Gongfa is an essential approach to prevent and treat diseases in traditional Chinese medicine(TCM),often used to prevent a disease before it arises.Guided by TCM and modern scientific theories,the Tuina(Chinese therapeutic massage)Gongfa prescription theory implements the principle,method,prescription,and form in clinical pattern-identified treatment to prescribe the corresponding Tuina Gongfa prescription,i.e.,to prescribe a basic Tuina Gongfa prescription,specifically for a systemic disease,and modify Gongfa forms based on the basic prescription according to different patterns.The Gongfa prescription for pulmonary diseases designs corresponding Gongfa forms from six perspectives:lifting Yang,securing the exterior,opening the orifices,soothing the chest,harmonizing the stomach,and regulating Qi to prevent and treat diseases.The application of the pulmonary Gongfa prescription indicates the potential to apply the Tuina Gongfa prescription theory for the clinical prevention,treatment,and rehabilitation of disorders of other systems,thereby fully realizing the unique role of TCM Gongfa.

OBJECTIVES: To analyze the changes in disease burden and risk factors of atrial fibrillation/atrial flutter (AF/AFL) in China and globally from 1990 to 2021 to provide epidemiological evidence for developing effective preventive measures for AF/AFL in China. METHODS: Based on data from the Global Burden of Disease Study 2021, we analyzed sex- and age-specific AF/AFL burden metrics across 204 countries or territories. Age-standardized incidence rate (ASIR), prevalence, mortality rate (ASMR), and disability-adjusted life-years (DALYs) rate (ASDR) were calculated. Joinpoint regression was employed to compute average annual percentage changes (AAPC) in trends. The risk factors were systematically evaluated and further validated using Mendelian randomization analysis. RESULTS: From 1990 to 2021, China experienced an increase in ASIR of AF/AFL (from 42.63 to 44.93 per 100 000), contrasting with the global decline. While China's ASMR decreased (from 4.93 to 4.33 per 100 000), global ASMR rose slightly (from 4.24 to 4.36 per 100 000). China's ASDR remained stable at 93.29 per 100 000, whereas global ASDR increased marginally (100.81 to 101.40 per 100 000). Significant sex disparities were observed: males showed higher ASIR and ASDR, while females exhibited greater ASMR and ASDR. China had higher incidence and prevalence but lower mortality and DALY rates compared to global averages. In 2021, the key risk factors for AF/AFL included elevated systolic blood pressure, high BMI, smoking, alcohol use, high-sodium diet, and low temperature. Gender-specific patterns emerged: smoking was predominant in males, whereas high BMI disproportionately affected females. CONCLUSIONS AF/AFL incidence and prevalence keep increasing in China, and its large population base and demographic aging pose significant public health challenges. Maintaining healthy lifestyle habits, including smoking cessation, alcohol moderation, and a low-sodium diet can help to lower AF/AFL incidence, and regular screenings is crucial for its early detection and treatment.
Humans ; China/epidemiology* ; Risk Factors ; Atrial Flutter/epidemiology* ; Atrial Fibrillation/epidemiology* ; Mendelian Randomization Analysis ; Male ; Female ; Global Burden of Disease ; Incidence ; Prevalence ; Middle Aged ; Disability-Adjusted Life Years ; Aged

Objective:To investigate the association of regulatory T cell (Treg) levels in peripheral blood with bronchopulmonary dysplasia (BPD) in preterm infants and its predictive value for BPD.Methods:In this case-control study, a total of 102 infants with gestational age ≤32 weeks who were hospitalized in the Neonatal Intensive Care Unit of the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were included.They were divided into a BPD group (31 cases) and a non-BPD group (71 cases) based on the diagnostic criteria of BPD.Peripheral blood samples were collected on 0 day, 7 days, 14 days, 21 days and 28 days after birth.Differences in Treg levels between the 2 groups and the relationship between Treg levels and BPD were analyzed.The independent sample t test or χ2 test was used to analyze differences between the 2 groups.One-Way ANOVA was used to compare data between groups.Multivariate Logistic regression was used to analyze the risk factors of BPD.The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of Treg levels on 7 days after birth for early diagnosis of BPD. Results:Gestational age[(28.1±1.4) weeks vs.(30.9±1.0) weeks], birth weight[(1 024±243) g vs.(1 301±188) g], Apgar score at 1 minute after birth[(4.3±1.9) points vs.(7.8±1.9) points], Apgar score at 5 minutes after birth[(7.2±1.7) points vs.(9.1±1.3) points], proportion of invasive mechanical ventilation time ≥7 days [87.1%(27/31) vs.45.1%(32/71)] and oxygen inhalation time[(45.1±11.7) days vs.(19.7±7.3) days] were statistically significantly different between BPD and non-BPD groups (all P<0.05).The Treg level in the peripheral blood of preterm infants increased first and then decreased after birth, with the peak observed on 7 days after birth.On 7 days after birth, the BPD group had a significantly higher Treg level than the non-BPD group[(10.4±1.2)% vs.(8.7±1.7)%] ( P<0.05).The multivariate Logistic regression analysis showed increased Treg levels in peripheral blood on 7 days after birth ( OR=3.320, 95% CI: 1.057-10.427, P=0.040), gestational age ( OR=0.040, 95% CI: 0.003-0.446, P=0.009), invasive mechanical ventilation time ≥7 days ( OR=4.126, 95% CI: 1.301-14.125, P=0.002), and oxygen inhalation time ( OR=1.716, 95% CI: 1.317-3.933, P=0.041) were risk factors of BPD in preterm infants.The ROC curve analysis showed that the area under the curve of Treg levels on 7 days after birth for BPD prediction was 0.794, the best cut-off value was 9.35%, the sensitivity was 90.3%, and the specificity was 66.2%. Conclusions:Treg levels in the peripheral blood of preterm infants increase first and then decrease in the early stage after birth, peaking at 7 days after birth.Elevated Treg levels at 7 days after birth may have early predictive value for the occurrence of BPD in preterm infants.

Gongfa is an essential approach to prevent and treat diseases in traditional Chinese medicine(TCM),often used to prevent a disease before it arises.Guided by TCM and modern scientific theories,the Tuina(Chinese therapeutic massage)Gongfa prescription theory implements the principle,method,prescription,and form in clinical pattern-identified treatment to prescribe the corresponding Tuina Gongfa prescription,i.e.,to prescribe a basic Tuina Gongfa prescription,specifically for a systemic disease,and modify Gongfa forms based on the basic prescription according to different patterns.The Gongfa prescription for pulmonary diseases designs corresponding Gongfa forms from six perspectives:lifting Yang,securing the exterior,opening the orifices,soothing the chest,harmonizing the stomach,and regulating Qi to prevent and treat diseases.The application of the pulmonary Gongfa prescription indicates the potential to apply the Tuina Gongfa prescription theory for the clinical prevention,treatment,and rehabilitation of disorders of other systems,thereby fully realizing the unique role of TCM Gongfa.

Objective:To investigate the association of regulatory T cell (Treg) levels in peripheral blood with bronchopulmonary dysplasia (BPD) in preterm infants and its predictive value for BPD.Methods:In this case-control study, a total of 102 infants with gestational age ≤32 weeks who were hospitalized in the Neonatal Intensive Care Unit of the First Affiliated Hospital of Xinxiang Medical University from April 2022 to April 2024 were included.They were divided into a BPD group (31 cases) and a non-BPD group (71 cases) based on the diagnostic criteria of BPD.Peripheral blood samples were collected on 0 day, 7 days, 14 days, 21 days and 28 days after birth.Differences in Treg levels between the 2 groups and the relationship between Treg levels and BPD were analyzed.The independent sample t test or χ2 test was used to analyze differences between the 2 groups.One-Way ANOVA was used to compare data between groups.Multivariate Logistic regression was used to analyze the risk factors of BPD.The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of Treg levels on 7 days after birth for early diagnosis of BPD. Results:Gestational age[(28.1±1.4) weeks vs.(30.9±1.0) weeks], birth weight[(1 024±243) g vs.(1 301±188) g], Apgar score at 1 minute after birth[(4.3±1.9) points vs.(7.8±1.9) points], Apgar score at 5 minutes after birth[(7.2±1.7) points vs.(9.1±1.3) points], proportion of invasive mechanical ventilation time ≥7 days [87.1%(27/31) vs.45.1%(32/71)] and oxygen inhalation time[(45.1±11.7) days vs.(19.7±7.3) days] were statistically significantly different between BPD and non-BPD groups (all P<0.05).The Treg level in the peripheral blood of preterm infants increased first and then decreased after birth, with the peak observed on 7 days after birth.On 7 days after birth, the BPD group had a significantly higher Treg level than the non-BPD group[(10.4±1.2)% vs.(8.7±1.7)%] ( P<0.05).The multivariate Logistic regression analysis showed increased Treg levels in peripheral blood on 7 days after birth ( OR=3.320, 95% CI: 1.057-10.427, P=0.040), gestational age ( OR=0.040, 95% CI: 0.003-0.446, P=0.009), invasive mechanical ventilation time ≥7 days ( OR=4.126, 95% CI: 1.301-14.125, P=0.002), and oxygen inhalation time ( OR=1.716, 95% CI: 1.317-3.933, P=0.041) were risk factors of BPD in preterm infants.The ROC curve analysis showed that the area under the curve of Treg levels on 7 days after birth for BPD prediction was 0.794, the best cut-off value was 9.35%, the sensitivity was 90.3%, and the specificity was 66.2%. Conclusions:Treg levels in the peripheral blood of preterm infants increase first and then decrease in the early stage after birth, peaking at 7 days after birth.Elevated Treg levels at 7 days after birth may have early predictive value for the occurrence of BPD in preterm infants.

Objective:To investigate the clinical characteristics of acute ischemic stroke with anterior circulation large vessel occlusion caused by cardioembolism (CE) and large artery atherosclerosis (LAA) and the efficacy of endovascular treatment.Methods:Patients with acute ischemic stroke caused by large vessel occlusion in anterior circulation and received endovascular treatment in the Stroke Center of the 971 st Hospital of the PLA Navy from April 2014 to April 2021 were retrospectively enrolled. The etiological classification of stroke was CE or LAA. According to the modified Rankin Scale score at 90 d after onset, the patients were divided into good outcome group (0-2) and poor outcome group (>2). The demographic and clinical data between the groups were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcome. Results:A total of 106 patients were enrollded. Their age was 61.39±13.73 years and 70 (66.0%) were males. Seventy-four patients (69.8%) were in the CE group and 32 (30.2%) were in the LAA group. Sixty-six patients (62.3%) had good outcomes. Univariate analysis showed that there were significant differences in gender, age, smoking, systolic blood pressure, diastolic blood pressure, baseline National Institutes of Health Stroke Scale (NIHSS) score, time from onset to femoral artery puncture, time from puncture to vascular recanalization, and the number of retrieval attempts between the CE group and the LAA group (all P<0.05), and there were no significant differences in the incidences of poor outcome, hemorrhagic transformation, and symptomatic intracranial hemorrhage. There were significant differences in systolic blood pressure, diastolic blood pressure, baseline NIHSS score, time from onset to femoral artery puncture, and blood perfusion grade after treatment between the good outcome group and the poor outcome group (all P<0.05). Multivariable logistic regression analysis showed that higher systolic blood pressure (odds ratio [ OR] 1.046, 95% confidence interval [ CI] 1.014-1.078; P=0.004), higher baseline NIHSS score ( OR 1.117, 95% CI 1.037-1.203; P=0.003), longer time from onset to femoral artery puncture ( OR 1.008, 95% CI 1.001-1.015; P=0.019) and poor blood perfusion after treatment ( OR 8.042, 95% CI 1.532-42.215; P=0.014) were significantly and independently associated with the poor outcomes. Conclusions:Compared with LAA, CE do not increase the risks of hemorrhagic transformation and symptomatic intracranial hemorrhage. The safety and efficacy of the two are similar.

Objective:To observe the effects of Xiaoqinglong Decoction and Qingqi Huatan Pills on interleukin-1β(IL-1β)-induced mucushypersecretion model of human airway epithelial H292 cellsand related molecules of nuclear factor-κB/microRNA-494 (NF-κB/miR-494) signaling pathway, and to explore the mechanism of the two medicines in improving pathological airway mucus.Methods:Methyl thiazolyl tetrazolium (MTT) colorimetric method was used to detect the effects of different concentrations of Xiaoqinglong Decoction and Qingqi Huatan Pills on the activity of H292 cellsinduced by IL-1β, and the appropriate concentration was selected for subsequent experiments. Cells were randomly divided into blank group, IL-1β model group (5 μg/L IL-1β), NF-κB inhibitor pyrrolidinedithiocarbamate (PDTC) group (5 μg/L IL-1β+100 μmol/L PDTC), Xiaoqinglong Decoction (5 μg/L IL-1β+1 000 mg/L Xiaoqinglong Decoction) and Qingqi Huatan Pill group (5 μg/L IL-1β+1 000 mg/L Qingqi Huatan Pills). 5 μg/L IL-1β was used to induce H292 cells for 24 hours to establish a model of airway epithelial mucus hypersecretion. Enzyme linked immunosorbent assay (ELISA) method was used to detect the levels of mucin 5AC (MUC5AC), tumor necrosis factor-α (TNF-α) and IL-8 and the synthesis of intracellular MUC5AC and cystic fibrosis transmembrane conductance regulator (CFTR). Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression levels of MUC5AC mRNA, CFTR mRNA, miR-494. Western blotting was used to detect protein expression of key proteins (p65) and NF-κB inhibitors (IκB) in NF-κB signaling pathway.Results:Xiaoqinglong Decoction and Qingqi Huatan Pills with the concentration of 1 000 mg/L were selected for the follow-up experiment. Compared with the blank group, the levels of MUC5AC, TNF-α and IL-8 were significantly increased in the model group, intracellular MUC5AC protein content and mRNA expression were also significantly increased, intracellular CFTR protein content and mRNA expression were significantly decreased, and intracellular p65 protein expression was significantly up-regulated, the expression of IκB protein was significantly down-regulated, and the expression of miR-494 was significantly increased. Compared with the model group, the levels of MUC5AC, TNF-α and IL-8 were significantly reduced in PDTC group, Xiaoqinglong Decoction group and Qingqi Huatan Pill group, intracellular MUC5AC protein content and mRNA expression were also significantly decreased, and intracellular p65 protein expression was significantly down-regulated, and IκB protein expression was significantly up-regulated, miR-494 expression was significantly reduced. Intracellular CFTR protein content and mRNA expression were significantly increased in both PDTC group and Qingqi Huatan Pill group. Compared with the PDTC group, the level of TNF-α in the Xiaoqinglong Decoction group was significantly increased (ng/L: 22.77±3.14 vs. 11.09±3.37, P < 0.05), the content and mRNA expression of CFTR and IκB protein expression was significantly decreased [CFTR protein (ng/L): 97.38±6.62 vs. 227.04±19.48, CFTR mRNA (2 -ΔΔCt): 0.99±0.08 vs. 1.21±0.08, IκB/β-actin: 1.69±0.11 vs. 2.00±0.18, all P < 0.05], the level of TNF-α in Qingqi Huatan Pill group was significantly higher (ng/L: 19.08±3.71 vs. 11.09±3.37, P < 0.05). Compared with Xiaoqinglong Decoction group, the protein content and mRNA expression of CFTR and IκB protein expression in Qingqi Huatan Pill group were significantly increased [CFTR protein (ng/L) : 235.01±22.71 vs. 97.38±6.62, CFTR mRNA(2 -ΔΔCt): 1.32±0.15 vs. 0.99±0.08, IκB/β-actin: 1.94±0.16 vs. 1.69±0.11, all P < 0.05]. Conclusions:The effect of Xiaoqinglong Decoctionin improving the hypersecretion of mucus in the airway epithelium may be related to the inhibition of NF-κB/miR-494 inflammatory signal-mediated MUC5AC hypersecretion, while the effect of Qingqi Huatan Pills may be related to the inhibition of NF-κB/miR-494 inflammatory signal-mediated MUC5AC hypersecretion and CFTR dysfunction. Therefore, the difference in the mechanism of the two treatments of airway pathological mucus is mainly in the regulation of CFTR mRNA and protein.

In addition to causing high disability and high fatality rates, ruptured intracranial aneurysms can also cause cognitive impairment. Although preventive surgical treatment can avoid intracranial aneurysm rupture and bleeding, patients may still have a certain degree of cognitive impairment, even in patients with good clinical recovery after surgery. There is no systematic review on the effect of different surgical methods on cognitive function, and the best surgical method is still inconclusive. This article reviews the cognitive impairment in patients with intracranial aneurysm, hoping to provide a basis for clinical treatment decisions.

Spontaneous recanalization after chronic occlusion of internal carotid artery (ICA) is a rare phenomenon, and its mechanism is not clear. This article reports a case of chronic occlusion of the extracranial segment of the right ICA. The right ICA occlusion was confirmed by the DSA and one year later, DSA showed the recanalization of occlusion ICA with tandem stenosis of the origin and the proximal petrosal segment. Carotid artery stenting was successfully performed, and postoperative angiography showed that the right ICA was patent and the stenosis was obviously improved. Therefore, drug therapy could be continued when artery lumen was completely normal or slightly narrow after spontaneous recanalization of chronic internal carotid artery occlusion;carotid endarterectomy or carotid artery stenting may be considered for tandem stenosis or severe stenosis with high risk of ischemic events.