Attention deficit hyperactivity disorder （ADHD） is often accompanied by tic disorder. The core pathogenesis is considered to be ministerial fire scorching yin and internal stirring of deficient wind， which leads to disharmony between the body and spirit， resulting in clinical manifestations. The treatment principles emphasize nourishing yin fluids， calming ministerial fire， and extinguishing endogenous wind （内风）. The method of nourishing yin fluids is applied throughout the entire treatment process， commonly using ingredients such as Shudihuang （Rehmanniae Radix Praeparata）， Shanzhuyu （Corni Fructus）， Gouqizi （Lycii Fructus）， Wuweizi （Schisandrae Chinensis Fructus）， and Tusizi （Cuscutae Semen）. These are combined with approaches to harmonize the zang-fu organs， primarily including extinguishing liver wind， clearing heart fire， nourishing kidney water， and strengthening spleen earth， thereby stabilizing ministerial fire and extinguishing endogenous wind. Additionally， emotional regulation and smoothing emotional constraint are essential to improve clinical symptoms in children with ADHD comorbid with tic disorder.

Objective: To investigate the epidemiological characteristics and spatial-temporal clustering of varicella in Changchun City from 2020 to 2024, so as to provide the evidence for formulating local varicella prevention and control measures. Methods: The individual case data of varicella were collected through the Surveillance and Reporting Management System of the Chinese Disease Prevention and Control Information System in Changchun City from 2020 to 2024. Descriptive epidemiological methods were used to analyze the population ,regional, and temporal distribution. Spatial autocorrelation and spatio-temporal scanning analyses were used to identify the spatial-temporal clustering characteristics. Results: A total of 8 850 varicella cases were reported in Changchun City from 2020 to 2024, with an average annual incidence of 19.64/105. There were 4 929 male cases and 3 921 female cases, with a male-to-female ratio of 1.26∶1. The age was mainly 0-<20 years (6 649 cases, 75.13%), and students were the predominant occupation (6 036 cases, 68.20%). The top three counties (cities, districts) with the highest number of cases were Chaoyang District (1 944 cases), Gongzhuling City (1 054 cases) and Nanguan District (987 cases), accounting for 45.03%. The peak incidence periods were from April to June and from October to December, with 2 166 and 4 226 cases, accounting for 24.47% and 47.75%, respectively. Spatial autocorrelation analysis showed that spatial clustering existed from 2020 to 2024. The high-high clustering areas were mainly some townships (streets) in Chaoyang District, Nanguan District, Changchun New District and Jingyue District. Spatio-temporal scanning analysis identified 6 high-risk clustering areas. The class Ⅰ clustering area was Nanhu Street in Chaoyang District, with the clustering period from September 2020 to February 2022. Conclusions Varicella cases in Changchun City were mainly males and students aged 0-<20 years from 2020 to 2024. The peak incidence was mainly in winter. Chaoyang District was a high-risk area, with obvious spatial-temporal clustering.

BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

As a new type of production factor that can empower the development of new quality productivity, the data element is an important engine to promote the high quality development of the industry. Traditional Chinese medicine(TCM) dispensing is the most basic work of TCM clinical pharmacy, and its quality directly affects the clinical efficacy of TCM. The integration of data elements and TCM dispensing can stimulate the innovation and vitality of the TCM dispensing industry and promote the high-quality and sustainable development of the industry. A large-scale, detailed, and systematic study on TCM dispensing was conducted. The innovative practice path of data fusion construction in the whole process of TCM dispensing was investigated by integrating the digital resources "nine full activities" of TCM dispensing, creating the digital dictionary of "TCM clinical information data elements", and exploring innovative applications of TCM dispensing driven by data and technology, so as to promote the standardized, digital, and intelligent development of TCM dispensing in medical health services. The research content of this project was successfully selected as the second batch of "Data element×" typical cases of National Data Administration in 2024, which is the only selected case in the field of TCM.
Medicine, Chinese Traditional/methods* ; Drugs, Chinese Herbal ; Humans

Objective To investigate the characteristics of intestinal flora and its correlation with peripheral blood microinflammatory factors in patients with pulmonary tuberculosis complicated with diabetes mellitus(PTB-DM).Methods A total of 162 patients with PTB-DM admitted to the hospital from September 2022 to September 2024 were selected as the PTB-DM group,and another 150 healthy subjects who underwent physi-cal examinations during the same period in the hospital were selected as the control group.The clinical data of all research subjects was collected.The composition of intestinal flora of the research subjects was analyzed by using 16S rRNA gene sequencing technology.The levels of peripheral blood microinflammatory factors[inter-feron-γ(IFN-γ),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]in all research subjects were detected.The clinical data,composition of intestinal flora and levels of microinflammatory factors of the PTB-DM group were compared with those of the control group.Spearman correlation analysis was used to analyze the correlation between the relative abundance of intestinal flora and the levels of peripheral blood microin-flammatory factors in patients with PTB-DM.Results The relative abundances of Bacteroidales and Clostridi-ales in the PTB-DM group were significantly lower than those in the control group,while the relative abun-dances of Enterobacterales and Actinobacteriales were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of IFN-γ,IL-6 and TNF-α in the PTB-DM group were significantly higher than those in the control group,and the differences were statistically signifi-cant(P<0.05).The relative abundances of Bacteroidales and Clostridiales in the PTB-DM group were nega-tively correlated with the levels of IFN-γ,IL-6 and TNF-α.The relative abundances of Enterobacterales and Actinobacteriales were positively correlated with the levels of IFN-γ,IL-6 and TNF-α(all P<0.05).Conclu-sion There is a significant imbalance of intestinal flora in patients with PTB-DM,and the levels of microin-flammatory factors IFN-γ,IL-6 and TNF-α in peripheral blood are significantly increased,and are closely re-lated to the relative abundance of specific flora.

Objective:To investigate the feasibility and effectiveness of three-dimensional visualization technology in the precise diagnosis and treatment of locally advanced differentiated thyroid cancer(DTC).Methods:A retrospective analysis was conducted on the clinical data of 196 patients with locally advanced DTC treated at the 960th Hospital of the PLA from December 2021 to August 2023. The cohort included 71 male and 125 female patients, with a mean age of 43.7 years (rangd from 18 to 77 years). All patients underwent neck-enhanced CT scans and were divided into two groups: the study group( n=102), which underwent preoperative three-dimensional visualization of CT data, and the control group( n=94), which did not. Baseline data for both groups were matched using SPSS27.0 with 1∶1 propensity score matching (PSM) and the caliper value was 0.02. A total of 49 patients were included in each group, including 35 first-time surgeries and 14 reoperation. Among the 70 first-time surgeries, 29 patients underwent robotic surgery and 41 underwent open surgery. Among the 28 reoperations, 4 underwent robotic surgery and 24 underwent open surgery. In the study group, three-dimensional visual models were used to comprehensively evaluate the tumor and metastatic lesion size, spatial location, and adjacent relationship with surrounding organs, surgical treatments were guided by these models, whereas the control group relied on two-dimensional imaging for guidance. The clinical data were statistically analyzed using SPSS27.0. Results:All operations were successfully completed. There were no statistical differences in baseline data between the two groups( P>0.05). Among first-time surgeries, the study group showed shorter operation times [175(145, 200) min vs 205(182, 249) min, P<0.001], a lower incidence of postoperative chyle leak (0 vs 8.57%, P=0.027), a higher rate of robotic surgery (48.57% vs 34.28%, P=0.225), a greater number of harvested lymph nodes [46(40, 62) vs 37(28, 56), P=0.032], a greater number of cervical lymph node metastasis[15(7, 22) vs 5(1, 14), P=0.004] and a larger diameter of metastasis lymph nodes[12(10, 16) mm vs 4(1, 10) mm, P<0.001]. There were no significant differences in intraoperative blood loss, postoperative drainage days and incidence of hypoparathyroidism( P>0.05). During the reoperation, the study group had shorter operation times[103.5(95.0, 122.5) min vs 146.50(133.25, 172.25) min, P<0.001], less intraoperative blood loss[12.50(8.75, 22.50) mL vs 30.00(17.50, 35.00) mL, P=0.021], fewer postoperative drainage days[5.00(4.00, 6.00) d vs 6.00(5.00, 7.25) d, P=0.016] and a lower incidence of hypoparathyroidism(7.14% vs 42.86%, P=0.038).The robotic surgery rate was higher in the study group (21.42% vs 7.14%, P=0.596). There were no significant differences in lymph node dissection numbers, metastatic lymph node counts, or chyle leak incidences between the two groups ( P>0.05). No acute bleeding or incision infection occurred in any patient postoperatively. Conclusion:Three-dimensional visualization technology is an effective preoperative assessment method for evaluating the resectability of tumors and metastases lesions in locally advanced DTC. It enhances the accuracy and safety of surgery for locally advanced DTC.

The concept of harmony between heaven and man is an important concept in TCM. The theory of "harmful hyperactivity and responding inhibition" has been developed and perfected by medical professionals throughout history to explain physiological and pathological changes in humans based on a natural understanding. Guided by the TCM philosophy of "harmful hyperactivity and responding inhibition", it provides guidance for attention deficit hyperactivity disorder (ADHD). Sorting out the complex pathogenesis, it has been found that core pathogenesis of the disease is the excessive damage to the five organs, which leads to the overall state of yin deficiency and yang hyperactivity in the human body. The treatment mainly focuses on regulating the hyperactivity and damage of the organs, restoring the balance of yin and yang, while also taking into account the harm of pathological products. Based on clinical manifestations, the secondary selection of medication for liver and liver hyperactivity and spleen and kidney dysfunction has been determined, while improving the hyperactivity of the external environment, in order to achieve the goal of "tolerance is control", which fully embodies the TCM syndrome differentiation thinking of "unity of heaven and man, holistic concept".

There are a variety of mechanical signals in the microenvironment of cells,which have temporal and spatial variability,which jointly regulate the histological processes such as cell proliferation,differentiation and migration.Piezo1 is a mechanically sensitive cationic channel.As a force sensor,it transmits signals to downstream pathways and participates in a variety of life activities in response to changes in the cell microenvironment.In this paper,the common signal pathways of Piezo1 were reviewed in order to identify the downstream signaling pathways regulated by Piezo1,thereby providing theoretical basis for inhibiting or delaying related diseases.

Objective:To explore a systematic training for quick identification for diagnosis and treatment of the causes of reversible cardiac arrest,which was assisted by bedside ultrasound simulator combined with memory mnemonic,so as to improve the treatment skill of physicians for the causes of disease,and enhance the success rate of cardiopulmonary resuscitation.Methods:Thirty clinical resident doctors who were rotating in the emergency intensive care unit(ICU)of Xuanwu Hospital,Capital Medical University,from May 2023 to May 2024 were selected.The bedside ultrasound simulator combined with memory mnemonic was used to simulate training,which can improve the ability of resident doctors in quickly determining the cause of reversible cardiac arrest.The self-made questionnaire was used to investigate the baseline situation of resident doctors before they were trained,and the teaching effectiveness after they received training.After training,the grasping states of resident doctors for the cause of reversible cardiac arrest were detected through 10 kinds of clinical cases included pulmonary embolism,myocardial infarction,aortic dissection,pericardial tamponade,ventricular fibrillation,electrolyte disturbance,hypovolemic shock,tension pneumothorax,poisoning and hypothermia.Results:The duration of quick retelling of resident doctors for the causes of reversible cardiac arrest was(15.07±3.68)s after training,which was lower than(47.27±10.25)s before training,and the difference was significant(t=14.763,P<0.05).The awareness rate of them for the causes of reversible cardiac arrest was 100%after training,which was significantly higher than 3.33%before training,and the difference was significant(x2=56.129,P<0.05).The identification of resident doctor for ultrasonic image was zero basis before training,and the identification rate was 0%.All of resident doctors can achieve 100%identification for routine ultrasound,cardiac arrest,pericardial tamponade and ventricular fibrillation within the simulator after training,and the correct recognition rates of them for pulmonary embolism,tension pneumothorax,acute myocardial infarction and aortic dissection were respectively 86.67%,63.33%,70%and 66.67%.After training,the duration of correct recognition of resident doctors for pulmonary embolism,tension pneumothorax and acute myocardial infarction were respectively(58.77±19.61)s,(69.05±10.47)s and(75.52±10.51)s,all of which were less than the duration of incorrect recognition,and the differences were statistically significant(t=2.153,2.781,2.124,P<0.05).Conclusion:Ultrasound combined with memory mnemonic can help resident doctors to quickly establish the clinical thinking clue about hypoxia,hypovolemia,hypo/hyperkalemia,hypo/hyperthermia,hypo/hyperglycemia,tamponade cardiac,thrombosis pulmonary,thrombosis coronary,toxins,tension pneumothorax(5H5T)for the cause of reversible cardiac arrest,which will contribute to strengthen and improve the practical ability of clinician in quick judgement for reversible etiology.

Objective To explore the effect of the horticultural therapy in the elderly with mild cognitive impairment in elderly care institutions.Methods A convenient cluster sampling method was used.The study was conducted among the elderly with mild cognitive impairment in 2 nursing homes with 5A-level in Guangzhou,from March to September 2024.Using a lottery method,subjects from 2 nursing areas across 2 elderly care institutions were allocated to an experimental group,with the other 2 nursing areas serving as a control group,each group comprising 55 cases.The experimental group participated in horticultural therapy on the basis of control group interventions,while the control group was given routine care and daily leisure activities.The cognitive function,basic psychological needs and quality of life were compared between the 2 groups after the intervention.Results Eventually,37 cases in the experimental group and 38 cases in the control group completed the study.After the intervention,the cognitive function,basic psychological needs and quality of life in the experimental group were all better than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion The horticultural therapy program can delay the progression of cognitive decline in the elderly with mild cognitive impairment in nursing homes,meet their basic psychological needs and improve their quality of life.