By examining the records related to the Fengfu （GV 16） acupoint in BIAN Que Heart Book （《扁鹊心书》） compiled by the Song Dynasty physician DOU Cai， this study analyzed various aspects， including the differentiation of conditions treated with Fengfu （GV 16） acupoint， the theoretical foundation for selection of Fengfu （GV 16） acupoint， the application of needling manipulation， and the sensation of obtaining qi during acupuncture. The findings suggest that DOU Cai's approach to utilizing Fengfu （GV 16） acupoint differs from traditional methods， particularly emphasizing the effectiveness of achieving a sensation of heat and numbness. His unique techniques include transverse insertion at Fengfu （GV 16） acupoint and penetrated insertion to Fengchi （GB 20） and Yifeng （TE 17） acupoints. The records of Fengfu （GV 16） acupoint in BIAN Que Heart Book provide a valuable reference for its modern clinical application and further development.

Objective To investigate the cognition level and behavior compliance of blood pressure measurement in community residents and analyze the related influencing factors, and to provide evidence for community health management and blood pressure control. Methods A questionnaire survey was conducted to investigate 4470 community patients. Questionnaires included basic personal information，blood pressure measurement cognition, and blood pressure measurement behavior related issues. SPSS 19.0 was used to analyze the basic information, blood pressure measurement cognition, and pressure measurement behavior of the survey subjects. Logistic regression was performed to analyze relevant factors affecting blood pressure measurement cognition and behavior compliance. Results The overall cognitive compliance rate for blood pressure measurement among the visiting community patients was 31.52%. Age, education level, and chronic disease had a statistically significant impact on the cognitive knowledge (P<0.05). The overall behavior compliance rate of blood pressure measurement among the community patients was 23.69%. The cognition, age and education had a statistically significant impact on the overall behavior compliance rate of blood pressure measurement (P<0.05). Conclusion The cognitive level and standardized behavior of blood pressure measurement of community patients need to be improved. More attention should be paid to the elderly, low education level residents and community residents without chronic diseases, to promote community residents to form correct and standardized behavior of blood pressure measurement through health education.

Background Chronic intermittent hypobaric hypoxia (CIHH) can effectively alleviate type 2 diabetes mellitus (T2DM). In this process, the underlying mechanism in its association with the epigenetic regulation of DNA methylation in the promoter regions of glucose metabolism key enzyme genes remains unclear yet. Objective To investigate the effects of CIHH on expression and promoter region methylation of key enzyme genes related to glucose metabolism in diabetes mice, and to explore the underlying mechanism by which CIHH regulates glucose metabolism. Methods Forty C57BL/6J male mice were divided randomly into a normobaric normoxic control (NN/CON) group, a chronic intermittent hypobaric hypoxia intervention control (CIHH/CON) group, a normobaric normoxic diabetic model (NN/DM) group, and a chronic intermittent hypobaric hypoxia intervention diabetic model (CIHH/DM) group. The mice in the NN/DM and the CIHH/DM groups were fed for 7 weeks with high-fat and high-sugar diet. Subsequently, these mice were intraperitoneally injected consecutively with 50 mmol·L⁻¹ streptozotocin (STZ) for 5 d at a dose of 40 mg·kg⁻¹ (body weight) per day to create T2DM model mice. The mice in the CIHH/DM and the CIHH/CON groups were intervened by simulating hypobaric hypoxia at 5000 m altitude for 6 h per day, while the mice in the NN/DM and the NN/CON groups were always placed in a normobaric normoxic environment. All mice were continuously treated for 4 weeks, and blood glucose were monitored during this period. After the CIHH intervention experiment, the glucose tolerance and insulin sensitivity of mice were evaluated. A set of indicators involved in key glycolytic enzymes glucokinase (GK) and pyruvate kinase (PK), as well as key gluconeogenic enzymes phosphoenolpyruvate carboxyl kinase (PEPCK) and glucose-6-phosphatase (G6P) were measured in the liver of mice, including enzyme activity, relative mRNA expression level, and DNA methylation level in the gene promoter regions. Results Compared with the mice in the NN/DM group, the blood glucose levels of the mice in the CIHH/DM group decreased after the 25^th day of the CIHH intervention (P<0.05). Regarding the diabetic glucose tolerance curves, the area under the curve (AUC) of the mice in the CIHH/DM group was lower than that of the NN/DM group (P<0.05). Compared with the mice in the NN/DM group, the mice in the CIHH/DM group showed that the serum insulin content and HOMA of insulin resistance index (HOMA-IRI) decreased (P<0.05), the enzyme activities of GK and PK increased and the relative mRNA expression levels of their genes were up-regulated (P<0.05), while the enzyme activities of PEPCK and G6P decreased and the relative mRNA expression levels of their genes were down-regulated (P<0.05) in liver. The average DNA methylation levels in the promoter regions of GK, PK, PEPCK, and G6P genes in liver of mice in each group were not significantly different (P>0.05), and their correlations with mRNA expression levels were also not statistically significant (P>0.05). Conclusion CIHH intervention may reduce blood glucose level, improve glucose tolerance, alleviate insulin resistance, and regulate the key enzyme activities of glucose metabolism and the relative mRNA expression of their corresponding genes in T2DM mice, but the above phenomena are not related to the DNA methylation levels in the promoter regions of these key enzymes.

Objective: To investigate the trends in incidence and mortality of prostate cancer in Huangpu District, Shanghai Municipality from 2002 to 2019, so as to provide insights into the prevention and treatment of prostate cancer. Methods: The incidence and mortality of prostate cancer among men in Huangpu District from 2002 to 2019 were collected from the Shanghai Cancer Registry System. The crude incidence, crude mortality, truncated age-standardized incidence (aged 35 to 64 years) and cumulative incidence (aged 0 to 74 years) of prostate cancer were calculated. The Chinese Fifth National Population Census in 2000 and the Segi's world standard population in 1960 were used to calculate Chinese-standardized rate and world-standardized rate. The trends in incidence and mortality of prostate cancer were evaluated using annual percent change (APC) and average annual percent change (AAPC). Results: A total of 2 672 cases of prostate cancer were reported in Huangpu District from 2002 to 2019, and the crude incidence was 33.35/105, the Chinese-standardized incidence was 14.93/105 and the world-standardized incidence was 12.37/105 (AAPC=7.675%, 4.886% and 4.983%, all P<0.05). The incidence of prostate cancer among males at ages of 60 to <70 years and 70 to <80 years appeared increasing trends (AAPC=4.554% and 5.045%, both P<0.05). A total of 1 214 deaths of prostate cancer were reported, and the crude mortality was 15.15/105, the Chinese-standardized mortality was 6.01/105 and the world-standardized mortality was 4.61/105 (AAPC=5.500%, 2.057% and 1.784%, all P<0.05). The mortality of prostate cancer among males at ages of 80 years and above appeared an increasing trend (AAPC=4.220%, P<0.05). Conclusions The incidence and mortality of prostate cancer appeared increasing trends in Huangpu District from 2002 to 2019, and the incidence among males at ages of 60 years and above also increased. The screening for prostate cancer among males at ages of 60 years and above should be strengthened.

[Objective] To explore the effects of dyslipidemia and obesity on high-risk prostate cancer, so as to provide reference for the prevention and treatment of prostate cancer. [Methods] The clinical data of 175 patients with prostate cancer admitted to our hospital during Jun.2016 and Jun.2022 were retrospectively analyzed, including 122 high-risk prostate cancer and 53 non-high-risk prostate cancer.The logistic regression analysis were conducted to identify independent risk factors affecting the occurrence of high-risk prostate cancer.Evaluate the predictive value and optimal cutoff value of risk factors such as age, cholesterol, body mass index (BMI), and prostate-specific antigen (PSA) for the occurrence of high-risk prostate cancer through receiver operating characteristic (ROC) curves.Spearman analysis was used to investigate the correlation between Gleason scores and different risk factors. [Results] The age, BMI, cholesterol, PSA, incidence of obesity (BIM≥25) and high cholesterol in the high-risk prostate cancer group were all higher than those in the non-high-risk prostate cancer group (P<0.05). Multivariate logistic regression showed that age (OR=1.097, 95%CI: 1.005-1.198, P=0.039), obesity (OR=4.459, 95%CI: 1.305-15.239, P=0.017), PSA (OR=1.170, 95%CI: 1.069-1.280, P=0.001), and cholesterol (OR=5.544, 95%CI: 1.304-23.577, P=0.020) were risk factors for high-risk prostate cancer.The ROC curve showed that the optimal cutoff values for age, cholesterol, BMI, and PSA were 74.50 years (AUC: 0.748, 95%CI: 0.678-0.818), 3.70 mmol/L (AUC: 0.800, 95%CI: 0.731-0.870), 24.97 (AUC: 0.621, 95%CI: 0.532-0.711), and 18.67 ng/mL (AUC: 0.864, 95%CI: 0.813-0.916), respectively, and the combined prediction value of age, cholesterol, BMI, and PSA for high-risk prostate cancer was the highest (AUC: 0.931, 95%CI: 0.895-0.967). The age (r=0.464, P<0.001), BMI (r=0.222, P=0.003), cholesterol (r=0.501, P<0.001), and PSA (r=0.473, P<0.001) were positively correlated with Gleason by Spearman analysis. [Conclusion] Obesity, age, PSA, and cholesterol level are independent risk factors for high-risk prostate cancer.When the age is ≥74.50 years, cholesterol level is ≥3.70 mmol/L, BMI is ≥24.97, PSA level is ≥18.67 ng/mL, the possibility of developing high-risk prostate cancer is high.

Objective To investigate the efficacy and safety of intravenous thrombolysis with low-dose and standard-dose recombinant tissue plasminogen activator(rt-PA)in the elderly patients(aged over 80 years)with acute ischemic stroke(AIS).Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt-PA low-dose group(n=93,0.6 mg/kg)and rt-PA standard-dose group(n=108,0.9 mg/kg).The incidence of intra-cranial hemorrhage,symptomatic intracranial hemorrhage,fatal intracranial hemorrhage,neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety.The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness.A stratified analysis of 90-day outcomes was performed based on stroke severity and age.Results The incidence of intracranial hemorrhage,symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt-PA low-dose group was lower than that in rt-PA standard-dose group(P＜0.05).There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index.The 90-day good prognosis rate of moderate stroke sub-group and of≥90 years of age sub-group in rt-PA low-dose group were both higher than that of rt-PA standard-dose group(P＜0.05).Conclusions For AIS patients with moderate stroke and aged over 90 years,intravenous thrombolytic therapy with rt-PA 0.6 mg/kg is recommended.

Objective To explore the differences in scapular motion and shoulder function between patients suffering from rotator cuff tears(RCT)with and without type Ⅲ scapular dyskinesis(SD).Meth-ods Between September 2021 and March 2023,sixteen patients suffering from rotator cuff tears with SD(SD group)and 17 counterparts without SD(non-SD group)were recruited from the Sports Hospital of the General Administration of Sport of China.Their scapular motion was assessed by measuring three parameters in the X-rays,including scapular spine line(LSS),scapular upward rotation angle(SU-RA),and coracoid upward shift distance(CUSD).Moreover,their shoulder range of motion in flexion,abduction and external rotation were recorded,and further evaluated using the Pain Visual Analog Scale(VAS)and American Shoulder and Elbow Surgeons Score(ASES).Results No significant differenc-es were found between the two groups in the average score of SURA,CUSD and LSS at 0°～30° shoul-der abduction,or in that of CUSD and LSS at 60°～90°shoulder abduction.However,the average SU-RA score of the SD group at 60°～90°shoulder abduction was significantly greater than the other group(P<0.05).The shoulder ranges of motion during active flexion,abduction and external rotation were significantly smaller in the SD group than in the non-SD group(P<0.05).Moreover,the average VAS score in the SD group was significantly higher than the non-SD group(P<0.05),while the average ASES score was significantly lower than the latter group(P<0.05).Conclusions RCT patients type III SD exhibits greater scapular upward rotation during shoulder abduction compared to those without SD.Moreover,the former patients suffer from more severe pain and have worse shoulder range of motion and functional performance than the latter.

Periodontitis is a complex chronic inflammatory disease. The invasion of pathogens induces the inflammatory microenvironment in periodontitis. Cell behavior changes in response to changes in the microenvironment, which in turn alters the local inflammatory microenvironment of the periodontium through factors secreted by cells. It has been confirmed that periodontal ligament stem cells (PDLSCs) are vital in the development of periodontal disease. Moreover, PDLSCs are the most effective cell type to be used for periodontium regeneration. This review focuses on changes in PDLSCs, their basic biological behavior, osteogenic differentiation, and drug effects caused by the inflammatory microenvironment, to provide a better understanding of the influence of these factors on periodontal tissue homeostasis. In addition, we discuss the underlying mechanism in detail behind the reciprocal responses of PDLSCs that affect the microenvironment.
Humans ; Periodontal Ligament ; Osteogenesis ; Stem Cells ; Periodontitis/metabolism* ; Cell Differentiation/physiology* ; Cells, Cultured

【Objective】 To observe the efficacy of abiraterone (AA) in the treatment of metastatic castration-resistant prostate cancer (mCRPC). 【Methods】 The clinical data of a newly diagnosed metastatic hormone sensitive prostate cancer (mHSPC) patient with high risk and high tumor load were analyzed. After operation and endocrine therapy, the disease evolution was observed. Relevant literature was reviewed. 【Results】 After laparoscopic radical prostatectomy, 6-month bicalutamide and androgen deprivation therapy (ADT), the total prostate specific antigen (tPSA) was reduced to the lowest of 0.51 ng/mL, and then increased month by month. After domestic abiraterone (trade name: Qingkeshu) in the 8th month was administered for 4 months, tPSA continued to increase to 12.39 ng/mL. The case was then diagnosed as mCRPC. The treatment was adjusted again in the 11th mouth and the patient received AA (trade name: Zeke) combined with prednisone and ADT, and tPSA decreased to 0.17 ng/mL 2 months later. After 14 months of treatment, tPSA remained at about 0.12 ng/mL. Systemic ECT examination indicated that the range of bone metastases decreased and some areas of nuclide concentration turned shallow without obvious adverse reactions. 【Conclusion】 AA combined with prednisone and ADT can produce rapid decline in PSA and a good response in mCRPC patients. It can also significantly slow the progression of bone metastasis and relieve pain symptoms without obvious adverse reactions. Long-term efficacy needs further observation.

ObjectiveTo understand the changes of health related behaviors among residents with chronic diseases，and to provide a reference for targeted health intervention. MethodsBased on the surveillance data of chronic diseases and relevant risk factors of the residents in Huangpu District from 2014 to 2019. The study focused on health related behaviors and sociodemographic characteristics which was analyzed by chi-square test. The Cochran-Armitage trend chi-squared test was used to analyze the standardization rate. ResultsSeveral behaviors had been ameliorated such as the health examinations （Z=-3.667， P<0.001）， the measurement of blood glucose （Z=-5.793， P<0.001）， daily vegetables consumption （Z=-5.741， P<0.001）， daily animal food consumption （Z=-23.214， P<0.001）， daily physical activity （Z=-18.361， P<0.001）， sedentary behavior （Z=4.190， P<0.001）， and current smoking （Z=4.615， P<0.001）. ConclusionAn improving trend of health behaviors is found among Huangpu District residents．Targeted health education and health promotion should be carried out according to the characteristics of the population in the future.