BACKGROUND:Traditional Chinese medicine has rich experience and unique advantages in the empirical treatment of phlegm-heat and Fu-organs excess syndrome of ischemic stroke.In order to further explore the therapeutic targets and mechanisms of traditional Chinese medicine for this disease,it is crucial to establish a stable and reliable animal model of phlegm-heat and Fu-organs excess syndrome combined with empirical symptoms of ischemic stroke. OBJECTIVE:To explore the establishment method and evaluation system of the rat model of ischemic stroke with phlegm-heat and Fu-organ excess syndrome. METHODS:Sixty male Sprague-Dawley rats were randomly divided into four groups:blank control group(n=12),ischemic stroke group(n=18),disease+syndrome group(n=18),phlegm-heat and Fu-organ excess syndrome group(n=12),all of which were given high-fat diet for 25 days.On the 26th day,the rats in the blank control group and ischemic stroke group were intragastrically given normal saline and high fat diet,while those in the other two groups were intragastrically given autologous feces suspension and high fat diet for 3 continuous days.After gavage,ischemic stroke models were established using the suture method in the ischemic stroke group and disease+syndrome group.The changes in diet,water intake,body mass,body temperature,fecal traits,nasal secretions,sputum in the throat,and tongue image were recorded.Neurological deficits,tongue image,blood lipid levels,morphological changes of brain tissue and carotid artery,and the serum levels of motilin and somatostatin were detected. RESULTS AND CONCLUSION:Compared with the control group,the rats in the disease+syndrome group had shortness of breath,listlessness,irritability,bradykinesia,a large number of secretions around the nose,audible and heavy sputum in the throat,decreased diet and water intake,increased body mass,body temperature,and slingual vein score,decreased fecal pellet count,Bristol score and fecal moisture content,increased serum total cholesterol,triglyceride,low-density lipoprotein and somatostatin levels,decreased motilin level,increased neurological deficit score,significant pathological changes of the carotid artery,and significant morphological changes of the brain tissue.The ischemic stroke group only showed pathological changes of ischemic brain tissue,without the characteristics of phlegm-heat and Fu-organ excess syndrome.The phlegm-heat and Fu-organ excess syndrome group could present with the typical characteristics of traditional Chinese medicine syndromes,without the pathological changes of brain tissue with ischemic stroke.To conclude,the compound modeling method of high-fat induction combined with suture method and autologous feces gavage can establish an animal model of ischemic stroke with phlegm-heat and Fu-organ excess syndrome.

BACKGROUND:Currently,traditional Chinese medicine has accumulated extensive experience in the treatment and management of ischemic stroke.The application of latent structure combined with association rule analysis to deeply explore and summarize the"medicine-prescription-syndrome"rules is conducive to promoting the optimization of ischemic stroke prevention and treatment strategies.OBJECTIVE:To explore the rules of Chinese medicine in the treatment of ischemic stroke,and provide a reference for the clinical treatment of ischemic stroke based on syndrome differentiationMETHODS:A systematic search was conducted for clinical research literature on traditional Chinese medicine treatment of ischemic stroke from China National Knowledge Infrastructure(CNKI),WanFang,VIP,and SinoMed databases,covering the period from January 1,1990,to August 15,2024.The relevant studies were selected and the data were extracted into an Excel 2019 database for analysis.The frequency of use of Chinese herbs,their properties,meridional tropism,therapeutic effects and associated syndromes were analyzed.High-frequency herbs(＞4％)were subjected to latent structure modeling,comprehensive clustering,and association rule analysis using Lantern 5.0 and RStudio software,followed by summary of medication patterns and potential traditional Chinese medicine syndromes for ischemic stroke.RESULTS AND CONCLUSION:(1)A total of 231 articles were included,involving 203 kinds of traditional Chinese medicine,and the frequency of use was 2 524 times.(2)The high-frequency Chinese herbs were Chuanxiong,Earthworm,Angelica,Astragalus,Salviorrhiza,red peony root,safflower,leech,peach kernel,and pinellia.These herbs had predominantly warm,cold,or neutral properties,with bitter,sweet,and pungent flavors.Primary meridional tropism targets the liver,spleen and heart.Drug for invigorating blood circulation and eliminating stasis,deficiency tonifying drug,calming liver wind drug,expectorant cough suppressant and anti-asthmatic drug were used more frequently.(3)The latent structure model analysis identified 7 latent variables,14 latent classes,6 comprehensive clustering models,and 19 core prescriptions.It is hypothesized that the main traditional Chinese medicine syndromes for ischemic stroke are qi deficiency and blood stasis syndrome,wind-phlegm obstructing the channels syndrome,phlegm and blood stasis obstructing the channels syndrome,and phlegm-heat obstructing the viscera syndrome.(4)The association rule analysis revealed 29 strongly associative rules,including 2 two-item rules and 27 three-item rules.The highest degree of support was Angelica-Chuanxiong,and the highest degree of confidence was Angelica+licorice-Chuanxiong.The results show that ischemic stroke is a syndrome with qi and blood deficiency,liver and kidney Yin deficiency as the root causes,and wind,phlegm,blood stasis,and fire as the manifestations.The treatment is mainly to benefit qi and strengthen health,promote blood circulation and remove blood stasis,combined with pathological factors such as"phlegm and heat,""qi stagnation,""Yin deficiency,"and"liver fire,"supplemented by clearing heat and phlegm,promoting qi stagnation,nourishing liver and kidney,clearing liver and reducing fire.

BACKGROUND:Currently,traditional Chinese medicine has accumulated extensive experience in the treatment and management of ischemic stroke.The application of latent structure combined with association rule analysis to deeply explore and summarize the"medicine-prescription-syndrome"rules is conducive to promoting the optimization of ischemic stroke prevention and treatment strategies.OBJECTIVE:To explore the rules of Chinese medicine in the treatment of ischemic stroke,and provide a reference for the clinical treatment of ischemic stroke based on syndrome differentiationMETHODS:A systematic search was conducted for clinical research literature on traditional Chinese medicine treatment of ischemic stroke from China National Knowledge Infrastructure(CNKI),WanFang,VIP,and SinoMed databases,covering the period from January 1,1990,to August 15,2024.The relevant studies were selected and the data were extracted into an Excel 2019 database for analysis.The frequency of use of Chinese herbs,their properties,meridional tropism,therapeutic effects and associated syndromes were analyzed.High-frequency herbs(＞4％)were subjected to latent structure modeling,comprehensive clustering,and association rule analysis using Lantern 5.0 and RStudio software,followed by summary of medication patterns and potential traditional Chinese medicine syndromes for ischemic stroke.RESULTS AND CONCLUSION:(1)A total of 231 articles were included,involving 203 kinds of traditional Chinese medicine,and the frequency of use was 2 524 times.(2)The high-frequency Chinese herbs were Chuanxiong,Earthworm,Angelica,Astragalus,Salviorrhiza,red peony root,safflower,leech,peach kernel,and pinellia.These herbs had predominantly warm,cold,or neutral properties,with bitter,sweet,and pungent flavors.Primary meridional tropism targets the liver,spleen and heart.Drug for invigorating blood circulation and eliminating stasis,deficiency tonifying drug,calming liver wind drug,expectorant cough suppressant and anti-asthmatic drug were used more frequently.(3)The latent structure model analysis identified 7 latent variables,14 latent classes,6 comprehensive clustering models,and 19 core prescriptions.It is hypothesized that the main traditional Chinese medicine syndromes for ischemic stroke are qi deficiency and blood stasis syndrome,wind-phlegm obstructing the channels syndrome,phlegm and blood stasis obstructing the channels syndrome,and phlegm-heat obstructing the viscera syndrome.(4)The association rule analysis revealed 29 strongly associative rules,including 2 two-item rules and 27 three-item rules.The highest degree of support was Angelica-Chuanxiong,and the highest degree of confidence was Angelica+licorice-Chuanxiong.The results show that ischemic stroke is a syndrome with qi and blood deficiency,liver and kidney Yin deficiency as the root causes,and wind,phlegm,blood stasis,and fire as the manifestations.The treatment is mainly to benefit qi and strengthen health,promote blood circulation and remove blood stasis,combined with pathological factors such as"phlegm and heat,""qi stagnation,""Yin deficiency,"and"liver fire,"supplemented by clearing heat and phlegm,promoting qi stagnation,nourishing liver and kidney,clearing liver and reducing fire.

Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.

Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.

ObjectiveTo investigate the effect of ropivacaine administered intrathecally on the pulmonary function after caesarean section.MethodsThirty-six ASA Ⅰ or Ⅱ parturients,aged 22-34 yr,with body mass index ≤35 kg/m2,undergoing elective cesarean section,were randomly divided into 2 groups (n=18 each):bupivacaine group (group B) and ropivacaine group (group R).Spinal anesthesia was performed at L3,4 interspace and 0.5％ bupivacaine 1.8 ml (in cerebrospinal fluid 3 ml) and 1.0％ ropivacaine 1.4 ml (in cerebrospinal fluid 3 ml) were injected into the subarachnoid space over 10 s in groups B and R respectively.Forced vital capacity (FVC),forced expiratory volume first second (FEV1) and peak expiratory flow (PEF) were measured by spirometry before surgery (T0),and at 1,1.5 and 2 h after intrathecal injection (T1-3).The motor block score was recorded at T1-3.It is regarded as the criteria for respiratory dysfunction that the measured values of FVC and FEV1 are lower than their 80 ％ and 70 ％ predicted levels respectively.ResultsFVC and FEV1 were significantly decreased at T1 compared with the baseline value at T0 in both groups (P＜0.05).Compared with that at T1,PEF was significantly increased at T2,3 in group R (P ＜0.05).Compared with group B,PEF at T1 and motor block score atT3 were significantly decreased in group R (P＜0.05).The respiratory dysfunction was not found in both groups.ConclusionSpinal anesthesia with ropivacaine and bupivacaine can inhibit the parameter level of carly pulmonary function afrer caesarean section in parturient without respiratory complications,but the pulmonary function still remains normal.