ObjectiveTo observe the effects of acupuncture at channel points in treating functional dyspepsia （FD） patients of spleen-stomach weakness syndrome and to explore its potential mechanism. MethodsSixty FD patients of spleen-stomach weakness syndrome were randomly divided into an acupuncture group and a domperidone group， with 30 patients in each group. Acupuncture group was given acupuncture at Zusanli （ST36）， Neiguan （PC6）， Gongsun （SP4）， and Yinlingquan （SP9） using even reinforcing-reducing method. Unilateral points were selected alternately on the left and right sides， once daily， for 30 minutes each session， 5 sessions per course， and a 2-day interval between courses. Domperidone group was given domperidone tablets orally， one tablet each time， three times daily， 15~30 minutes before meals. The total course of treatment was 4 weeks in both groups. Pairwise comparisons of the symptom scores including postprandial fullness and discomfort， early satiety， epigastric pain， and epigastric burning discomfort， and the levels of serum 5-hydroxytryptamine （5-HT）， vasoactive intestinal peptide （VIP）， and glucagon-like peptide-1 （GLP-1） were conducted at pre-treatment， 4， and 8 weeks post-treatment. The clinical efficacy was analyzed and evaluated after treatment. ResultsCompared with baseline， the symptom scores of postprandial fullness and discomfort， early satiety， epigastric pain and epigastric burning discomfort and the levels of serum 5-HT， VIP and GLP-1 of both groups were significantly decreased after 4 weeks and 8 weeks treatment （P＜0.05）. At 4 weeks post-treatment， all symptom scores and the levels of 5-HT and GLP-1 of the acupuncture group were significantly lower than those of the domperidone group （P＜0.05）. At 8 weeks post-treatment， the symptom scores of postprandial fullness and discomfort， early satiety and epigastric pain and the levels of 5-HT and VIP of the acupuncture group were significantly lower than those of the domperidone group （P＜0.05）. The total effective rate of the acupuncture group （96.67%， 29/30） was higher than that of the domperidone group （86.67%， 26/30， P＞0.05）. ConclusionAcupuncture at channel points shows good clinical efficacy in the treatment of spleen-stomach weakness syndrome FD， and its mechanism may be related to the decreased levels of 5-HT， VIP， and GLP-1 in serum.

Objective:Migraine and tremor share some genetic mutation sites,and clinical studies have also confirmed their correlation.This study aims to explore the clinical and electrophysiological characteristics of migraine patients with concomitant tremor,and to analyze the relevant influential factors of tremor occurrence. Methods:We retrospectively analyzed the clinical data of 217 migraine patients who visited the Third Affiliated Hospital of Qiqihar Medical University from June 2022 to October 2023.The Clinical Rating Scale for Tremor(CRST),Numerical Rating Scale(NRS),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)were respectively used to assess the tremor symptoms,degree of headache,anxiety,and depression of patients.All patients underwent routine head MR scanning and electromyography examination,and were divided into a migraine with tremor group and a migraine without tremor group based on the electromyogram examination. Results:The migraine with tremor group and the migraine without tremor group were included 52 patients(23.96%)and 165 patients(76.04%),respectively.Compared with the migraine without tremor group,the migraine with tremor group had a longer course and duration of headache,higher frequency of headache attacks,higher NRS score,GAD-7 score,and PHQ-9 score,and fewer weekly physical exercises.The differences were statistically significant(all P<0.05).There were no statistically significant differences in the presence or absence of prodromal headache and white matter hyperintensities(WMHs)between the 2 groups(both P>0.05).The evaluation results of the CRST showed that out of 217 migraine patients,39 patients(17.97%)were accompanied by tremors.The electromyographic results showed that all 52 migraine patients with tremors had upper limb tremors,including 28 migraine patients with postural tremors and 24 migraine patients with static tremors.Compared with the migraine patients with static tremors,the migraine patients with postural tremors had lower average frequency,peak frequency,and headache onset frequency(all P<0.05).Multiple linear regression analysis showed that frequency of physical exercise,duration of illness,frequency of headache attacks,NRS score,GAD-7 score,and PHQ-9 score were risk factors for migraine patients with concomitant tremors(all P<0.05). Conclusion:Patients with migraine mainly experience upper limb postural tremors.Reduced physical exercise,long course of disease,long duration of headache,frequent headache attacks,severe headache,anxiety,and depression are risk factors for migraine patients with concomitant tremors.

Objective: To investigate the spatial clustering characteristics of varicella public health emergency events in Nanjing City from 2017 to 2022, so as to provide the evidence for the development of varicella prevention and control strategies. Methods: Data of varicella public health emergency events in Nanjing City from 2017 to 2022 were collected through Emergency Public Health Management Information System of Chinese Disease Prevention and Control Information System. The software ArcGIS 10.2 was employed for trend-surface analysis, spatial autocorrelation analysis and hotspot analysis to understand the spatial clustering characteristics of varicella public health emergency events. Results: A total of 84 varicella public health emergency events were reported in Nanjing City from 2017 to 2022, with an average attack rate of 2.53% (2 558 cases). Ⅳ-level events were predominant, accounting for 90.48% (76 events). The trend-surface analysis showed lower incidence of varicella public health emergency events in the west of Nanjing City and higher in the east, and lower in the north and higher in the south. The global spatial autocorrelation analysis showed that there was a positive spatial correlation in varicella public health emergency events in 2017 and 2019, indicating spatial clustering (P<0.05). The hot spots were Jiangning District, Gaochun District, Yuhuatai District and Jianye District. Conclusion The incidence of varicella public health emergency events in Nanjing City from 2017 to 2022 has spatial aggregation, with a concentration in suburban areas such as Jiangning District and Gaochun District.

Currently，there are still obstacles for patients’ right of self-determination in medical decision-making. By sorting out its historical origins，this paper found that the reasons for the current situation mainly include the influence of familial culture and medical paternalism，as well as the constraints of the behavioral capacity system and the guardianship systems. In this context，this paper criticized the view that “the key to enjoying decision-making power is rationality”，and called for a return to the concept of patient autonomy，so as to achieve a balance between agency decision-making power of others and the special intervention rights of doctors. The legal system for resolving conflicts can be constructed by replacing behavioral capacity with medical decision-making ability，requiring the evaluation of medical decision-making ability based on actual conditions，establishing a pre-medical instruction system，and clarifying the boundaries of medical special intervention rights.

Objective:To develop an HPLC method with gradient elution for the simultaneous determination of 4 bacteriostatic agents in triamcinolone acetonide econazole cream from the different manufacturers.Methods:The test was performed on a Waters Symmetry C18 column(250 mm ×4.6 mm,5 μm)under gradient elution of metha-nol(A)and methanol-0.02 mol·L-1 sodium dihydrogen phosphate solution(B).The flow rate of 1.0 mL·min-1 and the column temperature was 35 ℃.The detection wavelengths were 228 nm and 254 nm.Results:The good separation of the bacteriostatic agents peaks were achieved.The linear ranges of benzoic acid,methyl hydroxybenzoate,ethylparaben and propylparaben fell into 0.010 348-0.155 22 mg·mL-1,0.009 876-0.148145 mg·mL-1,0.010 106-0.151 588 mg·mL-1 and 0.010 259-0.153 882 mg·mL-1 respectively.The av-erage recoveries were 99.68％(RSD=2.35％),100.21％(RSD=1.78％),100.47％(RSD=1.59％)and 100.06％(RSD=1.65％)respectively.The LODs were 3 × 10-5 mg·mL-1,1.67 × 10-5 mg·mL-1,1.67 × 10-5 mg·mL-1 and 1.67 × 10-5 mg·mL-1 respectively.Conclusion:The established method is sensitive and accurate,and has the good separation.It provides the reliable basis for the quality control of triamcinolone ace-tonide econazole cream.

Objective:To establish a feasible mouse model of post-stroke dysphagia(PSD).Methods:Thirty C57BL/6 male mice were randomly divided into a sham-operated group(Sham)and a model group(PSD),and the PSD mouse model was made by the photothrombosis method(PT)method,and the sham-operated group was only injec-ted with rose bengal staining solution in the tail vein.The cerebral blood flow of the mice was measured by laser scatter imaging,the ratio of cerebral infarct area was detected by TTC staining,the electromyographic area of the in vivo pha-ryngeal muscle group of mice swallowing was recorded by a multi-conductor physiological recorder MP160,the drinking function of the mice was measured by the 4-min water drinking experiment,and the weight changes were recorded,respectively,at 1,3,and 7 d.Results:Cerebral blood flow decreased at all time points,with a sharp drop in cerebral blood flow at 1 d,gradual recovery of cerebral blood flowat 3 and 7 d,establishment of collateral circulation,and gradu-al reduction of cerebral infarction area;compared with the Sham group,the myoelectric area of the PSD group was reduced at 1 and 3 d(P＜0.05),but with a trend of gradual recovery,and there was no significant difference between the PSD group and the Sham group at 7 d,and water consumption and weight decreased at 4 min at 1,3,and 7 d(P＜0.05).Conclusion:The mice showed some degree of dysphagia symptoms and are expected to be a translational model for PSD.

OBJECTIVE To provide reference for the subsequent landing of national medical insurance negotiated drugs （referred to as “national negotiated drugs”） at the provincial level. METHODS By reviewing the data publicly released by the official websites of National Healthcare Security Administration and the Healthcare Security Administration of Zhejiang Province， combined with policy documents， the descriptive analysis was conducted on the number of tertiary medical institutions， the actual allocation of national negotiated drugs， the availability rate of national negotiated drugs， the allocation rate of national negotiated drug varieties， and the allocation rate of medical institutions of various cities in Zhejiang province. The Spearman rank correlation test was used to analyze the correlation between the number of types of national negotiated drugs equipped in tertiary medical institutions in Zhejiang province and the per capita disposable income， the number of tertiary medical institutions equipped with national negotiated drugs， and the implementation time of disease diagnosis-related grouping （DRG） of various cities in Zhejiang province. RESULTS As of the first quarter of 2022， 135 tertiary medical institutions in Zhejiang province were equipped with a total of 261 types of national negotiated drugs， accounting for 94.91% of the 2021 edition of the National Negotiated Drugs Catalogue （275 types）. The allocation rates of Goserelin acetate sustained-release implant， Sacubitril valsartan sodium tablets， Alteplase for injection and other varieties were at high level， and the types of national negotiated drugs equipped were highly coincident with the top 10 causes of death with disease of urban and rural residents in Zhejiang province. The tertiary medical institutions in Hangzhou had the most types of national negotiated drugs， with 230 types， while Quzhou had the lowest， with only 34 types； allocation rate of national negotiated drugs in medical institutions of Zhoushan was the highest （100%）， while that of Lishui was the lowest （57.14%）. The types of national negotiated drugs equipped were positively correlated with per capita disposable income in various cities and the number of tertiary medical institutions equipped with national negotiated drugs （P＜0.01）， and there was no significant correlation with the length of implementation of DRG （P＞0.05）. CONCLUSIONS mail：lanyao@mails.tjmu.edu.cn The landing of national negotiated drugs in Zhejiang province is generally good， with a high rate of equipping tertiary medical institutions with national negotiated drugs and a high rate of equipping drug varieties. Therefore， it is recommended that the provincial implementation of national negotiated drugs should be multi-faceted， and policy-making departments should adopt a dual-channel of “unbundling” and “driving” to smooth the drug chain into hospitals. The health insurance sector should improve the “dual channel” management mechanism to share the pressure on hospitals to use drugs. At the same time， it should also improve the multi-level medical security system and raise the level of reimbursement of medical insurance for national negotiated drugs.