The rationale for the design of control groups in tuina clinical trial is the foundation for rigorously validating the effectiveness and safety of this therapy. This article reviewed the current state of the design of tuina placebo in control groups of clinical trials， pointed out the necessity of setting up tuina placebo in clinical trials of tuina， analyzed the challenges in implementing blinding of tuina manipulation， and concluded that tuina placebo is still challenged by the placebo effect， the diversification of tuina manipulation but the lack of standardization， and the difficulty of implementing blinding due to the high level of public awareness of tuina. This article also summarized the design of placebo manipulation in three types of clinical trials， including spinal manipulation， acupressure， and paediatric tuina， and proposed four strategies for designing placebo tuina manipulation-controlling placebo effects， developing operational standards for placebo tuina manipulation， ensuring the rigor of blinding implementation， and applying new technologies to enhance the standardization and blinding capacity of placebo tuina methods. So the article is aimed at improving the methodological quality of tuina clinical trial designs， and promoting the standardization and scientificity of tuina clinical trial design.

Ischemia-reperfusion injury (IRI) can lead to organ dysfunction and tissue necrosis in the liver, kidney, myocardium and spinal cord, and there is currently a lack of effective treatment options. Human umbilical cord mesenchymal stem cell (HUC-MSC) and their derivatives have anti-inflammatory, anti-apoptotic, reactive oxygen species scavenging, mitochondrial and endothelial function improvement properties, and are ideal gene therapy carrier cells, providing new possibilities for the treatment of IRI in different organs. This article reviews the concept and mechanisms of IRI, the biological characteristics of HUC-MSC and their derivatives and their comparison with mesenchymal stem cells from other sources, and the mechanisms of HUC-MSC in treating IRI in different organs. It also summarizes and analyzes the advantages and disadvantages of HUC-MSC in protecting different organs from IRI, and prospects future research directions to explore more valuable research paths.

Objective To investigate the expression of neutrophil extracellular traps (NETs) and phagocytic function in the peripheral blood of patients with hepatic alveolar echinococcosis (HAE), and to examine their correlations with clinical inflamma tory indicators and liver functions. Methods A total of 50 patients with HAE admitted to Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qinghai University from August 2022 to June 2023 were enrolled, while 50 age- and gender-matched healthy individuals from the Centre for Healthy Examinations of the hospital during the same period served as controls. The levels of NETs markers neutrophil myeloperoxidase (MPO) and neutrophil elastase (NE) were measured using enzyme-linked immunosorbent assay (ELISA). Peripheral blood neutrophils were isolated using density gradient centrifugation, stimulated in vitro using phorbol 12-myristate 13 acetate (PMA), and the levels of MPO and citrullination histone H3 (CitH3) released by neutrophils were quantified using flow cytometry. The phagocytic functions of neutrophils were examined using flow cytometry. In addition, the correlations of MPO and NE levels with clinical inflammatory indicators and liver biochemical indicators were examined using Spearman correlation analysis among HAE patients. Results The peripheral blood plasma MPO［(417.15 ± 76.08) ng/mL vs. (255.70 ± 80.84) ng/mL; t = 10.28, P < 0.05］, NE［(23.16 ± 6.75) ng/mL vs. (11.92 ± 3.17) ng/mL; t = 10.65, P < 0.05］and CitH3 levels［(33.93 ± 18.93) ng/mL vs. (19.52 ± 13.89) ng/mL; t = 4.34, P < 0.05］were all significantly higher among HAE patients than among healthy controls, and a lower phagocytosis rate of neutrophils was detected among HAE patients than among healthy controls［(70.85 ± 7.32)% vs. (94.04 ± 3.90)%; t = 20.18, P < 0.05］, and the ability to produce NETs by neutrophils was higher among HAE patients than among healthy controls following in vitro PMA stimulation. Pearson correlation analysis showed that the phagocytosis rate of neutrophils correlated negatively with platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), interleukin-6 (IL-6) level and C-reactive protein (CRP) level (r_s = −0.515 to −0.392, all P values < 0.05), and the MPO and NE levels positively correlated with inflammatory markers NLR, PLR, CRP and IL-6 (r_s = 0.333 to 0.445, all P values < 0.05) and clinical liver biochemical indicators aspartic transaminase, alanine aminotransferase, direct bilirubin and total bilirubin among HAE patients (r_s = 0.290 to 0.628, all P values < 0.001). Conclusions Excessive formation of NETs is found among HAE patients, which affects the phagocytic ability of neutrophils and results in elevated levels of inflammatory indicators. NETs markers may be promising novel biomarkers for early diagnosis, monitoring, and severity assessment of liver disease.

Hepatic echinococcosis is a chronic parasitic disease, which is caused by the larvae of Echinococcus multilocularis. It has a high risk of disability and mortality, which is also known as "parasite cancer". In clinical practice, hepatic echinococcosis can be divided into hepatic alveolar echinococcosis and hepatic cystic echinococcosis. Hepatic echinococcosis is widely prevalent worldwide. It mainly occurs in the populations residing agricultural and pastoral areas in western China, posing significant threats to the quality of life of local residents. At present, surgery is the main treatment for hepatic echinococcosis in clinical settings. With rapid development of surgical diagnosis and treatment technology and deepening understanding of hepatic echinococcosis, diagnosis and treatment regimens have also been constantly improved. In this article, research progresses on the diagnosis and treatment of hepatic alveolar echinococcosis were reviewed, aiming to provide reference for clinicians, deliver early diagnosis and treatment, mitigate adverse effects of this disease upon patients and improve clinical prognosis.

【Objective】 To explore the correlation between different feeding styles of caregivers and diet quality of children with nutritional problems, in order to provide reference for making effective feeding guidance and intervention strategy. 【Methods】 From January 2022 to August 2023, 2- to 6-year-old children who had been enrolled in kindergartens or nurseries and their caregivers from the combined outpatient department of Child Healthcare and Nutrition in Shanghai Children′s Hospital were selected into this study.The amount of dinner served and consumed was obtained through the three-day dinner intake survey, and the Chinese Healthy Eating Index (CHEI) was calculated.Feeding styles were divided into four groups through the Caregiver Feeding Style Questionnaire.Pearson correlation analysis was used to determine the correlation between served and consumed CHEI score.Chi-square test, t-test and ANOVA were used to compare the differences in CHEI score for dinner consumed in children with different feeding styles. 【Results】 1) Totally 133 parent-child pairs were included in this study.There were 68 boys (51.1%) and 65 girls (48.9%), with an average age of (4.6±0.6) years.2) CHEI scores for dinner served was highly correlated with that for dinner consumed (r=0.90, P<0.05).There was statistically significant difference between the CHEI score for dinner served and consumed by authoritative and authoritarian feeding styles (t=2.538, 1.732, P<0.05).3) After adjusting body shape, children in the authoritative feeding style actually completed a significantly higher diet quality CHEI score than those in the authoritarian feeding style (P<0.05).4)Authoritative and indulgent feeding styles had statistical differences in the distribution of children′s body size (χ²=13.587, P=0.035). 【Conclusions】 Parents with authoritarian feeding style and indulgent feeding style have worse control over their children′s dietary completion.Children with authoritative feeding style have higher dietary quality than those with authoritarian feeding style.Children with indulgent feeding style may have a higher proportion of non-low weight than those with authoritative feeding style.Although feeding style could not reverse the outcome of body shape deviation in children with disease, it may have some positive effects.

Benign liver lesions mainly include hepatic hemangioma， focal nodular hyperplasia of the liver， hepatocellular adenoma， and hepatic angiomyolipoma. Hepatic alveolar echinococcosis is a type of parasitic disease， and since it mainly occurs in the liver， it is also a benign lesion of the liver. The clinical treatment of benign liver lesions is mainly based on follow-up observation， supplemented by surgical resection. For patients with end-stage diseases， liver transplantation can be performed due to the large volume of the lesion， the invasion of a number of surrounding large vessels， unclear anatomic location， and the possibility of intraoperative rupture and massive hemorrhage. Since patients with poor liver function based on the liver allocation score for organ donation are more likely to get donor liver， it is difficult for patients with benign liver lesions to obtain the corresponding donor liver resources due to the growth pattern of benign liver lesions， thereby leading to the limited application of allogeneic liver transplantation. Since its emergence in the 1980s， ex vivo liver resection and autotransplantation （ELRA） has brought a new way for the treatment of such patients. This article summarizes the current application of ELRA in benign liver lesions， in order to provide a reference for diagnosis and treatment by clinical medical staff.

Objective To investigate the changes of cortical thickness in patients with insomnia disorder(ID).Methods High-resolution MRI data were collected from 32 ID patients(ID group)and 30 healthy controls(HC)(HC group).The cortical thickness of both groups were analyzed using statistical parametric mapping 12(SPM12)software,while considering age,gender,and educational level as covariates.The cortical thickness in brain regions showed statistically significant differences was extracted for Pearson's correla-tion analyses with sleep and mood-related scales.Results Compared with the HC group,the ID group exhibited significantly decreased cortical thickness in brain regions such as the left insula,fusiform gyrus,orbitofrontal lobe,superior temporal gyrus,middle temporal gyrus,lateral occipital lobe and right caudal anterior cingulate gyrus[P＜0.05,family-wise error(FWE)correction].Furthermore,reduced cortical thickness of the cingulate gyrus was negatively correlated with the Pittsburgh sleep quality index(PSQI)score(r=-0.437,P=0.012).Conclusion The cortical thickness of several brain regions associated with sleep and mood are significantly reduced in patients with ID,providing potential neuroimaging evidence for understanding the pathophysiological mechanism of ID.

Objective To investigate the effect of salidroside(SAL)on the proliferation and migration of human vascular endothelial cell line EA.hy926.Methods The cells were divided into control group and test groups of 1,10 and 100 nmol/L SAL,10 nmol/L SAL+2 μg/mL avastin(vascular endothelial growth factor(VEGF)blocker)group,10 nmol/L SAL+2 μg/mL IgG(blocker negative control)group,10 nmol/L SAL+8 μg/mL avastin group,10 nmol/L SAL+8 μg/mL IgG group,10 μmol/L YC-1[hypoxia inducible factor-1α(HIF-1α)blocker]group and 10 μmol/L YC-1+10 nmol/L SAL group.The proliferation and migration of EA.hy926 cells were detected by MTS assay and Transwell cell migration experiments.RT-qPCR and Western blot were used to measure the gene and protein level of HIF-1α and VEGF.The luciferase report gene experiment was used to find the effect of SAL on HIF-1α transcription activity of EA.hy926 cells.The guanylate cyclase activator(YC-1)was used as a HIF-1α blocker to verify potential effect of SAL on the expression of VEGF through HIF-1α.Results SAL significantly promoted proliferation of EA.hy926 cells(P＜0.05)and the proliferation promoting effect of SAL(10 nmol/L)was significantly reduced by the VEGF blocker bevacizumab avastin(2 μg/mL)(P＜0.05).SAL significantly promoted migration of EA.hy926 cells(P＜0.05),and this effect was significantly inhibited by avastin(8 μg/mL)(P＜0.05).SAL increased the expression of HIF-1α and VEGF gene and protein,and promoted the transcription of HIF-1α(P＜0.05).The level of HIF-1α and VEGF protein decreased by YC-1,a HIF-1α bloc-ker(P＜0.05).Conclusions HIF-1α/VEGF pathway is potentially involved in SAL promoted proliferation and migration of EA.hy926 cells.

Objective:To analyze the bacteria spectrum and antimicrobial resistance profile of bacterial meningitis among children in Baoji.Methods:Based on the acute meningeal and encephalitis syndrome surveillance project, cerebrospinal fluid samples were collected from 774 cases of bacterial meningitis in Baoji Municipal Maternal and Health Hospital from January 2016 to December 2023. Bacterial culture and drug sensitivity test were carried out.Results:A total of 105 positive strains were isolated with the detection rate of 13.57% (105/774). Among them, gram-positive strains accounted for 80.00% (84/105), mainly including Staphylococcus epidermidis, Staphylococcus hominis, and Streptococcus pneumoniae. Gram-negative bacteria accounted for 20.00% (21/105), and the predominant strain was Escherichia coli. Pathogenic bacteria were detected in every month of the year, with two peaks in March and September (26.67%, 28/105). The youngest was infected 20 min after birth, and the oldest was nine years old. There were statistical differences in the detection rates among different age groups (χ 2=35.91, P<0.05). The positive rate in the toddler group was lower than that in the infant group, the pre-school age group and the school age group, respectively (χ 2=15.01, 7.09, and 10.08; all P<0.05). There was no statistical difference between the toddler group and the neonate group (χ 2=1.60, P>0.05). The strains detected in the neonate group accounted for 44.76% (47/105), mainly including Escherichia coli and Staphylococcus epidermidis; the strains in the infant group accounted for 26.67% (28/105), mainly including Streptococcus pneumoniae; the strains in the toddler group accounted for 3.81% (4/105), mainly including Staphylococcus epidermidis; the strains in the pre-school age accounted for 11.43% (12/105), mainly including Staphylococcus epidermidis; the strains in the school age group accounted for 13.33% (14/105), mainly including Streptococcus pneumoniae. The results of drug sensitivity test showed that the resistance rates of Staphylococcus epidermidis to ampicillin/sulbactam, clindamycin, and levofloxacin were 47.06% (8/17), 41.18% (7/17), and 23.53% (4/17), respectively. Staphylococcus epidermidis strains were sensitive to vancomycin and linezolid. All of the Streptococcus pneumoniae strains were resistant to erythromycin and clindamycin, but sensitive to vancomycin and linezolid. The resistance rate of Streptococcus pneumoniae to penicillin was 69.23% (9/13). The resistance rates of Escherichia coli to ampicillin, levofloxacin, ceftriaxone, and cefotaxime were 66.67% (8/12), 41.67% (5/12), 33.33% (4/12), and 41.67% (5/12), respectively, but they were sensitive to ampicillin/sulbactam, cefoperazone/sulbactam, amikacin, and meropenem. Streptococcus agalactis strains were sensitive to penicillin, linezolid, and vancomycin, but resistant to erythromycin, clindamycin, ampicillin, and levofloxacin. Conclusions:The main pathogens causing bacterial meningitis in Baoji city are Staphylococcus epidermidis, Streptococcus pneumoniae, and Escherichia coli. The distribution of bacteria is varied in different age groups. The diagnosis and treatment of bacterial meningitis should be made based on the bacterial spectrum characteristics and the results of antimicrobial resistance profile.

The arising of biliary and pancreatic ampulla diseases is almost subtle, parti-cularly the symptoms are not readily apparent in the early stages, and patient condition become worse when jaundice and other symptoms manifest. This region′s imaging evaluation is highly intricate. There are significant similarities in the clinical symptoms of biliary and pancreatic ampulla disorders due to their similar imaging findings, complicated architecture, and close proximity to neighboring tissue structures, which make qualitative diagnosis difficult. In order to assist doctors in making treatment choices, the authors provide an overview of the application of endoscopic ultra-sound in the diagnosis of biliary and pancreatic ampulla diseases.