It is believed that the head and facial orifices are connected with the brain's spirit and the spirits of the five organs. Their functions， including vision， hearing， smell， taste， and speech， are manifestations of the activity of the spirit. Furthermore， head and facial orifice disorders are interrelated with spirit disorders， forming a cause-and-effect relationship. Acupuncture has a regulatory effect on the spirit. Based on this， acupuncture for regulating the spirit in treating head and facial orifice disorders is proposed. This includes regulating the brain's spirit to treat functional disorders， regulating the heart's spirit to clarify the functions of governing substances， regulating the organ's spirit to benefit the orifices and enhance the communication of the spirit， and regulating the liver's spirit to promote the flow of Qi （气） and relieve stagnation， thereby providing a framework for acupuncture to treat head and facial orifice disorders.

It is regarded that the disease location of refractory facial paralysis is in the channel sinews of the face， with its primary pathogenesis characterized by a combination of deficiency and stasis of the channel sinews. The integration of repeated shallow needling method and fire acupuncture can first remove stagnation within the channel sinews， and second utilize the warming effect of fire to reinforce yang， stimulate meridian qi， and nourish the channel sinews. This approach balances both supplementation and drainage manipulation， aligning with the underlying pathogenesis of deficiency and stasis combination. In clinical practice， diagnostic methods should be applied flexibly to accurately identify the affected channel sinews. The severity of facial symptoms， the size and mobility of the paralyzed facial muscles， as well as the depth and size of the reactive points identified through palpation， should be considered when determining the extent of the condition. By adjusting the appropriate level of stimulation， the fire acupuncture with repeated shallow needling method could effectively improve facial muscle morphology and function， promoting recovery from the disease.

The damage and death of retinal ganglion cells(RGCs)are central pathological events in optic nerve injury, leading to irreversible visual impairment. Autophagy, a regulated process of cellular degradation and death, is involved in the pathogenesis of various diseases, including tumors, neurological damage, and autoimmune disorders. Current research indicates that autophagy is significantly upregulated following optic nerve injury, exhibiting a dual role: while it may mediate cellular damage in the early stages, it tends to promote neuroprotection and axonal regeneration in later phases. Moreover, the activation of autophagy in microglia may play a crucial role in regulating their activation phenotype and neuroinflammation. Precisely modulating autophagy to promote RGCs survival and improve visual function has become a key challenge in the treatment of optic nerve injury. This review summarizes the role of autophagy in optic nerve injury and its therapeutic interventions.

OBJECTIVE: To observe the impact of indirect moxibustion with Taiyi moxa stick on pain severity and the quality of life in the patients with back myofascitis, and evaluate its clinical effect and safety. METHODS: Seventy-two patients with back myofascitis were randomly divided into an observation group (36 cases, 1 cases dropped out) and a control group (36 cases, 3 cases dropped out). Three to six ashi points were selected using acupoint diagnosis methods. In the observation group, the indirect moxibustion with Taiyi moxa stick was operated at the ashi points, once every other day, three times a week. In the control group, the topical treatment with diclofenac sodium gel was given at ashi points, three times daily. The treatment was delivered consecutively for 2 weeks in the two groups. The scores of visual analogue scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) were recorded before treatment, after 1 and 2 weeks of treatment, and after 4 weeks of treatment completion (follow-up visit) in the two groups separately. The difference value between VAS score after 2 weeks of treatment and that before treatment was taken as the primary outcome. The SF-36 score was observed before treatment, after 2 weeks of treatment and during the follow-up visit, and the safety was evaluated in the two groups. RESULTS: The difference value of VAS scores was (-4.57±1.50) points and (-2.40±1.31) points in the observation group and the control group, respectively, the reduction of the score in the observation treatment was larger than that of the control group (P<0.001). After 1 and 2 weeks of treatment and during the follow-up visit, VAS and SF-MPQ scores were reduced when compared with those before treatment (P<0.05) in the two groups, and VAS and SF-MPQ scores in the observation group were lower than those in the control group (P<0.05). In the follow-up visit, VAS and SF-MPQ scores in the observation group were dropped in comparison with those after 1 week of treatment (P<0.05), and these scores in the control group were elevated compared with those after 2 weeks of treatment (P < 0.05). After 2 weeks of treatment and during the follow-up visit, the score of each dimension and total score of SF-36 scale were increased in comparison with those before treatment in the observation group (P<0.05); and the scores of the dimensions except that of mental health of SF-36 scale were elevated in the control group (P<0.05). During the follow-up visit, in the control group, the scores of physical functioning, bodily pain, general health and role emotional were elevated when compared with those before treatment (P<0.05). After 2 weeks of treatment and during the follow-up visit, the score of every dimension and total score of SF-36 scale in the observation group were higher than those in the control group (P<0.05). During the follow-up visit, the score of bodily pain was increased when compared with that after 2 weeks of treatment in the observation group (P<0.05), while the scores of bodily pain and vitality were dropped in the control group (P<0.05). No adverse event happened in the two groups. CONCLUSION The indirect moxibustion with Taiyi moxa stick effectively reduces pain severity and improves the quality of life in the patients with back myofascitis. This therapy presents the superior and persistent effect compared with topical application of diclofenac sodium gel.
Humans ; Female ; Male ; Moxibustion ; Middle Aged ; Adult ; Treatment Outcome ; Acupuncture Points ; Young Adult ; Aged ; Quality of Life ; Myofascial Pain Syndromes/therapy*

Sarcoidosis is a granulomatous disease of unknown etiology that affects almost any organ. The clinical presentation, treatment responsiveness and outcome varies widely between patients. Patients with pulmonary sarcoidosis always need individualized treatment and should be monitored. In order to meet the above clinical needs, countries have successively formulated clinical diagnosis and treatment norms of sarcoidosis. This includes the clinical consensus on pulmonary sarcoidosis (BTS consensus) launched by the British Thoracic Society (BTS) in December 2020. This paper briefly describes the main parts of the BTS consensus to provide reference for the majority of clinical workers.

Some factors, such as age and gender, are common risks for the mild cognitive impairment (MCI) and late life depression. Multiple brain regions are involved in both MCI and late life depression. Late life depression is an early manifestation and risk factor for MCI. It is important to intervene early depressive symptoms.

Objective To determine the random spot albuminuria to creatinine ratio (ACR) of normal pregnant women , to track the pregnancy outcome , and to discuss the predictive value of ACR in women with hy-pertensive disorders complicating pregnancy (HDCP). Methods Except for 87 pregnant women suffering from HDCP, 2 038 pregnant women were enrolled in this study. ACR, routine examinations of blood and urine, blood biochemical, 24-hr urinary protein were determined. Results ACR, but not 24-hr urinary protein level,was sig-nificantly higher in women with HDCP. There was positive correlation between the ACR and 24-hr urinary protein quantitation. Age, gestational weeks, ACR, red blood cells, fasting plasma glucose, serum creatinine, total pro-tein were the independent risk factors for HDCP. The sensitivity , specificity and optimal cut off value of ACR for predicting HDCP were 0.78, 0.63, 1.46 mg/mmol. Conclusions There was positive correlation between ACR and 24-hr urinary protein quantitation , and ACR provided a more sensitive pathway for early predictionof HDCP.

Objective The aim of this randomized,double-blind,placebo-controlled trial was to evaluate the efficacy of the Saccharomyces boulardii (S.boulardii) power in preventing antibiotic-associated diarrhea (AAD) in hospitalized children with pneumonia.Methods Two hundred and forty-five hospitalized children with pneumonia were randomly divided into two groups,group 1 treated with antibiotics and S.boulardii power (n =104),and group 2 with antibiotics and placebo,along with S.boulardii power and zinc when suffered from diarrhea (n =141).All children received montmorillonite powder and fluid replacement therapy for diarrhea.The stool frequency and consistency were observed.Diarrhea incidence,diarrhea and pneumonia duration of treatment,and therapeutic effect were recorded.Results AAD is more prevalent in group 2 than in group 1 (P ＜0.05).A 55.7％ relative risk reduction in AAD was seen in group 1 compared with group 2 (RR =0.443,95％CI 0.233 ～ 0.845,P =0.012).Patients with preventive treatment of S.boulardii power in broup 1 had lower AAD incidence compared with those in group 2 (P ＜ 0.05).Both the diarrhea and pneumonia duration of treatment in group 1 were shorter than that in group 2(P =0.001 for diarrhea duration,P =0.030 for pneumonia duration,respectively).No drug related adverse reactions were found during the observation period.Conclusion Preventive use of S.boulardii power may effectively reduce the risk of AAD,improve therapeutic effect,and shorten hospital stays for hospitalized children with pneumonia.