Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Autism spectrum disorder (ASD) is one of the common neurodevelopmental disorders in children. Its etiology and pathogenesis are poorly understood. Previous studies have suggested potential changes in the complement and coagulation pathways in individuals with ASD. In this study, using multiple reactions monitoring proteomic technology, 16 of the 33 proteins involved in this pathway were identified as differentially-expressed proteins in plasma between children with ASD and controls. Among them, CFHR3, C4BPB, C4BPA, CFH, C9, SERPIND1, C8A, F9, and F11 were found to be altered in the plasma of children with ASD for the first time. SERPIND1 expression was positively correlated with the CARS score. Using the machine learning method, we obtained a panel composed of 12 differentially-expressed proteins with diagnostic potential for ASD. We also reviewed the proteins changed in this pathway in the brain and blood of patients with ASD. The complement and coagulation pathways may be activated in the peripheral blood of children with ASD and play a key role in the pathogenesis of ASD.
Child ; Humans ; Autism Spectrum Disorder/metabolism* ; Proteomics ; Brain/metabolism*

Objective Exploring the relationship between anxiety symptoms and neurometabolism in the ventrome-dial prefrontal cortex(vmPFC)of adolescents with bipolar depression.Methods Thirty-six adolescent patients with bi-polar depression were assessed and grouped by using the 14-item Hamilton anxiety rating scale(HAMA),including 20 pa-tients with anxiety symptoms and 16 patients without anxiety symptoms.The severity of depressive symptoms was assessed using the 24-Hamilton depression scale(HAMD),and 1H-magnetic resonance spectroscopy(1H-MRS)was used.The dif-ference of vmPFC neurometabolism between 2 groups was compared.Results Compared with the group without anxiety symptoms,the HAMD score[24.50(24.00,26.75)vs.23.00(22.00,24.00)]and the proportion of family history(40.0%vs.0)were significantly higher in the group with anxiety symptoms than in the group without anxiety symptoms(P<0.05).The level of mI/Cr was higher in the group with anxiety symptoms than that in the group without anxiety symptoms(0.58±0.12 vs.0.47±0.11),and the difference was significant(P<0.05).Cho/Cr and HAMD scores in patients with anxiety symptoms were positively correlated(r=0.589,P=0.006),and mI/Cr was negatively correlated with disease duration(r=-0.481,P= 0.032).Conclusions Anxiety symptoms in adolescent bipolar depression patients may be related to elevated levels of mI,a neurometabolite in the brain region of vmPFC.

Objective:To study the short-term clinical outcomes of different courses of antenatal corticosteroids (ACS) for preterm twins.Methods:From January 2017 to December 2021, preterm twins with gestational age (GA) 24-34 weeks admitted to the neonatal ward of our hospital and received ACS were retrospectively studied. The infants were assigned into single-course group, partial-course group and multiple-course group according to ACS courses. The short-term clinical outcomes were compared among the groups. SPSS software version 25.0 was used for statistical analysis.Results:A total of 286 infants were enrolled in this study, including 128 in single-course group, 89 in partial-course group and 69 in multiple-course group. Compared with single-course group, the risks of neonatal respiratory distress syndrome (RDS) in both partial-course group ( OR=2.332, 95% CI 1.028-5.293, P=0.043) and multiple-course group ( OR=3.872, 95% CI 1.104-13.584, P=0.034) were higher. The birth length in multiple-course group ( β=-0.016, 95% CI -0.029 - -0.002, P=0.024) was lower than single-course group. Conclusions:The risks of neonatal RDS in preterm twins are higher in partial-course and multiple-course of ACS. A full course of ACS should be used to prevent neonatal RDS until further evidence of effectiveness is available.

Objective:To investigate the level of plasma Betatrophin in pregnant women with gestational diabetes mellitus (GDM) and its correlation with the control of blood glucose.Methods:Forty-five pregnant women with GDM(GDM group) who received regular obstetric examinations in the Huaihua First People′s Hospital from July 2019 to January 2021 and 50 pregnant women with normal glucose tolerance (NGT) (NGT group) during the same period were enrolled in this study. Blood glucose and blood lipid indicators were collected, plasma Betatrophin level was detected, Logistic regression analysis was used to screen the influencing factors of blood glucose control effect, the pregnancy outcome was followed up, the predictive value of Betatrophin level in blood glucose control and pregnancy outcome was evaluated by receiver operating characteristic (ROC) curve.Results:The levels of systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FPG), 2 h postpartum blood glucose (2 h PG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), 2 h postprandial insulin (2 h FINS), insulin resistance index (HOMA-IR), low density lipoprotein cholesterin (LDL-C) and plasma Betatrophin in the GDM group were higher than those in the NGT group, and insulin function index (HOMA-β) and high density lipoprotein cholesterin (HDL-C) were lower than those in the NGT group ( P<0.05). Pearson correlation analysis showed that plasma Betatrophin level was positively correlated with HbA 1c and HOMA-IR in pregnant women and the GDM group ( r = 0.310, 0.314, 0.341, 0.333; P<0.05). In the GDM group, 12 patients with poor glucose control, 33 patients with good glucose control, the FPG, HbA 1c, HOMA-IR and plasma Betatrophin levels in poor glucose control patients were higher than those in good glucose control patients, HOMA-β was lower than that in the good glucose control patients: (5.82 ± 0.98)mmol/L vs. (5.04 ± 1.11) mmol/L, (9.78 ± 2.15)% vs. (8.22 ± 1.41)%, 2.71 ± 0.56 vs. 2.24 ± 0.48, (1 345.12 ± 256.32) ng/L vs. (1 165.10 ± 217.41) ng/L, 144.15 ± 22.71 vs. 158.63 ± 20.26, there were statistical differences ( P<0.05). The area under the curve of plasma Betatrophin level to predict the effect of blood glucose control was 0.775. A total of 8 pregnant women with GDM had poor pregnancy outcome, and the area under the curve predicted pregnancy outcome by plasma Betatrophin level was 0.728. Conclusions:The level of plasma Betatrophin in patients with GDM is closely related to the degree of insulin resistance and the effect of blood glucose control, and can provide some reference for clinical evaluation and therapeutic effect prediction.

Objective:To investigate the preoperative nutritional status of cardiac surgery patients in southwest China, analyze the incidence and characteristics of nutritional risk, and provide basis for establishing a standardized individualized nutritional intervention program for cardiac surgery patients.Methods:A cross-sectional survey was conducted on the nutritional status and intervention status of preoperative patients in cardiac surgery department of 23 general hospitals in Yunnan, Guizhou, Sichuan and Chongqing districts. At 00: 00 on July 7, 2022, the patients aged > 18 years old in cardiac surgery departments of the above hospitals who planned to undergo surgical treatment were enrolled as the survey objects to investigate the nutritional status on July 6, 2022 (the survey date), including basic information (general information, nutrition indicators, etc.), nutrition screening and evaluation (nutrition risk screening and organ support, etc.), nutrition treatment (nutrition supplement methods and prescriptions, etc.) and nutrition awareness of medical staff.Results:The 126 questionnaires were collected, of which 125 were valid (99.2%). ① Basic information: of the 125 patients, 67 patients were male (53.6%) and 58 patients were female (46.4%). The age ranged from 19 years old to 86 years old, with an average of (53.13±14.74) years old. Body mass index (BMI) was (22.21±3.78) kg/m 2. The age and BMI of men were significantly higher than those of women [age (years old): 56.63±13.34 vs. 49.09±15.35, BMI (kg/m 2): 22.74±3.86 vs. 21.59±3.61, both P < 0.05]. Of the 125 patients, 75 had valvular disease and 50 were with non-valvular diseases, which mainly included congenital heart disease [19 cases (15.2%)], aortic dissection [13 cases (10.4%)], coronary heart disease [12 cases (9.6%)], etc. The course of disease was 0.5 hour to 36 years, of which 93 patients (74.4%) were more than 6 months and 32 patients (25.6%) were equal to or less than 6 months. The proportion of female patients with disease duration > 6 months was significantly higher than that of male patients [87.9% (51/58) vs. 62.7% (42/67), P < 0.01]. The basic diseases mainly included hypertension [38 cases (30.4%)], coronary heart disease [12 cases (9.6%)], diabetes [7 cases (5.6%)], chronic obstructive pulmonary disease [COPD, 6 cases (4.8%)], etc. Among 125 patients, total protein (TP) < 60 g/L in 24 cases (19.2%), albumin (Alb) < 40 g/L in 64 cases (51.2%), anemia [male hemoglobin (Hb) < 120 g/L, female Hb < 110 g/L] in 33 cases (26.4%). A total of 60 cases of prealbumin data were collected, of which 23 cases (38.3%) were less than 200 mg/L.② Nutrition screening and assessment: 33.6% of the 125 patients did not undergo routine nutrition screening after admission, including the provincial and municipal tertiary hospitals. Among the 83 patients undergoing nutritional screening, 41 (32.8%) were at nutritional risk. Further analysis of patients with nutritional risk showed that of the 41 patients, 20 were male (48.8%) and 21 were female (51.2%); 27 cases (65.9%) was with valvular diseases and 14 cases (34.1%) was with non-valvular diseases; the course of disease was more than 6 months in 30 cases (73.2%), and ≤ 6 months in 11 cases (26.7%). Statistical comparison of the above 83 patients showed that women, basic disease, long term-valvular disease, anemia, low TP, and low Alb before operation were more prone to innutrition. ③ Nutritional therapy: of the 125 patients, 5 were receiving mechanical ventilation (4.0%) and 2 were using vasoactive drugs (1.6%); there were 5 cases with gastrointestinal dysfunction (4.0%), mainly manifested as abdominal distension, abdominal pain, constipation and diarrhea. One patient was treated with enteral nutrition through gastric tube combined with parenteral nutrition support, 124 patients were fed orally, and an irregular phenomenon of injecting amino acid fat emulsion through peripheral vein in 2 patients. ④ Nutrition awareness of medical staff: 124 (99.2%) of the 125 patients had a nutrition department in their hospital; 71 cases (56.8%) received nutrition education, of which 37 cases (52.1%) were consulted by the nutrition department. Of all the cases, only 38 (30.4%) were consulted by the nutrition department, of which 1 (2.6%) did not receive nutrition education after consultation. Conclusions:At present, the incidence of preoperative malnutrition in patients undergoing cardiac surgery is high in southwest China. The incidence of malnutrition in patients with basic diseases, long term-valvular disease, low TP, low Alb and anemia before operation is higher, and the incidence of malnutrition is hidden in women. The course of disease of women is longer than that of men at the time of treatment, and malnutrition is more likely to occur. The attending physicians should pay attention to the above groups. It is necessary to establish a standardized individualized nutritional intervention program and apply it to actual clinical diagnosis and treatment, so as to ultimately improve the prognosis of patients undergoing cardiac surgery and increase the benefits of patients in treatment.

In recent years，with the change in lifestyle and social environment and the increase in pressure in both life and work，male fertility has decreased significantly in China，and the incidence of male infertility has increased year by year，which has brought great challenges to andrologists. Traditional Chinese medicine （TCM） has a definite curative effect in the treatment of male infertility and is widely applied in clinical practice. In order to clarify the role of TCM in different types and each stage of male infertility，the China Association of Chinese Medicine （CACM） invited outstanding young andrologists in the clinic of TCM and western medicine to discuss topics such as idiopathic oligospermia and teratospermia，abnormal semen liquefaction，varicocele，immune infertility，improving success ratio of assisted reproductive technology，and ameliorating depression or anxiety. They conducted in-depth discussions on the advantages，characteristics，disadvantages，diseases responding specifically，and advantageous aspects of TCM treatment. The causes of male infertility and related links of treatment were summarized. Due to the unclear etiology and complex pathogenesis of male infertility，western medicine cannot achieve a good curative effect，while TCM，taking the holistic view as the core，specializes in improving functional diseases and can correspond to multiple targets and factors，with comprehensive treatments such as internal treatment and external treatment. This study summarized the advantageous diseases and advantageous stages of TCM treatment alone and integrated TCM and western medicine treatment and put forward suggestions for the treatment of the diseases by TCM and western medicine in order to promote the therapeutic effects and advantages of TCM among andrologists，increase mutual learning and communication between TCM and western physicians，provide patients with excellent and personalized treatment plans in clinical practice，and improve the curative effect of male infertility and fertility of males in China.

Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12^th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.

The use of bariatric and metabolic surgery as a central treatment for obesity has been steadily increasing. BMI, as a widely used metric for assessing obesity, has considerable relevance in the field of metabolic research. However, its limitations, such as its inability to account for variations in fat distribution, remain a subject of considerable controversy. In recent years, there has been a surge of interest in the relationship between changes in body composition and the risk of metabolic disease. Consequently, the study of the effects of bariatric and metabolic surgery on changes in body composition has become a major focus of bariatric and metabolic surgery research. As a potential replacement for BMI, body composition measurements are expected to improve and standardize the assessment of the effectiveness of bariatric and metabolic surgery. This underscores the urgent need for the development of methods and standards for body composition measurement. This paper undertakes a comprehensive review of the existing evidence on the application of body composition measurement techniques for the efficacy evaluation of bariatric and metabolic surgery. The intent is to provide new insights and pave the way for the exploration of future research directions in this area.

The use of bariatric and metabolic surgery as a central treatment for obesity has been steadily increasing. BMI, as a widely used metric for assessing obesity, has considerable relevance in the field of metabolic research. However, its limitations, such as its inability to account for variations in fat distribution, remain a subject of considerable controversy. In recent years, there has been a surge of interest in the relationship between changes in body composition and the risk of metabolic disease. Consequently, the study of the effects of bariatric and metabolic surgery on changes in body composition has become a major focus of bariatric and metabolic surgery research. As a potential replacement for BMI, body composition measurements are expected to improve and standardize the assessment of the effectiveness of bariatric and metabolic surgery. This underscores the urgent need for the development of methods and standards for body composition measurement. This paper undertakes a comprehensive review of the existing evidence on the application of body composition measurement techniques for the efficacy evaluation of bariatric and metabolic surgery. The intent is to provide new insights and pave the way for the exploration of future research directions in this area.