The classic formula Fangji Fulingtang is from ZHANG Zhongjing's Synopsis of the Golden Chamber in the Eastern Han dynasty. It is composed of Stephaniae Tetrandrae Radix， Astragali Radix， Cinnamomi Ramulus， Poria， and Glycyrrhizae Radix et Rhizoma， with the effects of reinforcing Qi and invigorating spleen， warming Yang and promoting urination. By a review of ancient medical books， this paper summarizes the composition， original plants， processing， dosage， decocting methods， indications and other key information of Fangji Fulingtang， aiming to provide a literature basis for the research， development， and clinical application of preparations based on this formula. Synonyms of Fangji Fulingtang exist in ancient medical books， while the formula composition in the Synopsis of the Golden Chamber is more widespread and far-reaching. In this formula， Stephaniae Tetrandrae Radix， Astragali Radix， Cinnamomi Ramulus， Poria， and Glycyrrhizae Radix et Rhizoma are the dried root of Stephania tetrandra， the dried root of Astragalus embranaceus var. mongholicus， the dried shoot of Cinnamomum cassia， the dried sclerotium of Poria cocos， and the dried root and rhizome of Glycyrrhiza uralensis， respectively. Fangji Fulingtang is mainly produced into powder， with the dosage and decocting method used in the past dynasties basically following the original formula. Each bag is composed of Stephaniae Tetrandrae Radix 13.80 g， Astragali Radix 13.80 g， Cinnamomi Ramulus 13.80 g， Poria 27.60 g， and Glycyrrhizae Radix et Rhizoma 9.20 g. The raw materials are purified， decocted in water from 1 200 mL to 400 mL， and the decoction should be taken warm， 3 times a day. Fangji Fulingtang was originally designed for treating skin edema， and then it was used to treat impediment in the Qing dynasty. In modern times， it is mostly used to treat musculoskeletal and connective tissue diseases and circulatory system diseases， demonstrating definite effects on various types of edema and heart failure. This paper clarifies the inheritance of Fangji Fulingtang and reveals its key information （attached to the end of this paper）， aiming to provide a theoretical basis for the development of preparations based on this formula.

The classic formula Fangji Fulingtang is from ZHANG Zhongjing's Synopsis of the Golden Chamber in the Eastern Han dynasty. It is composed of Stephaniae Tetrandrae Radix， Astragali Radix， Cinnamomi Ramulus， Poria， and Glycyrrhizae Radix et Rhizoma， with the effects of reinforcing Qi and invigorating spleen， warming Yang and promoting urination. By a review of ancient medical books， this paper summarizes the composition， original plants， processing， dosage， decocting methods， indications and other key information of Fangji Fulingtang， aiming to provide a literature basis for the research， development， and clinical application of preparations based on this formula. Synonyms of Fangji Fulingtang exist in ancient medical books， while the formula composition in the Synopsis of the Golden Chamber is more widespread and far-reaching. In this formula， Stephaniae Tetrandrae Radix， Astragali Radix， Cinnamomi Ramulus， Poria， and Glycyrrhizae Radix et Rhizoma are the dried root of Stephania tetrandra， the dried root of Astragalus embranaceus var. mongholicus， the dried shoot of Cinnamomum cassia， the dried sclerotium of Poria cocos， and the dried root and rhizome of Glycyrrhiza uralensis， respectively. Fangji Fulingtang is mainly produced into powder， with the dosage and decocting method used in the past dynasties basically following the original formula. Each bag is composed of Stephaniae Tetrandrae Radix 13.80 g， Astragali Radix 13.80 g， Cinnamomi Ramulus 13.80 g， Poria 27.60 g， and Glycyrrhizae Radix et Rhizoma 9.20 g. The raw materials are purified， decocted in water from 1 200 mL to 400 mL， and the decoction should be taken warm， 3 times a day. Fangji Fulingtang was originally designed for treating skin edema， and then it was used to treat impediment in the Qing dynasty. In modern times， it is mostly used to treat musculoskeletal and connective tissue diseases and circulatory system diseases， demonstrating definite effects on various types of edema and heart failure. This paper clarifies the inheritance of Fangji Fulingtang and reveals its key information （attached to the end of this paper）， aiming to provide a theoretical basis for the development of preparations based on this formula.

The purpose of this investigation was to elucidate the clinical characteristics and genetic underpinnings of a pediatric patient with neurodevelopmental disorder with ataxic gait, absent speech, and decreased cortical white matter (NDAGSW, OMIM#617807). The affected individual, a 1-year-9-month-old male, displayed physical development retardation and distinctive facial features, notably periorbital puffiness, upward-gazing palpebral fissures, a shortened philtrum, a tented mouth, and conical-shaped digits. Clinically, the patient presented with profound global developmental retardation, marked language deficits, hypotonia, and an ataxic gait. Subtle, non-diagnostic alterations were identified in cranial magnetic resonance imaging and visual evoked potential assessments. The trio-whole exome sequencing analysis revealed a de novo heterozygous mutation, c.202G>A (p.A68T), within the RAB11B gene, a known pathogenic variant linked to NDAGSW. Neurodevelopmental disorders due to RAB11B gene variants are rare disorders with clinical manifestations of severe mental retardation, aphasia, motor retardation, gait abnormalities with peculiar phenotypical features, structural abnormalities of the brain, and reduced cerebral white matter, cerebellar hypoplasia, and hypoplasia of the corpus callosum as seen on cranial imaging. Based on the characteristics of the disease, the heterozygous missense mutation c.202G>A (p.Ala68Thr) in the RAB11B gene was identified as the genetic etiology of the child.

Huangqintang， with its accurate efficacy， is a classic formula specialized in treating dysentery recommended and promoted by medical experts from successive generations， and it was included in the Catalogue of Ancient Classic Prescriptions （the Second Batch， Han Chinese medicine prescriptions） published by the National Administration of Traditional Chinses Medicine （TCM） in 2023. The method of bibliometrics was applied in this study to conduct textual research on the classic formula Huangqintang and provide a literature reference for the development of modern preparations of Huangqintang. A total of 2 026 pieces of ancient literature were searched with "Huangqintang" as the key word， and 23 pieces of effective data were selected， involving 15 ancient TCM books. The historic evolution， composition， dosage， origin， processing methods， preparation and decocting methods， efficiency， and application of Huangqintang were carefully reviewed. The results showed that Huangqintang was first recorded in the Treatise on Febrile Diseases written by ZHANG Zhongjing. It has the effect of clearing heat， stopping dysentery， regulating the middle， and downbearing counterflow and has become one of the classic formulas widely used in clinical practice. Because of its accurate efficacy， medical experts from later generations have modified it from its original composition. Though many prescriptions have different names， it is the manifestation of physicians' inheritance and development of the thought of ZHANG Zhongjing. Ancient literature showed this prescription had wide indications yet centered on digestive system diseases such as dysentery and abdominal pain. Modern applications of Huangqintang involve digestive， respiratory， ophthalmology and otolaryngology， gynecological， skin， musculoskeletal system， and connective tissue， and this prescription has great potential in treating ulcerative colitis， diarrhea， acute enteritis， and damp-heat dysentery. Through a systematic textual excavation and review of the ancient literature about Huangqintang， the paper has confirmed its key information， so as to provide a scientific basis for the clinical application and new drug development of classic formulas.

The purpose of this investigation was to elucidate the clinical characteristics and genetic underpinnings of a pediatric patient with neurodevelopmental disorder with ataxic gait, absent speech, and decreased cortical white matter (NDAGSW, OMIM#617807). The affected individual, a 1-year-9-month-old male, displayed physical development retardation and distinctive facial features, notably periorbital puffiness, upward-gazing palpebral fissures, a shortened philtrum, a tented mouth, and conical-shaped digits. Clinically, the patient presented with profound global developmental retardation, marked language deficits, hypotonia, and an ataxic gait. Subtle, non-diagnostic alterations were identified in cranial magnetic resonance imaging and visual evoked potential assessments. The trio-whole exome sequencing analysis revealed a de novo heterozygous mutation, c.202G>A (p.A68T), within the RAB11B gene, a known pathogenic variant linked to NDAGSW. Neurodevelopmental disorders due to RAB11B gene variants are rare disorders with clinical manifestations of severe mental retardation, aphasia, motor retardation, gait abnormalities with peculiar phenotypical features, structural abnormalities of the brain, and reduced cerebral white matter, cerebellar hypoplasia, and hypoplasia of the corpus callosum as seen on cranial imaging. Based on the characteristics of the disease, the heterozygous missense mutation c.202G>A (p.Ala68Thr) in the RAB11B gene was identified as the genetic etiology of the child.

Objective To establish a PTEN gene-downregulated ASD juvenile rat model(VPA-ADV)through combined application of valproic acid(VPA)and PTEN adenovirus(ADV),then to compare the newly constructed animal model with two traditional autistic animal models of VPA and AD,and ultimately to prove the advantages of this model in animal model establishment of acupuncture treatment for ASD.Methods Wista rats at 12.5 days of gestation were randomly divided into 2 groups.VPA rats were given 600 mg/kg of normal saline(NS)intraperito-neally.Weight,eye opening time and tail deformity were recorded.The newborn mice in NS group were randomly divided into three groups(10 rats in each group):normal(NS)group,virus(ADV)group and virus-negative control(ADV-NC)group;VPA group(20 young rats)was randomly divided into 2 groups(10 rats in each group):valproic acid(VPA)group and valproic acid-binding virus interference(VPA+ADV)group.The body weight,tail length,curved tail,geotaxis text time and skeletal deformity of 5 groups of young rats after birth,the neurobehavioral behavior of 21-day-old rats,and the myelin structure of brain tissue under electron microscope were observed,the expression levels of PTEN,PI3K,AKT,GSK3β and MBP were detected by immunohistochemistry,Western blot and q-PCR.Results Compared with the NS group,the VPA group had significantly increased mal-formation rate,slow weight gain,slow tail length growth,and long negative geotaxis reflex time(P＜0.05).Com-pared with the NS group,the weight gain,tail length growth and negative geotaxis reflex time of the three model groups were slower(P＜0.05),and the performance of VPA+ADV model was the most significant.There were significant differences in the time of crossing the central grid,the number of crossing the edge grid,and the time of crossing the edge grid in the open field test between the three groups and the NS group(P＜0.05).In the self-grooming experiment,the number of interactions in VPA-ADV model was the least(P＜0.05),and the number of digging and self-grooming was the most(P＜0.05).In the three-box social experiment,VPA-ADV model had the shortest average number of entries into the social box and the shortest residence time(P＜0.05),the time of find-ing the platform in the water maze experiment was the longest,and the number of times crossing the third quadrant was the least(P＜0.05).The structure of the myelin sheath layer in the corpus callosum was observed by transmis-sion electron microscopy.The structure of the NS group was clear and complete.Compared with the NS group,the myelin structure of the ADV-NC group was similar,and the myelin structure of the three model groups was stratified and broken,and there were pathological changes and myelin damage in the ASD.Among them,the myelin sheath of the VPA-ADV model was thickened,stratified,and severe visible disintegration.The results of immunohisto-chemistry,Western blot and q-PCR showed that the expression of PTEN in VPA+ADV model was down-regulated by about 50％,which was the most obvious.The expression of AKT and MBP increased,and the expression of GSK3β decreased(P＜0.05).However,the results of q-PCR showed that the expression of PI3K-mRNA in the three model groups significantly increased(P＜0.05),and the change of VPA+ADV model was the most signifi-cant.Conclusion The novel PTEN-ASD animal model established by VPA+ADV method is observed to have sig-nificant pathological changes that are typical of the manifestation of ASD myelin dysplasia and is determined to have better results than the two traditional autistic animal models.

Objective:To observe the clinical effect of acupuncture combined with occupational therapy on children with autism spectrum disorder(ASD). Method:Seventy-two children aged 3-6 with ASD admitted to our hospital from January 2021 to December 2022,were randomly divided into two groups(control group and observation group)by simple number table method,with 36 cases in each group.The control group was treated with occupational therapy,and the obser-vation group was treated with acupuncture on the basis of the control group.Both groups were treated continu-ously for 12 weeks.To compare the clinical effects of the two groups.The Gesell developmental scale(GDS),the autistic child behavior scale(ABC),the infantile and junior high school social living ability scale(S-M)and the psychoeducational scale for autistic children(PEP-3)were evaluated before and after treat-ment.And the side effects of acupuncture were analyzed. Result:The total response rate of the observation group was 83.33％,which was significantly improved com-pared with the total response rate of the control group of 61.11％in the study(P＜0.05).After treatment,the total score of Gesell in the two groups,adaptive behavior,gross motion,fine movement,language and personal-social,were improved compared with those before treatment,and the effect of observation group was signifi-cantly better than that of the control group,with statistically significant difference(P＜0.05).In both groups,ABC communication,self-care factor score and total score were lower compared with those before treatment,and the effect of the observation group was better than that of the treatment group(P＜0.05).The S-M score of the two groups was higher than before treatment,and the effect of the observation group was better than that of the control group(P＜0.05).The scores of self-care and adaptive behavior of PEP-3 in both groups were significantly improved,and the improvement was more obvious in the observation group(P＜0.05).The side effects of acupuncture were seldom in the observation group. Conclusion:Acupuncture combined with occupational therapy can effectively improve the developmental level of children with autism,improve their social life ability,and benefit the prognosis of children with autism.

This paper　explored the disease mechanism of autism spectrum disorders （ASD） from the perspectives of “vital activity” and “qi configuration”， and it is believed that “vital activity” represents the internal regulatory mechanisms of the human body， while “qi configuration” represents the ability of the body to communicate and adapt to the external environment. Abnormal genetic factors lead to the extinction of vital activity in children with ASD， resulting in increased susceptibility to ASD. Environmental instability leads to the solitary qi configuration in ASD， triggering and exacerbating the manifestations of ASD on the basis of genetic susceptibility. In addition， epigenetic mechanisms also play an important role in the pathogenesis of ASD. Imbalances in vital activity and disruptions in qi configuration result in failure in qi transformation of zang-fu organs， with abnormal symptoms manifested through the five orifices. It is proposed that the treatment of ASD should aim to achieve a harmonious interaction between “vital activity” and “qi configuration” to accelerate the recovery of affected children.

A case of limb girdle muscular dystrophy type 2S (LGMD2S) caused by maternal uniparental disomy on chromosome 4 at the First Affiliated Hospital of Henan University of Chinese Medicine in March 2020 was reported.The female child, aged 9 months and 4 days, presented with developmental delay after bacterial meningitis in early infancy, decreased muscle strength in infancy and increased muscle and liver enzymes.Family genetic analysis showed that the child′s monodiploid in chromosome 4 was maternal origin, and the homozygous c. 1066T > G (p.Y356D) of TRAPPC11 gene may had pathogenic variation, which came from the child′s mother.The final diagnosis of LGMD2S was made according to the clinical manifestations and gene test results.LGMD2S is a rare autosomal recessive disease caused by the pathogenic variation of TRAPPC11 gene.Its clinical characteristics include proximal limb weakness, motor and intellectual retardation, seizures, motor disorders, elevated serum creatine kinase and muscular dystrophy like pathological changes in children.

Objective To investigate the effects of low contrast agent concentration and optimal monoenergetic image on myocardial image quality in dual source, dual energy coronary CT angiography (CCTA).Methods Sixty patients,who were clinically suspected of coronary heart disease and referred to perform dual energy CCTA examination,were prospectively collected between January and June 2016 in the first affiliated hospital of Xinjiang Medical University and then randomly divided into two groups with thirty cases in each group.Dual-energy CCTA was performed in both groups with the same parameters expect the iodine contrast agent concentration.The iopamidol concentrations were 370 and 320 mg/ml for groups A and B, respectively. The raw images of the two groups were reconstructed to get conventional mixed energy images and 60,65,70,75,80,85,90 keV single energy images,respectively labeled as group A1 to A8 and group B1 to B8.The CT attenuation,noise,signal-to-noise ratio(SNR)and contrast to noise ratio(CNR)were measured in images from groups A1 to A8 and B1 to B8. And the optimal monoenergetic image set was selected.Rank sum test was used to compare the CT value,noise,SNR and CNR between groups A1 to A8 and B1 to B8.The differences of above-mentioned parameters between A1 and B5 group,A5 group and B5 group were compared by independent sample t test.Results The differences of CT value,noise,SNR and CNR between groups A1 and A8, B1 and B8 were statistically significant (P<0.05). The CNR and SNR of group A5 were significantly higher than that of group A1,and the image noise of group A5 was lower than that of group A1(all P<0.05),and the images of A5 group(75 keV)were the optimal monoenergetic image. The SNR and CNR of the left ventricular lateral wall in group B5 were significantly higher than those in group B1,and the noise was lower than that in group B1(all P<0.05),and the image of B5 group(75 keV) was the optimal monoenergetic image. The difference of image noise between groups A1 and B5 was statistically significant(P<0.05),while the differences of SNR and CNR between these two groups were not significant(all P>0.05).The differences of image noise,SNR and CNR between groups A5 and B5 were not significant(all P>0.05).Conclusions The myocardial CCTA image quality by using iodine contrast agent (320 mg/ml) and optimal monoenergetic imaging (75 keV) is equivalent to that of conventional iodine contrast agent(370 mg/ml)mixed energy image.The strategy can effectively reduce the amount of contrast agent when meeting the needs of the clinical diagnosis.