 95-95-95-95 by 2025. This study reported the characteristics of newly diagnosed primary HIV-1 infection in Shenzhen.Methods::This is a real-world retrospective study. Eighty-seven newly diagnosed primary HIV-1-infected patients were recruited from January 2021 to March 2022 at the Third People’s Hospital of Shenzhen. Demographic, epidemiological, diagnostic, drug resistance, and medical data were described and analyzed.Results::Overall, 96.6% (84/87) of the newly identified primary HIV-1-infected patients were male, including 88.5% (77/87) men have sex with men (MSM), with a median age of 29.0 years (Q 1-Q 3: 24.0-34.0 years); of these, 85.1% (74/87) reported high-risk sexual behaviors with casual partners. The rate of condom usage was only 28.7% (25/87). The overall rate of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) was 8.0% (7/87, including 4 PrEP and 3 PEP cases) around the potential exposure, although 41.4% of the patients had prior awareness of such interventions. Moreover, only 19.5% (17/87) had previously used PrEP or PEP. Of those, 58.8% (10/17) of the patients obtained drugs from the internet, and only 35.3% (6/17) reported good compliance. A total of 54.0% (47/87) of subjects were diagnosed by the HIV nucleic acid test. Acute retroviral syndrome appeared in 54.0% (47/87) of patients. The prevalence of transmitted drug resistance (TDR) mutation was 33.9% (19/56), including 6 (10.7%) against nucleoside reverse transcriptase inhibitor (NRTI) plus non-nucleoside reverse transcriptase inhibitor (NNRTI), 8 (14.3%) against NNRTI, and 5 (8.9%) against protease inhibitor (PI) only. Conclusions::Owing to the low utilization rate and incorrect usage of PrEP and PEP, massive efforts are needed to promote HIV-preventive strategies in the MSM population. The extremely high prevalence of TDR mutation in this population implies the need for future pretreatment drug resistance surveillance.

Objective To evaluate and compare the diagnosis and treatment quality of 15 tertiary hospitals in Beijing with the quality-evaluation model of STEMI.Methods The quality-evaluation model has been formatted with the document analysis method and expert consultation method,with the indicators weighted by analytic hierarchy process.By collecting the data of 15 hospitals,we can get the values of indicators,then synthetically evaluate and compare the diagnosis and treatment quality at these 15 hospitals with the method of WRSR.Results In the diagnosing and treating the cases of STEMI at the hospitals,gaps are found between the clinical guidelines and the tests,patient evaluation,reperfusion treatment and drug therapy,with some indicators falling even below 22％.Also,there are significant differences in the diagnosis and treatment quality among hospitals.All hospitals are consistent on the five dimensions-tests,patient evaluation,reperfusion treatment,drug therapy and prognosis.Conclusion The quality-evaluation model of STEMI can comprehensively reflect the diagnosis and treatment quality of cardiovascular medicine,and partly reflect hospital's overall management level,so as to provide operating methods in improving hospital diagnosis and treatment quality.