The shaoyang meridian is an important pivot between the internal organs and meridians system， with the functions of regulating qi and blood， balancing yin and yang， and coordinating the ascending and descending movement of qi. Dysfunction of the shaoyang pivot can lead to spleen and kidney deficiency， impaired liver and gallbladder qi regulation， and stagnation of qi and blood. It is believed that the onset and progression of Crohn's disease are closely related to shaoyang pivot dysfunction， with the core pathogenesis characterized by shaoyang disharmony， spleen deficiency， dampness retention， and blood stasis. Based on this understanding， the treatment principle centers on harmonizing the shaoyang pivot， supplemented by methods such as warming and nourishing the spleen and stomach， tonifying shaoyang， and soothing the liver and benefiting the gallbladder. Acupuncture is employed to target key acupoints along the shaoyang meridian to restore its regulatory functions， improve spleen and stomach transformation and transportation， facilitate liver and gallbladder qi flow， and promote the circulation of qi and blood. This provides a practical therapeutic approach for acupuncture-based treatment of Crohn's disease.

OBJECTIVE To establish a clinical pharmaceutical pathway of anti-infective therapy for high-risk populations of antibiotic-associated encephalopathy （AAE）， and analyze its application effects. METHODS Clinical pharmacists developed the “AAE High-Risk Population Screening Form” and “Antibiotic AAE Risk Comparison Form” based on literature and expert opinions， and established the “Clinical Pharmaceutical Pathway of Anti-infective Treatment for AAE High-Risk Population” in our hospital. A prospective， non-randomized controlled study was conducted from May 2023 to April 2024， including 50 cases in the observation group and 50 cases in the control group among patients with pulmonary infections admitted to the Dept. of Internal Medicine in our hospital. The observation group was involved in the development of an anti-infective treatment following the clinical pharmaceutical pathway by clinical pharmacists， while the control group received routine anti-infective treatment by clinical physicians. The occurrence of AAE， the rational antibiotic drug use， and the effectiveness of initial anti-infective treatment in the two groups were observed， and the intervention measures and outcomes of AAE cases were summarized. RESULTS The anti-infective treatment clinical pharmaceutical pathway for AAE high-risk population was preliminarily established in our hospital. The analysis of the application effects showed that there was 1 case of AAE in the observation group and 8 cases in the control group， with a significantly lower incidence of AAE in the observation group than in the control group； the rational antibiotic drug use and the effectiveness of initial anti-infective treatment in the observation group were both significantly superior to those in the control group （P＜0.05）. Drug withdrawal and dressing change were the preferred effective intervention measures for AAE， and encephalopathy treatment drugs could be used as auxiliary measures for symptom relief. Timely and effective intervention was conducive to rapid symptom relief， with a total improvement rate of AAE of 88.89%. CONCLUSIONS The anti-infective treatment clinical pharmaceutical pathway for AAE high-risk population can effectively prevent the occurrence of AAE as well as contribute to promoting rational drug use and the effectiveness of initial anti-infection plans and strengthening treatment outcomes.

Purpose To investigate the clinicopathological features,immunophenotypes,molecular characteristics,treat-ment and prognosis of nodal follicular helper T cell lymphoma,angioimmunoblastic type(nTFHL-AI)with B cell clonal hyper-plasia.Methods The clinicopathological data of 10 nTFHL-AI patients with B cell clonal hyperplasia were collected from medi-cal records,with HE and immunohistochemical staining and gene rearrangement analysis.Related literature was also re-viewed.Results The included 10 patients were 5 males and 5 females with a median age of 73 years.The clinical manifesta-tions were mainly systemic lymphadenopathy,splenomegaly and B symptoms.8 patients were categorized as stage Ⅳ and 2 pa-tients were staged as Ⅰ+Ⅱ according to Ann Arbor staging cri-teria.Major laboratory results were increased β2 microglobulin,lactate dehydrogenase and decreased hemoglobin,erythrocytes and thrombocytes.Plasma Epstein-Barr virus(EBV)nucleic acid quantification was positive in 8 cases.Microscopically,the morphological patterns were nodular aggregation or scattered clear cells,branched high endothelial vessels and disorderly"wind-blown"like follicular dendritic cells(FDC).The num-ber of infiltrated eosinophils was 0-5/HPF in 7 cases,5-10/HPF in 2 cases,and＞50/HPF in 1 case.Plasma cell count was≤5％in 6 cases,10％in 1 case,20％in 1 case,and the rest 2 had relative higher count of 30％.The tumor cells of 7 ca-ses coexisted with marked hyperplasia of histiocytes,and in only one case Reed-Sternberg(RS)-like large cells were found 5 ca-ses showed abundant background B cells while the other 5 cases had limited background B cells.All tumor cells expressed T cell markers,6 were positive for CD10,BCL6,CXCL13 and PD-1 simultaneously and all of 10 were positive for BCL6,CXCL13 and PD-1.8 cases were positive for EBV-encoded small RNA(EBER)by in situ hybridization.Clonal TCR gene rearrange-ments and IG gene rearrangement were detected in all 10 pa-tients.After diagnosis,all patients were treated with chemother-apy,and three of them died due to disease progression.Conclu-sion B cell clonal hyperplasia,the status of EBV infection and the number of EBV-positive cells may be related with disease progression,individualized treatment and prognosis of patients with nTFHL-AI.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

OBJECTIVE: To investigate the changes in gray matter volume in depressive-like mice and explore the possible mechanism. METHODS: Twenty-four 6-week-old C57 mice were randomized equally into control group and model group, and the mice in the model group were subjected to chronic unpredictable mild stimulation (CUMS) for 35 days. Magnetic resonance imaging was performed to examine structural changes of the grey matter volume in depressive-like mice. The expression of brain-derived neurotrophic factor (BDNF) in the grey matter of the mice was detected using Western blotting and immunofluorescence staining. RESULTS: Compared with the control mice, the mice with CUMS showed significantly decreased central walking distance in the open field test (P < 0.05) and increased immobile time in forced swimming test (P < 0.05). Magnetic resonance imaging showed that the volume of the frontal cortex was significantly decreased in CUMS mice (P < 0.001, when the mass level was greater than or equal to 10 756, the FDRc was corrected with P=0.05). Western blotting showed that the expression of mature BDNF in the frontal cortex was significantly decreased in CUMS mice (P < 0.05), and its expression began to decrease after the exposure to CUMS as shown by immunofluorescence staining. The volume of different clusters obtained by voxel-based morphometry (VBM) analysis was correlated with the expression level of mature BDNF detected by Western blotting (P < 0.05). CONCLUSION The decrease of frontal cortex volume after CUMS is related with the reduction of mature BDNF expression in the frontal cortex.
Animals ; Mice ; Blotting, Western ; Brain-Derived Neurotrophic Factor ; Cerebral Cortex ; Depression/physiopathology* ; Frontal Lobe/pathology*

Objective:To investigate the clinical efficacy of laparoscopic hepatic caudate lobectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with hepatic caudate lobe tumor who were admitted to the General Hospital of PLA Northern Theater Command from July 2018 to June 2021 were collected. There were 2 males and 3 females, aged 49(range, 26-55)years. All 5 patients underwent laparoscopic hepatic caudate lobectomy. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using telephone interview or outpatient examination to detect tumor recurrence. The follow-up was up to March 2023. Measurement data with skewed distribution were represented as M(range) and count data were described as absolute numbers. Results:(1) Intraoperative situations. All 5 patients underwent laparoscopic hepatic caudate lobectomy with the left approach, including 3 cases receiving laparoscopic partial resection of hepatic caudate lobe, 1 case receiving laparoscopic partial resection of hepatic caudate lobe+left lateral lobectomy and 1 case receiving laparoscopic partial resection of hepatic caudate lobe+cholecystectomy. Intraoperative hilar occlusion was performed in 3 patients. The operation time and volume of intraoperative blood loss of 5 patients was 240(range, 180-370)minutes and150(range, 100-200)mL, respectively. (2) Postoperative situations. On the first day after surgery, the levels of albumin, alanine aminotransferase, and aspartate aminotransferase in 5 patients was 32.9(range, 29.2-40.3)g/L, 104.09(range, 57.11-1 018.67)U/L, and 67.13(range, 58.00-852.66)U/L, respectively. Three of 5 patients showed no significant changes in prothrombin time (PT) on the first day after surgery, while two patients did not undergo PT test. On the third day after surgery, the visual analogue score of 5 patients was mild pain. Among the 5 patients, 1 case had anal exhaust on the postoperative 1st day, and 4 cases had anal exhaust on the postoperative 2nd day. The time to drainage tube removal for 5 patients was 6(range, 4-10)days. There was no postoperative complication such as bleeding, infection, bile leakage or liver failure in 5 patients. Results of postoperative histopathological examination showed that 2 cases with adenoma, 2 cases with cavernous hemangioma and 1 case with smooth myolipoma. The duration of postoperative hospital stay of 5 patients was 6(range, 5-11)days. (3) Follow-up. All 5 patients were followed up for 22 (range, 19-51)months, and there was no tumor recurrence.Conclusion:It is safe and feasible to selectively carry out laparoscopic hepatic caudate lobectomy by strictly gras-ping the indications.

Objective:To investigate the feasibility of classifying imaging patterns of dermatomyositis/polymyositis-related interstitial lung disease (DM/PM-ILD) into subtypes based on chest CT radiomics features and a model was constructed by machine learning algorithms.Methods:From November 2011 to November 2020, 107 patients diagnosed with PM/DM-ILD at the First Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. A total of 315 cases with chest CT were collected. Doctors pre-classified image patterns, including 105 cases with non-specific interstitial pneumonia (NSIP), 90 cases with organizing pneumonia (OP), and 66 cases with non-specific interstitial pneumonia combined with organizing pneumonia (NSIP+OP), 35 cases with common interstitial pneumonia (UIP), and 19 cases with diffuse alveolar damage (DAD), ANOVA was used to test the difference of baseline clinical information among the imaging classification groups. All images were divided into the training set and the est set by stratified random sampling at a ratio of 4∶1. In each CT scan, 3D slicer was used to segment each lung lobe, and then reconstructed into 3 mm 3 of voxels, and Pyradiomics library was used to extract the radiomic features of the whole lung and each lobe. The multi-classification goal was achieved by constructing random forest base classifiers for each of the five groups and then voting as the final model. In the process of constructing the base classifier, firstly, the balance between sample groups was achieved by SMOTETomek comprehensive sampling, and the optimal feature set was selected by independent sample t test and L1 regularized least absolute shrinkage and selection operator (LASSO) regression. In this study, the Radiomics model was constructed based on chest CT radiomics features, and the Radiomics + model was constructed by introducing gender and age information. The base classifier and the integration model use the mean accuracy and the area under the receiver operator characteristics analysis curve (AUC) to evaluate the performance, respectively. Results:There was a statistically significant difference ( P<0.05) between the ages of the NSIP, OP, NSIP+OP, UIP, and DAD groups [(57±13),(53±8),(54±10),(44±11), and (46±8)years old, respectively], F=11.82, P<0.001. In the Radiomics model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.87, 0.91, 0.91, 0.96, and 0.99, respectively, and the AUC of the test set were 0.81, 0.82, 0.79, 0.93, 0.89. In the final Radiomics + model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.89, 0.91, 0.92, 0.97, and 0.99, respectively, and the AUCs of the test set were 0.84, 0.82, 0.78, 0.94, 0.90. Conclusion:Based on chest CT radiomics features and key clinical features (sex, age), the Radiomics + model constructed by machine learning has good classification performance for the imaging patterns of PM/DM-LD.