This paper introduces Professor LIU Zhibin 's clinical experience in the treatment of subjective tinnitus with acupuncture based on the "kidney-bone-brain" axis. Professor LIU proposes that the disease is most closely related to the kidney and brain. The lesion is located in the brain, and the pathogenesis is kidney essence deficiency, marrow sea loss, and ear orifice dystrophy. The "kidney-bone-brain" shows close correlation in physiological function, pathological changes and treatment. According to the "kidney-bone-brain" axis, Professor LIU proposes that the treatment of subjective tinnitus should be tonifying kidney qi, tonifying essence and filling marrow, and the principle of local acupoint selection, touching bone acupuncture, matching distal acupoints and proximal acupoints, tonifying kidney and benefiting brain should be adopted. The acupoints of Tinggong (SI19) and Yifeng (TE17) are selected to be treated with touching bone acupuncture, combined with Taixi (KI3), Shenshu (BL23), Baihui (GV20) and Shenting (GV24), so as to achieve common benefit of kidney, bone and brain, and multi-angle treatment.
Humans ; Acupuncture Therapy/history* ; Tinnitus/physiopathology* ; Acupuncture Points ; Kidney/physiopathology* ; Brain/physiopathology* ; Bone and Bones/physiopathology* ; Female ; Male ; Adult ; Middle Aged

Objective:To evaluate our self-designed guide device for Kirschner-wire placement in the surgery for paediatric fractures of supracondylar humerus.Methods:A retrospective study was conducted of the 117 children who had been treated for fractures of supracondylar humerus at Department of Orthopedics, The First People's Hospital of Huaian Affiliated to Nanjing Medical University from March 2019 to January 2023. There were 64 boys and 53 girls with an age of (5.8±1.5) years. By the Gartland classification, there were 67 fractures of type Ⅱ and 50 fractures of type Ⅲ. The time from injury to operation averaged (48.5±10.8) hours. The children were divided into 2 groups according to how their Kirschner-wires were placed. In the control group of 58 cases, external percutaneous Kirschner-wire placement was assisted using a syringe needle; in study group of 59 cases, external percutaneous Kirschner-wire placement was assisted using our self-designed guide device for Kirschner-wire placement. The operation time, rate of one-time placement of disposable K-wire, intraoperative fluoroscopy frequency, Baumann angle, carrying angle, fracture healing time, Flynn score of elbow joint function at the final follow-up, and postoperative complications were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The 117 pediatric patients were followed up for (15.3±3.2) months after operation. The operation time [(30.6±4.5) min] and intraoperative fluoroscopy frequency [(15.6±2.1) times] in the study group were significantly less than those in the control group [(40.6±7.3) min and (23.7±4.9) times], while the rate of one-time placement of disposable K-wire in the study group was significantly higher than that in the control group [84.2%(149/177) versus 32.2%(56/174)] ( P<0.05). There were no significant differences in Baumann angle, carrying angle, fracture healing time, or Flynn score of elbow joint function at the final follow-up between the 2 groups ( P>0.05). The incidence of complications in the study group (6.8%, 4/59) was significantly lower than that in the control group (20.7%, 12/58) ( P<0.05). Conclusions:Our self-designed guide device for Kirschner-wire placement is simple and convenient to use. In the surgery for paediatric fractures of supracondylar humerus, it can improve the rate of one-time placement of disposable K-wire, reduce intraoperative fluoroscopy, and decrease the incidence of complications.

Objective:To analyze the relationship between serum inflammatory factors and prognosis in children with severe hand, foot and mouth disease (HFMD).Methods:According to the severity of the disease, 100 children with HFMD-treated in the Xingtai Third Hospital from June 2022 to December 2023 were divided into severe group (38 cases) and mild group (62 cases), and 52 children admitted for physical examination during the same period were selected as the control group for retrospective analysis. Serum levels of inflammatory factors in the three groups were compared, Pearson correlation was used to analyze the relationship between the severity of the disease and the levels of inflammatory factors in the three groups, the levels of inflammatory factors in the mild group and the severe group with different prognosis after treatment were compared, and the factors affecting the prognosis of the children with HFMD were analyzed by multivariate logistic regression.Results:The levels of interleukin 2, 6, 10, 17 (IL-2, IL-6, IL-10, IL-17), tumor necrosis factor-α (TNF-α), interferon-α (IFN-α), interferon-γ (IFN-γ) in the severe group before treatment [(7.89±2.04)ng/L, (59.15±14.21)ng/L, (81.54±12.54)ng/L, (59.63±12.17)ng/L, (33.74±9.55)ng/L, (91.37±23.44)ng/L, (116.48±15.77)ng/L] were higher than those in the mild and the control groups ( P<0.05). The levels of IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ in the mild group [(4.77±1.12)ng/L, (28.68±8.12)ng/L, (45.41±11.28)ng/L, (36.77±10.29)ng/L, (22.45±6.68)ng/L, (68.42±15.99)ng/L, (39.58±9.45)ng/L] were higher than those in the control group (all P<0.05). Pearson correlation analysis showed that the severity of HFMD was positively correlated with IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ (all P<0.05). After treatment, the levels of serum IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ of the children with poor prognosis in the mild and severe groups were higher than those of the children with good prognosis (all P<0.05). Logistic regression analysis showed that IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α, IFN-γ were the risk factors affecting the prognosis of children with severe HFMD ( OR=2.370, 1.937, 2.065, 2.344, 2.264, 2.370, 2.020, all P<0.05). Conclusions:With the occurrence and aggravation of HFMD, the level of inflammatory factors in children shows an increasing trend, which is a risk factor affecting prognosis and can predict the therapeutic effect to a certain extent.

Objective:To analyze the relationship between serum inflammatory factors and prognosis in children with severe hand, foot and mouth disease (HFMD).Methods:According to the severity of the disease, 100 children with HFMD-treated in the Xingtai Third Hospital from June 2022 to December 2023 were divided into severe group (38 cases) and mild group (62 cases), and 52 children admitted for physical examination during the same period were selected as the control group for retrospective analysis. Serum levels of inflammatory factors in the three groups were compared, Pearson correlation was used to analyze the relationship between the severity of the disease and the levels of inflammatory factors in the three groups, the levels of inflammatory factors in the mild group and the severe group with different prognosis after treatment were compared, and the factors affecting the prognosis of the children with HFMD were analyzed by multivariate logistic regression.Results:The levels of interleukin 2, 6, 10, 17 (IL-2, IL-6, IL-10, IL-17), tumor necrosis factor-α (TNF-α), interferon-α (IFN-α), interferon-γ (IFN-γ) in the severe group before treatment [(7.89±2.04)ng/L, (59.15±14.21)ng/L, (81.54±12.54)ng/L, (59.63±12.17)ng/L, (33.74±9.55)ng/L, (91.37±23.44)ng/L, (116.48±15.77)ng/L] were higher than those in the mild and the control groups ( P<0.05). The levels of IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ in the mild group [(4.77±1.12)ng/L, (28.68±8.12)ng/L, (45.41±11.28)ng/L, (36.77±10.29)ng/L, (22.45±6.68)ng/L, (68.42±15.99)ng/L, (39.58±9.45)ng/L] were higher than those in the control group (all P<0.05). Pearson correlation analysis showed that the severity of HFMD was positively correlated with IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ (all P<0.05). After treatment, the levels of serum IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α and IFN-γ of the children with poor prognosis in the mild and severe groups were higher than those of the children with good prognosis (all P<0.05). Logistic regression analysis showed that IL-2, IL-6, IL-10, IL-17, TNF-α, IFN-α, IFN-γ were the risk factors affecting the prognosis of children with severe HFMD ( OR=2.370, 1.937, 2.065, 2.344, 2.264, 2.370, 2.020, all P<0.05). Conclusions:With the occurrence and aggravation of HFMD, the level of inflammatory factors in children shows an increasing trend, which is a risk factor affecting prognosis and can predict the therapeutic effect to a certain extent.

OBJECTIVE To study the intervention effect and mechanism of Zhongfeng yure decoction on ischemic stroke model rats. METHODS Totally 85 rats were randomly divided into sham operation group （normal saline， n＝15）， model control group （normal saline， n＝18）， Nimodipine tablet group （positive control， 10.8 mg/kg， n＝18）， high-dose group of Zhongfeng yure decoction （20.52 g/kg， n＝17） and low-dose group of Zhongfeng yure decoction （5.13 g/kg， n＝17）， respectively. After 7 days of preventive continuous administration （once a day）， except for the sham operation group， the rats’ middle cerebral artery occlusion （MCAO） model was established by the modified suture method in other groups. After modeling， the rats in each group continued to be administered for 3 days. During experiment， general condition of the rats was observed， and the neurological function score was performed. After the last administration， the organ index was calculated， the cerebral infarction area and pathological changes of brain tissue were observed. The levels of tumor necrosis factor-α （TNF-α） and interleukin 6 （IL-6） in brain tissue and serum， and the average optical density value of caspase-3 and phosphorylated protein kinase B（p-AKT） protein in brain tissue were detected. RESULTS Three days after modeling， compared with sham operation group， the neurological function score， in brain tissue index， spleen tissue index， proportion of cerebral infarction area， the levels of TNF-α and IL-6 in brain tissue and serum， and the average optical density value of caspase-3 protein in brain tissue were significantly increased in the model control group （P＜0.05 or P＜0.01）； karyopyknosis， diffuse edema and other lesions appeared in brain tissue. Compared with the model control group， the above indexes in each administration group were improved to varying degrees. Among them， there were significant regression in brain tissue index， spleen tissue index， proportion of cerebral infarction area， TNF-α level in brain tissue and serum， and the average optical density values of caspase-3 protein and p-AKT protein in brain tissue of rats in high-dose group of Zhongfeng yure decoction （P＜0.05 or P＜0.01）. CONCLUSIONS Zhongfeng yure decoction has a certain intervention and therapeutic effect on MCAO model rats. The mechanism may be to reduce the secretion of inflammatory factors TNF-α and IL-6， down-regulate the expression of caspase-3 protein in ischemic brain tissue， up-regulate the expression of p-AKT protein， so as to protect the neurons.

Objective To observe the effect of combined opioid-free and loco-regional anesthesia on the quality of recovery after retrolaparoscopic renal surgery.Methods Sixty patients undergoing elective retrolaparoscopic renal surgery were divided into two groups(30 patients per group):the opioid-free anesthesia group(OFA group)and conventional anesthesia group with opioid(OA group)u-sing the random number table method.Both groups underwent ultrasound-guided anterior quadratus lumbar block(QLB)30minutes be-fore induction of anesthesia.In the OFA group,dexmedetomidine was given before induction,and induction was performed with propofol,midazolam,esketamine,and rocuronium,maintained with dexmedetomidine,propofol,sevoflurane anesthesia,and intermittent push of esketamine.In the OA group,propofol,midazolam,sufentanil,and rocuronium were given to induce anesthesia and maintained with remifentanil,propofol,and sevoflurane.Both groups were given intravenous self-administered analgesia after surgery.The mean arterial pressure(MAP)and heart rate(HR)at different time points,and the resting and motor VAS scores at 2,6,12,24 and 48h after sur-gery were recorded.QoR-40 was used to compare the quality of recovery at 24 hours after surgery between the two groups,and adverse effects and recovery of patients were recorded.Results QoR-40 scores were higher in the OFA group than that in the OA group(P＜0.05).Postoperative pain,postoperative opioid consumption,and incidence of nausea and vomiting were reduced in the OFA group(P＜0.05);and time to first ambulation,first exhaustion,and length of hospital stay were all reduced(P＜0.05).Conclusion Opioid-free anesthesia combined with quadratus lumbar block can significantly improve the quality of postoperative recovery,reduce postoperative pain,reduce postoperative opioid drug consumption,and promote postoperative recovery in patients undergoing retrolaparoscopic renal surgery.

Animals ; Glycyrrhiza/adverse effects* ; Plant Extracts/toxicity* ; Rats ; Rats, Sprague-Dawley ; Sargassum

ObjectiveTo evaluate the methodological quality of traditional Chinese medicine （TCM） diagnosis and treatment guidelines/consensus of constipation with Appraisal of Guidelines for Research and Evaluation Ⅱ （AGREE Ⅱ）tool， and to study the attention situation of the included Chinese patent medicines in China's National Reimbursement Drug List in the guidelines/consensus. MethodThe data of CNKI，VIP，Wanfang Data，SinoMed，PubMed and Cochrane from the inception of the databases to October 2021 were searched to collect the TCM diagnosis and treatment guidelines/consensus of constipation. Then，the diagnosis and treatment standards and recommended Chinese patent medicines were extracted. Two researchers assessed the methodological quality of the guidelines/consensus with AGREE Ⅱ tool independently. The quality of reports was evaluated by Reporting Items for practice Guidelines in HealThcare （RIGHT） Statement. The recommended Chinese patent medicines in the guidelines/consensus were compared with those in the National Reimbursement Drug List. ResultEleven consensus and 2 guidelines were included，involving 794 experts. The scores of AGREE II were clarity of presentation（59.0%），scope and purpose（44.0%），stakeholder involvement（23.1%），rigor of development （12.1%），applicability （11.1%），and editorial independence （8.3%） from high to low. Five articles were recommended at B level（recommended after revision） and 8 articles were at C level （not recommended）. The average scores of RIGHT Statement were as follows：basic information （93.59%），background （57.69%），evidence （18.46%），recommendations （20.88%），review and quality assurance （19.23%），funding，declaration and management of interests （0.00%）， and other information （0.00%）. The included guidelines/consensus recommended a total of 27 Chinese patent medicines，among which 20 were included in the National Reimbursement Drug List，with 4 species of Class A and 16 species of Class B， accounting for 74.1% of all recommended Chinese patent medicines. Ten purgative Chinese patent medicines in the National Reimbursement Drug List were recommended by the guidelines/consensus，accounting for 50% of all purgative drugs， and 8 were not recommended. There were prescriptions for purgation， for promoting digestion and removing food stagnation， for clearing heat and purging fire，and for warming the middle and dissipating cold，Tibetan medicine and Mongolian medicine. ConclusionBy the AGREE Ⅱ assessment，the methodological quality of the TCM diagnosis and treatment guidelines/consensus of constipation included in this study needed to be improved in the future. The report quality evaluated with RIGHT Statement was low. Most drugs included in the National Reimbursement Drug List were paid attention in the TCM diagnosis and treatment guidelines/consensus of constipation. Moreover，the drugs included in the National Reimbursement Drug List could basically fulfill the clinical needs reflexed from the guidelines/consensus recommendations. However， the reasons of some drugs failing to be included in the National Reimbursement Drug List needed to be studied in the future.

Objective:To investigate high mobility group protein 1(HMGB1), tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels and their clinical significance in elderly patients with viral pneumonia.Methods:One hundred and sixty elderly patients with viral pneumonia admitted to the Sixth Hospital Affiliated to Anhui Medical University were enrolled as research subjects.In addition, 40 elderly people who underwent regular physical examination were considered as the control group.Patients with viral pneumonia were divided into the low-risk group, middle-risk group and high-risk group according to CURB-65 scores and pneumonia severity index(PSI)scores.HMGB1, TNF-α and IL-6 levels were compared between different groups.The correlations of CURB-65 scores and PSI scores with HMGB1, TNF-α, IL-6 levels were analyzed.Multivariate Logistic regression analysis was used to examine influencing factors for the severity of viral pneumonia in elderly patients.Results:HMGB1, TNF-α and IL-6 levels were higher in research subjects than in the control group.As the severity of viral pneumonia increased, so did HMGB1, TNF-α and IL-6 levels(all P<0.05). HMGB1, TNF-α and IL-6 levels in the severe viral pneumonia group were significantly higher than those in the non-severe viral pneumonia group( P<0.05). HMGB1, TNF-α and IL-6 levels were positively correlated with CURB-65 scores and PSI scores(CURB-65 score: r=0.463, 0.392 and 0.497, P=0.015, 0.003 and 0.025; PSI score: r=0.596, 0.515 and 0.381, P=0.007, 0.011 and 0.009). HMGB1, TNF-α and IL-6 levels were influencing factors for the severity of viral pneumonia in elderly patients( OR=1.344, 1.422 and 1.351, P=0.006, 0.015 and 0.009). Conclusions:HMGB1, TNF-α and IL-6 levels are closely correlated with the severity of viral pneumonia and are helpful for early assessment of viral pneumonia.

Objective:The time sequence transmission map and the cases travel track were used to explain the chain of transmission, describe the characteristics of transmission and analyze the mode of epidemic of novel coronavirus pneumonia, so as to provide evidence for the relevant government departments to carry out epidemic prevention and control.Methods:The time sequence transmission map and the cases travel track table were drawn, according to the time of incidence, age, sex, number of close contacts and their interrelations.Results:At the end of February 10, 2020, 63 COVID-19 cases were reported in the research area. Among them, 57 cases were confirmed (1 deaths) and 6 cases were asymptomatic, 57 cases were imported cases (90.48 %), 36 cases were reported by cluster epidemic (57.14 %) among friends and relatives. Cases have been spread to the fourth generation. Conclusion:The time sequence transmission map and the cases travel track showed that, in the research area, the epidemic situation of COVID-19 was mainly caused by imported case, and the clustering transmission was the major spread model. The time sequence transmission map and the cases travel track are worth popularizing in the prevention and control of major infectious diseases.