Based on the theory of collateral disease， the treatment of late-stage sequela of cerebrovascular disease is considered to be primarily associated with deficiency and obstruction of cerebral collaterals and dysfunction of the spirit mechanism. Therefore， the fundamental therapeutic principle is to unblock and supplement the brain collaterals. Clinically， the late-stage sequelae of cerebrovascular disease are classified into four patterns， which are malnourishment， deficiency-heat， stasis obstruction， and phlegm clouding of brain collaterals. These are treated respectively with Tiansui Tongqiao Decoction （填髓通窍汤） to supplement essence and nourish the brain through moistening， unblocking and supplementing， Qingnao Touluo Decoction （清脑透络汤） to enrich yin， regulate spirit， and unblock collaterals through clearing and penetrating， Yiqi Tongluo Decoction （益气通络汤） to tonify qi and resolve stasis while softening tendons and unblocking collaterals， and Xinrun Touqiao Beverage （辛润透窍饮） to unblock and tonify yin and yang while unblocking the collaterals through acrid-moistening medicinals. Flexible modification of prescriptions according to individual symptoms was applied， resulting in favorable therapeutic outcomes.

This study explores the pathogenesis characteristics and treatment of somatic symptom disorder （SSD） from the perspective of the mutual influence among mental activities， qi transformation within membrane-striae-three jiao （焦）， and the functions of the five zang （脏） organs. It is proposed that the emotional， cognitive， and somatic perceptual abnormalities observed in SSD are closely associated with dysfunction of the spirit mechanism. Such dysfunction may disturb the ascent and descent of qi movement as well as the distribution of qi， blood， and body fluids， thereby leading to stagnation of membrane-striae-three jiao and disharmony of the five zang organs. Conversely， impaired membrane-striae and dysfunction of the five zang organs may further aggravate emotional abnormalities and somatic discomfort. These three aspects interact with one another and jointly contribute to the onset， progression， and persistence of SSD. Treatment should focus not only on calming the spirit， harmonizing the body， and regulating emotions， but also on unblocking membrane-striae and facilitating qi movement， and take into account the functional imbalances of the five zang organs. The ultimate goal is to achieve tranquility of the spirit， unobstructed membrane， and harmony of the zang organs， thereby addressing both the manifestations and the root causes of the disorder and reducing the risk of recurrence.

This study explores the pathogenesis characteristics and treatment of somatic symptom disorder （SSD） from the perspective of the mutual influence among mental activities， qi transformation within membrane-striae-three jiao （焦）， and the functions of the five zang （脏） organs. It is proposed that the emotional， cognitive， and somatic perceptual abnormalities observed in SSD are closely associated with dysfunction of the spirit mechanism. Such dysfunction may disturb the ascent and descent of qi movement as well as the distribution of qi， blood， and body fluids， thereby leading to stagnation of membrane-striae-three jiao and disharmony of the five zang organs. Conversely， impaired membrane-striae and dysfunction of the five zang organs may further aggravate emotional abnormalities and somatic discomfort. These three aspects interact with one another and jointly contribute to the onset， progression， and persistence of SSD. Treatment should focus not only on calming the spirit， harmonizing the body， and regulating emotions， but also on unblocking membrane-striae and facilitating qi movement， and take into account the functional imbalances of the five zang organs. The ultimate goal is to achieve tranquility of the spirit， unobstructed membrane， and harmony of the zang organs， thereby addressing both the manifestations and the root causes of the disorder and reducing the risk of recurrence.

Microglia efferocytosis,the process by which microglia phagocytose damaged and dead cells,has anti-inflammatory and pro-damage repair effects.Recent studies have shown that microglia efferocytosis plays a crucial role in the pathogenesis of Alzheimer's disease(AD)and may be a novel therapeutic target for AD.This paper reviews the relationship between microglia efferocytosis and AD pathogenesis and the potential of using efferocytosis-related molecules as therapeutic targets for AD.The aim of this review is to provide new ideas and approaches for the treatment of AD.

Microglia efferocytosis,the process by which microglia phagocytose damaged and dead cells,has anti-inflammatory and pro-damage repair effects.Recent studies have shown that microglia efferocytosis plays a crucial role in the pathogenesis of Alzheimer's disease(AD)and may be a novel therapeutic target for AD.This paper reviews the relationship between microglia efferocytosis and AD pathogenesis and the potential of using efferocytosis-related molecules as therapeutic targets for AD.The aim of this review is to provide new ideas and approaches for the treatment of AD.

Although NPM1 mutations are frequently found in acute myeloid leukemia patients, therapeutic strategies are scarce and unsuitable for those who cannot tolerate intensive chemotherapy. Here we demonstrated that heliangin, a natural sesquiterpene lactone, exerts favorable therapeutic responses in NPM1 mutant acute myeloid leukemia cells, with no apparent toxicity to normal hematogenous cells, by inhibiting their proliferation, inducing apoptosis, causing cell cycle arrest, and promoting differentiation. In-depth studies on its mode of action using quantitative thiol reactivity platform screening and subsequent molecular biology validation showed that the ribosomal protein S2 (RPS2) is the main target of heliangin in treating NPM1 mutant AML. Upon covalent binding to the C222 site of RPS2, the electrophilic moieties of heliangin disrupt pre-rRNA metabolic processes, leading to nucleolar stress, which in turn regulates the ribosomal proteins-MDM2-p53 pathway and stabilizes p53. Clinical data shows that the pre-rRNA metabolic pathway is dysregulated in acute myeloid leukemia patients with the NPM1 mutation, leading to a poor prognosis. We found that RPS2 plays a critical role in regulating this pathway and may be a novel treatment target. Our findings suggest a novel treatment strategy and lead compound for acute myeloid leukemia patients, especially those with NPM1 mutations.

Objective:To investigate the effectiveness and safety of the VA regimen, which combines venetoclax with azacitidine in the treatment of patients with newly diagnosed acute myeloid leukemia (AML) who are not suitable candidates for conventional chemotherapy.Methods:In the Department of Hematology at the Second Hospital of Hebei Medical University, 66 AML patients who received venetoclax and azacitidine treatment from May 2020 to March 2022 were the subject of a retrospective study. The complete remission (CR) rate, cCR rate, ORR rate, MRD negative rate, the incidence of adverse events,1-year EFS, and OS were retrospectively analyzed. Patients subgroups with varying ages, ECOG scores, primary and secondary, risk stratifications, and gene mutation were compared for differences in efficacy and survival.Results:The median follow-up was 4.25 (0.9-19.9) months, and the median number of treatment courses was 2 (1–8) cycles. After the first cycle, the cCR rate was 78.8% , and the MRD negative rate was 51.9% . After prolonged treatment, the cCR rate was 81.8% and MRD negative rate was 66.7% . The median EFS and OS, respectively, were13.2 and 15.3 months. Secondary AML showed inferior efficacy and prognosis. IDH1/2 or NPM1 mutation groups had a significantly higher rate of CR than the control group ( P<0.05) . The CR rate and MRD negative rate of patients with rebound thrombocytosis were significantly higher than those without rebound thrombocytosis ( P<0.05) . Those who had epigenetic modification mutations (DNMT3, ASXL1, TET2) were more likely to benefit from ongoing therapy. The most common grade 3 and 4 adverse reactions were neutropenia, thrombocytopenia, and anemia. Conclusions:In real-world patients with newly diagnosed AML who are not candidates for standard chemotherapy, the VA regimen produces rapid deep remission. Primary AML patients, rebound thrombocytosis, IDH1/2, and NPM1 gene mutations are favorable factors for treatment benefit, and adverse reactions were tolerable.

【Objective】 To study the mechanism of Apocynum leaves in the treatment of sepsis by network pharmacology method in order to explore the multi-dimensional research method of Xinjiang ethnic medicine treatment of infectious diseases and provide scientific theoretical basis for clinical medication. 【Methods】 TCMSP and literature collection were used to screen the main active components of Apocynum venetum leaf, and target prediction analysis was conducted by SwissTarget Prediction database. We used Genecards database to screen relevant targets for sepsis, used Omicshare to calculate Venn figure of the intersection targets, constructed the protein-protein interaction network diagram in the STRING database, used Ensembl for name conversion of protein targets, then entered Omicshare server for Go function and KEGG pathway enrichment of dynamic analysis. Last we used Cytoscape3.6.0 software to construct "Apocynum venetum leaf-the active ingredients-targets-Go-KEGG-sepsis" network to explore the mechanism of action of Apocynum’s resistance to sepsis. 【Results】 Kaferol, luteolin, proanthocyanidin B1 and phytosterol in Apocynum venetum leaves may treat sepsis by controlling signal transduction, regulating hormone level and anti-infection through predictive biological targets such as Akt1, VEGFA, MAPK3, EGFR, Src and PTGS2. They can play an important role through VEGF, EGFR, erbB, HIF-1, RAS and other enrichment pathways. 【Conclusion】 The active components of Apocynum venetum leaves can fight against sepsis through multiple targets and multiple pathways.

Objective:To study the application of students as standardized patients in orthopedical practice teaching of foreign medical students.Methods:A total of 116 students who received Surgical practice teaching in Affiliated Renhe Hospital of China Three Gorges University from January 2014 to December 2017 were randomly divided into two groups. Bedside teaching model was adopted in the control group ( n=58) to help the interns manage the in-patients under the guidance of the teacher. Additional teaching using standardized patients was applied 1 to 2 times per week in the experimental group ( n=58) on the basis of control group. After the teaching, practical test and assessment survey were adopted to evaluate the effectiveness of teaching. SPSS 13.0 was used to analyze the data by t-test. Results:The scores of the practical test of the experimental group were significantly higher than those of control group, such as history taking [(15.23±3.15) vs. (13.56±3.54), P=0.008], physical examination [(17.24±4.23) vs. (10.32±3.75), P=0.000], and basic skill [(17.32±2.58) vs. (13.22±3.65), P=0.000]. The assessment survey showed that learning motivation [(8.25±1.04) vs. (4.82±0.93), P=0.000], and communication ability [(6.22±1.12) vs. (5.59±0.89), P=0.001] of the experimental group were effectively improved than those of the control group. Conclusion:The teaching mode using standardized patients can effectively improve the learning motivation and clinical practical skills of foreign medical students, as well as the teaching quality.

Nonunion is the interruption of fracture healing process for a variety of reasons.The cause of the disease is different,and the treatment method is also different.Non-infective nonunion is that there are no local infection factors when nonunion occurs after wound and fracture,and it is most common in all nouunion.However,it is still a difficult problem for clinical orthopaedics.With the development of medical technology orthopaedics attach great importance to this kind of nonunion and study it deeply,its incidence is getting lower and lower.Despite brilliant results,the treatment for this kind of nonunion remains tricky.The treatment of non-infective nonunion can be divided into conservative treatment and surgical treatment,and the latter is still the main treatment.This article gives a systematic review of the treatment of non-infective nonunion.