This article summarizes Academician WANG Yongyan′s experience in the differentiation and treatment of motor neuron disease, which can be categorized into flaccidity syndrome, convulsive syndrome, and fei syndrome according to the clinical manifestations. These three syndromes may coexist, and the condition progressively worsens over time, which is believed to be caused by external pathogenic qi, based on "deficient-qi induced stagnation" , and with "toxins damaging collaterals" as the core etiology and pathogenesis. "Toxins damaging collaterals" involves three levels of qi collaterals, blood collaterals, and fluid collaterals, gradually overlapping and affecting the marrow collaterals. Academician WANG Yongyan′s theory is based on syndrome differentiation, breaking down the boundaries of flaccidity, convulsive, and fei syndromes according to different manifestations of the disease, and using the concept of "combined treatment" for treatment. The clinical presentation of motor neuron disease shows a bottom-up trend in the development of the sanjiao, and the combination of visceral syndrome differentiation and sanjiao syndrome differentiation can grasp the progress of the disease comprehensively. During the process of syndrome differentiation, the focus is on the use of xiang thinking, emphasizing the holistic correlation between diseases and syndromes and the integrated effect of reductionist analysis. Treatment is based on xiang differentiation and individualized treatment. The mid-stage of motor neuron disease is the key time point for the treatment of this disease. Based on the clinical symptoms of flaccidity, convulsive, and fei syndromes, where treatment should focus on reinforcing the spleen and kidney, combining moxibustion with herbal medicine. While targeting the disease, treatment should comprehensively apply the methods of "promoting, supplementing, softening, and warming" to eliminate toxins and unblock collaterals, and restore the neural regulation of the brain and spinal cord.

The "body schema" of acupuncture and moxibustion is centered on the meridian system and represents a corporeal perspective of "heaven-connection", embodying the harmony between nature and humanity. It integrates the cyclic schema of the heavenly cycling, the meridian growth and decline schema of the guaqi theory, the twelve zodiac demarcation schema from astrological and astronomical studies, and the nine-palace and eight-trigrams schema of temporal and spatial locations. It presents the theoretical origins of the harmony between nature and humanity in acupuncture and moxibustion along with medical thoughts under the background of social concepts. The numerical arts of acupoint number and acupuncture-moxibustion quantity, those of acupuncture-moxibustion time and taboos, as well as the time-based acupuncture-moxibustion patterns, all of these thoroughly reflect the application of the body schema of acupuncture and moxibustion by early medical practitioners in ancient time. The study on the body philosophy in acupuncture and moxibustion should start from the original appearance of early classical acupuncture-moxibustion theory, trace the source of body philosophy of acupuncture and moxibustion, seek the truth of temporal body medicine, and perfect the body philosophy research of contemporary acupuncture and moxibustion, so as to improve the dual attributes of acupuncture and moxibustion in humanities and science.
Moxibustion/history* ; Humans ; Acupuncture Therapy/history* ; History, Ancient ; Meridians ; Astrology

This paper explored the significance and value of building a doctor-patient narrative community in clinical practice.It was clarified that clinical practice guided by evidence-based medicine thinking is essentially a"narrative"process:patients narrate their illness stories,and doctors,through a series of humanistic narrative practices,strengthen trust and empathy between patients and doctors on an emotional and ethical level,while bridging cognitive gaps,enhancing diagnostic and treatment outcomes,and ultimately fostering a harmonious and efficient doctor-patient narrative community relationship.The realization of a doctor-patient narrative community not only optimizes the treatment process but also enhances patients'self-efficacy and doctors'professional satisfaction,which is conducive to saving medical costs,optimizing public health governance,and highlighting a harmonious social atmosphere.

This paper explored the significance and value of building a doctor-patient narrative community in clinical practice.It was clarified that clinical practice guided by evidence-based medicine thinking is essentially a"narrative"process:patients narrate their illness stories,and doctors,through a series of humanistic narrative practices,strengthen trust and empathy between patients and doctors on an emotional and ethical level,while bridging cognitive gaps,enhancing diagnostic and treatment outcomes,and ultimately fostering a harmonious and efficient doctor-patient narrative community relationship.The realization of a doctor-patient narrative community not only optimizes the treatment process but also enhances patients'self-efficacy and doctors'professional satisfaction,which is conducive to saving medical costs,optimizing public health governance,and highlighting a harmonious social atmosphere.

This article explores the practical situation,construction significance,core points,and enhancement dimensions in constructing the discourse system of traditional Chinese medicine from a macro perspective.It also examines the ways linguistics can help alleviate the challenges in this process.The discourse system of traditional Chinese medicine has gone through three stages.The theory is currently unclear,and the discourse cannot be transmitted without fundamentally solving the problem of"aphasia."The discourse system of traditional Chinese medicine is an inevitable requirement for creating modern and international traditional Chinese medicine models.Its construction must form a subjective understanding of the discourse system,strengthen the advantage of originality,establish an expression paradigm of original system interpretation and new expressions of modern novel quality development,and build an influential international discourse system.The improvement dimension of the discourse system of traditional Chinese medicine should focus on domestic popularization and global dissemination.Strong strategic support should be provided using the epistemological and methodological frameworks of both traditional and modern linguistics.

Objective:To construct the clinical practice pathway for narrative medicine in traditional Chinese medicine(TCM),with a view to providing clinical practice guidelines for narrative medicine in TCM for frontline practitioners.Methods:Using the realistic literature review and the Nominal Group Technique(NGT),the paper systematically sorted out the practices of humanistic care in ancient Chinese medical books and famous medical cases,as well as constructed the first draft of the clinical practice pathway and details for narrative medicine in TCM.Subsequently,experts from multiple fields were invited to demonstrate by using the NGT.After in-depth discussion and collective voting,various operational modules,and their detailed rules and supporting tools were determined,thus completing the construction of the entire practical pathway.Results:A complete set of clinical practice pathways for narrative medicine in TCM had been established.It encompassed six core modules,including"start of diagnosis and treatment","communication of disease conditions","diagnosis and explanation","joint decision-making","end of diagnosis and treatment",and"reflection and summary".Besides,detailed operating rules and supporting tools were also provided.Conclusion:The clinical practice pathway for narrative medicine in TCM integrates the humanistic spirit of TCM,the core concepts of narrative medicine,and the communication skills of psychology,providing medical workers with standardized,procedural,and operationally flexible practice guidance,which helps both doctors and patients to better communicate,empathize,and make joint decisions throughout the entire process of diagnosis and treatment.

【Objective:】 To explore the relationship between the moral courage of nurses in Intensive Care Unit (ICU) and the hospital ethical climate, and to provide a theoretical basis for enhancing the moral courage of ICU nurses. 【Methods:】 A total of 468 ICU nurses from 8 tertiary A hospitals in Shaanxi Province were selected as the subjects by convenience sampling method, and the General Information Form, Hospital Ethical Climate Survey, and Nurses’ Moral Courage Scale were used for the questionnaire survey. 【Results:】 A total of 468 questionnaires were distributed and 463 valid questionnaires were returned, with an effective recovery rate of 98.93%. The score of hospital ethical climate for ICU nurses was (100.69±19.76), and the score of moral courage was (83.67±15.48). There was a positive correlation between hospital ethical climate and moral courage (r=0.866, P<0.001). Hierarchical multiple regression analysis showed that hospital ethical climate entered the influencing factor model of ICU nurses’ moral courage, which can independently explain 57% of the variation in ICU nurses’ moral courage. 【Conclusion:】 The moral courage of ICU nurses was at a medium level, and positively correlated with the hospital ethical climate, that is, the better the hospital ethical climate perceived by ICU nurses, the higher their level of moral courage. Nursing managers should focus on deepening the hospital ethical climate, and enhance the level of hospital ethical climate through scientific methods to promote the improvement of ICU nurses’ moral courage.

Objective:To explore the influence of online and offline family therapy based on the Satir model on emotions of adolescents with depressive disorder and their parents in remote areas.Methods:A total of 98 cases adolescents with depressive disorder treated in the psychosomatic medicine of the Second Affiliated Hospital of Nanchang University from January 2021 to June 2021 and their parents were selected as the objects. The adolescents with depressive disorder and their parents were randomly divided into the control group (49 parents and 49 adolescents) and the observation group (49 parents and 49 adolescents). The control group received the medical treatment (sertraline 100 mg/d) and the routine health education, while the observation group received the online and offline Satir family therapy on the basis of the intervention of the control group. Generalized anxiety disorder-7 (GAD-7) and patient health questionnaire-9 (PHQ-9) were used to investigate the negative emotions of the parents of the two groups before and 12 weeks after the intervention. The screen for child anxiety related emotional disorders (SCARED) and depression self-rating scale for childhood (DSRS) were used to investigate the negative emotions of the adolescents before and 12 weeks after the intervention.The SPSS 20.0 software was used for statistical analysis. t test was used to compare the SCARED scale score and DSRS score changes of the adolescents in the two groups, and χ 2 test was used to compare the proportional changes of parents' anxiety and depression. Results:The scores of SCARED (51.55±12.69 vs 36.82±7.69, t=15.839) and DSRS (25.08±4.81 vs 16.88±2.16, t=13.047) of adolescents in the control group were significantly different before and after the intervention (both P<0.05). The scores of SCARED (51.16±15.84 vs 31.31±7.72, t=14.385) and DSRS (24.12±4.81 vs 14.08±2.03, t=14.723) of adolescents in the observation group were significantly different before and after the intervention (both P<0.05). After the intervention, the scores of SCARED and DSRS in the observation group were lower than those in the control group ( t=3.540, 6.609, both P<0.05). Before intervention, there was no significant difference in the proportion of anxiety and depression between the parents of the two groups (χ 2=1.837, 3.547, both P>0.05). After 12 weeks of intervention, there was a statistically significant difference in the proportion of anxiety and depression between the two groups, which were lower in the observation group than those in the control group (χ 2=5.995, 4.009, both P<0.05). Conclusion:Online + offline family therapy based on the Satir model can not only effectively reduce anxiety and depression of adolescents, but also effectively reduce anxiety and depression of their parents.It is especially suitable for outpatient management of children with depressive disorder in remote areas.

Helicobacter pylori (Hp) is a Gram-negative bacterium, mainly and specifically colonized on the surface of gastric mucosa, and closely related to upper gastrointestinal diseases such as chronic gastritis, peptic ulcer, gastric mucosa-associated lymphoid tissue lymphoma, and gastric cancer. At present, the infection rate of Hp in the world has been more than half of the population. In China, due to a series of reasons such as the abuse of antibiotics, the infection rate of Hp has already exceeded the world average. Solving the problem of antimicrobial resistance has become the key to the successful eradication of Hp. This article reviewed the advances in study on molecular mechanisms of antibiotic resistance of Hp.

Objective:To explore the effect of the hyperbaric oxygen therapy combined with percutaneous coronary intervention (PCI) on blood rheological properties in patients with unstable angina and its protective effect on myocardial injury.Methods:A total of 168 cases of patients with unstable angina admitted to Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from June 2017 to December 2018 were selected as research subjects and divided into control group (84 cases) and observation group (84 cases). The control group was given conventional PCI, and symptomatic and supportive treatment, while the observation group were given hyperbaric oxygen therapy (1 time/day, 10 days constitute one treatment course, 2 courses in total) on the basis of the treatments in the control group. The clinical efficacy was compared between the two groups. The changes in blood rheological indexes and myocardial injury markers of the patients were detected before and after treatment.Results:In the observation group, there were 45 cases with markedly efficacy, and 34 cases showed some efficacy. The total effective rate was 94.05%, which was significantly higher than that of 84.52% in the control group. The difference was statistically significant ( P<0.05). After treatment, the PaO 2 of the patients in the observation group significantly increased, while the PaCO 2 significantly decreased. The improvement of the blood oxygen metabolism was more significant than that in the control group ( P<0.05). Meanwhile, the levels of blood rheological indexes, e. g. whole blood viscosity (ηb), erythrocyte sedimentation rate (ESR), hematocrit (HCT), erythrocyte electrophoresis time (EET), erythrocyte aggregation index (EAI), and platelet aggregation rate (PAgT), in the two groups all declined obviously, and those in the observation group had greater decline than those in the control group ( P<0.05). The lysophospholipids acid (LPA) and platelet-activating factor P-selectin (CD62P) in the two groups significantly decreased, and the levels of LPA and CD62P in the observation group had greater decreases than those in the control group ( P<0.05). Moreover, the levels of the markers of myocardial injury, e. g. cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in both groups increased significantly, and the cTnI and CK-MB levels in the observation group were significantly lower than those in the control group. Conclusion:Through increasing blood oxygen content in body tissues, hyperbaric oxygen can effectively reduce blood viscosity, improve blood rheological properties, and therefore, reduce platelet activation, thus preventing thrombosis. It can also reduce myocardial injury and enhance the clinical efficacy for patients with unstable angina.