This article summarizes Professor Li Ziyong's clinical experience with the round-sharp needle.As one of the core needle types in the Huang Di Nei Jing(The Yellow Emperor's Inner Classic)nine-needle system,the round-sharp needle has long been marginalized in clinical practice due to historical discontinuities in its transmission and insufficient research on its morphological characteristics,resulting in its unique therapeutic value remaining largely unrecognized.Through nearly three decades of clinical practice,Professor Li innovatively proposed the acupuncture concept of"unblocking passages and guarding the pivotal mechanism",guided by the Yellow Emperor's Inner Classic principle that"ordinary practitioners focus on the joints,while superior practitioners focus on the pivotal mechanisms".Under this theoretical framework,he has extensively applied the round-sharp needle in clinical settings.With its unique design combining rounded and sharp features,the round-sharp needle demonstrates remarkable clinical efficacy by intervening at the fascial layer and releasing local fascial adhesions.It exhibits rapid onset and stable therapeutic outcomes.This article systematically reviews Professor Li's understanding of the round-sharp needle,its key operational techniques,and clinical case studies,aiming to establish a replicable paradigm for its modern application and promote the clinical translation of classical acupuncture theory.

The view of"inferior practitioner guarding the gate while the superior practitioner keeping the trigger"during the clinical practive was recorded in in Huang Di Nei Jing(Huangdi's Cannon of Medicine).This paper probes into the diagnosis and treatment of bi-syndrome from the perspecitve of"guarding the gate"and"keeping the trigger".It is proposed that the lesion of five body constituents(i.e.,skin,vessel,muscle,tendon,and bone)constitutes the injured"gate"of bi-syndrome,and the disharmony of qi and blood constitutes the"trigger"of the onset of bi-syndrome.The location of lesions will be found through examining the gate,and the state of qi and blood will be confirmed after checking the trigger.For the treatment of bi-syndrome,"guarding the gate"is to enable the normality of five body constituents,and"keeping the trigger"is to maintain the abundance and harmony movement of qi and blood,which cover the consideration of focal lesions and the regulation of holistic qi and blood."Guarding the gate"is as important as"keeping the trigger",and the two are interrelated.Only by carefully examining the gate of the lesions and strictly checking the trigger of qi-blood movement,it is possible to identify the deficiency of healthy qi and the excess of the pathogens,the nature of the pathogens and the severity of illness of bi-syndrome,and then the corresponding therapeutic methods can be performed to achieve the efficacy.The view of"guarding the gate"and"keeping the trigger"expands the clinical approach to the diagnosis and treatment of bi-syndrome.

Background: and Purpose Non-high-density lipoprotein cholesterol (non-HDL-C), which represents the total cholesterol content of all pro-atherogenic lipoproteins, has recently been included as a new target for lipid-lowering therapy in high-risk atherosclerotic patients in multiple guidelines. Herein, we aimed to explore the relationship between non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing stroke recurrence. Methods: This study comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II) trial, from which 5,901 patients with complete data on non-HDL-C were included and categorized by median non-HDL-C levels, using a cutoff of 3.5 mmol/L. The primary efficacy and safety outcomes were recurrent stroke and severe or moderate bleeding within 90 days. Results: Ticagrelor-aspirin significantly reduced the risk of recurrent stroke in patients with low non-HDL-C (71 [4.8%] vs. 119 [7.7%]; adjusted hazard ratio [HR] 0.54; 95% confidence interval [CI], 0.40–0.74), but not in those with high non-HDL-C (107 [7.3%] vs. 108 [7.6%]; adjusted HR, 0.88; 95% CI, 0.67–1.16), compared with clopidogrel-aspirin (P for interaction=0.010). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin for recurrent stroke decreased as non-HDL-C levels increased. No significant differences in the treatment assignments across the non-HDL-C groups were observed in terms of the rate of severe or moderate bleeding (5 [0.3%] vs. 8 [0.5%] in the low non-HDL-C group; 4 [0.3%] vs. 2 [0.1%] in the high non-HDL-C group; P for interaction=0.425). Conclusion CHANCE-2 participants with low non-HDL-C levels received more clinical benefit from ticagrelor-aspirin versus clopidogrel-aspirin compared to those with high non-HDL-C, following minor ischemic stroke or transient ischemic attack.

Objective To explore the association between lipid profiles and left ventricular hypertrophy in a Chinese general population. Methods We conducted a retrospective observational study to investigate the relationship between lipid markers [including triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL-cholesterol, apolipoprotein A-I, apolipoprotein B, lipoprotein[a], and composite lipid profiles] and left ventricular hypertrophy. A total of 309,400 participants of two populations (one from Beijing and another from nationwide) who underwent physical examinations at different health management centers between 2009 and 2018 in China were included in the cross-sectional study. 7,475 participants who had multiple physical examinations and initially did not have left ventricular hypertrophy constituted a longitudinal cohort to analyze the association between lipid markers and the new-onset of left ventricular hypertrophy. Left ventricular hypertrophy was measured by echocardiography and defined as an end-diastolic thickness of the interventricular septum or left ventricle posterior wall > 11 mm. The Logistic regression model was used in the cross-sectional study. Cox model and Cox model with restricted cubic splines were used in the longitudinal cohort. Results In the cross-sectional study, for participants in the highest tertile of each lipid marker compared to the respective lowest, triglycerides [odds ratio (OR): 1.250, 95％CI: 1.060 to 1.474], HDL-cholesterol (OR: 0.780, 95％CI: 0.662 to 0.918), and lipoprotein(a) (OR: 1.311, 95％CI: 1.115 to 1.541) had an association with left ventricular hypertrophy. In the longitudinal cohort, for participants in the highest tertile of each lipid marker at the baseline compared to the respective lowest, triglycerides [hazard ratio (HR): 3.277, 95％CI: 1.720 to 6.244], HDL-cholesterol (HR: 0.516, 95％CI: 0.283 to 0.940), non-HDL-cholesterol (HR: 2.309, 95％CI: 1.296 to 4.112), apolipoprotein B (HR: 2.244, 95％CI: 1.251 to 4.032) showed an association with new-onset left ventricular hypertrophy. In the Cox model with forward stepwise selection, triglycerides were the only lipid markers entered into the final model. Conclusion Lipids levels, especially triglycerides, are associated with left ventricular hypertrophy. Controlling triglycerides level potentiate to be a strategy in harnessing cardiac remodeling but deserve to be further investigated.

ObjectiveTo investigate the association between serum interleukin (IL) and liver pathological changes in patients with chronic hepatitis B (CHB). MethodsA total of 59 patients with CHB who were treated in Putuo District Central Hospital of Shanghai from February 2018 to February 2019 were enrolled as subjects, and liver biopsy was performed for all patients. According to the degree of liver inflammation, the patients were divided into mild inflammation (G1-G2) group and severe inflammation (G3-G4) group, and according to the degree of liver fibrosis, the patients were divided into mild fibrosis (S0-S2) group and severe fibrosis (S3-S4) group. Serum liver function parameters, blood lipids, interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), and interleukin-10 (IL-10) were measured for all patients. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon non-parametric test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. A Spearman correlation analysis was also performed. ResultsThe degree of liver fibrosis increased with the increase in liver inflammation (rs=0.538, P＜0.001). Compared with the mild inflammation group, the severe inflammation group had significantly higher serum levels of alanine aminotransferase ［95.00 (45.00-16925) U/L vs 51.00 (29.00-88.00) U/L, Z=-2.625, P=0.009］, aspartate aminotransferase ［54.50 (34.75-84.50) U/L vs 38.00 (30.00-49.00) U/L, Z=-2.014, P=0.044］, and gamma-glutamyl transpeptidase ［91.00 (56.72-192.25) U/L vs 44.00 (24.00-100.00) U/L, Z=-2.400, P=0.016］. The severe fibrosis group had a significantly higher serum level of high-density lipoprotein than the mild fibrosis group ［0.97 (0.32-1.08) mmol/L vs 1.23 (0.36-1.38) mmol/L, Z=-1.300, P=0.008］. The severe inflammation group had a significantly higher serum level of IL-2 receptor than the mild inflammation group ［704.00(418.00-103800) U/ml vs 436.00(335.00-555.00) U/ml, Z=-3.405, P=0.001］, and the severe fibrosis group had a significantly higher serum level of IL-2 receptor than the mild fibrosis group ［735.00(523.00-890.50) U/ml vs 447.00 (351.50-624.50) U/ml, Z=-5.358, P=0.001］. ConclusionThe degree of liver inflammation is positively correlated with that of liver fibrosis, while the serum level of IL-2 receptor increases with the increase in the degrees of liver inflammation and fibrosis, indicating that IL-2 receptor can reflect the degrees of liver inflammation and fibrosis to some extent.

Objective To investigate the detection results of GHB with different instruments, and to provide reliable basis for improving the accuracy of GHB detection. Methods ADVIA 1650 biochemical analyzer and HA-8160 glycosylated hemoglobin analyzer were used. The accurate detection of glycosylated hemoglobin in 100 healthy people was carried out, and the related data were recorded and analyzed statistically. Attention should be paid to this group according to glycosylated hemoglobin detection value, that is, within 6.5％ for A group, 6.5％-10.0％ for B group, more than 10％ for C group, and compare the above-mentioned different grouping of corresponding instrument glycosylated hemoglobin detection value. Results The analysis showed that there was no significant difference between the two groups of C instrument glycosylated hemoglobin levels, but the level of glycosylated hemoglobin detected by A in group HA-8160 and group B was significantly higher than that of ADVIA 1650(P<0.05). Conclusion Different instruments have some differences in the detection value of glycosylated hemoglobin. Clinicians should judge the disease comprehensively according to the actual situation and other indicators.

We have investigated the degradation of pure Polycaprolactone (PurePCL) and chitin short fiber reinforced Polycaprolactone composite (SFRP) in vitro in order to provide useful scientific basis for clinical application. PurePCL, SFRP and DL-PLA were immersed in 0.9% NaCL solution for periods of 2, 4, 8, 12, 16 and 24 weeks. Then pH values in immersing solution, weight loss and mechanical properties of tested materials were measured and SEM was used to study the change of the materials in the process of degradation. It was shown that the initial strength of SFRP was much higher than that of PurePCL. In the process of degradation of SFRP, the pH values maintained weak acid or remianed neutral. The rate of weight loss of SFRP was faster than that of PurePCL, but slower than that of DL-PLA. The strength and modulus of SFRP did not change much in 24 weeks, compared with the initial ones. In conclusion, the composites have excellent properties and may be optimal for clinical use in reconstruction of chest wall defects as well as in internal fixation of bone fracture.
Biocompatible Materials ; chemistry ; Bone Substitutes ; chemistry ; Chitin ; chemistry ; Composite Resins ; chemistry ; Materials Testing ; Polyesters ; chemistry ; Prostheses and Implants

Chitin short fiber reinforced polycaprolactone composite was prepared by melting blending method. The cytotoxicity and biocompatibility of pure polycaprolactone and of chitin short fiber reinforced polycaprolactone composite were investigated in order to provide useful scientific basis for clinical application. The biocompatibility of pure polycaprolactone and that of chitin short fiber reinforced polycaprolactone composite were evaluated by a series of tests, including cytotoxicity test in vitro, acute systemic toxicity test, hemolysis test, pyrogen test and sensitivity test. The results showed that the cytotoxicity scores of the two materials were grade 0 and the growth and proliferation of the cultured cells were not significantly inhibited by the two materials. There were no potential allergic materials in the composites and the maceration extract showed no hemolytic reaction, no acute systemic toxicity and no pyrogen reaction. We conclude that the composites have fine biocompatibility and are safe for clinical use in the reconstruction treatment for chest wall defect.
Biocompatible Materials ; chemistry ; Bone Substitutes ; chemistry ; Chitin ; chemistry ; Materials Testing ; Polyesters ; chemistry

Cytotoxicity and cytocompatibility remains the principal theme for biomaterials application in medicine. The purpose of this study was to investigate the cytotoxicity and cytocompatibility of collagen/hydroxyapatite(CHA) composite material in vitro in order to provide useful scientific basis for clinical use. Cellular cultivation in vitro and MTT assay were conducted for evaluating the composite material's influence on the morphology, growth and proliferation of cultured cell(L-929 cell). The hemolysis test was also performed for evaluating the impact on the function and metabolism of erythrocyte. These results demonstrated that the CHA composite material had no cytotoxicity and no hemolytic effect, and it might not be harmful to the morphology of the L-929 cell. The growth and proliferation of the L-929 cell could not be inhibited significantly. The cytotoxicity score of the composite material was grade 0. The hemolysis rate was 1.85%. In conclusion, collagen/hydroxyapatite (CHA) composite material might have good cytocompatibility and be safe for clinical use.
Animals ; Biocompatible Materials ; toxicity ; Cells, Cultured ; Collagen ; toxicity ; Hydroxyapatites ; toxicity ; Mice ; Prostheses and Implants ; Toxicity Tests ; Trachea