The concepts of manifestation-root cause,Yin-Yang balance,reinforcing-reducing for deficiency and excess should not only be focused on the traditional Chinese medicine formulations,but also be consistently applied in clinical practice of acupuncture treatment.The"Tongdu Qishen"acupuncture method,developed by Professor Li Zhigang based on years of experience in treating psychosis,demonstrates unique advantages in treating stroke sequela hemiplegia.From the three aspects of theoretical basis,classic medical records,acupoint selection and operation analysis,this study introduces the clinical application of"Tongdu Qishen"combined with manifestation-root cause Yin-Yang and reinforcing-reducing balance acupuncture in the treatment of stroke sequela hemiplegia,offering new insights and strategies for exploring effective clinical treatment with syndrome differentiation.

Objective: To analyze the potential categories and influencing factors of the compliance trajectory of orthokeratology lenses (OK lens) in myopic children and adolescents, so as to provide a basis for dynamic and accurate intervention of OK lens compliance in myopic children and adolescents. Methods: From January to June 2024, 310 myopic children and adolescents wearing OK lens were selected as research subjects from the Ophthalmology Medical Center of Cangzhou Central Hospital using a convenient sampling method. Data were collected at four time points: when the glasses were first fitted (T0), 2 weeks after fitting (T1), 1 month later (T2), 3 months later (T3), and 6 months later (T4). The data collection methods included general information questionnaires, compliance surveys for OK lens wearers, the Behavior Rating Inventory of Executive Function-Self-report Version (BRIEF-SR), family support scales, and a self-made questionnaire on myopia control attitudes. A growth mixed model was used to identify the trajectory categories of compliance with OK lens wearing among myopic children and adolescents, and multiple Logistic regression analysis was employed to examine the influencing factors. Results: The compliance with OK lens among myopic children and adolescents were roughly divided into four developmental trajectories: C1 exemplary adherent (58 cases, 18.71%), C2 gradual progressor (130 cases, 41.94%), C3 fluctuating (85 cases, 27.42%), and C4 stubborn low follower (37 cases, 11.94%). Multivariate Logistic regression analysis showed that, with C1 group as the reference, age (C3, OR = 0.74 ), parental education level (C4, OR =0.67), executive function (C2, OR =0.69; C4, OR =0.44), family support (C3, OR =0.75) and myopia control attitude (C2, OR =0.39) were all influencing factors for the compliance trajectory of OK lens; with C2 group as the reference, age (C3, OR = 0.55 ), parental education level (C3, OR =0.34; C4, OR =0.64), executive function (C3, OR =0.77), and family support (C4, OR =0.58) were all influencing factors for the compliance trajectory of OK lens; with C3 group as the reference, age (C4, OR = 0.68 ), and myopia control attitude (C4, OR =0.44) were both influencing factors for the compliance trajectory of OK lens ( P <0.05). Conclusions The compliance of wearing OK lens in children and adolescents with myopia can be roughly divided into four trajectories, and there is group heterogeneity. Dynamic and precise compliance intervention strategies should be given based on different trajectories and influencing factors.

Objective:To summarize the surgical strategies and to evaluate the clinical outcomes of up-per urinary tract reconstruction in patients with stone-related ureteral strictures.Methods:This retro-spective study included 71 patients diagnosed with ureteral strictures secondary to urinary stones who un-derwent upper urinary tract reconstructive surgery at Peking University First Hospital between March 2014 and November 2023.Patient data were collected,including demographic characteristics,clinical presen-tation,laboratory results,imaging findings,surgical procedures,and follow-up outcomes.Ureteral stric-tures were classified according to anatomical location into upper,middle,lower,or multiple segments.Surgical procedures were carried out depending on the stricture characteristics.Surgical success was de-fined as resolution or improvement of clinical symptoms,radiographic improvement or stabilization of hy-dronephrosis,and maintenance of normal and stable renal function.Results:Among the 71 patients,36(50.7％)had strictures in the upper ureter,9(12.7％)in the middle ureter,15(21.1％)in the lower ureter,and 11(15.5％)had multifocal ureteral strictures.The median stricture length was 5.0 cm(interquartile range:3.0-15.0 cm).Surgical approach selection was individualized based on the location and extent of the stricture.For upper ureteral strictures,the most frequently employed techniques were oral mucosal graft ureteroplasty(13/36,36.1％)and appendiceal flap ureteroplasty(8/36,22.2％).Other options included ureteroureterostomy and ileal ureter replacement for longer or more complex strictures.In middle ureteral strictures,treatment was stratified by length:balloon dilation(1/9,11.1％)and ureteroureterostomy(1/9,11.1％)were applied in shorter strictures,while oral mucosal graft ureteroplasty(3/9,33.3％)and ileal ureter replacement(4/9,44.4％)were reserved for longer segments.For lower ureteral strictures,ureteral reimplantation into the bladder was the most common approach(10/15,66.7％),often combined with a psoas hitch or Boari flap when necessary.All the patients with multiple segmental strictures underwent ileal ureter replacement due to the extensive nature of the disease.The median follow-up period was 14.2 months(range:6.1-107.1 months).During follow-up,69 of 71 patients(97.2％)achieved surgical success.Conclusion:Stone-related ure-teral strictures present with considerable heterogeneity in terms of anatomical location,length,and com-plexity.Careful preoperative evaluation and individualized surgical planning are critical to successful re-construction.With appropriate selection of surgical methods,favorable long-term clinical outcomes can be achieved in the majority of patients.

Objective:To summarize the surgical strategies and to evaluate the clinical outcomes of up-per urinary tract reconstruction in patients with stone-related ureteral strictures.Methods:This retro-spective study included 71 patients diagnosed with ureteral strictures secondary to urinary stones who un-derwent upper urinary tract reconstructive surgery at Peking University First Hospital between March 2014 and November 2023.Patient data were collected,including demographic characteristics,clinical presen-tation,laboratory results,imaging findings,surgical procedures,and follow-up outcomes.Ureteral stric-tures were classified according to anatomical location into upper,middle,lower,or multiple segments.Surgical procedures were carried out depending on the stricture characteristics.Surgical success was de-fined as resolution or improvement of clinical symptoms,radiographic improvement or stabilization of hy-dronephrosis,and maintenance of normal and stable renal function.Results:Among the 71 patients,36(50.7％)had strictures in the upper ureter,9(12.7％)in the middle ureter,15(21.1％)in the lower ureter,and 11(15.5％)had multifocal ureteral strictures.The median stricture length was 5.0 cm(interquartile range:3.0-15.0 cm).Surgical approach selection was individualized based on the location and extent of the stricture.For upper ureteral strictures,the most frequently employed techniques were oral mucosal graft ureteroplasty(13/36,36.1％)and appendiceal flap ureteroplasty(8/36,22.2％).Other options included ureteroureterostomy and ileal ureter replacement for longer or more complex strictures.In middle ureteral strictures,treatment was stratified by length:balloon dilation(1/9,11.1％)and ureteroureterostomy(1/9,11.1％)were applied in shorter strictures,while oral mucosal graft ureteroplasty(3/9,33.3％)and ileal ureter replacement(4/9,44.4％)were reserved for longer segments.For lower ureteral strictures,ureteral reimplantation into the bladder was the most common approach(10/15,66.7％),often combined with a psoas hitch or Boari flap when necessary.All the patients with multiple segmental strictures underwent ileal ureter replacement due to the extensive nature of the disease.The median follow-up period was 14.2 months(range:6.1-107.1 months).During follow-up,69 of 71 patients(97.2％)achieved surgical success.Conclusion:Stone-related ure-teral strictures present with considerable heterogeneity in terms of anatomical location,length,and com-plexity.Careful preoperative evaluation and individualized surgical planning are critical to successful re-construction.With appropriate selection of surgical methods,favorable long-term clinical outcomes can be achieved in the majority of patients.

The concepts of manifestation-root cause,Yin-Yang balance,reinforcing-reducing for deficiency and excess should not only be focused on the traditional Chinese medicine formulations,but also be consistently applied in clinical practice of acupuncture treatment.The"Tongdu Qishen"acupuncture method,developed by Professor Li Zhigang based on years of experience in treating psychosis,demonstrates unique advantages in treating stroke sequela hemiplegia.From the three aspects of theoretical basis,classic medical records,acupoint selection and operation analysis,this study introduces the clinical application of"Tongdu Qishen"combined with manifestation-root cause Yin-Yang and reinforcing-reducing balance acupuncture in the treatment of stroke sequela hemiplegia,offering new insights and strategies for exploring effective clinical treatment with syndrome differentiation.

ObjectiveTo explore the effects of Bushen Huoxue prescription on the expression of arginine vasopressin （AVP） and aquaporins （AQP）1 and AQP4 in the brain and AQP1， AQP4， and AQP7 in the myocardial tissue of the rat model of heart failure after myocardial infarction. MethodSixty healthy male SD rats were selected and randomized into sham surgery， model， Bushen Huoxue prescription， and tolvaptan groups. The rats in the sham surgery group only had their coronary arteries exposed without ligation， while those in the other groups were subjected to ligation of the left coronary artery combined with exhaustive swimming and starvation for the modeling of heart failure after myocardial infarction. After the successful modeling， the rats in the tolvaptan （1.35 mg·kg^-1） and Bushen Huoxue prescription （15.75 g·kg^-1） groups were treated with corresponding drugs， and those in the sham surgery and model groups were treated with an equal volume of normal saline for 4 weeks. Color doppler echocardiography was employed to measure changes of the left ventricular structure and function in rats. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the serum level of N-terminal pro-B-type natriuretic peptide （NT-proBNP）. Hematoxylin-eosin （HE） staining was conducted to reveal the pathological changes in the myocardial tissue. Western blotting was employed to measure the protein levels of AVP， AQP1， and AQP4 in the brain tissue and AQP1， AQP4， and AQP7 in the myocardial tissue. Real-time fluorescence quantitative PCR was conducted to determine the mRNA levels of AVP， AQP1， and AQP4 in the brain tissue and AQP1， AQP4， and AQP7 in the myocardial tissue. ResultCompared with the sham surgery group， the model group showed increased left ventricular internal diameter （LVID） （P<0.01）， decreased ejection fraction （EF） and short axis fractional shortening rate （FS） （P<0.01）， increased left ventricular septal and posterior wall thicknesses （LVS and LVPW） （P<0.01）， elevated serum NT-proBNP level （P<0.01）， edema and vacuolar degeneration of nerve cells in the brain tissue， necrosis of myocardial cells and rupture of myocardial fibers in the infarcted area， and upregulated mRNA and protein levels of AVP， AQP1， and AQP4 in the brain tissue （P<0.01） and AQP1， AQP4， and AQP7 in the myocardial tissue （P<0.01）. Compared with the model group， tolvaptan and Bushen Huoxue prescription restored LVID， EF， FS， LVS， and LVPW （P<0.05， P<0.01）， lowered the serum NT-proBNP level （P<0.05）， alleviated the edema of nerve cells in the brain tissue， improved the arrangement of myocardial fibers， mitigated the necrosis of myocardial cells， and downregulated the mRNA and protein levels of AVP， AQP1， and AQP4 in the brain tissue （P<0.01） and AQP1， AQP4， and AQP7 in the myocardial tissue （P<0.05， P<0.01）. ConclusionBushen Huoxue prescription can regulate cardiovascular and cerebrovascular fluid metabolism disorders， delay ventricular remodeling， and improve the cardiac function by downregulating the expression of AVP， AQP1， and AQP4 in the brain tissue and AQP1， AQP4， and AQP7 in the myocardial tissue in the rat model of heart failure after myocardial infarction.