Stroke is the leading cause of death and disability among adults in China， and its common complications include digestive system abnormalities， cognitive impairment， depression， stroke-associated pneumonia， and hemiplegia. The combination of traditional Chinese and Western medicine has great potential in treating post-stroke complications. Xinglou Chengqitang （XLCQT） is a representative prescription of alleviating the disease in the upper part by treating the lower part. It has definite therapeutic effect and high safety. Clinically， XLCQT is often used to treat stroke and its complications. However， the quantity and quality of clinical trials of XLCQT in treating post-stroke complications need to be improved. Additionally， since the basic research is weak， the material basis and multi-target mechanism for the efficacy of this prescription are unknown. This article reviews XLCQT in terms of the pharmacodynamic basis， medicinal properties， safety evaluation， and progress in clinical research and mechanisms in treating post-stroke complications. This article summarizes 22 key active ingredients of XLCQT in treating acute stroke complicated with syndrome of phlegm heat and fu-organ excess. Among these key active ingredients， resveratrol， kaempferol， luteolin， chrysoeriol， apigenin， （+）-catechin， and adenosine have good pharmacokinetic properties and high bioavailability. The mechanisms of XLCQT in treating post-stroke complications are complex， including inflammatory response， brain-gut axis， hypothalamic-pituitary-adrenal （HPA） axis， intestinal flora， neurotrophic factors， autophagy， oxidative stress， and free radical damage. This review helps to deeply understand the pharmacodynamic basis and mechanisms of XLCQT in treating post-stroke complications and provides a theoretical basis for the clinical application of XLCQT against post-stroke complications and the development of drugs.

The morphological characteristics and pathological progression of vulnerable plaques in atherosclerosis （AS） exhibit a high degree of similarity to the concept of "abscesses and ulcers" in traditional Chinese medicine （TCM）. Therefore， vulnerable atherosclerotic plaques can be analogized as "abscesses and ulcers within the vessels"， for which deficiency， stasis and toxin constitute the core pathogenesis. The pathological evolution progresses through three sequential stages， deficiency leading to pathological substances， with phlegm and stasis accumulating into a mass； the mass transforming into putridity， with internal decay and external thinning； putridity brewing toxin， and toxin accumulation threatening rupture， ultimately resulting in plaque instability. Accordingly， a stage-specific treatment strategy is established. In the early stage， it is suggested to supplement deficiency， resolve the mass， dissipate stasis， and prevent putridity， using Liujunzi Decoction （六君子汤） combined with Danshen Decoction （丹参饮） with modifications. In the middle stage， the treatment should focus on transforming putridity to generate new tissue， and rectifying healthy qi to consolidate the body， with modified Tuoli Xiaodu Powder （托里消毒散）. In the late stage， the treatment principle is clearing and resolving putridity toxin， cooling the blood， and preventing ulcerative rupture， using modified Simiao Yong'an Decoction （四妙勇安汤） combined with Xijiao Dihuang Decoction （犀角地黄汤）.

Objective: To investigate the association between emotional intelligence and sleep problems at the symptom level among junior and senior high school students, so as to provide new insights for interventions targeting junior and senior high school students sleep disorders. Methods: From November 2023 to May 2024, a stratified cluster random sampling method was employed to select 3 531 first year junior high school and first year senior high school students from 6 schools in Guangyuan City and Liangshan Yi Autonomous Prefecture in Sichuan Province, as well as Lhasa City in Tibet Autonomous Region. The Insomnia Severity Index Scale and the Wong and Law Emotional Intelligence Scale(WLEIS) were used to assess sleep problems and emotional intelligence. A network analysis was performed to explore the relationship between emotional intelligence and sleep disorders, and a gender based network comparison analysis was conducted. Results: The reported rate of sleep problems among junior and senior high school students was 47.3%, with severe sleep problems of 2.2%. Difficulty maintaining sleep, worry about sleep, and emotional application were the core symptoms in the network (node strength values: 1.11, 0.98, and 0.82, respectively). Dissatisfaction with sleep and emotional application served as bridge symptoms connecting emotional intelligence and sleep problems (bridge strength values: 1.77 and 1.59, respectively). The edge weights of the emotional intelligence and sleep problems network differed significantly between genders (maximum difference in edge weight values was 0.13， P <0.05). Conclusions Emotional application ability and dissatisfaction with sleep are the key nodes in the network connecting emotional intelligence and sleep problems. Targeted efforts to enhance emotional application ability may effectively reduce the risk of sleep problems among junior and senior high school students.

Objective:To explore the correlation between triglyceride-glucose (TyG) index-body mass index (BMI) product (TyG-BMI) and hypertension.Methods:Based on the cross-sectional survey data of adult hypertension prevalence in Hunan Province from June 2013 to May 2014, 4 012 subjects aged ≥18 years with complete key data were included. Binary logistic regression analysis was used to analyze the correlation between TyG-BMI and hypertension, and receiver operating characteristic (ROC) curve was used to compare the ability of TyG index and TyG-BMI to identify hypertension.Results:A total of 4 012 subjects were included in this study, with an average age of (54.6±12.6)years, and males accounted for 40.98%(1 644/4 012). The prevalence of hypertension was 38.33%(1 538/4 012). Logistic regression analysis showed that elevated TyG-BMI was an independent risk factor for hypertension ( P<0.05). In the fully adjusted model, each 1/4 increase in TyG-BMI was associated with a 1.017-fold increase in the risk of hypertension ( OR=1.017, 95% CI: 1.014-1.019). Compared with the lowest quartile group (Q 1), the higher quartile groups (Q 2, Q 3, Q 4) of TyG-BMI had a higher risk of hypertension, with OR values of 1.841, 2.265, and 4.386, respectively. Restricted cubic spline plot showed a linear dose-response relationship between TyG-BMI and the risk of hypertension (overall trend P<0.001). In subgroup analyses stratified by age, gender, smoking and drinking status, TyG-BMI was positively correlated with hypertension. In addition, ROC curve analysis showed that TyG-BMI had better diagnostic value for hypertension compared with TyG index. Conclusions:TyG-BMI is an independent risk factor for hypertension. Excessively high TyG-BMI or gradual increase of TyG-BMI will increase the risk of hypertension, and TyG-BMI has higher value in identifying hypertension compared with TyG index.

Objective:To evaluate the feasibility, safety, and clinical outcomes of full-time full-endoscopic lumbar interbody fusion (FELIF) using a bladed retractor fusion channel (BRFC) system with reversed-mounting designed instruments compared to a tubular fusion channel (TFC).Methods:This retrospective study analyzed 101 cases of uniportal coaxial endoscopic lumbar interbody fusion performed between June 2018 and April 2023. Based on the type of fusion channel utilized, patients were divided into the TFC group (59 cases) and the BRFC group (42 cases). The BRFC technique involved neurological decompression, endplate preparation, and interbody fusion performed under full-time endoscopic monitoring with reversed-mounting designed instruments. Key parameters, including surgery duration, intraoperative estimated blood loss (IEBL), complication incidence, and interbody fusion rate (assessed by Bridwell criteria), were compared between the two groups. Clinical outcomes, including visual analog scale (VAS) scores for back and leg pain, Japanese Orthopaedic Association (JOA) scores, and Oswestry Disability Index (ODI), were recorded preoperatively, postoperatively, and at the final follow-up. Additionally, disc height at the fusion level was measured at one week postoperatively.Results:The mean follow-up duration was 42.9±12.1 months in the TFC group and 20.9±4.9 months in the BRFC group. No statistically significant differences were observed between the two groups in terms of surgery duration, IEBL, complication incidence, or interbody fusion rate (Grade 1 or 2 by Bridwell criteria) ( P>0.05). For single-level cases, the TFC group showed significantly better short-term clinical outcomes than the BRFC group at one week postoperatively, with JOA scores of 23(20, 25) versus 20(18, 23) ( Z=3.020, P=0.003) and ODI scores of 16%(11%, 21%) versus 28%(21%, 41%) ( Z=4.740, P<0.001). For double-level cases, the JOA score in the TFC group [23(20, 25)] was also significantly better than that in the BRFC group [20(18, 21)] ( Z=2.054, P=0.040) at one week postoperatively. However, at the final follow-up, all clinical indicators showed no significant differences between the two groups ( P>0.05). The disc height at the fusion level significantly increased at one week postoperatively compared to preoperative measurements in both groups ( P<0.05). However, the BRFC group demonstrated a significantly more recovery of disc height at one week postoperatively [(1.46±0.28) cm] compared to the TFC group [(1.17±0.20) cm] ( t=5.947, P<0.001). Conclusion:Full-time FELIF using the BRFC system and reversed-mounting designed instruments is a feasible, safe, and effective approach. However, its short-term clinical outcomes appear inferior to traditional FELIF using the TFC system.

Objective:To compare the clinical outcomes of APTT-HTO and Biplanar-high tibial osteotomy (Biplanar-HTO) in treating medial compartment knee osteoarthritis.Methods:A non-randomized controlled trial was conducted. Twenty-eight patients with medial compartment knee osteoarthritis who underwent HTO at the Affiliated Hospital of Guizhou Medical University from August 2021 to January 2022 were enrolled. Based on the patients' surgical preference, they were assigned to either the APTT-HTO group ( n=15) or the Biplanar-HTO group ( n=13), followed up for 12 months postoperatively. Postoperative pain Visual Analog Scale (VAS) scores, Knee Society Score (KSS), changes in patellar height (Caton-Deschamps Index, CDI), and posterior tibial slope (PTS) were compared between the two groups. Results:The APTT-HTO group demonstrated a significantly shorter operative time (64.13±4.85 min) compared to the Biplanar-HTO group (81.54±6.09 min) ( P<0.05). No significant differences were observed in intraoperative correction (APTT-HTO: 12.19°±4.85°; Biplanar-HTO: 11.23°±3.02°) or postoperative drainage volume (APTT-HTO: 47.00±13.79 ml; Biplanar-HTO: 47.00±11.17 ml) ( P>0.05). At 12-month follow-up (APTT-HTO: 13.93±2.05 months; Biplanar-HTO: 14.08±2.14 months; no dropouts), the APTT-HTO group showed no significant changes in PTS (9.32°±2.04° vs. preoperative 8.82°±1.89°) or CDI (0.95±0.11 vs. 0.98±0.11) ( P>0.05), while the Biplanar-HTO group exhibited increased PTS (13.27°±1.99° vs. 8.86°±1.99°) and decreased CDI (0.64±0.10 vs. 0.97±0.16) ( P<0.05). The differences in PTS and CDI between the APTT HTO group and the Biplanar HTO group at 12 months after surgery were statistically significant ( P<0.05). Both groups achieved significant clinical improvements: in APTT-HTO, VAS decreased (preopreation 4.80±1.01 to postopreation 1.06±0.88), KSS knee scores increased (47.67±12.03 to 87.93±4.38), and KSS function scores improved (48.00±4.93 to 67.00±5.91); in Biplanar-HTO, VAS reduced (5.08±1.12 to 1.85±1.14), KSS knee scores rose (46.85±11.48 to 85.85±5.11), and KSS function scores enhanced (46.92±5.60 to 66.92±5.22) ( P<0.05 for all). Complications included soft tissue irritation (2 cases per group), with Biplanar-HTO additionally reporting deep vein thrombosis (1 case), hinge fracture (1 case), and patella baja (3 cases). Conclusions:Both APTT-HTO and Biplanar-HTO effectively treat medial compartment knee osteoarthritis. However, APTT-HTO outperforms Biplanar-HTO in preventing postoperative patella infera and minimizing alterations in PTS.

Objective:To compare the clinical outcomes between all-inside and conventional transtibial tunnel reconstructions for posterior cruciate ligament (PCL) injuries.Methods:A retrospective study was conducted to analyze the clinical data of the 108 patients who had been treated for PCL injuries at Department of Arthrosis Surgery, Xuzhou Renci Hospital, from March 2021 to March 2023. There were 48 females and 60 males, with an age of (30.3±10.8) years and an injury-to-surgery interval of (25.7±6.4) days. Of them, 49 left and 59 right knees were affected. By the difference in the tunnel reconstruction, the patients were divided into 2 groups: an all-inside group ( n=52) in which the PCL was reconstructed using the all-inside techniques and a conventional group in which the PCL was reconstructed using the conventional techniques. The following were observed and compared: operation time and postoperative hospital stay; visual analogue scale (VAS) pain scores, The International Knee Documentation Committee (IKDC) subjective scores and Lysholm knee function scores at preoperation, postoperative 3 months and the last follow-up; posterior drawer test, posterior sag sign, reverse Lachman test and the diameter and morphology of the PCL shown by the knee joint MRI at the last follow-up. Results:The baseline characteristics were comparable between the 2 groups ( P>0.05). All patients were followed up for (12.3±1.2) months. The all-inside group incurred significantly longer operation time [(128.3±7.6) min] than the conventional group [(103.5±6.9) min] ( P<0.05), but no significant difference was observed in postoperative hospital stay between the 2 groups ( P> 0.05). There was no significant difference in VAS pain score, IKDC subjective score, or Lysholm score between the 2 groups at preoperation, postoperative 3 months or the last follow-up ( P>0.05). In both groups, the VAS pain scores, IKDC subjective scores and Lysholm scores at postoperative 3 months and the last follow-up were significantly improved compared with those at preoperation ( P<0.05). At the last follow-up, the posterior drawer test, posterior sag sign, reverse Lachman test were negative in both groups, and the knee joint MRI showed good diameter and morphology of the PCL reconstructed. Conclusions:Both conventional and all-inside reconstructions yield satisfactory clinical outcomes for PCL injuries, demonstrating comparable functional recovery and complication incidence. However, the all-inside technique requires longer operation time than the conventional approach.

Keratoconus is a progressive eye disease that primarily affects individuals in adolescence and early adult-hood.Dilating changes in the cornea cause it to thin and become steeper,resulting in irregular astigmatism and decreased vision.Keratoconus has multiple etiologies and pathogenic factors,including genetic,environmental,biomechanical and cellular factors.Environmental factors encompass eye rubbing,UV exposure,and wearing contact lenses.At the cellular level,the interaction of complex factors such as hormonal changes,extracellular enzyme activity,and changes in biochemi-cal and biomechanical signaling pathways disrupts collagen crosslinking within the stroma,leading to the loss and distortion of the integrity of normal corneal anatomical structures.Detection of keratoconus in its early stages remains a challenge,and corneal topographic maps are the primary diagnostic tool for keratoconus.However,in early cases,the use of a single parameter to diagnose keratoconus is not sufficient.In addition to corneal topographic maps,corneal thickness measure-ments and high-order aberration data are now commonly used detection methods.Clinically,keratoconus is diagnosed by clinical examination and corneal imaging.Advanced imaging platforms can improve the detection rate of keratoconus,facil-itating early diagnosis and monitoring of disease progression.Treatment strategies for keratoconus are tailored to the severi-ty and progression of the disease.In the early stages,glasses or soft contact lenses for vision correction are sufficient.As the disease progresses,rigid breathable contact lenses or scleral contact lenses may be needed.Corneal crosslinking has emerged as a key treatment aimed at stopping the progression of corneal dilation.The epidemiology,pathogenesis and treatment of keratoconus will be comprehensively reviewed in this paper.

Naringin is a flavonoid compound with a wide range of biological and pharmacologi-cal activities,which can be used in treating tumor,diabetes,neurodegenerative diseases,cardiovascu-lar diseases,metabolic syndrome,etc.Among them,the application of naringin in cardiovascular diseases has attracted the attention of many re-searchers.This article mainly reviews the role of naringin in cardiovascular disease(regulating blood lipids,anti atherosclerosis,lowering blood pres-sure,inhibiting myocardial hypertrophy,anti myo-cardial infarction,protecting myocardial ischemia/reperfusion injury,reducing myocardial ischemia/reperfusion injury and improving pulmonary arteri-al hypertension),the protective effect on cardiotox-icity,and the signal pathways in cardiovascular dis-ease(PI3K-Akt-mTOR,p-eNOS/p-Akt/p-ERK,miR-126/GSK-3 β/β-Catenin),clinical trials,etc.This pa-per is expected to review the current research sta-tus of naringin in cells and animal models so as to reveal its clinical application prospects and provide reference for further research in related fields.

Objective:To observe the effect of reconstruction of Achilles insertion with Suture bridge technology after extirpation of avulsed bones block in the treatment of Beavis type Ⅲ avulsion fracture of the calcaneal tuberosity.Methods:The retrospective analysis was used. From January 2013 to January 2023, 78 patients with Beavis type Ⅲ avulsion fracture of the calcaneal tuberosity, treated in the Department 1 of Foot and Ankle and Department 2 of Foot and Ankle of the second Hospital of Tangshan were selected as research objects. According to different operation performed, 41 patients with the reconstruction of Achilles insertion with Suture bridge technology after extirpation of avulsed bones block were divided into the observation group and 37 patients with the open reduction internal fixation (ORIF) were divided into the control group. The delayed wound healing rate and the Haglund malformation rate, Maryland foot score, the American Orthopedic Foot and ankle Society (AOFAS) ankle-hindfoot score, the pain Visual Analogue Scale/Score (VAS) score, the Victorian Institute of Sports Assessment-Achilles (VISA-A) score, Arner-Lindholm scale of One-year postoperative were compared between these two groups. The measurement data with normal or approximate normal distribution were analyzed using t test, count data using chi-square test for comparison of between groups.Results:One year after surgery, the incidence of Haglund malformation in the observation group was 4.88% (2/41), which was lower than the control group's 29.73% (11/37). The difference between the two groups was statistically significant ( χ2=8.65,P=0.003). The excellent and good rate of Maryland foot function assessment in the observation group was 85.37% (35/41) higher than that in the control group (56.76% (21/37), and the difference between the two groups was statistically significant ( χ2=7.86, P=0.005). The AOFAS ankle hind foot score of the observation group ((90.44±6.66) points) was higher than that of the control group ((82.84±7.43) points), and the difference between the two groups was statistically significant ( t=4.77, P<0.001). The pain score of the observation group ((1.51±1.05) points) was lower than that of the control group ((2.95±1.13) points), and the difference between the two groups was statistically significant ( t=-5.81, P<0.001). The Achilles tendon score of the observation group ((81.05±5.87) points) was higher than that of the control group ((71.62±8.60) points), and the difference between the two groups was statistically significant ( t=5.70, P<0.001). The excellent and good rate of Arner Lindholm treatment efficacy evaluation for Achilles tendon in the observation group was 87.80% (36/41), which was higher than that in the control group (67.57% (25/37)), and the difference between the groups was statistically significant. Conclusion:The treatment of Beavis Ⅲ type calcaneal nodule avulsion fracture by removing the bone fragment can simultaneously remove the hypertrophic osteophyte, hardened bone, and Haglund deformity of the calcaneus, and clean the degenerated Achilles tendon and inflammatory tissue around the insertion point; The use of suture bridge technology to reconstruct the Achilles tendon insertion point has the advantages of high fixed strength, allowing early functional exercise, avoiding secondary removal of internal fixation, and achieving satisfactory therapeutic effects, which is worthy of clinical promotion.