The paper introduces Professor FAN Gangqi's clinical experience in treatment of migraine. Regarding the syndrome/pattern differentiation of TCM, a four-approach framework is established, identifying the nature of illness, analyzing the syndrome/pattern and pathogenesis, determining the stage of illness, and identifying body constitution. In treatment, the principle of treatment is determined in line with syndrome/pattern differentiation, so as to ensure the therapeutic effect by means of "four dimensions". The acupuncture regimens are formulated in terms of the illness stages, "strong needling stimulation in acute stage for analgesia, and needle retaining in chronic stage for long-term effect". "Focusing on neuovascular pathway" is the effective approach to treatment of migraine with acupuncture and moxiubstion. The clinical holistic model by combining acupuncture with medication is advocated because that "the single acupuncture is weak in therapeutic effect, but with medication combined, the effect is enhanced". The different acupuncture techniques are provided comprehensively in treatment of migraine such as horizontal and row-like needling, collateral needling at Taiyang (EX-HN5), acupuncture at Sankong (Yuyao [EX-HN4], Sibai [ST2] and Jiachengjiang [Extra]), acupoint injection at Tianyou (TE16) and Renying (ST9), and acupoint embedding therapy at Fengchi (GB20).
Humans ; Migraine Disorders/diagnosis* ; Acupuncture Therapy ; Moxibustion ; Acupuncture Points ; Female ; Male ; Adult

OBJECTIVE: To investigate the differences in indwelling duration, clinical scenarios, and complications between the modified midline catheter (MMC) and the central venous catheter (CVC) in the treatment of patients in the medical intensive care unit (ICU) and the risk factors for complications based on real-world data. METHODS: A retrospective cohort study was conducted. The adult patients admitted to the medical ICU of the Third Xiangya Hospital of Central South University and had undergone placement of either a MMC or a CVC between January 1, 2023, and July 31, 2024, were consecutively enrolled by querying the hospital's electronic medical record system. Based on the type of catheter inserted, the patients were divided into the MMC group and the CVC group. The two groups were compared regarding the selection of catheters in the context of different underlying diseases, the actual clinical application after catheterization, catheter-related complications, the international normalized ratio (INR) and platelet count (PLT) during puncture and catheterization, the length of ICU stay, total length of hospital stay, catheter indwelling duration, and mortality during hospitalization. Multivariate Logistic regression analysis was employed to identify independent risk factors for catheter removal. RESULTS: Among the 274 patients, 52 received a MMC and 222 received a CVC. The utilization rate of MMC was significantly higher than that of CVC in patients with acute respiratory distress syndrome (ARDS), cardiovascular disease, and cancer [ARDS: 92.3% (48/52) vs. 70.3% (156/222), cardiovascular disease: 84.6% (44/52) vs. 54.5% (121/222), cancer: 30.8% (16/52) vs. 17.1% (38/222), all P < 0.05]. However, the use of MMC was significantly lower than CVC when vasoactive drug infusion was required [57.7% (30/52) vs. 79.7% (177/222), P < 0.05]. A significantly higher proportion of patients in the MMC group had a catheter indwelling time ≥ 12 days as compared with the CVC group [32.7% (17/52) vs. 13.5% (30/222), P < 0.05]. There were no statistically significant differences in other underlying diseases, venous access usage, INR and PLT during puncture and catheterization, length of ICU stay, total length of hospital stay, and in-hospital mortality of patients between the two groups. Regarding catheter-related complications, although the incidence of partial or complete catheter removal in the MMC group was significantly higher than that in the CVC group [36.5% (19/52) vs. 5.4% (12/222), P < 0.05], the incidence of puncture site fluid leakage, puncture site skin allergy, and deep vein thrombosis were significantly lower than those in the CVC group [puncture site fluid leakage: 1.9% (1/52) vs. 22.1% (49/222), puncture site skin allergy: 0% (0/52) vs. 20.7% (46/222), deep vein thrombosis: 3.8% (2/52) vs. 16.7% (37/222), all P < 0.05]. Furthermore, the proportion of patients experiencing three or more types of complications in the MMC group was significantly lower than that in the CVC group [5.8% (3/52) vs. 17.6% (39/222), P < 0.05]. Multivariate Logistic regression analysis of risk factors for catheter removal identified the use of a MMC [odds ratio (OR) = 8.518, 95% confidence interval (95%CI) was 3.710-19.560, P < 0.001] and a catheter indwelling time ≥ 12 days (OR = 3.133, 95%CI was 1.297-7.567, P = 0.011) as independent risk factors. CONCLUSIONS MMC was more frequently used in patients with ARDS, cardiovascular disease, and cancer, whereas CVC was primarily employed for vasoactive drug infusion. The use of MMC and a longer indwelling time were identified as independent risk factors for catheter removal. Despite a higher removal rate, the overall incidence of complications was significantly lower with MMC than with CVC. These findings suggest that MMC could serve as a routine alternative to CVC in most of clinical scenarios, provided that measures are implemented to prevent removal.
Humans ; Retrospective Studies ; Intensive Care Units ; Catheterization, Central Venous/methods* ; Central Venous Catheters ; Risk Factors ; Length of Stay ; Male ; Female ; Middle Aged ; Adult ; Catheters, Indwelling ; Aged

OBJECTIVE To establish an ion chromatography method for the simultaneous determination of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）. METHODS The chromatographic column was a Dionex IonpacTM AS11-HC anion analysis column， with a Dionex IonPacTM AG11-HC guard column. The mobile phase was 10 mmol/L potassium hydroxide at an isocratic elution flow rate of 1.2 mL/min. The detector was a conductivity detector， and the suppressor was a Dionex AERS with a suppressor current of 30 mA. The column temperature was maintained at 30 ° C， and the injection volume was 10 μL. Chloride and sulfate contents were calculated by external standard method， while bicarbonate content was determined by double logarithmic fitting standard curve method. RESULTS Under these chromatographic conditions， chloride， sulfate and bicarbonate ions were effectively separated with linear ranges of 0.055 to 0.219 mg/mL （r＝0.999 9）， 0.155 to 0.618 mg/mL （r＝1.000 0）， and 0.065 to 0.121 mg/mL （r＝0.999 9）， respectively. The recoveries were 98.06% to 101.34%， 97.37% to 101.25%， and 97.16% to 99.81%， respectively， with RSDs of 1.1%， 1.3% and 1.0% （n＝9）. The RSDs for the evaluation of precision， accuracy， stability and ruggedness were all less than 2%. CONCLUSIONS The established ion chromatography is simple， rapid， accurate， precise and durable， can simultaneously determine the contents of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）， which is suitable for its quality control.

Objective: To investigate whether melatonin (MT) secretion in different parts of the gastrointestinal tract (GIT) exhibits seasonal variations and its correlation with immune regulation. Methods: Sixty Sprague-Dawley rats were divided into control and model groups, and the pineal gland was removed in the model group. Stomach, jejunum, ileum, and colon tissues were obtained during the spring equinox, summer solstice, beginning of autumn, autumn equinox, and winter solstice. The levels of MT, MT receptors (MR), arylalkylamine N-acetyltransferase (AANAT), hydroxyindole-O-methyltransferase (HIOMT), interleukin-2 (IL-2), and interleukin-10 (IL-10) in the GIT were measured using enzyme-linked immunosorbent assay. Results: Except for the stomach, the jejunum, ileum, and the colon showed seasonal tendencies in MT secretion. In the control group, MT secretion in the jejunum and ileum was the highest in the long summer, and colonic MT secretion was the highest in winter. In the model group, MT levels in the colon were highest in the summer. The seasonal rhythms of the MR, AANAT, HIOMT, IL-2, and IL-10 in the colon were roughly similar to those of MT, and changed accordingly after pinealectomy. Conclusions Gastrointestinal MT secretion is related to seasonal changes, and MT secretion in each intestinal segment is influenced by different seasons. The biological effects of MT in the gut are inextricably linked to the mediation of MR, and a hormone-receptor linkage exists between MT and MR. The effect of seasonal changes on the gastrointestinal immune system may be mediated through the regulation of seasonal secretion of MT.

Objective To analyze the structural changes and reasons for hospitalization expenditure among patients with thyroid cancer,so as to provide a reference basis for reasonable control of medical costs,making the structure of hospitalisation costs for patients undergoing surgery for thyroid cancer more rational.Methods The degree of structural change and the grey correlation method were used to quantitatively analyze the changes in the structure of hospitalization expenses and the degree of correlation of patients with thyroid cancer surgery in a hospital in Shanxi Province from 2017 to 2022.Results From 2017 to 2022,the hospitalization expenses of thyroid cancer surgery patients in the hospital showed a decreasing trend,and drug fees and consumables fees accounted for a large proportion.Consumables fees and treatment fees showed positive contribution changes,drug fees and diagnosis fees showed negative contribution changes.Nursing fees and general medical service fees showed positive contribution changes,but were not obvious.During the 6-year period,the top two related factors affecting the hospitalization expenses of thyroid cancer patients were drug fees and consumables fees.Conclusion The structure of hospitalization expenses of per thyroid cancer patients tends to be reasonable,but there is still a large room for improvement.It is suggested to continue to strengthen the control of drugs and medical consumables,and clarify the value composition of technical labor and material consumables,so as to further optimize the structure of hospitalization expenses.

Objective This study aims to investigate the therapeutic effect and mechanism of Naoxinqing on non-alcohol fatty liver disease (NAFLD) induced by a high-fat diet through network pharmacology,molecular docking and in vitro and in vivo experiments. Methods ApoE-/-mice were given a high-fat diet for 12 weeks to establish the NAFLD model,followed by a 12-week Naoxinqing administration. To evaluate the therapeutic effect of Naoxinqing on NAFLD induced by a high-fat diet,biochemical and histopathological experiments were performed,including assessment of blood lipids,liver function,serum inflammatory factors,as well as Hematoxylin and eosin (HE),Oil red O,and Sirius red staining of liver. Subsequently,network pharmacology and molecular docking techniques were employed to predict the key targets of Naoxinqing. Finally,the mechanism of Naoxinqing was validated by Western Blot in HepG2 cells and liver tissue. Results The results of serum biochemistry and liver tissue pathology showed that Naoxinqing can significantly improve high-fat diet-induced hepatic lipid accumulation,hepatocellular injury,and inflammation. Network pharmacology and molecular docking analysis results suggested that Naoxinqing may affect lipid metabolism through the AMP-activated protein kinase (AMPK)/Sirtuin 1 (SIRT1) pathway. Finally,in vitro cell experiment confirmed that the main mechanism of Naoxinqing is to activative the AMPK/SIRT1 pathway,upregulate the expression of downstream carnitine palmitoyltransferase 1 (CPT1A),promote fatty acid oxidation,and ultimately improve NAFLD. Conclusion This study demonstrated that Naoxinqing improved NAFLD by promoting fatty acid oxidation through the activation of the AMPK/SIRT1 pathway.

Objective To establish a method for the determination of contents of sodium metabisulfite and sodium sulfate in phentolamine mesylate injection.Methods The ion chromatography method with a DionexIonPac AS11-HC(250 mm×4.0 mm,5 pm)column was used,with potassium hydroxide solution as eluent,gradient elution,flow rate of 1.0 mL/min.The column temperature was 30 ℃ and the injection volume was 25 μL.Results Sodium metabisulfite showed good linearity(r=0.999 3)in the range of 10.596-211.920 μg/mL,and its average recovery rate was 100.00％,with an RSD of 1.4％(n=9).Sodium sulfate showed good linearity(r=0.999 8)in the range of 1.027-20.540 μg/mL,and its average recovery rate was 99.96％,with an RSD of 1.8％(n=9).Conclusion The established method is simple,accurate,sensitive and suitable for the determination of sodium metabisulfite and sodium sulfate contents in phentolamine methylate injection.

Objective:To review the application of virtual reality in cardiac rehabilitation patients, identify intervention types, intervention elements, outcome indicators, and application effects.Methods:Electronic retrieval was implemented on PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, WanFang Data, and China Biology Medicine disc, using the Joanna Briggs Institute (JBI) scoping review guideline as the methodological framework. The search period was from the establishment of the database to April 10, 2023. The literature was extracted, summarized, and analyzed.Results:A total of 16 articles were included. The main types of virtual reality interventions were immersive and non-immersive. The intervention population included patients at different stages of cardiac rehabilitation, with unrestricted intervention venues. The intervention frequency was mostly 2 to 3 times per week, with intervention duration mostly ranging from 30 to 60 minutes and intervention cycles mostly ranging from 3 weeks to 12 months. Virtual reality improved the physical function and mental health of cardiac rehabilitation patients to a certain extent, and patient feedback showed good participation and satisfaction.Conclusions:Virtual reality has a positive impact on cardiac rehabilitation patients, with good safety and feasibility, but the recovery of cardiac function is still controversial. It is still necessary to conduct large sample size, multi center research, and track long-term effects.

Objective To explore the effect and possible mechanism of aerobic exercise and empagliflozin(EMPA)on isoproterenol(ISO)-induced pathological cardiac remodeling.Methods Mice were divided randomly into control(Con),ISO,exercise(EX)+ISO,EMPA+ISO,and EX+EMPA+ISO groups.Mice in the EX groups were trained continuously for 6 weeks,mice in the EMPA groups were gavaged continuously for 4 weeks,and mice in the ISO groups were injected subcutaneously with ISO for 7 days before dissection.After euthanasia,the whole heart mass index,left heart mass index,heart mass to tibial length ratio,and left heart mass to tibial length ratio were calculated by weighing and measuring.Pathological changes,collagen fiber deposition,and myocardial cell cross-sectional area in the hearts were detected by hematoxylin and eosin,Sirius red,and wheat germ agglutinin staining.The expression levels of genes and proteins related to cardiac fibrosis and hypertrophy,macrophage infiltration,ferroptosis,and the phosphoinositide 3-kinase(PI3K)/AKT pathway were examined by quantitative reverse transcription-polymerase chain reaction,Western Blot,and immunofluorescence staining.Results(1)The whole heart mass index,left heart mass index,heart mass to tibial length ratio,and left heart mass to tibial length ratio showed downward trends in the EX+ISO group compared with the ISO group.The whole heart mass index and left heart mass index were significantly decreased in the EMPA+ISO group(P＜0.01,P＜0.05),and the heart mass to tibial length ratio and left heart mass to tibial length ratio were both down regulated.Mice in the EX+EMPA+ISO group had a significant decrease in whole heart mass index(P＜0.05),and the other three indicators were all down-regulated.(2)Myocardial cells were more orderly in the three intervention groups compared with the ISO group,with significant reductions in inflammatory cell infiltration(P＜0.01),the area of cardiac fibrosis,and the cross-sectional area of myocardial cells(P＜0.001).(3)The mRNA and protein expression levels of Col 1 and Anp were significantly reduced in the three intervention groups compared with the ISO group(P＜0.05,P＜0.01,P＜0.001).Col 3 mRNA expression significantly reduced in the EMPA+ISO and EX+EMPA+ISO groups(P＜0.05),and showed a downward trend in the EX+ISO group.(4)Macrophage infiltration and IL-6 mRNA levels were significantly reduced in the three intervention groups compared with the ISO group(P＜0.05,P＜0.01,P＜0.001).(5)Nrf2 and Gpx4 mRNA levels were upregulated in the three intervention groups compared with the ISO group,with a significant increase in GPX4 protein expression(P＜0.01,P＜0.001)and a significant decrease in HO-1 protein expression(P＜0.01,P＜0.001).(6)Pi3k mRNA levels were significantly increased in the EX+ISO group compared with the ISO group(P＜0.05),and Pi3k mRNA was upregulated in the EMPA+ISO and EX+EMPA+ISO groups.Akt mRNA levels showed an upward trend in the three intervention groups.PI3K and phospho-AKT protein levels were significantly increased in the EX+ISO group(P＜0.01,P＜0.05),and showed an increasing trend in the EMPA+ISO and EX+EMPA+ISO groups.Conclusions Moderate intensity aerobic exercise,the novel hypoglycemic drug EMPA,and their combination can alleviate ISO-induced pathological cardiac remodeling,possibly via a mechanism related to activation of the PI3K/AKT signaling pathway and inhibition of cardiac ferroptosis.

Purpose/Significance To build an evaluation index system of hospital intelligence in line with China's national conditions,so as to provide references for the quantitative evaluation of the degree of hospital intelligence,and to help the orderly development of hospi-tal intelligence construction.Method/Process Based on the review of the existing evaluation standard system of hospital informatization con-struction,Delphi method and analytic hierarchy process are used to discuss the construction process of hospital intelligence evaluation index system from four processes:construction of an evaluation index system,selection of experts in letter consultation,evaluation of indicator im-portance and verification of letter consultation results,and determination of the evaluation index weight.Result/Conclusion The construc-tion of hospital intelligence evaluation index system,which includes 3 first-level indexes,8 second-level indexes and 33 third-level in-dexes,is complementary to the existing evaluation system of smart hospitals,can reflect the construction foundation and development goals of the current intelligent hospitals,and has certain applicability and guidance for the future construction of smart hospitals.