Objective Based on the assumption of spatial heterogeneity,the distribution pattern and risk characteristics of health poverty in middle-aged and elderly people with chronic diseases are described from the perspective of spatial differentiation.In order to providing a theoretical basis for the optimization of subsequent poverty reduction policies and a model policy for other countries.Methods It used factor detector and interaction detector to capture the role of single-factor and multi-factor interactions on the spatial differentiation of health poverty,and risk detectors were utilized to explore the high-risk factors in risky areas Results The single factor explanation of medical assistance and health education activities is prominent,and the factors such as PM2.5,old-age dependency ratio and urban unemployment rate have strong interaction.Furthermore,it identified high-risk factor characteristics in areas at high risk of health poverty.Conclusion The spatial differentiation pattern of health poverty among the middle-aged and elderly chronic disease population in China is the result of the synergistic driving effect of multidimensional factors,and there is variability in the risk characteristics among regions.The government should establish a contextual optimization strategy and pay attention to the joint effect of multiple factors to establish a synergistic management system.

Objective Based on the assumption of spatial heterogeneity,the distribution pattern and risk characteristics of health poverty in middle-aged and elderly people with chronic diseases are described from the perspective of spatial differentiation.In order to providing a theoretical basis for the optimization of subsequent poverty reduction policies and a model policy for other countries.Methods It used factor detector and interaction detector to capture the role of single-factor and multi-factor interactions on the spatial differentiation of health poverty,and risk detectors were utilized to explore the high-risk factors in risky areas Results The single factor explanation of medical assistance and health education activities is prominent,and the factors such as PM2.5,old-age dependency ratio and urban unemployment rate have strong interaction.Furthermore,it identified high-risk factor characteristics in areas at high risk of health poverty.Conclusion The spatial differentiation pattern of health poverty among the middle-aged and elderly chronic disease population in China is the result of the synergistic driving effect of multidimensional factors,and there is variability in the risk characteristics among regions.The government should establish a contextual optimization strategy and pay attention to the joint effect of multiple factors to establish a synergistic management system.

In recent years， the research data on the combination model of insomnia of liver depression and qi stagnation syndrome in traditional Chinese medicine （TCM） were sorted out and summarized in terms of the selection of experimental animals， modelling methods， and model evaluation， with a view to providing references for the standardized preparation of the experimental model of insomnia of liver depression and qi stagnation syndrome and the study of the intervention mechanism. As for the selection of experimental animals， rats and mice are commonly used for the study of sleep patterns in the insomnia model of liver depression and qi stagnation syndrome because their sleep patterns are similar to those of human beings； zebrafish is suitable for the study of sleep patterns in early development because of its high genetic homology； and rhesus macaques， common marmosets， and crab-eating monkeys are used for the study of highly complex sleep disorders because their physiological and behavioural characteristics are closer to those of human beings. In terms of modelling methods， electrical stimulation， chronic restraint， chronic emotional stress and impact psychological stress each have their own characteristics and application scenarios， while chronic tail-clamping stimulation combined with intraperitoneal injection of p-chlorophenylalanine （PCPA） combines physical and chemical stimuli， in order to simulate the complex mechanism of insomnia in human beings， and to more comprehensively simulate the pathology of insomnia with liver depression and qi stagnation syndrome. In terms of evaluation indexes， electroencephalography （EEG） and electromyography （EMG） monitoring and barbiturate synergistic sleep test are the most commonly used and scientific methods for evaluating insomnia animal models with liver depression and qi stagnation syndrome， which can provide intuitive and continuous sleep state monitoring； barbiturate synergistic sleep test can reflect the sensitivity and responsiveness of the model animals to the sleep-regulating medications； and the introduction of the method of using formulas to measure syndromes for the evaluating the model can combine the treatment and diagnostic principles of TCM with modern scientific research.

Objective To investigate the dietary patterns of rural residents in the high-incidence areas of esophageal cancer (EC), and to explore the clustering and influencing factors of risk factors associated with high-incidence characteristics. Methods A special structured questionnaire was applied to conduct a face-to-face survey on the dietary patterns of rural residents in Yanting county of Sichuan Province from July to August 2021. Univariate and multivariate logistic regression models were used to analyze the influencing factors of risk factor clustering for EC. Results There were 838 valid questionnaires in this study. A total of 90.8% of rural residents used clean water such as tap water. In the past one year, the people who ate fruits and vegetables, soybean products, onions and garlic in high frequency accounted for 69.5%, 32.8% and 74.5%, respectively; the people who ate kimchi, pickled vegetables, sauerkraut, barbecue, hot food and mildew food in low frequency accounted for 59.2%, 79.6%, 68.2%, 90.3%, 80.9% and 90.3%, respectively. The clustering of risk factors for EC was found in 73.3% of residents, and the aggregation of two risk factors was the most common mode (28.2%), among which tumor history and preserved food was the main clustering pattern (4.6%). The logistic regression model revealed that the gender, age, marital status and occupation were independent influencing factors for the risk factors clustering of EC (P<0.05). Conclusion A majority of rural residents in high-incidence areas of EC in Yanting county have good eating habits, but the clustering of some risk factors is still at a high level. Gender, age, marital status, and occupation are influencing factors of the risk factors clustering of EC.

Objective To investigate the role of transcranial magnetic stimulation(TMS)in the modulation of abnormal functional status and damage characteristics of key brain regions in adult patients with anisometropic amblyopia via the resting-state functional magnetic resonance imaging(rs-fMRI)technique.Methods Single(left)eyes of 20 adult refractive amblyopia patients were included in this study and randomly divided into a surgical group[Implantable Collamer Lens(ICL)surgery]and a TMS combined group(TMS treatment on top of the surgical group),with 10 patients in each group.In both groups,the visual a-cuity of patients was examined before and after treatment via international standard visual acuity charts to evaluate the therapeu-tic effect.Moreover,patients in both groups underwent an fMRI examination once before and after treatment,and local coher-ence(ReHo),amplitude at low frequency(ALFF),and ratio amplitude at low frequency(fALFF)algorithms were used to char-acterize the functional state and response characteristics of the brain regions in the acquired f MRI images.Results Compared with that before treatment,the visual acuity of patients in both groups significantly improved after treatment and was signifi-cantly greater than the pretreatment corrected visual acuity(P＜0.05).Compared with that in the two groups after treatment,the improvement in visual acuity in the TMS combined group was greater than that in the surgical group(P＜0.05).There was no difference in the ReHo or fALFF values before and after treatment between the TMS combined group and surgical group.Compared with those before treatment,the ipsilateral frontal ALFF values were increased in the surgical group after treatment,and the ipsilateral cerebellar ALFF values were decreased in the TMS combined group.Compared with those in the surgical group,the ipsilateral frontal lobe and superior frontal gyrus ReHo values decreased,the contralateral temporal lobe and superior temporal gyrus ALFF values decreased,and the contralateral occipital lobe and cuneiform lobe fALFF values increased after treatment in the TMS combined group(all P＜0.05).Conclusion The improvement in spontaneous brain activity in pa-tients with anisometropic amblyopia in the surgical group and in the TMS combined group was significant.ICL implantation may act by activating the ipsilateral frontal lobe,ICL implantation in combination with TMS may act by improving cerebellar func-tion,increasing the excitability of the contralateral occipital and cuneate lobes,modulating neuronal activity in the adjacent cor-tex of the occipital lobe and in the other visually related cortices(ipsilateral frontal and contralateral temporal lobes),and correc-ting the difference in excitability between the two eyes of the patients.and correcting the excitability differences between the pa-tient's two eyes.

Objective:To observe the effects of liver-soothing spirit-regulating acupuncture on the behaviors and expression levels of 5-hydroxytryptamine receptor 1A(5-HT1AR)and 5-hydroxytryptamine receptor 2A(5-HT2AR)in the hippocampus of insomnia rats due to liver Qi stagnation. Methods:Ten of the 70 Wistar rats were randomly selected as the blank group,and the remaining rats were subjected to preparing the insomnia model due to liver Qi stagnation by the chronic tail clamping stimulation combined with intraperitoneal injection of para-chlorophenyl alanine.Fifty successful model rats were randomly divided into a model group,a grasp group,a Western medicine group,an acupuncture group,and a sham acupuncture group,with 10 rats in each group.Rats in the grasp group were grabbed in the same way as those in the acupuncture group.Rats in the Western medicine group were given estazolam solution by intragastric administration.Rats in the acupuncture group received liver-soothing spirit-regulating acupuncture at Baihui(GV20),Neiguan(PC6),Shenmen(HT7),and Taichong(LR3);rats in the sham acupuncture group received acupuncture at 4 non-meridian non-point spots.All groups were treated once a day for 7 d.Pentobarbital sleep test was used to evaluate the sleep latency(SL)and sleep time(ST)of rats in each group after 7 d of intervention;the proportion of the number of entry into the open arms(OE％)and the proportion of the residence time in the open arms(OT％)were monitored by elevated plus maze test(EPMT);the open field test(OFT)was used to monitor the numbers of standing upright,horizontal cross-grid,and fecal grains in rats.The expression levels of 5-HT1AR and 5-HT2AR in rat hippocampus were detected by Western blotting. Results:The body mass gain,ST,OE％,OT％,upright standing times,horizontal cross-grid times,and the 5-HT1AR expression level in the hippocampus were significantly decreased(P<0.01),while the SL and 5-HT2AR expression level in the hippocampus were significantly increased(P<0.01)in the model group compared with the blank group.After intervention,the body mass,ST,OT％,OE％,upright standing times,horizontal cross-grid times,and hippocampal 5-HT1AR expression level were significantly increased(P<0.01 or P<0.05),while the SL and hippocampal 5-HT2AR expression level were significantly decreased(P<0.01 or P<0.05)in the acupuncture group and the Western medicine group compared with the grasp group.Compared with the Western medicine group,OT％,SL,and hippocampal 5-HT1AR expression level were significantly increased in the acupuncture group(P<0.05).The body mass,OT％,OE％,ST,upright standing times,horizontal cross-grid times,and the 5-HT1AR expression level in the hippocampus were significantly increased(P<0.01),while the SL and 5-HT2AR expression level in the hippocampus were significantly decreased(P<0.01)in the acupuncture group compared with the sham acupuncture group. Conclusion:Liver-soothing spirit-regulating acupuncture can not only improve sleep but also improve the abnormal behaviors and mood of insomnia rats due to liver Qi stagnation,and the improvement effect on abnormal mood is better than that of Western medicine.The mechanism may be related to the regulation of 5-HT1AR and 5-HT2AR

ObjectiveTo explore the efficacy of acupuncture intervention for children with monocular refractive-parallax amblyopia and the possible mechanisms of brain function based on resting-state functional magnetic resonance （rs-fMRI）. MethodsSeventy-six children with anisometropic amblyopia were randomly divided into routine treatment group （38 cases） and acupuncture treatment group （38 cases）. In the conventional group， the children were given three regular treatments of red flash， grating and visual stimulation for 5 mins each time； in the acupuncture group， on the basis of the conventional treatment， the children were given acupuncture for 20 mins each time on bilateral Jingming （BL 1）， Cuanzhu （BL 2）， Guangming （GB 37） and Fengchi （GB 20）； the children in both groups were treated once every other day and three times a week for 4 weeks. The corrected visual acuity was compared between groups before and after treatment. Fifteen children with left-sided refractive amblyopia were randomly selected from each of the above two groups and underwent brain rs-fMRI scans before and after treatment， and 10 healthy children with normal visual acuity of the matched gender and age were included in the normal group and underwent brain rs-fMRI scans. Based on the activation likelihood estimation （ALE） method， we constructed the what visual pathway network， and compared and analyzed the spherical regions of interest （ROIs） of the children with normal children， and both groups of children with differences in functional connectivity （FC values） within the what pathway in the brain before and after treatment. ResultsTwo cases dropout in the acupuncture group， and finally 36 cases in the acupuncture group and 38 cases in the conventional group were included in the analysis. Compared with before treatment， the best corrected visual acuity of amblyopia in both groups was significantly improved after treatment （P＜0.05）， and the improvement of vision in the acupuncture group was significantly better than that in the conventional group （P＜0.05）. The results of rs-fMRI showed that the FC values of the primary optic cortex and the right fusiform gyrus， the left lingual gyrus and the right fusiform gyrus， and the right infraoccipital gyrus and the right middle temporal gyrus were significantly elevated in the brain of the refractive amblyopia children with the whitepathic amblyopia， compared with that of the normal children （P＜0.05）. The FC values of the left lingual gyrus， the right suboccipital gyrus with the right fusiform gyrus， the left lingual gyrus with the right middle temporal gyrus， the right and left lateral middle occipital gyrus， and the right and left lateral middle occipital gyrus with the right suboccipital gyrus were significantly （P＜0.05） lower in the conventional group compared with those in the conventional group before treatment. Compared with that before acupuncture treatment， the FC values of the right lingual gyrus and the right fusiform gyrus， the primary visual cortex and the right middle temporal gyrus increased significantly after acupuncture treatment （P＜0.05）， and the FC values of the left inferior occipital gyrus and the right middle temporal gyrus， the FC values of the left lingual gyrus and the right middle occipital gyrus decreased significantly （P＜0.05）. Compared between groups after treatment， the FC between the left suboccipital gyrus and the right fusiform gyrus in the acupuncture group was significantly higher than that in the conventional group （P＜0.05）， and the FC between the left middle occipital gyrus and the right and left suboccipital gyrus was significantly lower than that in the conventional group （P＜0.05）. ConclusionAcupuncture can significantly improve the corrected vision of anisometropic amblyopic children， and its effect mechanism may focus on regulating the occipito-temporal interlobular functional connectivity within the what pathway， thus improving the children's visual function of shape and color vision and visual learning and memory ability.

Objective:To investigate the relationship between single nucleotide polymorphism (SNPs) of Zeste homolog enhancer 2 (EZH2) gene and the risk of breast cancer.Methods:Recruiting 1 039 breast cancer patients and 1 040 controls at 22 referral hospitals nationwide in China, the genotype distribution of 3 SNPs loci of EZH2 genes was observed to detect the correlation between different genotypes and the risk of breast cancer genotypes EZH2 expression in breast cancer tissues and its correlation with patient prognosis were analyzed using breast cancer data from the database.Results:EZH2 rs6464926 CC genotype was compared with TT genotype (TT vs. CC: OR=1.362, 95% CI: 1.063-1.746, P=0.015) and dominant model (TC+TT vs .CC: OR=1.22, 95% CI: 1.004-1.483, P=0.045) .In women with BMI ≥24 kg/m 2, the TC genotype ( P=0.050), TT genotype ( P=0.025) and dominant model (TC+TT, P=0.021) of rs6464926 locus were significantly different from CC genotype in cancer risk. rs6464926 was correlated with EZH2 gene expression ( P=6.89E-47). EZH2 gene is highly expressed in breast cancer tissues, and patients with high expression were associated with shorter OS ( HR=1.27, P=0.013), DMFS ( HR=1.37, P<0.01), and RFS ( HR=1.44, P<0.01). Conclusions:The polymorphism rs6464926 of EZH2 gene is associated with breast cancer susceptibility in Chinese women. rs6464926 might regulate breast cancer risk and prognosis by changing EZH2 expression.

Pain is a complex physiological and psychological activity, involving at least three dimensions, including pain sensation, pain emotion, and pain cognition. Acupuncture can clearly relieve the pain sensation of patients and improve pain emotion and pain cognition induced by pain; acupuncture participates in the multi-dimensional regulation of pain through brain regions of the limbic system such as anterior cingulate cortex (ACC), amygdala (AMY), and hippocampus. By analyzing relevant literature, it has been found that the regulation of acupuncture on pain emotion is mainly related to the activation of pertinent opioid receptors in the ACC, the decrease of the expression of extracellular signal-regulated kinase (ERK), and the promotion of the expression of glutamic acid (Glu) A1, metabotropic glutamate receptor-1 (mGluR1), and γ-aminobutyric acid aminobutyric acid (GABA) B2 protein in the AMY. The regulation of acupuncture on pain cognition is mainly related to the elevation of the expression of protein kinase A (PKA) and phospho-p38 mitogen-activated protein kinase (phospho-p38 MAPK) and the inhibition of cyclic adenosine monophosphate (cAMP)/PKA/cAMP response element-binding protein (CREB) signaling pathway in the ACC.