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.

Objective To investigate the protective effect and mechanism of calcium dobesilate on oxidative damage induced by high-glucose in Müller cells.Methods The oxidative damage model of Müller cells induced by high-glucose was established and the cells were divided into 4groups.The control group was cultured normally,and the high glucose group was cultured in the medium of 35mmol/L glucose.The control+calcium dobesilate group was treated with 0.5μmol/L calcium dobesilate intervention cells on the basis of routine culture,and the high sugar+calcium dobesilate group was treated with 0.5μmol/L calcium dobesilate intervention cells on the basis of high glucose.Cell proliferation was assessed by CCK-8,apoptosis was detected by flow cytometry,and oxidative stress markers were detected by the kit.Intracellular correction potassium channel subtype 4.1(Kir4.1)and aquaporin 4(AQP4)protein levels were detected by western blot.Results Compared with the control group,the proliferative activity of Müller cells of the high glucose group was decreased,apoptosis rate was increased,oxidative stress occurred,AQP4 protein expression level was increased and Kir4.1 protein level was decreased(P＜0.05).Compared with the high glucose group,the cell activity and apoptosis rate of the high glucose+calcium do-besilate group were increased,the oxidative stress damage was alleviated,the AQP4 protein expression level was decreased and the Kir4.1 protein level was increased(P＜0.05).Conclusion Calcium dobesilate may inhibit the oxidative damage of Müller cells induced by high-glucose by regulating the AQP4/Kir4.1 axis.

Objective:To investigate the therapeutic effectiveness of ultrasound-guided percutaneous catheterization for continuous negative pressure drainage combined with polidocanol in treating large thyroid cysts.Method:Clinical data of 38 patients with large thyroid cysts who were treated consecutively with catheter drainage combined with polidocanol sclerotherapy by the same doctor at Beijing Tsinghua Changgung Hospital from Jan 2021 to May 2024 were retrospectively analyzed. The effectiveness and safety were statistically evaluated, and the relationship between drainage volume and cyst volume was analyzed.Results:Among the 38 patients with thyroid cysts who completed the treatment, the median follow-up was 9 months (range: 3-24 months). The effectiveness rate was 92% (35/38), of which 32 cases (84%) met the cure standard. The maximum diameter of the cysts before treatment was (4.8±1.0) cm, and the maximum diameter of the residual nodules after treatment was (1.5±1.1) cm, the difference was statistically significant ( t=17.389, P<0.01). The amount of drainage exudate is related to the volume of the cyst and the maximum diameter before treatment ( t=-3.149, P=0.003; t=-3.057, P<0.005). 19% of patients showed transient low fever after the injection of polidocanol, with no other complications. Conclusion:For large thyroid cysts, ultrasound-guided percutaneous catheterization for continuous negative pressure drainage combined with polidocanol sclerotherapy is a safe and effective method.

Objective To investigate the protective effect of LncRNA MEG3 on the retina in early-stage diabetic rats through regulation of the COX-2/PGE2/VEGF signaling pathway.Methods 50 male SD rats of SPF grade were selected for the study.Among them,10 rats were assigned to the control group,while 40 rats were used to establish diabetic retinopathy models.A total of 32 rats successfully underwent modeling and were subsequently divided into four groups(n=8 per group):model group,negative control group,MEG3 overexpression group,and MEG3 overexpression+COX-2 inhibitor group.Histopathological changes,vascular permeability,glucose and lipid metabolism,inflammatory factors,oxidative stress indices,PGE2 levels,as well as the relative mRNA and protein expression levels of COX-2 and VEGF were evaluated in each group.Results Compared with the control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly decreased,whereas the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly increased in the model group(P<0.05).Compared with the negative control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly increased in the MEG3 overexpression group,while the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly decreased(P<0.05).Compared with the MEG3 overexpression group,HDL-C,CAT,GSH-PX,and SOD levels were further increased in the MEG3 overexpression+COX-2 inhibitor group,and the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were further decreased(P<0.05).Conclusion LncRNA MEG3 is capable of regulating the COX-2/PGE2/VEGF pathway,enhancing glucose and lipid metabolism in rats,suppressing the expression of inflammatory factors,attenuating stress responses,and alleviating diabetic retinopathy.

Objective To explore the therapeutic effect of cornuside on diabetic retinopathy(DR)in rats and ana-lyze the acting mechanism of the reactive oxygen species(ROS)/thioredoxin interacting protein(TXNIP)/NOD-like recep-tor thermal protein domain associated protein 3(NLRP3)signaling pathway in this process.Methods A total of 56 suc-cessfully modeled DR rats were randomly divided into the model group,the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,the calcium dobesilate 5.8 mg·kg-1 group,with 14 rats in each group;while,meanwhile another 14 healthy rats were selected as the control group.After the corresponding intervention of rats in each group,retinal tissue in-flammation,oxidative stress indicators,fasting blood glucose(FBG),and angiogenic factor levels were detected by the en-zyme-linked immunosorbent assay(ELISA).The hematoxylin-eosin(HE)staining and terminal deoxynucleotidyl transfer-ase dUTP nick end labeling(TUNEL)staining were used to observe retinal histopathology and retinal cell apoptosis,re-spectively.The mRNA expression of ROS,TXNIP,and NLRP3 in the retinal tissue was detected by the quantitative fluores-cence polymerase chain reaction(PCR).The apoptosis of retinal cells and the protein expression of the ROS/TXNIP/NL-RP3 signaling pathway were detected by Western blotting.Results Compared with the control group,the model group showed disordered arrangement of retinal cells and a significant decrease in the cell number,accompanied by nuclear con-densation and edema;interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),FBG,angiopoie-tin-1(Ang-1),vascular endothelial growth factor(VEGF),retinal cell apoptosis rate,ROS,and the mRNA and protein ex-pression levels of TXNIP and NLRP3 increased significantly,while superoxide dismutase(SOD)and B cell lymphoma-2(Bcl-2)protein expression levels decreased significantly(all P＜0.05).Compared with the model group,the arrangement of retinal cells in the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,and the calcium dobesilate 5.8 mg·kg-1 group gradually became normal,the number of retinal cells increased,and the nuclear condensation and edema were relieved;IL-6,TNF-α,MDA,FBG,Ang-1,VEGF,retinal cell apoptosis rate,ROS,and the mRNA and protein expression level of TXNIP and NLRP3 decreased significantly,while the protein expression level of SOD and Bcl-2 increased signifi-cantly(all P＜0.05).In the intergroup comparison of the pathological damage of retinal tissue and the improvement degree of the above quantitative indexes in DR rats,the cornuside 40 mg·kg-1group was superior to the cornusin 20 mg·kg-1 group(all P＜0.05);the calcium dobesilate 5.8 mg·kg-1 group was superior to the cornusin 20 mg·kg-1 group,but infe-rior to the cornuside 40 mg·kg-1 group(all P＜0.05).Conclusion Cornuside can mitigate retinal inflammation,oxi-dative stress,and pathological damage in DR rats and inhibit blood glucose,retinal angiogenesis,and cell apoptosis.The acting mechanism of cornuside may be related to the inhibition of the ROS/TXNIP/NLRP3 signaling pathway.

Objective To investigate the protective effect and mechanism of calcium dobesilate on oxidative damage induced by high-glucose in Müller cells.Methods The oxidative damage model of Müller cells induced by high-glucose was established and the cells were divided into 4groups.The control group was cultured normally,and the high glucose group was cultured in the medium of 35mmol/L glucose.The control+calcium dobesilate group was treated with 0.5μmol/L calcium dobesilate intervention cells on the basis of routine culture,and the high sugar+calcium dobesilate group was treated with 0.5μmol/L calcium dobesilate intervention cells on the basis of high glucose.Cell proliferation was assessed by CCK-8,apoptosis was detected by flow cytometry,and oxidative stress markers were detected by the kit.Intracellular correction potassium channel subtype 4.1(Kir4.1)and aquaporin 4(AQP4)protein levels were detected by western blot.Results Compared with the control group,the proliferative activity of Müller cells of the high glucose group was decreased,apoptosis rate was increased,oxidative stress occurred,AQP4 protein expression level was increased and Kir4.1 protein level was decreased(P＜0.05).Compared with the high glucose group,the cell activity and apoptosis rate of the high glucose+calcium do-besilate group were increased,the oxidative stress damage was alleviated,the AQP4 protein expression level was decreased and the Kir4.1 protein level was increased(P＜0.05).Conclusion Calcium dobesilate may inhibit the oxidative damage of Müller cells induced by high-glucose by regulating the AQP4/Kir4.1 axis.

Objective To investigate the protective effect of LncRNA MEG3 on the retina in early-stage diabetic rats through regulation of the COX-2/PGE2/VEGF signaling pathway.Methods 50 male SD rats of SPF grade were selected for the study.Among them,10 rats were assigned to the control group,while 40 rats were used to establish diabetic retinopathy models.A total of 32 rats successfully underwent modeling and were subsequently divided into four groups(n=8 per group):model group,negative control group,MEG3 overexpression group,and MEG3 overexpression+COX-2 inhibitor group.Histopathological changes,vascular permeability,glucose and lipid metabolism,inflammatory factors,oxidative stress indices,PGE2 levels,as well as the relative mRNA and protein expression levels of COX-2 and VEGF were evaluated in each group.Results Compared with the control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly decreased,whereas the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly increased in the model group(P<0.05).Compared with the negative control group,HDL-C,CAT,GSH-PX,and SOD levels were significantly increased in the MEG3 overexpression group,while the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were significantly decreased(P<0.05).Compared with the MEG3 overexpression group,HDL-C,CAT,GSH-PX,and SOD levels were further increased in the MEG3 overexpression+COX-2 inhibitor group,and the mRNA and protein expression levels of vascular permeability,TG,TC,LDL-C,IL-6,IL-1β,TNF-α,MDA,PGE2,COX-2,and VEGF were further decreased(P<0.05).Conclusion LncRNA MEG3 is capable of regulating the COX-2/PGE2/VEGF pathway,enhancing glucose and lipid metabolism in rats,suppressing the expression of inflammatory factors,attenuating stress responses,and alleviating diabetic retinopathy.

Objective To explore the therapeutic effect of cornuside on diabetic retinopathy(DR)in rats and ana-lyze the acting mechanism of the reactive oxygen species(ROS)/thioredoxin interacting protein(TXNIP)/NOD-like recep-tor thermal protein domain associated protein 3(NLRP3)signaling pathway in this process.Methods A total of 56 suc-cessfully modeled DR rats were randomly divided into the model group,the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,the calcium dobesilate 5.8 mg·kg-1 group,with 14 rats in each group;while,meanwhile another 14 healthy rats were selected as the control group.After the corresponding intervention of rats in each group,retinal tissue in-flammation,oxidative stress indicators,fasting blood glucose(FBG),and angiogenic factor levels were detected by the en-zyme-linked immunosorbent assay(ELISA).The hematoxylin-eosin(HE)staining and terminal deoxynucleotidyl transfer-ase dUTP nick end labeling(TUNEL)staining were used to observe retinal histopathology and retinal cell apoptosis,re-spectively.The mRNA expression of ROS,TXNIP,and NLRP3 in the retinal tissue was detected by the quantitative fluores-cence polymerase chain reaction(PCR).The apoptosis of retinal cells and the protein expression of the ROS/TXNIP/NL-RP3 signaling pathway were detected by Western blotting.Results Compared with the control group,the model group showed disordered arrangement of retinal cells and a significant decrease in the cell number,accompanied by nuclear con-densation and edema;interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),FBG,angiopoie-tin-1(Ang-1),vascular endothelial growth factor(VEGF),retinal cell apoptosis rate,ROS,and the mRNA and protein ex-pression levels of TXNIP and NLRP3 increased significantly,while superoxide dismutase(SOD)and B cell lymphoma-2(Bcl-2)protein expression levels decreased significantly(all P＜0.05).Compared with the model group,the arrangement of retinal cells in the cornuside 20 mg·kg-1 group,the cornuside 40 mg·kg-1 group,and the calcium dobesilate 5.8 mg·kg-1 group gradually became normal,the number of retinal cells increased,and the nuclear condensation and edema were relieved;IL-6,TNF-α,MDA,FBG,Ang-1,VEGF,retinal cell apoptosis rate,ROS,and the mRNA and protein expression level of TXNIP and NLRP3 decreased significantly,while the protein expression level of SOD and Bcl-2 increased signifi-cantly(all P＜0.05).In the intergroup comparison of the pathological damage of retinal tissue and the improvement degree of the above quantitative indexes in DR rats,the cornuside 40 mg·kg-1group was superior to the cornusin 20 mg·kg-1 group(all P＜0.05);the calcium dobesilate 5.8 mg·kg-1 group was superior to the cornusin 20 mg·kg-1 group,but infe-rior to the cornuside 40 mg·kg-1 group(all P＜0.05).Conclusion Cornuside can mitigate retinal inflammation,oxi-dative stress,and pathological damage in DR rats and inhibit blood glucose,retinal angiogenesis,and cell apoptosis.The acting mechanism of cornuside may be related to the inhibition of the ROS/TXNIP/NLRP3 signaling pathway.

Objective:To investigate the therapeutic effectiveness of ultrasound-guided percutaneous catheterization for continuous negative pressure drainage combined with polidocanol in treating large thyroid cysts.Method:Clinical data of 38 patients with large thyroid cysts who were treated consecutively with catheter drainage combined with polidocanol sclerotherapy by the same doctor at Beijing Tsinghua Changgung Hospital from Jan 2021 to May 2024 were retrospectively analyzed. The effectiveness and safety were statistically evaluated, and the relationship between drainage volume and cyst volume was analyzed.Results:Among the 38 patients with thyroid cysts who completed the treatment, the median follow-up was 9 months (range: 3-24 months). The effectiveness rate was 92% (35/38), of which 32 cases (84%) met the cure standard. The maximum diameter of the cysts before treatment was (4.8±1.0) cm, and the maximum diameter of the residual nodules after treatment was (1.5±1.1) cm, the difference was statistically significant ( t=17.389, P<0.01). The amount of drainage exudate is related to the volume of the cyst and the maximum diameter before treatment ( t=-3.149, P=0.003; t=-3.057, P<0.005). 19% of patients showed transient low fever after the injection of polidocanol, with no other complications. Conclusion:For large thyroid cysts, ultrasound-guided percutaneous catheterization for continuous negative pressure drainage combined with polidocanol sclerotherapy is a safe and effective method.