The concept of"musculoskeletal imbalance with soft tissue primacy"posits that tendon injury induced by intervertebral disc degeneration constitutes the core pathogenesis of spinal musculoskeletal imbalance.This study systematically elucidates the pathological mechanisms through which tendon injury leads to spinal instability by integrating traditional Chinese medicine(TCM)"musculoskeletal balance"theory with contemporary biomechanical research on disc degeneration.In the process of intervertebral disc degeneration,the change of stress distribution revealed by modern biomechanics is highly consistent with the TCM principle of"tendon impairment affecting bone".Finite element analysis revealing the"stability-instability-restabilization"process further validates the pathological progression from musculoskeletal imbalance to rebalance.This integrated TCM-Western medicine perspective establishes a novel theoretical framework for predicting disease progression and developing personalized therapeutic strategies,particularly in guiding clinical practice of"treating bone disorders through tendon regulation".

Objective To investigate the influence of Salvia miltiorrhiza polyphenolate injection combined with tirofiban on the curative effect,macrophage migration inhibitory factor(MIF)level and hemorheology in patients with acute cerebral infarction(ACI).Methods A total of 116 patients with ACI were divided into the western medicine group(treated with tirofiban)and the combined group(treated with Salvia miltiorrhiza polyphenolate injection combined with tirofiban)by random number table method,with 58 cases in each group.Neurological deficit score(NIHSS)reduction was calculated,and the therapeutic effect was evaluated.Serum MIF,interleukin(IL)-6 and IL-1β levels were detected by enzyme-linked immunosorbent assay(ELISA)before and after treatment.Changes of hemorheological indexes(whole blood viscosity,whole blood low tangential viscosity and fibrinogen)of ACI patients were detected by SA-6600 automatic hemorheometer before and after treatment.The occurrence of adverse reactions during treatment was recorded.The modified Rankin Scale(mRS)was used to evaluate the clinical outcome at 90 days of onset,and the Barthel index was used to evaluate the living ability of the patients before and after treatment.Results The total clinical effective rate of ACI patients was higher in the combined group than that in the western medicine group(89.66%vs.74.14%,P＜0.05).After treatment,the levels of MIF,whole blood viscosity,whole blood low shear viscosity,fibrinogen,IL-6 and IL-1β were lower in 2 groups than those before treatment,and those were lower in the combined group than those in the western medicine group(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).The Barthel index was higher after treatment in the two groups,and which was higher in the combined group than that of the western medicine group(P＜0.05).The good outcome rate was higher in the combination group than that of the western medicine group(51.72%vs.32.76%,P＜0.05).Conclusion Salvia miltiorrhiza polyphenolate injection combined with tirofiban has a obvious effect for ACI patients,which can reduce serum levels of MIF and inflammatory factors,improve hemorheology indicators and has a high safety.

The concept of"musculoskeletal imbalance with soft tissue primacy"posits that tendon injury induced by intervertebral disc degeneration constitutes the core pathogenesis of spinal musculoskeletal imbalance.This study systematically elucidates the pathological mechanisms through which tendon injury leads to spinal instability by integrating traditional Chinese medicine(TCM)"musculoskeletal balance"theory with contemporary biomechanical research on disc degeneration.In the process of intervertebral disc degeneration,the change of stress distribution revealed by modern biomechanics is highly consistent with the TCM principle of"tendon impairment affecting bone".Finite element analysis revealing the"stability-instability-restabilization"process further validates the pathological progression from musculoskeletal imbalance to rebalance.This integrated TCM-Western medicine perspective establishes a novel theoretical framework for predicting disease progression and developing personalized therapeutic strategies,particularly in guiding clinical practice of"treating bone disorders through tendon regulation".

ObjectiveThis study aimed to explore the correlation between the quality of life （QOL） and different traditional Chinese medicine （TCM） syndromes in patients with myasthenia gravis （MG）， identifying potential influencing factors to provide new insights for clinical interventions and improving the QOL of patients with MG. MethodsA questionnaire survey was conducted on 93 adults with MG who visited the Department of Neurology at the Affiliated Hospital of Changchun University of Chinese Medicine from March 2023 to January 2024. Statistical analysis was performed on the clinical data collected using SPSS 24.0 software. ResultsAmong the 93 patients with MG， the average score for myasthenia gravis quality of life-15 （MGQOL-15） was 17.65±6.27， and that for the 36-item short form health survey （SF-36） was （106.13±11.83） scores. The QOL was rated as good for 16 patients and moderate for 77 patients. There were no statistically significant differences in the scores of MGQOL-15， SF-36， and their individual scales by gender or education level. Age showed statistically significant differences in MGQOL-15 and the role physical （RP） scale （P<0.05）， and occupational type showed significant differences in the vitality （VT） scale （P<0.01）. The Myasthenia Gravis Foundation of America （MGFA） classification had statistical significance on the total SF-36 score （P<0.01）， VT scale （P<0.01）， role emotional （RE） scale （P<0.05）， social functioning （SF） scale （P<0.05）， and physical functioning （PF） scale （P<0.01）. Among patients with different TCM syndromes， there were significant differences in MGQOL-15 scores （F=4.919， P<0.01）. Moreover， significant differences were observed in SF-36 scores （P<0.01）， VT scale （P<0.01）， RE scale （P<0.05）， mental health （MH） scale （P<0.01）， and SF scale （P<0.05）. ConclusionFactors affecting the QOL of patients with MG include age， occupational type， and clinical classification of MG. Specifically， a greater impact on the QOL of older patients is observed， while physical laborers have a poorer QOL compared to non-physical laborers. Patients classified as MGFA type Ⅱ and higher have a poorer QOL. Additionally， there is a potential correlation between the QOL and TCM syndromes， with patients presenting with spleen and kidney Qi deficiency having a lower QOL than those with spleen and stomach Qi deficiency or Qi and Yin deficiency， which is particularly evident in the VT， RE， MH， and SF scales.

Objective To investigate the influence of Salvia miltiorrhiza polyphenolate injection combined with tirofiban on the curative effect,macrophage migration inhibitory factor(MIF)level and hemorheology in patients with acute cerebral infarction(ACI).Methods A total of 116 patients with ACI were divided into the western medicine group(treated with tirofiban)and the combined group(treated with Salvia miltiorrhiza polyphenolate injection combined with tirofiban)by random number table method,with 58 cases in each group.Neurological deficit score(NIHSS)reduction was calculated,and the therapeutic effect was evaluated.Serum MIF,interleukin(IL)-6 and IL-1β levels were detected by enzyme-linked immunosorbent assay(ELISA)before and after treatment.Changes of hemorheological indexes(whole blood viscosity,whole blood low tangential viscosity and fibrinogen)of ACI patients were detected by SA-6600 automatic hemorheometer before and after treatment.The occurrence of adverse reactions during treatment was recorded.The modified Rankin Scale(mRS)was used to evaluate the clinical outcome at 90 days of onset,and the Barthel index was used to evaluate the living ability of the patients before and after treatment.Results The total clinical effective rate of ACI patients was higher in the combined group than that in the western medicine group(89.66%vs.74.14%,P＜0.05).After treatment,the levels of MIF,whole blood viscosity,whole blood low shear viscosity,fibrinogen,IL-6 and IL-1β were lower in 2 groups than those before treatment,and those were lower in the combined group than those in the western medicine group(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).The Barthel index was higher after treatment in the two groups,and which was higher in the combined group than that of the western medicine group(P＜0.05).The good outcome rate was higher in the combination group than that of the western medicine group(51.72%vs.32.76%,P＜0.05).Conclusion Salvia miltiorrhiza polyphenolate injection combined with tirofiban has a obvious effect for ACI patients,which can reduce serum levels of MIF and inflammatory factors,improve hemorheology indicators and has a high safety.

Objective To explore the clinical efficacy and mechanism of Qinggan Sanjie Xiaoying Decoction in the treatment of Hashimoto's thyroiditis with syndrome of stagnation heat of liver meridian and stagnation of spleen deficiency and phlegm.Methods Totally 70 patients were divided into control group and medicine group according to their wishes,with 35 patients in each group.Both groups were restricted to an iodine diet.The medicine group was given Qinggan Sanjie Xiaoying Granules,1 sachet at a time,twice a day,orally.The treatment for both groups lasted for 4 weeks.20 healthy people were chosen as the healthy group.The clinical efficacy of both groups was observed.TCM symptom score,thyroid antibody titer levels(TPOAb,TGAb),changes in thyroid volume and isthmus of both groups before and after treatment were compared.Levels of serum IKKα,IKBα and TNF-α of the three groups were compared.Adverse reactions of patients daring the treatment period were monitored.Results The total effective rate of the medicine group was 85.71%(30/35),while the control group was 20.00%(7/35).The medicine group was superior to the control group(P<0.05).Compared with before treatment,the medication group showed significant improvement in TCM symptom scores,TPOAb and TGAb titer levels,thyroid volume,and thyroid isthmus thickness after treatment(P<0.05).After treatment,TCM symptom score,thyroid volume in the medicine group were lower than those in the control group(P<0.05),and the decrease rate of TPOAb titer was higher than that in the group(P<0.05).The levels of IKKα and TNF-α before treatment of medicine group and control group were higher than that in the healthy control group,and the level of IKBα was lower than that of the healthy control group(P<0.05);compared with before treatment,the levels of IKKα and TNF-α in the medicine group decreased,and the level of IKBα increased(P<0.05);after treatment,the levels of IKKα and TNF-α in the medicine group were lower than that in the control group,and IKBα was higher than the control group(P<0.05).No adverse events were observed during the treatment period in both groups of patients.Conclusion Qinggan Sanjie Xiaoying Decoction can reduce the antibody titer level,thyroid enlargement,isthmus thickness,and TCM syndrome score in the treatment of Hashimoto's thyroiditis.It is safe and effective in clinical practice.Qinggan Sanjie Xiaoying Decoction may play a therapeutic role by interfering with NF-κB signaling pathway.

Objective:To evaluate the clinical efficacy of Professor Ding Zhiguo's internal and external combined treatment of Hashimoto's disease, and to explore its mechanism.Methods:Prospective cohort study. A total of 85 patients of professor Ding Zhiguo from Sun Simmiao Hospital of Beijing University of Chinese Medicine and Dongzhimen Hospital of Beijing University of Chinese Medicine from August 2022 to March 2023 were selected and divided into control group (43 cases) and drug group (42 cases) by random number table method. Another 20 healthy volunteers were recruited for health control observation. The control group was given iodine restricted diet, the drug group was treated with Qinggan Sanjie Xiaoying Prescription combined with Liqi Sanjie Xiaoying Ointment, and the healthy control group was not treated with any intervention. Both drug group and control group were observed continuously for 4 weeks. TCM syndrome scores were performed before and after treatment. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to assess the degree of anxiety and depression, Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and fatigue severity Scale (FSS) was used to assess the degree of fatigue. Lower limb lymphedema self-sensory symptoms assessment questionnaire was used to evaluate the symptoms of lower limb lymphedema. The serum levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were measured by automatic electrochemiluminescence immunoassay, and the reduction rate was calculated. The levels of serum Akt, ERK and protein kinase C (PKC) were detected by ELISA. The thyroid volume was calculated and the anterior and posterior diameter of the isthmus was recorded. The clinical efficacy and safety were evaluated.Results:The total effective rate was 71.43% (30/42) in the drug group and 27.91% (12/43) in the control group, with statistical significance ( χ2=16.10, P<0.01). The serum TPOAb [137.95 (141.44) IU/ml vs. 153.40 (154.93) IU/ml, Z=-4.37] and TGAb [182.00 (238.52) IU/ml vs. 190.50 (257.55) IU/ml, Z=-2.13] levels in the drug group were lower after treatment ( P<0.01 or P<0.05), and the decrease rate of TPOAb [15.62 (21.90)% vs. -6.42 (32.89)%, Z=-4.12] and TGAb [5.25 (20.49)% vs. -0.72 (17.67)%, Z=-2.67] were higher than that in the control group ( P<0.01). The thyroid volume [11.37 (6.48) cm 3vs. 12.89 (6.63) cm 3, Z=-2.95] and isthmus thickness [0.27 (0.14) cm vs. 0.28 (0.15) cm, Z=-2.18] in the drug group were reduced after treatment compared with that before treatment ( P<0.05). TCM syndrome scores (6.10±1.38 vs. 14.42±7.35, t=-7.29), HAMA (5.21±1.32 vs. 9.28±2.25, Z=-7.02), HAMD (8.28±3.17 vs. 10.42±5.28, t=-2.26), PSQI (6.00±2.16 vs. 9.47±3.08, t=-6.01), FSS (34.71±5.51 vs. 38.23±8.35, t=-2.30), lower limb lymphedema self-induced symptom evaluation questionnaire scores (4.95±2.56 vs. 7.86±3.07, t=-4.74) after treatment were lower than before treatment and lower than control group ( P<0.001 or P<0.05).The serum levels of Akt [52.28 (17.72) μmol/L vs. 44.38 (2.75) μmol/L],ERK [2 843.43 (607.90) ng/L vs. 2 648.25 (290.74) ng/L],PKC [8.87 (3.10) pmol/L vs. 7.88 (1.25) pmol/L] in drug group were higher than those in the healthy control group before treatment ( P<0.05), the levels of Akt [37.37 (7.90) μmol/L vs. 44.38 (2.75) μmol/L], ERK [2 432.74 (402.56) ng/L vs. 2 648.25 (290.74) ng/L] in drug group were lower than those in the healthy group after treatment ( P<0.05). After treatment, the levels of Akt [37.37 (7.90) μmol/L vs. 52.28 (17.72) μmol/L, 49.56 (9.12) μmol/L], ERK [2 432.74 (402.56) ng/L vs. 2 843.43 (607.90) ng/L, 3 021.76 (360.22) ng/L], PKC [7.37 (1.84) pmol/L vs. 8.87 (3.10) pmol/L, 10.00 (2.42) pmol/L] in drug group were lower than before treatment and lower than control group ( P<0.01). There were no adverse events during treatment in both groups. Conclusion:The internal and external treatment of Hashimoto's disease by Professor Ding Zhiguo can effectively reduce the level of thyroid antibody titer, reduce the thyroid swelling and isthmus thickness, improve the clinical symptoms of patients with Hashimoto's disease, and may play a therapeutic role by interfering with MAPK signaling pathway.

BACKGROUND: Syringomyelia is a progressive chronic disease that leads to nerve pain, sensory dissociation, and dyskinesia. Symptoms often do not improve after surgery. Stem cells have been widely explored for the treatment of nervous system diseases due to their immunoregulatory and neural replacement abilities. METHODS: In this study, we used a rat model of syringomyelia characterized by focal dilatation of the central canal to explore an effective transplantation scheme and evaluate the effect of mesenchymal stem cells and induced neural stem cells for the treatment of syringomyelia. RESULTS: The results showed that cell transplantation could not only promote syrinx shrinkage but also stimulate the proliferation of ependymal cells, and the effect of this result was related to the transplantation location. These reactions appeared only when the cells were transplanted into the cavity. Additionally, we discovered that cell transplantation transformed activated microglia into the M2 phenotype. IGF1-expressing M2 microglia may play a significant role in the repair of nerve pain. CONCLUSION Cell transplantation can promote cavity shrinkage and regulate the local inflammatory environment.Moreover, the proliferation of ependymal cells may indicate the activation of endogenous stem cells, which is important for the regeneration and repair of spinal cord injury.

Objective To investigate the effects of Danshen polyphenolate combined with edara-vone on cognitive function,cerebral artery pulse index(PIMCA)and serum trypanoprotein-like pro-tein-1(VILIP-1)levels in patients with acute cerebral infarction(ACI).Methods A total of 88 pa-tients with ACI were selected as study objects.The patients were divided into single drug group(n=44)and combination group(n=44)according to random number table method.The single drug group was treated with edaravone,and the combination group was treated with edaravone combined with salvianolic acid for injection.The efficacy,cognitive function,PIMCA and serum VILIP-1 levels of the two groups were observed and compared.Results The overall effective rate of treatment in the combi-nation group was higher than that of the single drug group(81.82％versus 54.55％,P＜0.05).Af-ter treatment,the scores of Montreal Cognitive Assessment Scale(MoCA),Reactivity Exploration Scale(RSS)and Simple Mental State Assessment Scale(MMSE)in two groups were higher than be-fore treatment,and the combination group was higher than the single drug group(P＜0.05).After treatment,the levels of PIMCA and serum VILIP-1 in two groups were lower than before treatment,and the combination group was lower than the single drug group(P＜0.05).Conclusion Compared with edaravone alone,salvia miltiorrhiza polyphenolate injection combined with edaravone has a better therapeutic effect in ACI patients,which can effectively improve the patients'cognition,reduce PIMCA and serum VILIP-1 levels.

Objective To investigate the effects of Danshen polyphenolate combined with edara-vone on cognitive function,cerebral artery pulse index(PIMCA)and serum trypanoprotein-like pro-tein-1(VILIP-1)levels in patients with acute cerebral infarction(ACI).Methods A total of 88 pa-tients with ACI were selected as study objects.The patients were divided into single drug group(n=44)and combination group(n=44)according to random number table method.The single drug group was treated with edaravone,and the combination group was treated with edaravone combined with salvianolic acid for injection.The efficacy,cognitive function,PIMCA and serum VILIP-1 levels of the two groups were observed and compared.Results The overall effective rate of treatment in the combi-nation group was higher than that of the single drug group(81.82％versus 54.55％,P＜0.05).Af-ter treatment,the scores of Montreal Cognitive Assessment Scale(MoCA),Reactivity Exploration Scale(RSS)and Simple Mental State Assessment Scale(MMSE)in two groups were higher than be-fore treatment,and the combination group was higher than the single drug group(P＜0.05).After treatment,the levels of PIMCA and serum VILIP-1 in two groups were lower than before treatment,and the combination group was lower than the single drug group(P＜0.05).Conclusion Compared with edaravone alone,salvia miltiorrhiza polyphenolate injection combined with edaravone has a better therapeutic effect in ACI patients,which can effectively improve the patients'cognition,reduce PIMCA and serum VILIP-1 levels.