This paper introduces professor WU Rongzu's clinical experience in using Fuyang Tongmi Decoction （扶阳通秘汤， FTD） to treat irritable bowel syndrome with constipation （IBS-C）. It is believed that yang qi depletion， water cold， earth dampness， and wood constraint are the key pathogenesis.The treatment principle is warming water， drying the earth and venting wood， with the basic formula FTD adjusted according to the symptoms. This approach aims to transport the qi movement of the middle jiao （焦） and support the recovery of intestinal function of directing turbidity downward， providing a treatment strategy for IBS-C caused by yang deficiency.

Renal metastasis of oral adenoid cystic carcinoma is rare. A patient with bilateral renal metastasis secondary to surgery for oral adenoid cystic carcinoma was reported. The left kidney was treated with radiofrequency ablation, and the right kidney was treated with radical nephrectomy. The creatinine was 74 μmol/L at 3 months after surgery. The multidisciplinary comprehensive diagnosis and treatment model adopted in this case provided diagnosis and treatment ideas for patients with bilateral renal secondary malignant tumors.

The paper introduces Professor SUN Shentian's experience in clinical practice of Ningshen (tranquilizing the mind) point. This point is an empirical point discovered by Professor SUN on the basis of meridian differentiation, nerve function and anatomic location, and in association with the years of clinical practice. The point is located in the prefrontal area, jointed with the distribution of the governor vessel, and responded to the body surface projection area of the frontal pole. It works on regulating the mind, regaining consciousness, improving cognition, alleviating depression, mutually treating physical and mental disorders, as well as unblocking collaterals, regulating the tendons and relieving spasm. This point is widely used in treatment of mental disorders, stroke and extrapyramidal diseases and obtains the reliable therapeutic effect in clinical practice.
Humans ; Acupuncture Points ; Acupuncture Therapy/history* ; China ; Meridians ; History, 20th Century

Renal metastasis of oral adenoid cystic carcinoma is rare. A patient with bilateral renal metastasis secondary to surgery for oral adenoid cystic carcinoma was reported. The left kidney was treated with radiofrequency ablation, and the right kidney was treated with radical nephrectomy. The creatinine was 74 μmol/L at 3 months after surgery. The multidisciplinary comprehensive diagnosis and treatment model adopted in this case provided diagnosis and treatment ideas for patients with bilateral renal secondary malignant tumors.

Objective To explore the correlation between malignant tumors and serum N-terminal pro-brain natriuretic peptide(NT-proBNP)levels.Methods A total of 336 patients with malignant tumors(cancer group)who were admitted to the Department of Cardiology,Chinese PLA General Hospital and underwent coronary angiography from January 1,2009 to December 31,2020,and were newly diagnosed and had not received any anti-tumor treatment were selected.They were matched with 1 008 patients(non-cancer group)in a 1:3 ratio using propensity score matching based on gender and age.Clinical data of the patients were collected,including age,gender,serum NT-proBNP,left ventricular ejection fraction(LVEF),SYNTAX score,serum creatinine,and tumor diagnosis information.The patients were divided into 4 groups based on the quartiles of NT-proBNP levels:low-level group(NT-proBNP ≤ 61.80 pg/mL),medium-level group(61.80 pg/mL＜NT-proBNP≤ 152.95 pg/mL),high-level group(152.95 pg/mL＜NT-proBNP≤470.10 pg/mL),and very high-level group(NT-proBNP＞470.10 pg/mL).Ordered logistic regression analysis was used to analyze the correlation between malignant tumors and serum NT-proBNP.Results A total of 1 344 patients were included,with an average age of(65.78±9.18)years old,1 003 males(74.63％),LVEF of 60.00％(55.00％,64.00％),SYNTAX score of(13.84±11.63)points,and creatinine level of 76.60(66.50,88.88)μmol/L.Among the 336 cancer patients,the top 3 types of cancer were lung cancer(84 cases,25.00％),colorectal cancer(58 cases,17.26％),and gastric cancer(52 cases,15.48％).The NT-proBNP levels in the cancer group were significantly higher than those in the non-cancer group(208.45[85.75,601.83]pg/mL vs 134.35[57.18,430.23]pg/mL,P＜0.001).Ordered logistic regression analysis showed that in the unadjusted model,malignant tumors were significantly associated with higher NT-proBNP levels(OR=1.561,95％CI 1.538-1.584,P＜0.001);after adjusting for relevant factors,malignant tumors remained significantly associated with higher serum NT-proBNP levels(OR=1.384,95％CI 1.070-1.791,P=0.013).Conclusions NT-proBNP in malignant tumor patients is higher than that in non-malignant tumor patients,and there is a significant correlation between malignant tumors and serum NT-proBNP levels.

Objective:To investigate the role of lateral spread response (LSR) of the facial nerves in distinguishing primary hemifacial spasm (HFS), HFS caused by facial palsy and Meige syndrome, and explore the relationship between LSR presence or absence before microvascular decompression (MVD) and MVD efficacy in patients with primary HFS.Methods:A retrospective analysis was performed; 127 patients with HFS, including primary HFS ( n=86), HFS caused by facial palsy ( n=27) and Meige syndrome ( n=14), were enrolled in Department of Neurology, Zhongshan Hospital, Fudan University from November 2021 to July 2023. All patients underwent needle electrode electromyography in the lateral facial muscles, and tests of motor branch conduction of facial nerves, blinking reflex and LSR; the general data, myokymia incidence, latency of facial nerves, abnormal rate and R1 amplitude of blinking reflex, and LSR detection rate and latency were compared among the 3 groups. Spearman correlation was used to analyze the correlation between course of primary HFS and LSR presence or absence. For patients with primary HFS accepted MVD, MVD efficacy was evaluated according to Shorr efficacy evaluation criteria 1 month after procedure, and efficacy differences between patients with LSR presence and LSR absence were compared. Results:(1) Compared with the Meige syndrome group, the group of HFS caused by facial palsy had significantly younger age, and the group of HFS caused by facial palsy and primary HFS group had statistically higher incidence of left side lesions ( P<0.05). The latency of facial nerves in group of HFS caused by facial palsy ([2.97±0.63] ms) was significantly longer than that in the primary HFS group ([2.46±0.59] ms) and Meige syndrome group ([2.53±0.62] ms, P<0.05). The abnormal rate of blinking reflex in group of HFS caused by facial palsy (59.26%) was significantly higher than that in primary HFS group (23.26%) and Meige syndrome group (21.43%, P<0.05). The LSR detection rate in primary HSF group (48.84%) was statistically higher than that in group of HFS caused by facial palsy (37.04%) and Meige syndrome group (7.14%, P<0.05). The LSR latency in group of HFS caused by facial palsy (12.30[12.30, 13.80] ms) was significantly longer than that in the primary HFS group (11.20[9.73, 11.20] ms, P<0.05). (2) No significant correlation was noted between course of primary HFS and LSR presence or absence ( rs=0.051, P=0.640). (3) In 33 patients with primary HFS accepted MVD, no significant difference in MVD efficacy was noted between patients with LSR presence ( n=22) and those with LSR absence ( n=11, P>0.05). Conclusion:In patients with LSR presence and long latency of facial nerves and LSR, HFS caused by facial palsy should be considered; preoperative LSR can not predict the MVD efficacy in patients with primary HFS.

Objective:To investigate the clinical effect of jujube core-shaped tissue resection technique in the treatment of alar reduction.Methods:A retrospective analysis was performed for the clinical data of patients who underwent alar reduction from February 2019 to June 2022. A spindle-shaped incision line was designed along the outer edge of the base of the nasal lobule, with a width of 4-5 mm and a length of 8-12 mm. The incision line was 1-2 mm away from the alar groove, and the inner side of the design line was extended to the inside of the nasal vestibule. After the incision was made, the subcutaneous tissue was undermining dissected with curved sharp scissors, and the shape of the extended excision tissue was similar to that of jujube core. After reduction, the incision was closed with vertical mattress suture. The surgical effect and complications were followed up after surgery, and an independent attending plastic surgeon evaluated the outcome and scarring based on photos before and at the last postoperative follow-up using the global aesthetic improvement scale (GAIS) and the Vancouver scar scale (VSS). GAIS is graded as 1, 2, 3, 4, and 5 points, and the lower the score, the better the improvement(≤3 points as effective improvement). VSS includes four parameters: color (0-3 points), thickness (0-4 points), vascular distribution (0-3 points), and softness (0-5 points). The higher the score, the more significant the scar is.Results:A total of 20 patients were enrolled, including 6 males and 14 females, aged 20 to 33 years, with an average age of 24.9 years. Before the operation, there were different degrees of alar flare and alar hypertrophy. After surgery, 13 patients had mild swelling, ecchymosis, which resolved after 3 days. There were no major complications as infection, incision dehiscence, and delayed healing. After 3 to 16 months of postoperative follow-up, 2 patients gradually developed cartilage deformation and affected the appearance of the nostrils 6 to 9 months after surgery due to the combination of rib-based rhinoplasty, and the satisfactory results were obtained after revision surgery. The symmetry of the nostrils was significantly improved. The GAIS score of 20 patients was (1.20±0.41) points, of which, 16 patients were rated as 1 point and 4 patients were rated as 2 points, all of which met the improvement criteria, and the VSS score was (1.45±0.60) points, in which the average score for color, thickness, vasculature and compliance are 0.60, 0.05, 0.55 and 0.30 points respectively.Conclusion:The application of jujube core-shaped tissue resection technique for alar reduction can increase the amount of tissue removal with the same incision width, which can not only fully narrow the alar effectively but also correct the hypertrophy of the alar tissue.

Objective:To investigate the clinical effect of jujube core-shaped tissue resection technique in the treatment of alar reduction.Methods:A retrospective analysis was performed for the clinical data of patients who underwent alar reduction from February 2019 to June 2022. A spindle-shaped incision line was designed along the outer edge of the base of the nasal lobule, with a width of 4-5 mm and a length of 8-12 mm. The incision line was 1-2 mm away from the alar groove, and the inner side of the design line was extended to the inside of the nasal vestibule. After the incision was made, the subcutaneous tissue was undermining dissected with curved sharp scissors, and the shape of the extended excision tissue was similar to that of jujube core. After reduction, the incision was closed with vertical mattress suture. The surgical effect and complications were followed up after surgery, and an independent attending plastic surgeon evaluated the outcome and scarring based on photos before and at the last postoperative follow-up using the global aesthetic improvement scale (GAIS) and the Vancouver scar scale (VSS). GAIS is graded as 1, 2, 3, 4, and 5 points, and the lower the score, the better the improvement(≤3 points as effective improvement). VSS includes four parameters: color (0-3 points), thickness (0-4 points), vascular distribution (0-3 points), and softness (0-5 points). The higher the score, the more significant the scar is.Results:A total of 20 patients were enrolled, including 6 males and 14 females, aged 20 to 33 years, with an average age of 24.9 years. Before the operation, there were different degrees of alar flare and alar hypertrophy. After surgery, 13 patients had mild swelling, ecchymosis, which resolved after 3 days. There were no major complications as infection, incision dehiscence, and delayed healing. After 3 to 16 months of postoperative follow-up, 2 patients gradually developed cartilage deformation and affected the appearance of the nostrils 6 to 9 months after surgery due to the combination of rib-based rhinoplasty, and the satisfactory results were obtained after revision surgery. The symmetry of the nostrils was significantly improved. The GAIS score of 20 patients was (1.20±0.41) points, of which, 16 patients were rated as 1 point and 4 patients were rated as 2 points, all of which met the improvement criteria, and the VSS score was (1.45±0.60) points, in which the average score for color, thickness, vasculature and compliance are 0.60, 0.05, 0.55 and 0.30 points respectively.Conclusion:The application of jujube core-shaped tissue resection technique for alar reduction can increase the amount of tissue removal with the same incision width, which can not only fully narrow the alar effectively but also correct the hypertrophy of the alar tissue.

Objective:To investigate the role of lateral spread response (LSR) of the facial nerves in distinguishing primary hemifacial spasm (HFS), HFS caused by facial palsy and Meige syndrome, and explore the relationship between LSR presence or absence before microvascular decompression (MVD) and MVD efficacy in patients with primary HFS.Methods:A retrospective analysis was performed; 127 patients with HFS, including primary HFS ( n=86), HFS caused by facial palsy ( n=27) and Meige syndrome ( n=14), were enrolled in Department of Neurology, Zhongshan Hospital, Fudan University from November 2021 to July 2023. All patients underwent needle electrode electromyography in the lateral facial muscles, and tests of motor branch conduction of facial nerves, blinking reflex and LSR; the general data, myokymia incidence, latency of facial nerves, abnormal rate and R1 amplitude of blinking reflex, and LSR detection rate and latency were compared among the 3 groups. Spearman correlation was used to analyze the correlation between course of primary HFS and LSR presence or absence. For patients with primary HFS accepted MVD, MVD efficacy was evaluated according to Shorr efficacy evaluation criteria 1 month after procedure, and efficacy differences between patients with LSR presence and LSR absence were compared. Results:(1) Compared with the Meige syndrome group, the group of HFS caused by facial palsy had significantly younger age, and the group of HFS caused by facial palsy and primary HFS group had statistically higher incidence of left side lesions ( P<0.05). The latency of facial nerves in group of HFS caused by facial palsy ([2.97±0.63] ms) was significantly longer than that in the primary HFS group ([2.46±0.59] ms) and Meige syndrome group ([2.53±0.62] ms, P<0.05). The abnormal rate of blinking reflex in group of HFS caused by facial palsy (59.26%) was significantly higher than that in primary HFS group (23.26%) and Meige syndrome group (21.43%, P<0.05). The LSR detection rate in primary HSF group (48.84%) was statistically higher than that in group of HFS caused by facial palsy (37.04%) and Meige syndrome group (7.14%, P<0.05). The LSR latency in group of HFS caused by facial palsy (12.30[12.30, 13.80] ms) was significantly longer than that in the primary HFS group (11.20[9.73, 11.20] ms, P<0.05). (2) No significant correlation was noted between course of primary HFS and LSR presence or absence ( rs=0.051, P=0.640). (3) In 33 patients with primary HFS accepted MVD, no significant difference in MVD efficacy was noted between patients with LSR presence ( n=22) and those with LSR absence ( n=11, P>0.05). Conclusion:In patients with LSR presence and long latency of facial nerves and LSR, HFS caused by facial palsy should be considered; preoperative LSR can not predict the MVD efficacy in patients with primary HFS.

Objective:To evaluate the relationship between preoperative pain threshold and chronic postsurgical pain (CPSP) in the patients undergoing thoracoscopic pneumonectomy.Methods:One hundred patients of both sexes, aged 18-75 yr, with body mass index of 18-35 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for thoracoscopic pneumonectomy at West China Hospital of Sichuan University from December 2019 to February 2020, were selected. The pain threshold was measured using Pain Vision at 1 day before surgery. Telephone follow-up was implemented by a pain questionnaire to assess CPSP (numerical rating scale score ≥1) at 3 months after surgery. Multivariate logistic regression was used to identify the risk factors for CPSP, and the receiver operating characteristic curve was used to evaluate the accuracy of preoperative pain threshold in predicting CPSP. Results:Ninety-four patients were finally enrolled, of which 38 cases (40%) developed CPSP. The results of multivariate logistic regression analysis showed that low preoperative pain threshold was an independent risk factor for CPSP ( OR=0.899, 95% confidence interval 0.854-0.946, P<0.001). The area under the receiver operating characteristic curve was 0.882 (95% confidence interval 0.804-0.960), Youden Index was 0.673, the sensitivity was 0.816, and the specificity was 0.857. Conclusions:Low preoperative pain threshold is an independent risk factor for CPSP, and preoperative pain threshold can predict the occurrence of CPSP in the patients undergoing thoracoscopic pneumonectomy.