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 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 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 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 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.

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.

BackgroundSleep disorder can adversely affect human physical and mental health， with important implications for socioeconomic development. And higher vocational college students are subject to various pressures and stimuli exerted by academic studies， job seeking and family socioeconomic status， which may contribute to the onset insomnia symptom or sleep disorder. ObjectiveTo discuss the sleep status and influencing factors among higher vocational college students， and to provide references for improving their sleep status. MethodsIn January and February， 2022， a stratified random sampling method was utilized to enroll 3 300 students from five higher vocational colleges in Wenjiang district of Chengdu city. All the participants were assessed using Insomnia Severity Index （ISI）， Patient Health Questionnaire Depression Scale-9 item （PHQ-9） and Generalized Anxiety Disorder Scale-7 （GAD-7）. Pearson correlation analysis was conducted to test the correlation of ISI with PHQ-9 and GAD-7 scores， and the Logistic regression analysis was performed to identify the influencing factors of insomnia symptom in higher vocational college students. ResultInsomnia symptom was detected in 81.90% （2 497 / 3 300） of higher vocational college students. The detection rate of insomnia symptom among vocational college students yielded statistical difference in terms of gender， family socioeconomic status， being an only child or having siblings， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom （χ²=21.032， 22.172， 8.983， 75.939， 36.781， 32.350， 54.512， 86.561， P<0.01 or 0.05）. Among higher vocational college students， ISI score was positively correlated with GAD-7 and PHQ-9 scores （r=0.620， 0.714， P<0.01）， and GAD-7 score was positively correlated with PHQ-9 score （r=0.824， P<0.01）. Gender， family socioeconomic status， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom were effective factors in predicting the insomnia symptom in higher vocational college students （P<0.01 or 0.05）. ConclusionFemale gender， average and below average family socioeconomic status， moderate-to-severe degree of psychological pressure exerted by academic studies or job seeking， spending 2~5 h， 5~7 h or >7 h on Internet per day， inadequate physical exercise and presence of depressive symptom are the risk factors for insomnia symptom in higher vocational college students.［Funded by Sichuan Provincial Primary Health Development Research Center in 2022， North Sichuan Medical College （number， SWFZ22-C-89）］

Objective:To explore the clinical application of time of flight-magnetic resonance angiography (TOF-MRA), silent magnetic resonance angiography (SilenZ-MRA) and high-resolution vessel wall imaging (HR-VWI) in non-invasive evaluation of intracranial aneurysm after embolization.Methods:From February 2021 to February 2022, 39 patients, including 8 males and 31 females, who were 29-86 (54.50±11.80) years old and had received intracranial aneurysm embolization were collected in the Second Affiliated Hospital of Nanchang University. Kruskal-Wallis test was used to compare the image quality score and the evaluation results of lumen stenosis rate in the stent segments by TOF-MRA, SilenZ-MRA and HR-VWI. The diagnostic value of TOF-MRA, SilenZ-MRA and HR-VWI was analyzed by receiver operating characteristic (ROC) curve with DSA as the reference standard.Results:The image quality scores of TOF-MRA, SilenZ-MRA and HR-VWI were 2(1, 3), 4(3, 4) and 4(4, 4), respectively, with statistically significant difference ( H=80.78, P<0.05). The pairwise comparison results were as follows: TOF-MRA vs SilenZ-MRA, P<0.017; TOF-MRA vs HR-VWI, P<0.017; SilenZ-MRA vs HR-VWI, P>0.017. The lumen stenosis rates of stent segments measured by TOF-MRA, SilenZ-MRA, HR-VWI and DSA were 45.00% (29.60%, 61.05%), 17.60% (10.80%, 26.80%), 13.35% (8.90%, 15.95%) and 7.95% (4.80%, 11.25%), respectively, with statistically significant difference ( H=67.96, P<0.05). The results of comparison between TOF-MRA, SilenZ-MRA, HR-VWI and DSA were respectively as follows: TOF-MRA vs DSA, P<0.017; SilenZ-MRA vs DSA, P<0.017; HR-VWI vs DSA, P>0.017. DSA review showed that 12 (27.91%,12/43) aneurysms were not completely embolized, and 31 (72.09%, 31/43) aneurysms were completely embolized. The area under the curve of TOF-MRA, SilenZ-MRA and HR-VWI for evaluating the postoperative complete embolization of aneurysm was 0.75, 1.00 and 0.94, respectively, with statistically significant differences between TOF-MRA and HR-VWI ( Z=2.53, P<0.05) as well as between TOF-MRA and SilenZ-MRA ( Z=3.32, P<0.05). Conclusions:HR-VWI can clearly display the stent-segment lumen of the parent artery, and evaluate the stent-segment arterial wall and whether the stent-segment lumen is unobstructed or not. SilenZ-MRA is significantly superior to TOF-MRA in the evaluation of postoperative embolization status of aneurysms, and slightly superior to HR-VWI in tumor neck display. Combined application of HR-VWI and SilenZ-MRA has certain clinical significance for non-invasive evaluation of intracranial aneurysm after embolization.

Objective:To explore the effect of detail control management based on risk assessment tracking in the management of equipment in the Disinfection Supply Room.Methods:The convenience sampling was used to select the medical and nursing staff working in the Disinfection Supply Room of the First Affiliated Hospital of Zhengzhou University from January to December 2019 as the control group. The medical and nursing staff working in the Disinfection Supply Room from January 2020 to June 2021 were selected as the observation group. The control group adopted routine management, and the observation group adopted detailed control management based on risk assessment tracking. Work Management Quality Questionnaire, Work Ability Questionnaire and sterilization qualification rate were used to evaluate the effect of intervention.Results:Four weeks after management, the total scores and each dimension scores of Work Management Quality Questionnaire, Work Ability Questionnaire of medical and nursing staff in the observation group were higher than those in the control group, with statistically significant differences ( P<0.05) . The qualified rate of equipment tested by visual inspection, magnifying glass and ATP biofluorescence in the observation group was higher than that in the control group, with a statistically significant difference ( P<0.05) . Conclusions:The detailed control management based on risk assessment tracking can improve the work management quality and work ability of medical and nursing staff in the Disinfection Supply Room, and increase the qualification rate of equipment sterilization.