The paper introduces Professor LIU Xing's clinical experience and characteristics of integrative acupuncture and medication in treatment of primary trigeminal neuralgia (PTN). It is believed that the essential pathogenesis of PTN is pathogenic wind, and qi and blood obstruction results from invasion of pathogenic wind. Hence, dispelling wind is the key principle of treatment. Palpation is done at first in the neck, face and buccal mucosal region to detect the masses in treatment. Acupotomy is operated at the masses distributed at Shangguan (GB3), Xiaguan (ST7) and the white line of buccal mucosa, so as to release masses. Additionally, five-wind points (Fengfu [GV16], bilateral Fengchi [GB20], Yifeng [TE17], Bingfeng [SI12] and Fengmen [BL12]), three-nape points (bilateral Naokong [GB19], Tianzhu [BL10] and Jianjing [GB21]) and three-governor-vessel points (Baihui [GV20], Zhiyang [GV9] and Yintang [GV24⁺]) are selected to dispel wind and stop pain. Besides, herbal decoction (wu feng tang) and blood-letting at ear apex are administered in combination. The integration of acupuncture and medication obtains a holistic effect on PTN by dispelling wind pathogen, and promoting qi and blood circulation.
Humans ; Trigeminal Neuralgia/drug therapy* ; Acupuncture Therapy ; Acupuncture Points ; Female ; Male ; Middle Aged ; Drugs, Chinese Herbal/administration & dosage* ; Combined Modality Therapy ; Adult ; Aged

Objective:To discuss the role of changes of serum total bile acid(TBA)levels induced by long-term high-fat diet in the occurrence of supraventricular arrhythmia(SVA)in the apolipoprotein E knockout(ApoE-/-)mice,and to clarify its mechanism.Methods:Twenty ApoE-/-mice were randomly divided into normal diet group and high-fat diet(HFD)group(n=10);after 20 weeks of feeding,surface electrocardiogram was used to detect cardiac electrophysiology of the mice in various groups;echocardiography was used to detect cardiac systolic function and structure in the mice in various groups;enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of blood lipids,total bile acid(TBA)and inflammatory factors in the mice in various groups;hematoxylin-eosin(HE)staining was used to detect cardiac inflammatory response in the mice in various groups;Masson staining was used to observe myocardial fibrosis degree in the mice in various groups.Results:Compared with normal diet group,4 cases of junctional premature beat(JPB)/junctional tachycardia(JT),1 case of premature atrial contraction(PAC)and 1 case of premature ventricular contraction(PVC)were found in HFD group,while only 1 case of JPB/JT and 1 case of PAC were found in normal diet group.Compared with normal diet group,the heart rate of the mice in HFD group was significantly decreased(P<0.05);the QRS and QT intervals were significantly prolonged(P<0.05);the ejection fraction(EF)and fractional shortening(FS)were significantly decreased(P<0.05);the end-diastolic volume(EDV)was increased(P<0.05),but there was no significant difference in end-systolic volume(ESV)between groups(P>0.05);the left ventricular internal diameter at end-diastole(LVIDd)and left ventricular internal diameter at end-systole(LVIDs)were significantly increased(P<0.05).There were no significant differences in plasma total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-c)and low-density lipoprotein(LDL-c)levels and body weight between normal diet group and HFD group(P>0.05).Compared with normal diet group,the TBA level of the mice in HFD group was significantly increased(P<0.05).There were no significant differences in interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1),and C-X-C motif chemokine ligand 1(CXCL-1)levels between HFD group and normal diet group.Compared with normal diet group,the interleukin-1β(IL-1β)level in HFD group showed an increasing trend,but there was no significant difference between groups(P>0.05).The HE staining results showed that the inflammatory cell infiltration was similar between HFD group and normal diet group.The Masson staining results showed that compared with normal diet group,the fibrosis of the mice in HFD group showed an increasing trend,but there was no significant difference in myocardial fibrosis area between groups(P>0.05).Conclusion:Long-term high-fat diet may increase serum TBA level in ApoE-/-mice,which may induce SVA.

Objective:To investigate the correlation between body mass index (BMI)/high-density lipoprotein cholesterol (HDL-C) ratio and cerebral small vessel disease (CSVD) in middle-aged and elderly people.Methods:Consecutive middle-aged and elderly patients (aged ≥40 years) who were hospitalized for chronic disease examinations in the Department of Neurology, Jiangning Hospital Affiliated to Nanjing Medical University between February 2022 and May 2024 were included prospectively. According to the overall burden score of CSVD, they were divided into CSVD group (≥1) and non-CSVD group (0). According to age, they divided into middle-aged group (40-59 years old) and elderly group (≥60 years old). The demographic characteristics and clinical data were collected. Binary multivariate logistic regression analysis was used to determine the independent correlation between BMI/HDL-C ratio and CSVD. Forest plot was used to analyze the correlation between BMI/HDL-C ratio and CSVD in different age groups. Results:A total of 710 patients were included, with an age of 66.0±10.0 years and 361 were males (50.8%). There were 261 patients (36.8%) in the CSVD group and 449 (63.2%) in the non-CSVD group. The BMI/HDL-C ratio in the CSVD group was significantly higher than that in the non-CSVD group (23.60±7.00 vs. 20.78±6.40; P<0.001). Multivariate logistic regression analysis showed that BMI/HDL-C ratio was an independent risk factor for CSVD in middle-aged and elderly populations (odds ratio 1.046, 95% confidence interval 1.027-1.064; P<0.001). There were 475 patients in the elderly group, of which 198 (41.7%) had CSVD; there were 235 patients in the middle-aged group, of which 63 (26.8%) had CSVD. Forest plot analysis showed that the association between BMI/HDL-C ratio and CSVD still had statistical significance in different age groups, but the effect intensity was higher in the elderly group than in the middle-aged group. Conclusion:The BMI/HDL-C ratio is independently correlated with CSVD in middle-aged and elderly population, particularly significant in the elderly population.

Succinic semialdehyde dehydrogenase deficiency (SSADHD) is a rare autosomal recessive neurometabolic disease.Pathogenic mutations in ALDH5A1 genes lead to abnormalities in the structure, activity and function of succinic semialdehyde dehydrogenase, resulting in a series of neurological damage.Due to the rarity of SSADHD and the huge differences in its clinical manifestations, it often leads to misdiagnosis or delayed diagnosis, and the treatment is mainly symptomatic.There is no specific drug or treatment.In March 2024, the SSADHD consensus group, composed of SSADHD researchers from 19 institutions in 11 countries and regions, released the " Consensus Guidelines for the Diagnosis and Management of Succinic Semialdehyde Dehydrogenase Deficiency" , which elaborates on the definition, epidemiology, clinical manifestations, diagnosis, and treatment of SSADHD, aiming to standardize and unify the diagnosis and management of SSADHD.This article interprets the key contents of the guidelines, in order to provide guidance for the early screening, diagnosis and treatment of SSADHD in China.

BACKGROUND:Polyetheretherketone is a special plastic polymer with good mechanical properties,biocompatibility,and chemical stability,which can be added with different fillers to form new composite materials and has potential clinical application value in post core repair. OBJECTIVE:To review the properties of polyetheretherketone and its composite materials,as well as the clinical application progress in post core repair. METHODS:CNKI database was searched using the Chinese search terms"polyetheretherketone,post core repair,metal post,fiber post,zirconia post".PubMed database was searched using English search terms"PEEK,polyetheretherketone post,post core repair,dental dowels".Search time ranged from January 2019 to October 2023.By reading literature titles,abstracts,and selecting the entire text,the inclusion and exclusion criteria were used to screen and finally include 71 articles for review. RESULTS AND CONCLUSION:Polyetheretherketone is a high-performance thermoplastic polymer.Experimental studies have proven that polyetheretherketone and its composites have advantages in mechanical properties,biocompatibility,aging resistance,chemical stability,adhesive properties,etc.,and have promising application prospects in the field of post core repair.The clinical application of polyetheretherketone and its composite materials as post core restorations is limited to anterior teeth and premolars,but they have achieved satisfactory restoration results.Polyetheretherketone and its composite materials are new materials in post core repair,and there are still many problems to be solved,such as whether the 3D printing equipment and printing process will affect the mechanical properties of the materials;short observation time for clinical repair effects,lack of long-term research validation.There is a lack of case reports on the use of polyetheretherketone and its composite materials as post and core materials for repairing molars,and further research is needed to continuously improve related studies.

Objective:To investigate the influence of maternal autoimmune diseases and anticoagulants, including low-molecular-weight heparin (LMWH) and aspirin, on the fetal fraction of maternal plasma cell-free DNA of non-invasive prenatal testing (NIPT).Methods:A prospective cohort study was conducted on women with singleton pregnancies receiving NIPT in the Nanjing Drum Tower Hospital from March 2021 to July 2022. NIPT was carried out using a polymerase chain reaction (PCR)-free amplification platform. In this study, four types of maternal autoimmune diseases, which were antiphospholipid syndrome, undifferentiated connective tissue disease, Sj?gren's syndrome, and systemic lupus erythematosus (SLE), and two anticoagulants, LMWH and aspirin, were studied. Univariate and multivariate linear regression models were used to analyze the factors influencing fetal fraction of maternal plasma cell-free DNA.Results:A total of 4 102 singleton pregnant women were enrolled in the prospective cohort, and 3 948 were finally included after excluding the cases with unclear dosing time of LMWH or aspirin, other autoimmune diseases, conceiving through ovulation induction alone, and having true positive or failed NIPT result. There were 96 cases with antiphospholipid syndrome, 35 with undifferentiated connective tissue disease, 34 with Sj?gren's syndrome, and 18 with SLE. A total of 108 patients only received LMWH treatment, 121 only received aspirin treatment, and 113 received both LMWH and aspirin treatment. Univariate linear regression analysis showed that maternal body mass index at blood collection ( B=－0.423), conceived by assisted reproductive technology ( B=－0.803), male fetus ( B=－0.458), undifferentiated connective tissue disease ( B=1.774), and SLE ( B=3.467) had influence on the fetal fraction (all P<0.05). Multivariate linear regression analysis showed that maternal body mass index at blood collection ( B=－0.415), conceived by assisted reproductive technology ( B=－0.585), male fetus ( B=－0.322), SLE ( B=3.347) and undifferentiated connective tissue disease ( B=1.336) were factors influencing fetal fraction (all P<0.05). Conclusions:Maternal use of LMWH or aspirin does not affect fetal fraction when performing NIPT on a PCR-free amplification platform, but undifferentiated connective tissue disease and SLE are the influencing factors. Therefore, pregnant women should be informed before the NIPT that the fetal fraction of maternal plasma cell-free DNA may be affected by maternal autoimmune diseases.

The glymphatic system (GS) is a dynamic fluid transport and material clearance system based on aquaporin 4 on the astrocytic endfeet. It mainly includes the inflow pathway of cerebrospinal fluid in the periarterial space, the exchange pathway of cerebrospinal fluid and tissue fluid in the brain parenchyma, and the outflow pathway of cerebrospinal fluid in the perivenous space. The exact pathogenesis of cerebral small vessel disease (CSVD) is still unclear. There is currently a lack of effective means to intervene in its occurrence or progression. Existing studies suggest that CSVD and GS are closely related. This article elaborates on the role of GS in CSVD and looks forward to seeking new ideas for the treatment of CSVD.

Objective:To evaluate and study the current status of safety and quality control of moxifloxacin hydro-chloride and sodium chloride injection.Methods:Fifteen production enterprises nationwide producing moxifloxacin hydrochloride and sodium chloride injection were sampled and tested according to each manufacturer's respective quality standards.Additionally,the safety-related items of"bacterial endotoxins"and"abnormal toxicity"were further studied and expanded upon.The rationality of the existing standards was analyzed.Results:According to the standard test,the qualification rate of 187 batches of moxifloxacin hydrochloride was 100％.However,compa-ring the quality standards used by various enterprises,it was found that there are significant differences in their re-quirements for bacterial endotoxin projects and abnormal toxicity projects.After using a unified and stricter standard for expansion testing,all 187 batches of samples still passed.Conclusion:The overall quality of moxifloxacin hydrochloride and sodium chloride injection in China is satisfactory in terms of safety control.It is recommended to unify the safety standards according to the draft quality standard for"moxifloxacin hydrochloride and sodium chlo-ride injection"issued by the National Pharmacopoeia Commission.

With the increasing number of adolescents with chronic diseases surviving into adulthood, various problems have arisen in the transition from a sheltered pediatric environment to an adult medical independent environment. In this context, transitional care has emerged, which plays an important role in increasing disease knowledge, enhancing self-management abilities, reducing admission and visit rates, and improving the quality of life for adolescents with chronic diseases. This paper reviews the overview, implementation methods, strategies, and suggestions for transitional care for adolescents with chronic diseases, so as to provide reference and guidance for standardizing and promoting transitional care for adolescents with chronic diseases.

Objective:To detect the expressions of S100P, mucin 5A, mucin 6, estrogen-inducing protein pS2, C-reactive protein (CRP), N-cadherin and CD56 in intrahepatic cholangiocarcinoma (ICC) and to analyze the sensitivity and specificity in the diagnosis of large and small bile duct cholangiocarcinoma.Methods:Clinical data of 47 patients (22 patients small bile duct and 25 patients large bile duct ICC) diagnosed with ICC at Ningbo Clinical Pathology Diagnosis Center from January 2018 to September 2019 were retrospectively analyzed, including 29 males and 18 females, aged (64.0±11.1) years. Cancer tissue specimens were collected. The expressions of S100P, mucin 5A, mucin 6, estrogen-induced protein pS2, CRP, N-cadherin and CD56 in cancer tissues were detected by immunohistochemical method, and the sensitivity and specificity of these proteins in the diagnosis of small bile duct and large bile duct ICC were analyzed.Results:In 22 patients with small bile duct type ICC, CD56 expression was positive in 12 (54.5%), CRP expression in 22 (100.0%) and N-cadherin expression in 21 (95.5%), large bile duct type ICC were 8.0%(2/25), 28.0%(7/25), 40.0%(10/25). In 25 cases of large bile duct type ICC, S100 calcium-binding protein P expression was positive in 23 cases (92.0%), estrogen-induced protein pS2 expression in 21 (84.0%) and mucin 5A expression in 23 (92.0%), small bile duct type ICC were 9.1%(2/22), 36.4%(8/22), 0. The positive expression rates of CD56, CRP and N-cadherin in small bile duct type ICC were significantly higher than those in large bile duct type ICC, while S100 calcium-binding protein P, estrogen-induced protein pS2 and mucin 5A were lower than those in large bile duct type ICC (all P<0.05). The sensitivity of CD56, CRP and N-cadherin in the diagnosis of small bile duct type ICC were 54.5%, 100.0% and 95.5%, and the specificity were 92.0%, 72.0% and 60.0%, respectively. The sensitivity of S100 calcium-binding protein P, estrogen-induced protein pS2 and mucin 5A in the diagnosis of large bile duct type ICC were 92.0%, 84.0% and 92.0%, and the specificity were 90.9%, 63.6% and 100.0%, respectively. Conclusion:The positive expressions of CD56, CRP, N-cadherin, S100 calcium-binding protein P, estrogen-induced protein pS2 and mucin 5A are of great value in the differential diagnosis of large bile duct type and small bile duct type ICC, and the diagnostic accuracy is reasonable, which could facilitate the accurate histological classification of ICC.