ObjectiveTo evaluate the impact of yang-reinforcing and blood-activating therapy on the long-term prognosis for patients with dilated cardiomyopathy （DCM） of yang deficiency and blood stasis syndrome. MethodsA retrospective cohort study was conducted involving 371 DCM patients with yang deficiency and blood stasis syndrome. The yang-reinforcing and blood-activating therapy was defined as the exposure factor. Patients were categorized into exposure group （186 cases） and non-exposure group （185 cases） according to whether they received yang-reinforcing and blood-activating therapy combined with conventional western medicine for 6 months or longer. The follow-up period was set at 48 months， and the Kaplan-Meier survival analysis was used to assess the cumulative incidence of major adverse cardiovascular events （MACE） in both groups. Cox regression analysis was used to explore the impact of yang-reinforcing and blood-activating therapy on the risk of MACE， and subgroup analysis was performed. Changes in traditional Chinese medicine （TCM） syndrome score， left ventricular ejection fraction （LVEF）， left ventricular fractional shortening （LVFS）， left ventricular end-diastolic diameter （LVEDD）， and Minnesota Living with Heart Failure Questionnaire （MLHFQ） score were compared between groups at the time of first combined use of yang-reinforcing and blood-activating therapy （before treatment） and 1 year after receiving the therapy （after treatment）. ResultsMACE occurred in 31 cases （16.67%） in the exposure group and 47 cases （25.41%） in the non-exposure group. The cumulative incidence of MACE in the exposure group was significantly lower than that in the non-exposure group ［HR=0.559， 95%CI（0.361，0.895）， P=0.014］. Cox regression analysis showed that yang-reinforcing and blood-activating therapy was an independent factor for reducing the risk of MACE in DCM patients ［HR=0.623， 95%CI（0.396，0.980）， P=0.041］， and consistent results were observed in different subgroups. Compared with pre-treatment， the exposure group showed decreased TCM syndrome score and MLHFQ score， reduced LVEDD， and increased LVEF and LVFS after treatment （P＜0.05）； in the non-exposure group， TCM syndrome score decreased， LVEF and LVFS increased， and LVEDD reduced after treatment （P＜0.05）. After treatment， the exposure group had higher LVEF and LVFS， smaller LVEDD， and lower TCM syndrome score and MLHFQ score compared with the non-exposure group （P＜0.05）. ConclusionCombining yang-reinforcing and blood-activating therapy with conventional western medicine can reduce the risk of MACE in DCM patients with yang deficiency and blood stasis syndrome， meanwhile improving their clinical symptoms， cardiac function， and quality of life.

Objective:To explore the relationship between international collaboration papers and academic impact in global health,using the member universities of the Chinese Consortium of Universities for Global Health(CCUGH)as a case study.Methods:The study focuses on journal articles in global health field published by 31 CCUGH member universities between 2014 and 2024.Descriptive statistical analysis of international and non-international collaboration publication volumes was conducted using Excel.Regression analysis and chi-square tests were performed using R to examine the relationship between international collaboration papers and academic impact,and the correlation between the breadth of collaboration and the academic impact of the papers.Results:From 2014 to 2023,the total number of publications,the number of non-international collaborationpublications,and the number of internationally collaborated publications all showed a consistent annual increase,with average annual growth rates of 56.7%,68.3%,and 41.4%,respectively.By the first half of 2024,the total number of publications had increased to 1.5 times that of the corresponding period in 2023.International collaboration positively influenced academic impact,with broader collaborative networks correlating with higher academic influence.Conclusion:The global health publication output of CCUGH member universities has steadily increased,but the volume of international collaboration papers and their proportion remain relatively low.Therefore,it is necessary for CCUGH member universities to strengthen international collaboration papers in global health.

Objective:To analyze the predictive value of dynamic changes of myocardial enzymes for late microvascu-lar obstruction(MVO)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:The clinical data of 123 AMI patients who underwent PCI in Peking University Third Hospital Qinhuangdao Hospital between June 2020 and December 2022 were retrospectively analyzed.Patients were divided into late MVO group(n=52)and non-late MVO group(n=71)according to the occurrence of late MVO 4-7 d after PCI.The myocardial enzyme spectrum indexes of the two groups before and 1 d after operation were collect-ed.Myocardial enzyme spectrum indexes were compared between the two groups.Multivariate Logistic regression a-nalysis was used to analyze the related factors affecting late MVO in AMI patients after PCI.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of myocardial enzyme changes for late MVO in AMI patients after PCI.Results:At 1 d after operation,compared to patients in non-late MVO group,those in the late MVO group had significant higher lactate dehydrogenase(LDH)[(332.12±34.28)IU/L vs.(308.66±30.9)IU/L],aspartate aminotransferase(AST)[(64.89±6.11)IU/L vs.(58.84±4.96)IU/L],crea-tine kinase(CK)[(240.60±32.51)IU/L vs.(214.69±30.27)IU/L],creatine kinase isoenzyme(CK-MB)[(35.01±4.73)IU/L vs.(30.27±4.60)IU/L]and α-hydroxybutyrate dehydrogenase(α-HBDH)[(55.24±4.20)U/L vs.(50.64±3.87)U/L](P＜0.001 all).Multivariate Logistic regression analysis showed that LDH(OR 1.034,95％CI 1.013～1.054),AST(OR 1.173,95％CI 1.052～1.308),CK(OR 1.038,95％CI 1.014～1.062),CK-MB(OR 1.310,95％CI 1.139～1.508)and α-HBDH(OR 1.379,95％CI 1.167～1.630)at 1 d af-ter operation were independent risk factors of late MVO in AMI patients after PCI(P＜0.01 all).ROC analysis showed that the area under the curve(AUC)of LDH,AST,CK,CK-MB,α-HBDH alone and combined detec-tion in predicting late MVO in AMI patients after PCI were 0.705(95％CI 0.609～0.801),0.793(95％CI 0.707～0.879),0.712(95％CI 0.621～0.804),0.767(95％CI 0.683～0.851),0.798(95％CI 0.718～0.878)and 0.950(95％CI 0.914～0.986)respectively.The AUC of combined prediction was better than those of single predic-tions(Z=2.807～4.882,P＜0.05 or＜0.01).Conclusion:Changes in myocardial enzyme spectrum may increase the risk of late MVO in AMI patients after PCI and combined detection have good predictive efficacy for it.

Objective:To analyze the predictive value of dynamic changes of myocardial enzymes for late microvascu-lar obstruction(MVO)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:The clinical data of 123 AMI patients who underwent PCI in Peking University Third Hospital Qinhuangdao Hospital between June 2020 and December 2022 were retrospectively analyzed.Patients were divided into late MVO group(n=52)and non-late MVO group(n=71)according to the occurrence of late MVO 4-7 d after PCI.The myocardial enzyme spectrum indexes of the two groups before and 1 d after operation were collect-ed.Myocardial enzyme spectrum indexes were compared between the two groups.Multivariate Logistic regression a-nalysis was used to analyze the related factors affecting late MVO in AMI patients after PCI.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of myocardial enzyme changes for late MVO in AMI patients after PCI.Results:At 1 d after operation,compared to patients in non-late MVO group,those in the late MVO group had significant higher lactate dehydrogenase(LDH)[(332.12±34.28)IU/L vs.(308.66±30.9)IU/L],aspartate aminotransferase(AST)[(64.89±6.11)IU/L vs.(58.84±4.96)IU/L],crea-tine kinase(CK)[(240.60±32.51)IU/L vs.(214.69±30.27)IU/L],creatine kinase isoenzyme(CK-MB)[(35.01±4.73)IU/L vs.(30.27±4.60)IU/L]and α-hydroxybutyrate dehydrogenase(α-HBDH)[(55.24±4.20)U/L vs.(50.64±3.87)U/L](P＜0.001 all).Multivariate Logistic regression analysis showed that LDH(OR 1.034,95％CI 1.013～1.054),AST(OR 1.173,95％CI 1.052～1.308),CK(OR 1.038,95％CI 1.014～1.062),CK-MB(OR 1.310,95％CI 1.139～1.508)and α-HBDH(OR 1.379,95％CI 1.167～1.630)at 1 d af-ter operation were independent risk factors of late MVO in AMI patients after PCI(P＜0.01 all).ROC analysis showed that the area under the curve(AUC)of LDH,AST,CK,CK-MB,α-HBDH alone and combined detec-tion in predicting late MVO in AMI patients after PCI were 0.705(95％CI 0.609～0.801),0.793(95％CI 0.707～0.879),0.712(95％CI 0.621～0.804),0.767(95％CI 0.683～0.851),0.798(95％CI 0.718～0.878)and 0.950(95％CI 0.914～0.986)respectively.The AUC of combined prediction was better than those of single predic-tions(Z=2.807～4.882,P＜0.05 or＜0.01).Conclusion:Changes in myocardial enzyme spectrum may increase the risk of late MVO in AMI patients after PCI and combined detection have good predictive efficacy for it.

Alzheimer’s disease (AD) is a central neurodegenerative disease characterized by progressive cognitive decline and memory impairment in clinical. Currently, there are no effective treatments for AD. In recent years, a variety of therapeutic approaches from different perspectives have been explored to treat AD. Although the drug therapies targeted at the clearance of amyloid β-protein (Aβ) had made a breakthrough in clinical trials, there were associated with adverse events. Neuroinflammation plays a crucial role in the onset and progression of AD. Continuous neuroinflammatory was considered to be the third major pathological feature of AD, which could promote the formation of extracellular amyloid plaques and intracellular neurofibrillary tangles. At the same time, these toxic substances could accelerate the development of neuroinflammation, form a vicious cycle, and exacerbate disease progression. Reducing neuroinflammation could break the feedback loop pattern between neuroinflammation, Aβ plaque deposition and Tau tangles, which might be an effective therapeutic strategy for treating AD. Traditional Chinese herbs such as Polygonum multiflorum and Curcuma were utilized in the treatment of AD due to their ability to mitigate neuroinflammation. Non-steroidal anti-inflammatory drugs such as ibuprofen and indomethacin had been shown to reduce the level of inflammasomes in the body, and taking these drugs was associated with a low incidence of AD. Biosynthetic nanomaterials loaded with oxytocin were demonstrated to have the capability to anti-inflammatory and penetrate the blood-brain barrier effectively, and they played an anti-inflammatory role via sustained-releasing oxytocin in the brain. Transplantation of mesenchymal stem cells could reduce neuroinflammation and inhibit the activation of microglia. The secretion of mesenchymal stem cells could not only improve neuroinflammation, but also exert a multi-target comprehensive therapeutic effect, making it potentially more suitable for the treatment of AD. Enhancing the level of TREM2 in microglial cells using gene editing technologies, or application of TREM2 antibodies such as Ab-T1, hT2AB could improve microglial cell function and reduce the level of neuroinflammation, which might be a potential treatment for AD. Probiotic therapy, fecal flora transplantation, antibiotic therapy, and dietary intervention could reshape the composition of the gut microbiota and alleviate neuroinflammation through the gut-brain axis. However, the drugs of sodium oligomannose remain controversial. Both exercise intervention and electromagnetic intervention had the potential to attenuate neuroinflammation, thereby delaying AD process. This article focuses on the role of drug therapy, gene therapy, stem cell therapy, gut microbiota therapy, exercise intervention, and brain stimulation in improving neuroinflammation in recent years, aiming to provide a novel insight for the treatment of AD by intervening neuroinflammation in the future.

A 20-year-old male patient presented to the Department of Dermatology of Peking Union Medical College Hospital with complaints of an 8-year history of facial scarring, swelling of the lower limbs, and a 4-year history of scalp thickening. Physical examination showed thickening furrowing wrinkling of the skin on the face and behind the ears, ciliary body hirsutism, blepharoptosis, and cutis verticis gyrate. Both lower limbs were swollen, especially the knees and ankles. The skin of the palms and soles of the feet was keratinized and thickened. Laboratory examination using bone and joint X-ray showed periostosis of the proximal middle phalanges and metacarpals of both hands, distal ulna and radius, tibia and fibula, distal femurs, and metatarsals.Genetic testing revealed two variants in SLCO2A1, c.1658T > A and c.96+4A > C.Through multidisciplinary consultation, we confirmed the diagnosis of pachydermoperiostosis.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

OBJECTIVE: To investigate the clinical effect of minimally invasive technique in the treatment of moderate and severe gluteal muscle contracture. METHODS: A retrospective study was conducted on 85 patients (170 sides) with bilateral gluteal muscle contracture admitted from January 2016 to December 2019. All patients were treated with minimally invasive release of tendon knife. There were 32 males and 53 females, ranging in age from 15 to 37 years old, with an average age of (22.3±6.3) years old. Operation time, intraoperative blood loss, incision length, first postoperative ambulation time, complication rate, recurrence rate, and Harris hip score (HHS) were analyzed and evaluated. RESULTS: The average follow-up time was (16.2±4.6) months, ranging from 12 to 30 months. The operation time ranged from 7 to 15 min, with an average of (10.2±3.1) min. Intraoperative blood loss ranged from 2 to 20 ml, with an average of (8.4±2.2) ml. The incision length ranged from 0.6 to 2.0 cm, with an average of (0.8±0.3) cm. The time to postoperative ambulation ranged from 12 to 28 h, with an average of (20.0±3.2) h. All patients achieved primary wound healing without sciatic nerve injury or recurrence. HHS hip function scores ranged from 90 to 98, with an average score of (96.2±1.4). Complications included intraoperative tendon blade tip fracture in two cases (removed under fluoroscopic guidance) and subcutaneous hematoma in three cases-two resolved with compression and one with open evacuation.. Twenty-nine patients exhibited transient swaying gait postoperatively, of which 24 patients returned to normal after 4 weeks and 5 patients returned to normal after 6 weeks. CONCLUSION Minimally invasive tendon blade release is a safe and effective technique for treating gluteal muscle contracture, offering minimal trauma, rapid recovery, and excellent cosmetic and functional outcomes. However, it exhibits a low risk of blade tip fracture and sciatic nerve injury, warranting experienced surgical handling.
Humans ; Male ; Female ; Adult ; Minimally Invasive Surgical Procedures/methods* ; Adolescent ; Retrospective Studies ; Buttocks/surgery* ; Young Adult ; Contracture/surgery* ; Tendons/surgery* ; Muscle, Skeletal/surgery*

OBJECTIVE: To compare clinical efficacy of musculoskeletal ultrasound-guided acupuncture treatment and radiation extracorporeal shock wave therapy in myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy. METHODS: From June 2021 to April 2022, 75 patients with myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy were admitted and divided into musculoskeletal ultrasound group and extracorporeal shock wave group according to different treatment methods. There were 39 patients in musculoskeletal ultrasound group, including 12 males and 27 females, aged from 43 to 77 years old with an average of (56.33±9.45) years old;11 patients on the left side and 28 patients on the right side;the course of disease with a median of 7.00(4.00, 12.00) weeks;acupuncture treatment was performed under the guidance of musculoskeletal ultrasound. There were 36 patients in extracorporeal shock wave group, including 16 males and 20 females, aged from 46 to 72 years old with a median of (58.94±8.94) years old;12 patients on the left side and 24 patients on the right side;the course of disease with an average of 5.50(4.00, 8.00) weeks;extracorporeal shock wave therapy with radiation were performed. Visual analogue scale (VAS) and American shoulder and elbow surgeons score (ASES) were compared between two groups to evaluate improvement of shoulder joint pain and function before treatment and 1, 3, 6, 12, and 24 months after treatment. RESULTS: Both of two groups were followed up for 24 to 27 months with an average of (24.68±0.89) months. No complications such as infection and vascular and nerve injury occurred during follow-up period. At 6 months after treatment, VAS of musculoskeletal ultrasound group (2.00±1.19) was lower than that of extracorporeal shock wave group (3.08±1.02), and the difference was statistically significant (P<0.05). At 1, 3, 12 and 24 months after treatment, there were no statistically significant difference in VAS between two groups (P>0.05). At 3, 6 and 12 months after treatment, ASES scores of musculoskeletal ultrasound group were (77.44±11.56), (86.06±6.11), and (89.44±4.66) respectively, which were higher than those of extracorporeal shock wave group (55.23±12.76), (58.10±10.25), (84.03±7.36), the differences were statistically significant (P<0.05);there were no statistically significant difference in ASES between two groups at 1 and 24 months after treatment(P>0.05). CONCLUSION Musculoskeletal ultrasound-guided acupuncture treatment has advantages of faster pain relief and more rapid improvement of shoulder joint function for myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy compared with radioactive extracorporeal shock wave therapy.
Humans ; Male ; Female ; Middle Aged ; Acupuncture Therapy/methods* ; Adult ; Aged ; Arthroscopy/adverse effects* ; Myofascial Pain Syndromes/etiology* ; Ultrasonography ; Rotator Cuff/surgery*

The objective assessment of hearing loss is one of the critical components in forensic clini-cal research.Auditory brainstem response(ABR)is an important method for objectively assessing hearing levels.It is divided into various types based on different stimulus signals,each with its own characteris-tics and applications.Among them,narrow-band Chirp ABR,due to its frequency specificity,fulfills the basic requirements for objective assessment of forensic audiology,promising to be an important method of objective hearing assessment in forensic medicine.This article reviews the development history,charac-teristics and clinical applications of Chirp ABR,and envisions its application prospects in forensic audi-tory identification.