Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective To explore the effect and safety of magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia. Methods We retrospectively analyzed the clinical and pathological data of 81 patients with mpMRI-TRUS image fusion targeted transperineal prostate biopsy using electromagnetic needle tracking under local anesthesia. Visual analog scale (VAS) and visual numeric scale (VNS) were used to evaluate the pain level and satisfaction of patients during prostate biopsy (VAS-1 and VNS-1), one hour after puncture (VAS-2 and VNS-2), and one day after surgery (VAS-3 and VNS-3). The perioperative clinical data and tumor positive rate of postoperative biopsy were recorded. Results The average prostate volume of 81 patients was 53.39±29.46 cm³. The PSA values of patients with PI-RADS scores of 2, 3, 4, and 5 were 9.14±2.31, 9.95±4.10, 14.77±6.36, and 32.17±24.39 ng/ml, respectively. The scores of VAS-1, VAS-2, and VAS-3 were 1.70±0.73, 1.16±0.58, and 0.53±0.55, respectively; the scores of VNS-1, VNS-2, and VNS-3 were 2.74±0.44, 3.69±0.46, and 3.84±0.37, respectively. The average surgical time was 17.47±3.44 minutes. Postoperative pathological results showed that the tumor positive rate of targeted prostate biopsy was 64.20%. According to the PI-RADS score for subgroup analysis, the tumor positive rates of patients with PI-RADS scores of 2, 3, 4, and 5 were 21.43%, 44.44%, 61.11%, and 96.77%, respectively. After transperineal prostate biopsy, gross hematuria occurred in 19.75% patients, and urinary retention occurred in 3.70%. The latter were relieved after symptomatic treatment. All patients did not experience complications, such as perineal puncture area hematoma, urinary tract infection, hematospermia, hematoma in perineal puncture area, urinary tract infection, hematospermia, vagus nerve reaction, or septic shock. Conclusion For suspected prostate cancer patients, mpMRI-TRUS image fusion targeted transperineal biopsy technique using electromagnetic needle tracking under local anesthesia is a feasible and easily tolerated surgical procedure. It has good safety and high tumor positive-detection rate, indicating that this technique is worthy of further clinical promotion and application.

Objective To explore the application value of mpMRI-TRUS multi-modal image fusion transperineal biopsy technique using electromagnetic needle tracking under local anesthesia combined with rapid paraffin-embedded section of small specimen in the diagnosis of prostate cancer.Methods The clinicopathological data of 138 patients with PI-RADS score≥3 who underwent mpMRI-TRUS image fusion transperineal biopsy using electromagnetic needle tracking under local anesthesia were retrospectively analyzed.AI technology was used to fuse mpMRI and TRUS multi-mode images,and two-core targeted biopsies were performed on suspicious lesions,followed by 12-core systematic biopsies.The specimens obtained from targeted biopsies were sent for rapid paraffin-embedded section pathological examination,and the detection rates of csPCa were compared.Results The detection rate of csPCa in 138 patients was 71.01% .The detection rates of csPCa in targeted biopsies and systematic biopsies were 62.32% and 70.29%,respectively(P=0.20).The detection rate of combined biopsies was higher than those of targeted biopsies and systematic biopsies,but the difference was not statistically significant(P>0.05).The detection rates of csPCa in targeted biopsies,systematic biopsies,and combined biopsies in patients with PI-RADS score 3 were 30.95%,38.10%,and 40.48%,respectively;and the percentages were 52.94%,61.76%,and 61.76% in patients with PI-RADS score 4,respectively;and the percentages were 90.32%,96.77%,and 96.77% in patients with PI-RADS score 5,respectively,without statistically significant difference(all P>0.05).In the subgroups with PI-RADS scores of 3,4,and 5,the missed diagnosis rates of csPCa by targeted biopsies were 23.53%,14.29%,and 6.67%,respectively.Conclusion For patients with suspected prostate cancer and PI-RADS v2.1 score≥3,transperineal biopsy using electromagnetic needle tracking combined with rapid paraffin-embedded section of small specimen can obtain pathological results rapidly and has good diagnostic accuracy.However,combined biopsy is still the most suitable method for the diagnosis of prostate cancer at present.

Objective Evaluate the performance of the encephalon state index(ESI)in depth of anesthesia monitoring during clinical surgery,compared with the bispectral index(BIS).Methods ESI and BIS data were collected from 60 patients in a single-center clinical trial to compare their efficacy in measuring the depth of anesthesia.Results Consistency analysis revealed mean differences and standard deviations of-0.18±5.42 and-0.11±6.51 between ESI and BIS for awake and anesthetized states,respectively.Correlation analysis showed a correlation coefficient of 0.92 throughout the operative period.Prediction probability analysis indicated that both ESI and BIS had prediction probabilities of 0.97,effectively predicting anesthesia status.Conclusion ESI and BIS show good equivalence in monitoring depth of anesthesia during clinical surgery,which meet the requirements of clinical anesthesia.

Objective To explore the efficacy and safety of multi-parametric magnetic resonance imaging and transrectal ultrasonography(mpMRI-TRUS)fusion targeted transperineal biopsy(TPB)under local anesthesia(LA)with"one-plane three-point"dual probe ultrasound localization.Methods Clinical data of 134 suspected prostate cancer(PCa)patients treated with this method in our hospital during Jan.and Sep.2023 were retrospectively analyzed.The same doctor applied visual analog scale(VAS)and visual digital scale(VNS)to evaluate the pain level and satisfaction of patients during TPB(VAS-1 and VNS-1)and 1 hour after TPB(VAS-2 and VNS-2),and recorded the perioperative clinical data and detection rate of clinically significant prostate cancer(csPCa).Results VAS-1 score was(1.60±0.68)and VAS-2 score was(1.13±0.55);VNS-1 score was(2.84±0.41),and VNS-2 score was(3.74±0.44).The operation time was(16.12±3.35)minutes.The postoperative pathological results showed that the detection rate of csPCa was 65.67％(88/134).According to the PI-RADS score in subgroup analysis,the detection rates of patients with PI-RADS scores of 2,3,4,and 5 were 23.08％(6/26),52.94％(18/34),62.50％(15/24)and 98.00％(49/50),respectively.After TPB,gross hematuria occurred in 20.90％(28/134)patients,and urinary retention occurred in 4.00％(5/125)patients,which were relieved after symptomatic treatment.No complications such as perineal puncture area hematoma,urinary tract infection,hematospermia,vagal nerve reaction,and septic shock occurred.Conclusion The mpMRI-TRUS fusion targeted TPB under LA with"one-plane three-point"dual probe ultrasound localization provides a feasible and tolerable surgical procedure for suspected PCa patients with a high detection rate of csPCa,which is worthy of further clinical promotion and application.

Objective To retrospectively analyze the clinical efficacy of Xuanfei Tongqiao Acupuncture for the treatment of allergic rhinitis(AR)based on real world studies.Methods Clinical data in the hospital information system of Acupuncture and Moxibustion Rehabilitation Department of the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2021 to October 2022 and Excel sheet records were extracted.The data were screened according to the criteria.Based on the thresholds of receiver operating characteristic(ROC)curve,the treatment grouping thresholds were clarified.The acupuncture patients was divided into acupuncture group A and acupuncture group B,the treatment was Xuanfei Tongqiao Acupuncture.Groups A and B were compared using propensity score matching(PSM)to make the baseline balance comparable between groups.The efficacy,total effective rate,total nasal symptom score(TNSS),total non nasal symptoms score(TNNSS),adverse events,and recurrence were then compared between the two groups.In stratified analyses,the inverse probability of treatment weighting(IPTW)method was used for between-group comparisons.The efficacy,total effective rate,TNSS and TNNSS,incidence of adverse events,and recurrence were compared between the two groups,respectively.The TNSS and TNNSS before and after treatment within the group were also compared.Results A total of 209 patients'data were collected,including 7 non-acupuncture patients and 202 acupuncture patients,and the acupuncture patients was divided into acupuncture group A(<6 weeks of treatment)and acupuncture group B(≥6 weeks of treatment)according to the ROC curve characteristics,and there was a difference in comparing the conditions of the two groups(P<0.05).66 pairs of patients were successfully matched after PSM,and there was no significant difference between the two groups at baseline(P>0.05).After PSM,the efficacy,total effective rate,post-treatment TNSS and TNNSS and TNSS at the follow-up between the two groups were compared,and the post-treatment TNSS and TNNSS within the groups were also compared,with statistical significance(P<0.01).There was statistical significance in the recurrence rate between the two groups before PSM(P<0.05),while there was no statistical significance in the incidence of adverse events before PSM and in the recurrent rate after PSM between the two groups(P>0.05).Stratified analysis was conducted on patients in the acupuncture patients based on their condition.Mild and moderate to severe patients were divided into acupuncture group A and group B according to the course of treatment.The TNSS and TNNSS before and after treatment were compared within the two groups,with statistical significance(P<0.01).IPTW was performed on two groups to ensure baseline balance and comparability,and there was statistical significance in the distribution of efficacy levels between the two groups(P<0.05),but there was no statistical significance in the total effective rate,TNSS and TNNSS scores after treatment and at follow-up,incidence of adverse events,and recurrence rate between the two groups(P>0.05).The distribution of efficacy levels,total effective rate,TNSS and TNNSS after treatment and at follow-up were compared between the two groups of moderate to severe patients,and the differences were statistically significant(P<0.01).There was no statistical significance in the incidence of adverse events and recurrence rates between the two groups(P>0.05).The TNSS and TNNSS of two groups of moderate to severe patients significantly decreased after treatment compared with before treatment(P<0.01).Conclusion Xuanfei Tongqiao Acupuncture treatment for AR with a duration of 6 weeks or more shows more significant and long-lasting clinical efficacy compared with a duration of less than 6 weeks.Especially for patients with moderate-to-severe AR,this course of treatment can better reflect the advantages of its efficacy.

Ischemic stroke has a high rate of disability and mortality and is often accompanied by white matter injury(WMI).WMI patients often have cognitive disorders,emotional disorders,sensorimotor disorders,urinary incontinence and other symptoms,which seriously affect daily life.WMI can be detected early through imaging techniques,but there is a lack of appropriate intervention and specific treatment.Studying the pathological mechanism of WMI after ischemic stroke is helpful to prevent the occurrence of WMI,delay its progression,and contribute to the development of effective drugs or specific treatments.This article reviewed the research progress of WMI mechanism after ischemic stroke in order to provide scientific basis for clinical prevention and treatment.

Objective To investigate the protective mechanism of electroacupuncture(EA)serum against blood-brain barrier(BBB)damage after ischemic stroke from regulating the S1PR2 pathway via m6A methylation of lncRNA H19.Methods Preparation of EA serum:the focal cerebral ischemia/reperfusion model rats were established,and three EA interventions were performed at 5 min after ischemia,24 h and 48 h after reperfusion,with acupuncture at Renzhong and Baihui acupoints for 30 min.EA serum was taken from the rats after the three EA interventions.Cellular experiments:The BBB model in which brain microvascular endothelial cells and pericytes were co-cultured was divided into five groups,including the control,model,EA,EA combined with METTL3 overexpression and EA combined with lncRNA H19 overexpression groups.Except for the control group,the remaining groups were deprived of oxygen and sugar for 2 h and then reoxygenated and reoxygenated for 24 h.EA serum,METTL3 and lncRNA H19 overexpression lentivirus were given at the same time of reoxygenation and reoxygenation.In this experiment,transendothelial cell resistance(TEER)and Na-F were used to detect the function of BBB;the colorimetry was perform to detect the quantification of total RNA m6A modification;Western blot was used to detect the METTL3,ZO-1,S1PR2,TLR4 and NLRP3 protein levels;and qPCR was used to detect the METTL3,ZO-1,lncRNA H19,S1PR2,TLR4,NLRP3 and NLRP3 mRNA levels.Results Compared with the model group,the TEER was increased(P<0.01);Na-F value was decreased(P<0.01);total RNA m6A modification level was decreased(P<0.01);METTL3,S1PR2,TLR4,NLRP3,and lncRNA H19 expression were downregulated(P<0.01),and ZO-1 protein and mRNA expression was upregulated(P<0.01)in the EA group.Compared with the EA group,the TEER was decreased(P<0.05);the Na-F value was increased(P<0.01);the level of total RNA m6A modification was increased(P<0.01),and the expression of METTL3,S1PR2,TLR4,NLRP3,and lncRNA H19 was were up-regulated(P<0.05),and ZO-1 protein and mRNA expression were down-regulated(P<0.01)in the EA combined METTL3 and lncRNA H19 overexpression groups.Conclusion EA serum has a protective role on the co-culture BBB model after oxygen-glucose deprivation,and this effect may be that EA regulates the methylation process of target gene lncRNA H19 through METTL3,thereby inhibiting the S1PR2/TLR4/NLRP3 signaling pathway,and attenuating the BBB injury after cerebral ischemia.

Objective To investigate the protective mechanism of electroacupuncture(EA)serum against blood-brain barrier(BBB)damage after ischemic stroke from regulating the S1PR2 pathway via m6A methylation of lncRNA H19.Methods Preparation of EA serum:the focal cerebral ischemia/reperfusion model rats were established,and three EA interventions were performed at 5 min after ischemia,24 h and 48 h after reperfusion,with acupuncture at Renzhong and Baihui acupoints for 30 min.EA serum was taken from the rats after the three EA interventions.Cellular experiments:The BBB model in which brain microvascular endothelial cells and pericytes were co-cultured was divided into five groups,including the control,model,EA,EA combined with METTL3 overexpression and EA combined with lncRNA H19 overexpression groups.Except for the control group,the remaining groups were deprived of oxygen and sugar for 2 h and then reoxygenated and reoxygenated for 24 h.EA serum,METTL3 and lncRNA H19 overexpression lentivirus were given at the same time of reoxygenation and reoxygenation.In this experiment,transendothelial cell resistance(TEER)and Na-F were used to detect the function of BBB;the colorimetry was perform to detect the quantification of total RNA m6A modification;Western blot was used to detect the METTL3,ZO-1,S1PR2,TLR4 and NLRP3 protein levels;and qPCR was used to detect the METTL3,ZO-1,lncRNA H19,S1PR2,TLR4,NLRP3 and NLRP3 mRNA levels.Results Compared with the model group,the TEER was increased(P<0.01);Na-F value was decreased(P<0.01);total RNA m6A modification level was decreased(P<0.01);METTL3,S1PR2,TLR4,NLRP3,and lncRNA H19 expression were downregulated(P<0.01),and ZO-1 protein and mRNA expression was upregulated(P<0.01)in the EA group.Compared with the EA group,the TEER was decreased(P<0.05);the Na-F value was increased(P<0.01);the level of total RNA m6A modification was increased(P<0.01),and the expression of METTL3,S1PR2,TLR4,NLRP3,and lncRNA H19 was were up-regulated(P<0.05),and ZO-1 protein and mRNA expression were down-regulated(P<0.01)in the EA combined METTL3 and lncRNA H19 overexpression groups.Conclusion EA serum has a protective role on the co-culture BBB model after oxygen-glucose deprivation,and this effect may be that EA regulates the methylation process of target gene lncRNA H19 through METTL3,thereby inhibiting the S1PR2/TLR4/NLRP3 signaling pathway,and attenuating the BBB injury after cerebral ischemia.