Objective To investigate the impact of overweight on the prognosis of patients with acute mild ischemic stroke or moderate-high risk transient ischemic attack (TIA). Methods A total of 366 patients with acute mild ischemic stroke or moderate-high risk TIA who carried CYP2C19 loss-of-function alleles were included in the study. Baseline data were collected at admission, and clinical outcomes were collected within 3 months post-onset (primary outcomes: stroke recurrences within 3 months post-onset; secondary outcomes: composite outcome of stroke recurrence or death within 3 months post-onset, vascular events, and quality of life within 3 months). Kaplan-Meier method was used to plot the cumulative incidence curve of outcomes. Multivariate Cox proportional hazards model and multivariate Logistic regression model were used to evaluate the relationship between overweight and clinical outcomes within 3 months post-onset in patientswith ischemic stroke or TIA. The integrated discrimination improvement index (IDI) and net reclassification improvement index (NRI) were calculated to assess the predictive value of adding body mass index (BMI, whether overweight or not) based on traditional models for predicting the prognosis of acute ischemic stroke or TIA. Results After 3 months of follow-up, 28 patients had stroke recurrence, 1 patient died, and 31 patients had vascular events. The Kaplan-Meier cumulative incidence curve showed that the cumulative incidences of stroke recurrence, stroke recurrence or death, and vascular events after 3 months of onset were lower in overweight patients compared with non-overweight patients (Log-rank P < 0.05). Multivariate analysis showed that compared with non-overweight patients, overweight patients had significantly reduced risks of stroke recurrence within 3 months (HR=0.24; 95%CI, 0.08 to 0.71), composite outcome of stroke recurrence or death (HR=0.24; 95%CI, 0.08 to 0.69), and vascular events (HR=0.22; 95%CI, 0.07 to 0.63), and significantly improved quality of life within 3 months (OR=0.39; 95%CI, 0.20 to 0.76). The IDI and NRI calculations showed that compared with traditional models, the new model adding BMI (whether overweight) had significantly improved predictive ability for the prognosis of acute ischemic stroke or TIA. Conclusion Overweight may be a protective factor for the prognosis of TIA patients with acute mild ischemic stroke or moderate-high risk who carry CYP2C19 loss-of-function alleles. Compared with non-overweight patients, overweight patients have reduced risks of stroke recurrence, composite outcome of stroke recurrence or death, and vascular events within 3 months post-onset, and improved quality of life within 3 months post-onset.

Objective To explore the rules of acupoint selection and manipulation application of Tuina in the treatment of diabetes peripheral neuropathy(DPN)with data mining technology.Methods The clinical research literature of Tuina for DPN from October 2022 was selected by searching four Chinese databases that CNKI,WanFang,VIP and Chinese Biomedical Literature Database.Using the traditional Chinese medicine inheritance assistance platform software,analyze and summarize the rules of selecting acupoints and applying manipulations in the treatment of DPN with Tuina.Results A total of 110 articles were included,including 65 acupoints and 33 manipulations.The acupoints with the highest frequency are Zusanli(ST 36),Sanyinjiao(SP 6),Taixi(KI 3),Yongquan(KI 1),Taichong(LR 3),Yanglingquan(GB 34),etc.The meridians mainly include Taiyin Spleen Meridian of Foot,Yangming Stomach Meridian of Foot,Taiyang Bladder Meridian of Foot and Shaoyin Kidney Meridian of Foot.Five-shu Points,Lower He-sea Points and Yuan-primary Points are commonly used specific points.The acupoints are mostly distributed in the lower limbs.The categories of Tuina manipulations mainly include squeezing-pressing manipulations,pushing rolling manipulations and composite manipulations.The Tuina manipulations mainly include kneading manipulation,pressing manipulation,point-pressing manipulation,pressing-kneading manipulation and twisting manipulation with both palms.Conclusion The acupoint selection and manipulation application of Tuina in treating DPN have certain rules,and the main treatment principles are to regulate the organs and dredge collaterals,and to replenish qi and promote blood circulation,which can provide objective basis for clinical treatment.

Objective: To summarize the clinical manifestations of IgG4-related diseases in the head and neck, explore treatment methods. Methods : The clinical data of 21 patients diagnosed with IgG4-related diseases were retrospectively analyzed. The clinical data and the results of glucocorticoid and immunosuppressive therapy were studied retrospectively. Results: All patients had swollen sclerotic masses, and CT showed irregular high-density masses with uniform enhancement in the enlarged glands. Some patients had mucosal thickening and mass-like changes in theoral cavity, nose, sinuses, throat and other tissues, and most of the patients had cervical lymphadenopathy and elevated serum IgG4 levels (≥ 1.35 g/L). Histopathological examination of affected exosine glands and affected mucosa and lymph nodes in all patients showed infiltration of lymphocytes, plasma cells and IgG4+ plasma cells. In 21 patients, the mass in the affected glands and mucosa (including head, neck and other tissues) disappeared, and the clinical symptoms were relieved after the application of glucocorticoids. However, with a reduction in glucocorticoids, the mass recurred or even worsened. Conclusion For patients with a single mass in the submandibular gland, parotid gland and other salivary glands, as well as lymph node enlargement, CT is the first choice to identify the nature of gland neoplasms. Combined with pathological examination, related auxiliary examination and peripheral blood examination are also needed to obtain a definitive diagnosis. Glucocorticoid therapy is used to achieve a good prognosis, and long-term follow-up and timely adjustment of medication regimens are required.

The depth of invasion is a new index in the 8th edition of TNM classification and staging of oral cancer. Currently, there is no standardized evaluation method for the diagnosis of bone invasion and depth of invasion in lower gingival squamous cell carcinoma (LGSCC). The evaluation of LGSCC bone invasion depth not only provides a reference for surgical margin, but also determines the choice of surgical method, and is an independent prognostic factor for predicting cervical lymphatic metastasis. At present, the main evaluation methods of LGSCC bone invasion and invasion depth include X-ray, MRI, CT, positron emission tomography(PET)/CT, PET/MRI, singlephoton emission CT(SPECT)/CT and pathological examination. In this paper, the evaluation methods and effects of LGSCC bone invasion and invasion depth are summarized, and its advantages and disadvantages are analyzed in order to provide reference for clinical application.

Objective: To examine the outcome of surgical treatment in patients with stages Ⅱ-Ⅲ bisphosphonate-related osteonecrosis of the jaw. Methods: Twenty-nine patients with bisphosphonate-related osteonecrosis of the jaw were examined. The patients were followed up for more than 6 months, and the treatment outcome was reviewed. Results: After curettage of local lesions, 19 out of the 21 patients were cured, and 2 were relieved of symptoms. Six patients underwent subtotal resection of the maxilla, and the symptoms disappeared completely after the surgery. Two patients underwent partial resection of the mandible and recovered. Conclusion Surgical debridement is an effective measure for the treatment of patients with bisphosphonate-related osteonecrosis of the jaw in stages Ⅱ-Ⅲ. In most cases, curettage of local lesions via the intraoral approach can completely remove sequestrum and inflammatory granulomatous tissue. Subtotal maxillary resection or partial mandible resection is performed when the bone death reaches the level of the maxillary sinus floor or continues to the mandible. By timely surgical intervention, the bone lesion is removed to maintain the sterile, active bone microenvironment locally.

The pace of discovery of new antiretroviral (ARV) drugs has slowed, although the efficacy and safety of once-daily fixed dose combinations have been extensively investigated. Several traditional ARV drugs remain in phase III clinical trials. This review summarizes current information on ARV drugs in phase III clinical trials and focuses on the development of ARV drugs in the next decade.

Chlamydia psittaci is a causative agent of psittacosis,which can infect a wide range of hosts including birds and humans.However,information regarding C.psittaci infection in pigeons is scarce.In the present study,a total of 399 fecal samples from pigeons were collected from Jilin Province,northeastern China,between March and May 2015,and examined by nested PCR amplification of outer membrane protein A (ompA) gene.The overall Chlamydiosis prevalence was 5.01％ (21/399),with 3.19％ in Changchun City and 9.40％ in Jilin City.Furthermore,breed was the major risk factor associated with Chlamydia infection in pigeon,boiler pigeons had a prevalence of 7.49％,whereas no C.psittaci was detected in racing pigeons.Sequence analysis of the ompA gene revealed that all the identified isolates represented C.psittaci genotype B.Our results firstly indicated the presence of zoonotic C.psittaci in boiler pigeons in Jilin Province,northeastern China,and effective measures should be implemented to reduce the risk of C.psittaci transmission from pigeons to humans.

Objective:To investigate the clinical effect of probiotics adjuvant therapy and influence on inflammation in the patients with type 2 diabetes mellitus (T2DM). Methods:Totally 102 patients with T2DM were divided into probiotics group (n=53) and the control group (n=49)according to the odd-even admission number. The control group received metformin tablets of 0. 5g,po,tid,pro-bioties group received bifid triple viable capsules of 0. 42g,po,tid additionally, and the treatment course was 8 weeks. Before and after the treatment, the levels of fructosamine(FMN), fasting bloodglucose(FBG),HbA1c,and the serum levels of TNF-αand adiponectin were determined, and the adverse reactions were recorded. Results:After the treatment, the levels of FMN, FBG, HbA1c and TNF-αof the two groups were significantly decreased than before, and adiponectin was significantly increased than before (P<0. 05); com-pared with those of the control group, the indicators mentioned above were improved more greatly in probiotic group (P<0. 05). There were no obvious adverse reactions appeared in both groups. Conclusion:Probiotics is beneficial to glycemic control, and the mecha-nism is related to reducing inflammation.

Objective:To investigate the clinical effect of probiotics adjuvant therapy and influence on inflammation in the patients with type 2 diabetes mellitus (T2DM). Methods:Totally 102 patients with T2DM were divided into probiotics group (n=53) and the control group (n=49)according to the odd-even admission number. The control group received metformin tablets of 0. 5g,po,tid,pro-bioties group received bifid triple viable capsules of 0. 42g,po,tid additionally, and the treatment course was 8 weeks. Before and after the treatment, the levels of fructosamine(FMN), fasting bloodglucose(FBG),HbA1c,and the serum levels of TNF-αand adiponectin were determined, and the adverse reactions were recorded. Results:After the treatment, the levels of FMN, FBG, HbA1c and TNF-αof the two groups were significantly decreased than before, and adiponectin was significantly increased than before (P<0. 05); com-pared with those of the control group, the indicators mentioned above were improved more greatly in probiotic group (P<0. 05). There were no obvious adverse reactions appeared in both groups. Conclusion:Probiotics is beneficial to glycemic control, and the mecha-nism is related to reducing inflammation.