Central positional nystagmus （CPN） is a form of positional nystagmus caused by lesions of the central vestibular system. Since the clinical manifestations and nystagmus features of CPN are highly similar with those of benign paroxysmal positional vertigo， the diagnosis of CPN is highly challenging. The etiology of CPN is complex， involving both structural lesions such as stroke and tumors and non-structural disorders such as vestibular migraine. The primary lesion sites of CPN included the cerebellar nodulus， the uvula， and the tonsil. CPN can be classified into paroxysmal （transient） CPN and persistent CPN. The clinical features of paroxysmal CPN （including latency， duration， direction， intensity， and their correlation with the type and speed of positional maneuvers） suggest that it originates from the semicircular canal， and its pathogenesis involves post-rotatory rebound nystagmus caused by the disinhibition of irregular afferent signals transmitted to the vestibular nuclei due to central damage （often involving the cerebellar nodulus and the uvula）. Persistent CPN may be caused by damage to the velocity storage pathway， resulting in an erroneous assessment of gravity direction and inertia. This article summarizes the latest advances in the etiology， lesion sites， pathogenesis， clinical features， differential diagnosis， and treatment of CPN in China and globally， in order to help clinicians better understand and identify CPN and thus achieve timely diagnosis and effective treatment.
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Objective:To explore the influencing factors of dietary habits on the progression from prediabetes to type 2 diabetes mellitus(T2DM)in elderly individuals undergoing health check-ups.Methods:In the cross-sectional study, we enrolled individuals aged 60-70 years with fasting plasma glucose (FPG)≥6.0 mmol/L who underwent health examinations at the Health Management Medical Center of Wenjiang District People's Hospital in Chengdu from 2019 to 2022.Demographic characteristics, dietary habit questionnaires, and FPG values were collected.Unconditional binary logistic regression analysis was used to identify factors influencing the natural progression from prediabetes to T2DM.A nomogram prediction model was established based on logistic regression results, and its predictive performance was evaluated by calculating the C-statistics and drawing a calibration curve.Results:A total of 13 681 elderly participants with FPG ≥6.0 mmol/L were included, comprising 4 306(31.5%)prediabetes cases(FPG 6.0-7.0 mmol/L), aged(63.54±16.49)years and 9 375(68.5%)T2DM cases(FPG>7.0 mmol/L), aged(63.09±16.21)years.Unconditional binary logistic regression analysis showed that frequent breakfast( OR=0.777, 95% CI: 0.696-0.868, P<0.001), dietary preference for light diet( OR=0.781, 95% CI: 0.710-0.858, P<0.001), salty taste( OR=0.571, 95% CI: 0.504-0.648, P<0.001), raw food( OR=0.327, 95% CI: 0.224-0.478, P<0.001)and spicy taste( OR=0.124, 95% CI: 0.112-0.137, P<0.001)were the protective factors for the conversion of prediabetes to the T2DM stage in the elderly physical examination population.While fast eating rate( OR=4.327, 95% CI: 3.978-4.772, P<0.001), dietary preference for sweets( OR=5.168, 95% CI: 4.703-5.678, P<0.001), and high-fat diet( OR=1.401, 95% CI: 1.275-1.539, P<0.001)were risk factors for conversion of prediabetes to T2DM stage.C-statistic of the Nomogram prediction model was 0.781; the goodness-of-fit test of the calibration curve was χ2=11.258, P=0.188, and the model predicted well. Conclusions:Regular breakfast, light diet, and dietary preferences for salty, raw, and spicy foods were protective factors for the transition from prediabetes to T2DM stage, whereas rapid eating rate, preference for sweets, and high-fat diets were risk factors for the transition from prediabetes to T2DM stage in the medical examination population.The constructed risk prediction model helped to find out the magnitude of the risk of T2DM in an individual, which increases the evidence for the transition from prediabetes to T2DM stage prevention evidence.

Objective:To explore the influencing factors of dietary habits on the progression from prediabetes to type 2 diabetes mellitus(T2DM)in elderly individuals undergoing health check-ups.Methods:In the cross-sectional study, we enrolled individuals aged 60-70 years with fasting plasma glucose (FPG)≥6.0 mmol/L who underwent health examinations at the Health Management Medical Center of Wenjiang District People's Hospital in Chengdu from 2019 to 2022.Demographic characteristics, dietary habit questionnaires, and FPG values were collected.Unconditional binary logistic regression analysis was used to identify factors influencing the natural progression from prediabetes to T2DM.A nomogram prediction model was established based on logistic regression results, and its predictive performance was evaluated by calculating the C-statistics and drawing a calibration curve.Results:A total of 13 681 elderly participants with FPG ≥6.0 mmol/L were included, comprising 4 306(31.5%)prediabetes cases(FPG 6.0-7.0 mmol/L), aged(63.54±16.49)years and 9 375(68.5%)T2DM cases(FPG>7.0 mmol/L), aged(63.09±16.21)years.Unconditional binary logistic regression analysis showed that frequent breakfast( OR=0.777, 95% CI: 0.696-0.868, P<0.001), dietary preference for light diet( OR=0.781, 95% CI: 0.710-0.858, P<0.001), salty taste( OR=0.571, 95% CI: 0.504-0.648, P<0.001), raw food( OR=0.327, 95% CI: 0.224-0.478, P<0.001)and spicy taste( OR=0.124, 95% CI: 0.112-0.137, P<0.001)were the protective factors for the conversion of prediabetes to the T2DM stage in the elderly physical examination population.While fast eating rate( OR=4.327, 95% CI: 3.978-4.772, P<0.001), dietary preference for sweets( OR=5.168, 95% CI: 4.703-5.678, P<0.001), and high-fat diet( OR=1.401, 95% CI: 1.275-1.539, P<0.001)were risk factors for conversion of prediabetes to T2DM stage.C-statistic of the Nomogram prediction model was 0.781; the goodness-of-fit test of the calibration curve was χ2=11.258, P=0.188, and the model predicted well. Conclusions:Regular breakfast, light diet, and dietary preferences for salty, raw, and spicy foods were protective factors for the transition from prediabetes to T2DM stage, whereas rapid eating rate, preference for sweets, and high-fat diets were risk factors for the transition from prediabetes to T2DM stage in the medical examination population.The constructed risk prediction model helped to find out the magnitude of the risk of T2DM in an individual, which increases the evidence for the transition from prediabetes to T2DM stage prevention evidence.

Objective To explore the characteristics of TCM syndromes in patients with coronary heart disease complicated with hypertension and diabetes based on latent structure model.Methods A multi-center cross-sectional study was used to collect the four diagnostic information of patients with coronary heart disease by using the Four Diagnostic Collection Scales of TCM developed by our research group,and a clinical database was established.Combined with frequency analysis and expert opinions,the four diagnostic information was screened to construct a latent structure model.Results Totally 702 patients with coronary heart disease complicated with hypertension and diabetes were collected.A total of 40 high-frequency four-diagnosis symptoms were screened,and 18 latent variables were obtained by latent structure model analysis.The model BIC score was-17 604.38.The latent variables in the model were comprehensively clustered,and it was found that the syndrome elements of disease location in patients with coronary heart disease complicated with hypertension and diabetes were mainly heart,liver,kidney,etc.,and the syndrome elements of disease nature were mainly qi deficiency,yin deficiency,qi stagnation,phlegm turbidity,blood stasis,etc.The syndrome types were mainly phlegm and blood stasis syndrome,spleen and kidney yang deficiency syndrome,liver depression and qi stagnation syndrome,liver and kidney yin deficiency syndrome,damp-heat intrinsic syndrome,and the mutual information and information coverage between each syndrome type and the four diagnostic information were suggested.Conclusion Latent structure model analysis can provide a qualitative and quantitative basis for the syndrome classification of patients with coronary heart disease complicated with hypertension and diabetes.

Purpose/Significance To understand the fragmented reading behavior of the core user group of hospital libraries,and to propose countermeasures to improve the reading service.Method/Process The fragmented reading behavior data of 3 user groups(doc-tors,nurses,and medical technicians)in Children's Hospital of Soochow University are collected through the questionnaire method,and the characteristics of fragmented reading behavior of each group of users are analyzed.Result/Conclusion Fragmented reading has be-come an important informal learning approach for core users of hospital libraries.Users with different positions,titles and educational backgrounds have different fragmented reading behaviors.Hospital libraries can improve the level of fragmented reading service by provi-ding diversified reading services,promoting the learning type fragmented reading platforms,integrating collection resources and optimizing the overall spatial layout.

Background: and Purpose The eye-movement examination can be applied as a noninvasive method to identify multiple-system atrophy (MSA). Few studies have investigated eye movements during the early stage of MSA with predominant parkinsonism (MSA-P). We aimed to determine the characteristic oculomotor changes in the early stage of MSA-P. Methods: We retrospectively selected 17 patients with MSA-P and 40 with Parkinson’s disease (PD) with disease durations of less than 2 years, and 40 age-matched healthy controls (HCs).Oculomotor performance in the horizontal direction was measured in detail using videonystagmography. Results: We found that the proportions of patients with MSA-P and PD exhibiting abnormal eye movements were 82.4% and 77.5%, respectively, which were significantly higher than that in the HCs (47.5%, p<0.05). Compared with HCs, patients with MSA-P presented significantly higher abnormal proportions of fixation and gaze-holding (17.6% vs. 0%), without-fixation (47.1% vs. 0%), prolonged latency in reflexive saccades (29.4% vs. 5.0%), memory-guided saccades (93.3% vs. 10.0%), and catch-up saccades in smooth-pursuit movement (SPM, 41.2% vs. 0) (all p<0.05). Compared with those with PD, patients with MSA-P presented a significantly higher proportion of catch-up saccades in SPM (41.2% vs. 2.5%, p<0.001). Conclusions MSA-P presented the characteristic of catch-up saccades in SPM in the early stage, which may provide some value in differentiating MSA-P from PD.

Objective To clarify the distribution of traditional Chinese medicine(TCM)pattern and its associated risk factors after percutaneous coronary intervention(PCI),and evaluate the re-porting quality of existing studies to guide future research standardization. Methods English databases including PubMed,Cochrane Library,and Web of Science,as well as Chinese databases including China National Knowledge Infrastructure(CNKI),China Scientific Journal Database(VIP),and Wanfang Database were searched to retrieve papers about PCI.The time span for the paper retrieval was set from the foundation of the databases to October 1,2023.Statistical analyses were performed using Stata 12 and Python(V 3.9).The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement was used to assess the reporting quality of included studies. Results Overall,1 356 articles were selected,and 40 cross-sectional studies were included with 10 270 participants.The most common TCM patterns before,one to two weeks after,and six months to one year after PCI was Qi stagnation and blood stasis(n=261,36.45%),inter-twined phlegm and blood stasis(n=109,27.18%),and Qi deficiency and blood stasis(n=645,37.03%),respectively.Smoking[odds ratio(OR)=1.15,95%confidence interval(CI)(0.83-1.47),I2=24.7%,P=0.257],pattern of congealing cold and Qi stagnation[OR=4.62,95%CI(1.37-7.86),I2=61.6%,P=0.074],and low-density lipoprotein(LDL)[OR=1.38,95%CI(0.92-1.85),I2=12.2%,P=0.286]were risk factors for restenosis.Hypertension[OR=7.26,95%CI(3.54-14.88),I2=91.6%,P=0.001],and overweight[i.e.,body mass index(BMI)>23][OR=1.20,95%CI(1.07-1.35),I2=85.3%,P=0.009]were significant risk factors of concomi-tant anxiety. Conclusion This systematic review and meta-analysis revealed that patients with different TCM pattern types have distinct characteristics and risk factors after PCI.More high-quality studies are warranted to provide supportive evidence for future research and clinical practice.

Objective:To analyze TCM tongue diagnosis related research on coronary heart disease (CHD) at home and abroad using the method of bibliometrics; To provide reference for further research on clinical diagnosis and treatment of CHD.Methods:Research literature about TCM tongue diagnosis for CHD was retrieved from CNKI, VIP, CBM, Wanfang Data, PubMed, Embase, Cochrane Library and Web of Science from the establishment of the databases to December 31st, 2022. The key features of literature related to tongue diagnosis from CHD, including publication volume, region, institution, authors, and research hotspots, were analyzed using BICOMBS2.0, CiteSpace 6.1.R6, and Excel 2019 software.Results:Totally 364 Chinese articles and 5 English articles were included. Liaoning University of Traditional Chinese Medicine was the institution that published the most relevant research in Chinese, and Shanghai University of Traditional Chinese Medicine was the institution that published the most relevant research in English. Professor Wang Yiqin of Shanghai University of Traditional Chinese Medicine was the author with the largest number of publications in both Chinese and English, and the authors with the largest number of publications on Chinese research worked closely cooperate with each other. Chinese research focused on syndrome characteristics of CHD, objectification of tongue diagnosis and data mining based on the clinical experience of renowned TCM practitioners; the English research topic included modern data collection and analysis and expert consensus.Conclusions:The research team of tongue diagnosis for CHD in China has begun to take shape. There are few English articles on tongue diagnosis for CHD, and the development level is relatively lagging behind. In the future, different institutions and researchers need to strengthen international cooperation to enhance the international influence of TCM diagnostics.

Objective To study Chinese medicine consultation strategies to achieve rapid capture of key information about patients'conditions and to advance the development of objectification in Chinese medicine consultation.Methods A symptom questioning model based on frequent pattern mining algorithm in correlation analysis was used,and a cross-merging method was used to establish a TCM symptom questioning strategy between single-system symptom questioning and multi-system integrated symptom questioning in TCM,to achieve the shortest time and highest efficiency in capturing key information about the patient's condition.Results A breakthrough from single-system questioning to five-system integrated questioning was achieved,and the process of efficiently obtaining information about the patient's condition was achieved through both single-system and five-system symptom questioning modes,and the system was able to obtain 92%of the patient's symptom information with at most 65%fewer questions than the traditional scale questioning method,greatly improving the efficiency of obtaining information about the patient's symptoms.Conclusion With the two different symptom questioning modes,the traditional TCM questioning mode of asking patients based on scales is broken,the time to obtain symptoms from patients is shortened,the questioning process is simplified,and discrepancies due to inexperience or human subjectivity are reduced,which can be used in clinical aids to diagnosis in TCM.

Objective To collect information from the traditional Chinese medicine(TCM)four diagnostic information of patients with coronary heart disease(CHD)and to observe the characteristics of their Chinese medicine syndrome factor at different ages,to provide an objective basis for the Chinese medicine treatment of patients with CHD at different ages.Methods The TCM Four Diagnostic Information Collection Scale for CHD developed by the group was used to collect the four diagnostic information of patients with coronary heart disease,and the syndrome elements were extracted according to the syndrome differentiation standard to observe the distribution of syndrome elements at different ages.Results CHD is located in the heart and accompanied by liver,kidney,stomach,lung and other organs.Qi deficiency is the most common syndrome factor,followed by phlegm turbidity,yin deficiency,blood stasis and qi stagnation.Among the syndrome elements of disease location,the heart and liver were the most common in the young group,and the heart and kidney were more common in the middle-aged group and the elderly group.Among the syndrome elements of disease nature,qi deficiency was more common in the young group,phlegm turbidity and qi stagnation were more common in the empirical group,and qi deficiency and phlegm turbidity were the most frequent.In the middle-aged group,qi deficiency was more common in deficiency syndrome,phlegm turbidity and blood stasis were more common in excess syndrome,and the frequency of qi deficiency and phlegm turbidity and blood stasis was the highest.In the elderly group,qi deficiency and yin deficiency were more common in deficiency syndrome,phlegm turbidity and blood stasis were more common in excess syndrome,and qi and yin deficiency combined with phlegm turbidity and blood stasis had the highest frequency.Conclusion The combination of syndrome elements in patients with CHD in different age groups has its own characteristics.The young,middle and elderly groups are all visible in the mixture of deficiency and excess,while the young group is the most common with qi deficiency and phlegm turbidity,the middle-aged group is the most common with qi deficiency and phlegm turbidity and blood stasis,and the elderly group is the most common with qi and yin deficiency and phlegm turbidity and blood stasis.With the increase of age,the complexity of the combination of syndrome elements is higher.