In this paper， the name， origin， producing area， harvesting， processing and functional indications of Arcae Concha were systematically combed and verified by consulting the ancient and modern literature， in order to provide a basis for the development of famous classical formulas containing Arcae Concha. Arcae Concha was first recorded in the name of Han in Bencao Shiyi， but later， due to the influence of LI Shizhen's error of combining Han item with Kuiha in the Ming dynasty， there were aliases such as Kuilu and Fulao， and Yizong Bidu began to include Walengzi as its correct name and has been used ever since. The textual descriptions and illustrations of the medicinal materials of Arcae Concha contained in the materia medica of the past generations were consistent with the modern Arca inflata， A. subcrenata and A. granosa. In ancient times， there were medicinal records of two parts of shell and meat， but now the shell is used as medicine， and the meat is mostly edible. In ancient times， Zhejiang， Shandong， Guangdong and Guangxi were the main producing areas， and Zhejiang was the best. It is now believed that A. inflata is mostly distributed in the northern part of the Huanghai Sea， A. granosa is mostly distributed in the coastal areas south of Shandong Peninsula in China， and A. subcrenata is widely distributed in the coastal areas of China. Its quality is better in a complete， white， no residual meat and sand. In ancient times， there was no clear harvesting period， and the processing was mainly based on vinegar quenching after calcination or powdering of calcined shell， but now the harvesting period is autumn and winter. After harvesting， it is directly washed and crushed for raw use or processed by calcined method. The records of the medicinal materials in the past dynasties on the properties of Arcae Concha were mainly warm， sweet， salty and mild， and it is now believed that Arcae Concha is salty in taste and mild in nature. In ancient times， it was believed that Arcae Concha were mainly used for coldness in the heart and abdomen， coldness in the waist and spine， benefiting the five internal organs， strengthening the stomach. Nowadays， it is believed that Arcae Concha can eliminate phlegm and remove blood stasis， soften the hardness and dissipate the lumps， produce acid and relieve pain. It can be used in the treatment of stubborn phlegm， gall tumor， scrofula and other symptoms. In conclusion， it is suggested that for the famous classical formulas containing Arcae Concha， the corresponding methods should be selected according to the processing requirements of the drug in the formulas， while those without processing requirements can be determined according to the functional position of the products.

Objective:To investigate the clinical characteristics of residual dizziness（RD） after repositioning in patients with benign paroxysmal positional vertigo（BPPV）, identify its potential risk factors, and develop a predictive risk model. Methods:A total of 137 patients diagnosed with BPPV at the First Affiliated Hospital of Xi'an Jiaotong University between January 2023 and June 2023 were enrolled. Based on the presence or absence of subjective discomfort within 3 months after successful repositioning, patients were divided into the non-RD group（NRD, n=93） and the RD group（n=44）. Differences in demographic characteristics, comorbidities, and disease-related features were compared between groups. Multivariate logistic regression analysis was used to identify independent risk factors for RD, and a nomogram was constructed based on these factors. The predictive performance of the model was assessed using the area under the curve（AUC）. Results:The RD group showed significantly higher values in body mass index, prevalence of diabetes and motion sickness history, dizziness duration before repositioning, history of repositioning at external hospitals, number of treatments, and recurrence（all P<0.001）. Multivariate logistic regression revealed that diabetes（adjusted OR=8.73, P=0.039）, motion sickness history（adjusted OR=23.08, P<0.001）, dizziness duration ≥30 days before repositioning（adjusted OR=15.16, P<0.001）, and recurrence（adjusted OR=15.72, P=0.001） were independent risk factors for RD. The nomogram model based on these variables demonstrated good predictive ability, with an AUC of 0.804（95%CI 0.684-0.924）. Conclusion:Diabetes, motion sickness history, dizziness duration ≥30 days, and recurrence are independent risk factors for RD after repositioning in patients with BPPV. The nomogram model based on these variables shows good predictive performance, with recurrence having the highest predictive value. This model can aid in early identification of high-risk patients and guide individualized intervention strategies.
Humans ; Nomograms ; Benign Paroxysmal Positional Vertigo/therapy* ; Dizziness/etiology* ; Risk Factors ; Risk Assessment ; Multivariate Analysis ; Male ; Female ; Logistic Models ; Middle Aged ; Patient Positioning ; Adult

Through consulting the ancient herbal books and modern literature， this paper has carried out the textual research on the name， origin， place of origin， harvesting and processing， and other contents of Bruceae Fructus， combed its ancient and modern medicinal history， so as to provide reference for the development of famous classical formulas containing Bruceae Fructus. Through the herbal textual research， It can be verified that， since the Qing dynasty， Bruceae Fructus has been recorded in the materia medica， most of the materia medica in previous dynasties took Bruceae Fructus as its proper name， and Laoyadan， Kushenzi and Yadanzi as the aliases. The main origin of Bruceae Fructus is Brucea javanica， its medicinal part is the fruit， which is harvested from August to October every year， the fruit can be harvested when it is ripe. Bruceae Fructus was first distributed in Fujian， Guangdong and Guangxi， and gradually expanded to the south of China with the change of time. The traditional processing method of Bruceae Fructus is mainly to remove the shell and kernel， and remove the oil by frosting. The 2020 edition of Chinese Pharmacopoeia stipulates that its processing method is to remove the shell and impurities. Based on the research results， it is suggested that the dried mature fruit of B. javanica should be selected for the development of famous classical formulas containing this herb， and the raw products can be used if the original formula does not specify the processing requirements.

Purpose/Significance To construct a specialized database for inflammatory demyelinating disease of the central nervous system(CNS),so as to contribute to clinical research and improve the diagnostic and treatment capabilities of primary healthcare institu-tions.Method/Process Using the internet to collect medical data,after processing and analysis,the CNS inflammatory demyelinating disease database is constructed.Using statistical analysis,natural language processing(NLP),artificial intelligence(AI)image recog-nition and data visualization and other technologies,the database information is integrated and analyzed.Result/Conclusion A standard-ized big database for CNS inflammatory demyelinating diseases is constructed,which enables visualization of clinical research data,pro-vides patient education and specialist training,and facilitates multi-center teleconsultations.The establishment of a specialized database for the CNS inflammatory demyelinating disease can promote the transformation of medical research achievements,provide references for future real-world clinical research,optimize the process of diagnosis and treatment,and improve the clinical capability of primary healthcare institutions.

Objective:To explore the detection capability of p16/Ki-67 double staining technique in women with various abnormal thinprep cytologic test (TCT) results and its diagnostic value for cervical intraepithelial neoplasia Ⅱ+ grade (CIN2+).Methods:A total of 225 women with abnormal TCT results, i.e. the atypical squamous cells of undetermined significance(ASC-US), in the Tianjin Central Hospital of Gynecology Obstetrics, Nankai University Affiliated Maternity Hospital from December 2018 to December 2019 were enrolled. p16/Ki-67 double staining were detected and compared with the high risk human papillomavirus (HR-HPV) and pathological results.Results:The positive rates of p16/Ki-67 double staining increased with cytologic and pathologic categories. For diagnosis of CIN2+, p16/Ki-67double staining (90.1%) was less sensitive than HR-HPV testing (98.2%)( P<0.05), but the specificity of p16/Ki-67 double staining (58.8%) was significantly higher than HR-HPV(21.6%) ( P<0.001). Conclusions:Compared with HR-HPV, p16/Ki-67 double staining has better effect on diagnosing CIN2+. p16/Ki-67 double staining can be considered as triaging method for management of ASC-US and LSIL patients, significantly reduce the colposcopy referral rate (nearly 50%), which has high clinical application value.

Objective: To evaluate the role of hippocampal mast cells in the early postoperative cognitive impairment in rats. Methods: Eighty male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 4 groups (n=20 each) using a random number table method: normal saline control group (group C), cromolyn injected into lateral cerebral ventricle group (group L), operation group (group O), and cromolyn injected into lateral cerebral ventricle plus operation group (group LO). Cromolyn 2 μl (100 μg/ul) was intracerebroventricularly injected in L and LO groups.The equal volume of normal saline was given instead in C and O groups.Open reduction and internal fixation was performed after tibial fracture was induced 30 min later in O and LO groups.Contextual fear conditioning and Y-maze tests were performed at 1 and 3 days after operation, and the freezing time and the number of learning trails were recorded.The animals were then sacrificed, and hippocampal tissues were obtained for determination of activated mast cell count (by toluidine blue staining) and expression of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) mRNA (by polymerase chain reaction). Results: Compared with group C, the number of learning trails was significantly increased, and the freezing time was shortened, the number of activated mast cells in hippocampi was increased, and the expression of IL-1β mRNA was up-regulated at 1 and 3 days after operation, and the expression of TNF-α mRNA was up-regulated at 1 day after operation in group O(P<0.05), and no significant change was found in the parameters mentioned above in group L (P>0.05). Compared with group O, the number of learning trails was significantly decreased, and the freezing time was prolonged, the number of activated mast cells in hippocampi was decreased, and the expression of IL-1β mRNA in hippocampi was down-regulated at 1 and 3 days after operation, and the expression of TNF-α mRNA in hippocampi was down-regulated at 1 day after operation in group LO (P<0.05). Conclusion Activation of hippocampal mast cells can induce central inflammatory responses and is involved in the mechanism of early postoperative cognitive impairment in rats.

Objective To study the changes of hippocampal caspase-3 and PSD-95 expression levels in the mice exposed to ketamine 30 mg/(kg·d)for three months. Methods Forty C57BL/6 mice were randomly divided into two groups,and the chronic ketamine addiction model was established by giving mice a three month course of daily intraperitoneal injections of ketamine. Immunohistochemical study and Western blot-ting were applied to observe the expression of caspase-3 and PSD-95 protein. Results There were more expression of caspase-3 and less of PSD-95 in ketamine group as detected by immuohistochemistry. Western blotting results showed caspase-3 active fragment level significantly increased com-pared to saline group,but PSD-95 protein level was decreased. Conclusion The increased level of caspase-3 protein and reduced expression of PSD-95 are observed after long-term ketamine administration. These findings may provide an evidence for the neurotoxicity in mouse hippocampus of chronic ketamine addition as a recreational drug.

Objective To observe the effect of saxagliptin combined insulin four times to strengthen the vola-tility on blood glucose variability in patients with type 1 diabetes.Methods According to random number table meth-od,60 patients with type 1 diabetes were divided into DPP4 group(28 cases)and the control group(32 cases).The control group was given insulin four times to strengthen the volatility(insulin aspart/insulin lispro +insulin glargine /insulin detemir),the DPP4 group on the basis of insulin four times to strengthen the volatility plus the saxagliptin 5mg/d,all patients into the group after1 -3D and 13 -15D using CGMS(Medtronic)continuously monitor the blood glucose.Results (1)Within the group comparison:the DPP4 group:1 -3d after treatment:MAGE and SDBG,MBG, LAGE,PT10.0,PT3.9 were lower than before treatment,including MAGE [(6.91 ±1.63)mmol/L vs.(6.31 ± 1.42)mmol/L,t =0.993],SDBG[(2.63 ±0.81)mmol/L vs.(2.41 ±0.51)mmol/L,t =0.751],MBG[(11.51 ± 1.24)mmol/L vs.(10.87 ±2.01)mmol/L,t =1.077],LAGE[(9.43 ±1.73)mmol/L vs.(8.56 ±1.97)mmol/L, t =1.125],PT10.0[(12.99 ±5.61)% vs.(9.66 ±5.03)%,t =1.427],PT3.9[(5.51 ±2.43)% vs.(5.07 ± 2.44)%,t =1.141],there were statistically significant differences compared with before treatment(all P <0.05), 1 -3d after treatment,SDBG[(2.77 ±0.73)mmol/L vs.(2.14 ±0.69)mmol/L,t =1.547],MBG[(11.67 ± 1.46)mmol/L vs.(9.76 ±1.58)mmol/L,t =1.1.326]were decreased,but there were no statistically significant differences compared with before treatment(all P >0.05);13 -15d after treatment:MAGE[(6.88 ±1.49)mmol/L vs.(2.97 ±0.86)mmol/L,t =3.021],SDBG[(2.77 ±0.73)mmol/L vs.(1.12 ±0.43)mmol/L,t =1.964],MBG [(11.67 ±1.46)mmol/L vs.(7.44 ±0.93)mmol/L,t =2.760],LAGE[(9.55 ±1.77)mmol/L vs.(6.53 ±1.21)mmol/L, t =2.409],PT10.0[(13.58 ±5.14)% vs.(4.72 ±2.37)%,t =2.657],PT3.9[(5.36 ±2.05)% vs.(3.05 ± 2.60)%,t =1.840]were decreased,there were statistically significant differences compared with before treatment (P <0.05 or P <0.01 );the control group:1 -3d after treatment:MAGE [(6.91 ±1.63)mmol/L vs.(6.31 ± 1.42)mmol/L,t =0.993],SDBG[(2.63 ±0.81)mmol/L vs.(2.41 ±0.51)mmol/L,t =0.751],MBG[(11.51 ± 1.24)mmol/L vs.(10.87 ±2.01)mmol/L,t =1.077],LAGE[(9.43 ±1.73)mmol/L vs.(8.56 ±1.97)mmol/L, t =1.125],PT10.0[(12.99 ±5.61)% vs.(9.66 ±5.03)%,t =1.427],PT3.9[(5.51 ±2.43)% vs.(5.07 ± 2.44)%,t =1.141]were lower than before treatment,but compared with before treatment,there were no statistically significant differences(all P >0.05 );13 -15d after treatment:MAGE [(6.91 ±1.63 )mmol/L vs.(6.07 ± 1.36)mmol/L,t =1.223],SDBG[(2.63 ±0.81)mmol/L vs.(1.91 ±0.93)mmol/L,t =0.984],MBG[(11.51 ± 1.24)mmol/L vs.(8.82 ±1.13)mmol/L,t =1.808],LAGE[(9.43 ±1.73)mmol/L vs.(7.06 ±1.57)mmol/L, t =1.963],PT10.0[(12.99 ±5.61)% vs.(6.74 ±3.35)%,t =2.012],PT3.9[(5.51 ±2.43)% vs.(4.73 ± 2.57)%,t =1.541]were decreased,there were statistically significant differences in MBG,LAGE,PT10.0 compared with before treatment(all P <0.05).Group comparision:1 -3d after treatment:the DPP4 group:MAGE[(4.81 ± 1.15)mmol/L vs.(6.31 ±1.42)mmol/L,t =2.351],SDBG[(2.14 ±0.69)mmol/L vs.(2.41 ±0.51)mmol/L, t =1.332],MBG[(9.76 ±1.58)mmol/L vs.(10.87 ±2.01)mmol/L,t =0.856],LAGE[(7.74 ±1.88)mmol/L vs.(8.56 ±1.97)mmol/L,t =2.102],PT10.0 [(7.47 ±4.96)% vs.(9.66 ±5.03)%,t =2.667],PT3.9 [(4.64 ±2.14)% vs.(5.07 ±2.44)%,t =1.890]were all significantly lower than the control group,there were statistically significant differences in MAGE,LAGE,PT10.0 between the two groups(all P <0.05).13 -15d after treatment:the above indictors,the DPP 4 group was decreased obviously compared with the control group,MAGE [(2.97 ±0.86)mmol/L vs.(6.07 ±1.36)mmol/L,t =2.854],SDBG[(1.12 ±0.43)mmol/L vs.(1.91 ± 0.93)mmol/L,t =2.328],MBG[(7.44 ±0.93)mmol/L vs.(8.82 ±1.13)mmol/L,t =2.125],LAGE[(6.53 ± 1.21)mmol/L vs.(7.06 ±1.57)mmol/L,t =2.111],PT10.0[(4.72 ±2.37)% vs.(6.74 ±3.35)%,t =2.312] and PT3.9 [(3.05 ±2.60)% vs.(4.73 ±2.57)%,t =2.237],there were statistically significant differences between the two groups (P <0.05 or P <0.01).Conclusion The combination of DPP4 inhibitors and insulin four renforcement can improve blood glucose fluctuation in patients with type 1 diabetes,reduce the dosage of insulin and not increase incidence of hypoglycemic events.

Objective To observe the epithelial mesenchymal transition (EMT) of podocyte induced by high glucose,and to explore the potential protective mechanism of ursolic acid (UA).Methods The podocytes cultured in vitro were divided into four groups:normal group (glucose 5.5 mmol/L),mannitol group (glucose 5.5 mmol/L+mannitol 19.5 mmol/L),high glucose group (glucose 25 mmol/L) and UA group (glucose 25 mmol/L + UA 5 μmol/L).Podocyte morphology changes were observed by inverted phase contract microscope.The expression of zonula occludens-1 (ZO-1) and α-smooth muscle actin (α-SMA) were detected by immunofluorescence.The expressions of β-catenin and glycogen synthesis kinase-3β (GSK3β) were detected by Western blotting.The expressions of Wnt1,Wnt3a,Wnt5a,Wnt5b and GSK3β were detected by real-time PCR.Results Podocytes showed irregular arborization shape in normal glucose and transited to longer cobblestone-like shape as mesenchyme cell by high glucose culture.Compared with normal group,the expression of ZO-1 protein was down-regulated and the expression of α-SMA was up-regulated by high glucose culture (P ＜ 0.05).The expression of Wnt5a mRNA was down-regulated;β-catenin mRNA and protein were up-regulated (P ＜ 0.05);and GSK3β protein was down-regulated by high glucose culture (P ＜ 0.05).Compared with high glucose group,ursolic acid inhibited podocyte EMT,up-regulated the expression of ZO-1 protein,Wnt5a mRNA,GSK3β (P ＜ 0.05),and down-regulated the expressions of α-SMA protein,β-catenin mRNA and protein (P ＜ 0.05).Conclusion Ursolic acid attenuates high glucose induced epithelial mesenchymal transition of podocyte by inhibiting Wnt/β-catenin signaling pathway.

Objective To investigate the effect of transcranial direct current stimulation (tDCS) on aphasia recovery after stroke. Meth-ods From April, 2012 to January, 2013, 20 aphasic patients after stroke were enrolled in an A-B experiment design. During phase A, ten times of sham tDCS and language training (five days a week) were implemented, then ten times language training combined with tDCS (five days a week) were implemented in phase B. The treatment lasted for four weeks. Picture naming was measured for all patients before and af-ter treatment both in phase A and phase B. Results The D-value scores of picture naming before and after treatment were significantly more in phase B than in phase A in both treatment items and non-treatment items (t>3.030, P<0.05). Conclusion tDCS could raise the accuracy of picture naming in patients with aphasia after stroke.