Objective To explore the distribution of common TCM syndromes and symptoms of insomnia;To prepare for the construction of the theoretical framework and item pool of syndrome diagnosis and efficacy evaluation scale.Methods TCM guideline standards of insomnia,textbooks and journals over the years were retrieved,the information of TCM syndromes,syndrome elements and symptoms was extracted,the guideline textbook and journal database were established,and descriptive statistics,association rules,systematic clustering,factor analysis,potential categories and implicit structure analysis were carried out.Results Totally 116 guide standards and textbooks over the years were included,and 454 articles of journals were included.The high-frequency symptoms accounted for≥3%of the guide textbooks and journal databases were 87 and 79 categories,respectively,and the cumulative proportion was 87.48%and 87.75%,respectively.According to the analysis results,five common TCM syndromes and their characteristic symptom classification of insomnia were finally deduced.According to the frequency/person time distribution,they were heart and spleen deficiency syndrome,yin deficiency and fire hyperactivity syndrome,liver fire disturbing heart syndrome,phlegm heat disturbing heart syndrome,heart and gallbladder qi deficiency syndrome.Conclusion There are five common TCM syndromes of insomnia,and the characteristic symptoms of each TCM syndrome provide a reference source for the theoretical framework of syndrome diagnosis and efficacy evaluation scale and the establishment of item pool.

Objective To explore the distribution of common TCM syndromes and symptoms of insomnia;To prepare for the construction of the theoretical framework and item pool of syndrome diagnosis and efficacy evaluation scale.Methods TCM guideline standards of insomnia,textbooks and journals over the years were retrieved,the information of TCM syndromes,syndrome elements and symptoms was extracted,the guideline textbook and journal database were established,and descriptive statistics,association rules,systematic clustering,factor analysis,potential categories and implicit structure analysis were carried out.Results Totally 116 guide standards and textbooks over the years were included,and 454 articles of journals were included.The high-frequency symptoms accounted for≥3%of the guide textbooks and journal databases were 87 and 79 categories,respectively,and the cumulative proportion was 87.48%and 87.75%,respectively.According to the analysis results,five common TCM syndromes and their characteristic symptom classification of insomnia were finally deduced.According to the frequency/person time distribution,they were heart and spleen deficiency syndrome,yin deficiency and fire hyperactivity syndrome,liver fire disturbing heart syndrome,phlegm heat disturbing heart syndrome,heart and gallbladder qi deficiency syndrome.Conclusion There are five common TCM syndromes of insomnia,and the characteristic symptoms of each TCM syndrome provide a reference source for the theoretical framework of syndrome diagnosis and efficacy evaluation scale and the establishment of item pool.

[Objective]To summarize Professor YU Tugen's clinical experience in treating oral lichen planus(OLP).[Methods]Through apprenticeship and clinical following up,medical cases data are documented,collated and analyzed.Simultaneously,by combining research on the pathogenesis of OLP from domestic and international sources,the experiences of Professor YU Tugen in treating OLP are summarized and compiled.The etiology,pathogenesis,principles,methods of treatment and daily care approaches for OLP are comprehensively summarized.Additionally,one clinical case is provided for validation.[Results]OLP is a multifaceted condition,regarded by Professor YU Tugen as an intricate interplay of intrinsic and extrinsic factors rooted in the symbiotic relationship between the spleen and stomach.Pathogenic elements such as heat accumulation,Yin deficiency and emotional perturbations are implicated in its etiology.Therapeutic interventions prioritize the clearance of heat and dampness,fortification of the spleen and stomach and consideration of psychosocial factors,with pharmacological strategies tailored to individual presentations.Proactive health promotion strategies,underscored by the precept of disease prevention,are advocated.A clinical vignette was exemplified for favorable treatment outcomes targeting spleen deficiency and damp-heat oral ulcers.[Conclusion]Professor YU Tugen's treatment of OLP emphasizes the priority of clearing heat and eliminating dampness,with a foundational focus on invigorating the spleen.He pays attention to psychological factors,supplementing the approach with methods to nourish Yin,moisten dryness,resolve emotional stagnation and dispel blood stasis.The therapeutic outcomes have been remarkably positive,offering valuable insights for study and reference.

Objective:To study the influencing factors of postoperative complications in patients with malignant biliary obstruction treated by endoscopic radiofrequency ablation(RFA).Methods:Data of patients with malignant biliary obstruction who underwent endoscopic RFA at the Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine from January 2010 to June 2021 were retrospectively analyzed. There were 62 males and 48 females, with age (74.1±11.1) years. Based on occurrence of postoperative complications, these patients were divided into the complication group ( n=18) and the control group ( n=92). Univariate and multivariate logistic regression analysis were used to analysis the influencing factors of complications. Results:RFA was successfully performed in 110 patients with malignant biliary obstruction, and the technical success rate was 100.0% (110/110). Postoperative complications occurred in 18 patients (16.4%), including 12 patients with of biliary tract infection (8 patients with acute cholangitis, 4 patients with acute cholecystitis) and 6 patients with acute pancreatitis. All these patients responded well to treatment. The proportion of patients who developed complications having associated diabetes, bile duct stenosis length >2.5 cm, fractional RFA for bile duct stenosis, and single stent drainage were significantly higher than those in the control group (all P<0.05). Multivariate logistic regression analysis showed that the risk of complications after endoscopic RFA was significantly increased in patients with diabetes ( OR=6.967, 95% CI: 1.256-38.658) and fractional RFA of bile duct stenosis ( OR=8.297, 95% CI: 1.526-45.122), while the risk of complications after multiple stents drainage ( OR=0.037, 95% CI: 0.008-0.169) was significantly decreased (all P<0.05). Conclusion:Diabetes and fractional RFA of bile duct stenosis were risk factors for complications after endoscopic RFA of malignant biliary obstruction. Multiple stents drainage was a protective factor. Better clinical attention should be paid to the patients with high risk factors.

Objective To investigate the incidence rate, pathologic changes, mechanisms and diagnostic methods in renal bone disease.Methods The blood levels of carboxyterminal parpthyriod hormone (C-PTH), 1,25(OH)2D3, calcium and phosphate, aluminum in serum and bone tissue were measured. The bone biopsy and bone scan with 99m technetium methylene diphosphonate (99m TC-MDP) were performed in 51 uremic patients.Results One hundred per cent of the patients had varying degree of pathologic changes in bone, in which 50.9% of the patients presented high-turnover bone disease, 7.8% of the patients presented lowe-turnover bone disease and 41.8% of the patients had mixed-type bone disease. The levels of serum C-PTH were predominently high in high-turnover bone disease while the levels of serum 1,25(OH)2D3 were significantly decreased in low-turnover bone disease. There was a high positive rate for the diagnosis of renal bone disease by bone scan with 99m TC-MDP.Conclusions The examination of bone pathology is the most valuable method for the diagnosis of renal bone disease. Bone scan with 99m TC-MDP has reference value when clinical conditions do not allow to make bone biopsy.