This paper summarizes Professor WANG Xiuxia's clinical experience in treating hyperprolactinemia using the liver soothing therapy. Professor WANG identifies liver qi stagnation and rebellious chong qi （冲气） as the core pathomechanisms of hyperprolactinemia. Furthermore， liver qi stagnation may transform into fire or lead to pathological changes such as spleen deficiency with phlegm obstruction or kidney deficiency with essence depletion. The treatment strategy centers on soothing the liver， with a modified version of Qinggan Jieyu Decoction （清肝解郁汤） as the base formula. Depending on different syndrome patterns such as liver stagnation transforming into fire， liver stagnation with spleen deficiency， or liver stagnation with kidney deficiency， heat clearing， spleen strengthening， or kidney tonifying herbs are added accordingly. In addition， three paired herb combinations are commonly used for symptom specific treatment， Danggui （Angelica sinensis） with Chuanxiong （Ligusticum chuanxiong）， Zelan （Lycopus lucidus） with Yimucao （Leonurus japonicus） ， and Jiegeng （Platycodon grandiflorus） with Zisu （Perilla frutescens）.

Objective To provide reference for the subsequent clinical application of WBV,based on the impacts of whole body vibration(WBV)with different frequencies on gross motor function and walking function in children with dyskinetic cerebral palsy.Methods 60 children aged 6～12 with dyskinetic cerebral palsy,who had been treated at the department of rehabilitation medicine in the Affiliated Southwest Medical University from October 2021 to November 2022,were selected.They were randomly divided into a control group(n = 20),(25±5)Hz group(n = 20),and(35±5)Hz group(n = 20).All the three groups received conventional rehabilitation,while the(25±5)Hz group received additional WBV with(25±5)Hz and the(35±5)Hz group received WBV with(35±5)Hz.They were treated for eight weeks.The scores on D and E domains of GMFM-88,TUGT,the score on Berg Balance Scale,and footprint analysis were used for assessment of the efficacy after treatment.Results As compared with the baselines,the scores were improved in the three groups after treatment(P＜0.001).BBS(F = 12.502),TUGT(F = 8.211),scores on D and E domains of GMFM-88(F = 12.802 and 8.505),stride length(F = 12.279),1MWT distance(F = 12.619),and step width(F = 13.582)were better in the(35±5)Hz group than in the(25±5)Hz group and the control group(P＜0.05 and P＜0.01);and the efficacy was better in the(25±5)Hz group than in the control group,the difference was statistically significant(P＜0.05 and P＜0.01).Conclusion WBV can improve trunk control,lower limb gross motor function,and walking function in children with involuntary motor type cerebral palsy.(35±5)Hz is better than(25±5)Hz for the efficacy of WBV.

Objective: To investigate the status of passive smoking among pregnant women in Jinshan District, Shanghai Municipality, so as to provide insights into developing targeted smoking control measures and promoting maternal and infant health. Methods: Pregnant women who had early pregnancy registration at Jinshan District Community Health Service Center from April 2021 to December 2023 were selected as subjects. The basic information, passive smoking and awareness of passive smoking hazards among pregnant women were collected through questionnaire surveys, and passive smoking rate and awareness rate of passive smoking hazards were analyzed. Results: Totally 8 273 questionnaires were allocated, and 8 216 valid questionnaires were recovered, with an effective rate of 99.31%. The mean age of participants was (29.52±4.60) years. There were 4 991 participants with an education of college degree or above, accounting for 60.75%; 3 565 participants with the first pregnancy, accounting for 43.39%; 3 990 primiparas, accounting for 48.56%; 3 193 participants living with smokers, accounting for 38.86%. A total of 3 710 participants passively smoked, with a passive smoking rate of 45.16%. There were 2 817 participants passively smoked in public places, accounting for 75.93%; 2 253 participants passively smoked in workplaces, accounting for 60.73%; 1 563 participants that passively smoked at home, accounting for 42.13%. The awareness rates regarding the hazards of passive smoking to health, causing lung cancer in adults, causing lung diseases in children, causing preterm birth and low birth weight infants, and causing heart diseases in adults were 92.13%, 88.85%, 87.99%, 82.05% and 62.56%, respectively. Conclusion The rate of passive smoking among pregnant women in Jinshan District is comparatively high, while their awareness regarding non-respiratory diseases emanating from passive smoking is comparatively low.

Objective To explore the current research situation,hotspots and development trend in the field of acupuncture and mox-ibustion intervention for post-stroke dysphagia(PSD). Methods The literature on acupuncture and moxibustion intervention for PSD was retrieved from CNKI,VIP and Wan-fang database from 1994 to December 31st,2023,and analyzed with VOSviewer and CiteSpace. Results A total of 1 816 articles were included,and the number of publications increased year by year,reaching a peak in 2021 with 180 articles.There were 274 core authors included in the literature,among which Cheng Hongliang,Zhou Hongfei and Feng Weixing were the authors with the highest publication volume.The First Affiliated Hos-pital of Tianjin University of Chinese Medicine was the most productive institution,and the connections between institutions were relatively scattered.The high-frequency keywords were swallowing dysfunction,stroke,acu-puncture and moxibustion therapy,as well as rehabilitation therapy,among which tongue triple acupuncture,elec-troacupuncture,nape acupuncture and scalp acupuncture were the most commonly used methods.In addition,acupuncture combined with rehabilitation training,electrical stimulation,or other methods for PSD and acupoint selection rules were also research hotspots.When evaluating the efficacy of acupuncture intervention for PSD,the focus gradually shifted from the effective rate to the use of videofluorographic swallowing study,water swal-lowing test,standardized swallowing assessment,surface electromyography and other indicators to evaluate the swallowing function and the severity of dysphagia. Conclusion Research on acupuncture and moxibustion interventions for PSD has developed rapidly,with hotspots in-cluding the selection of specific acupuncture and moxibustion techniques,the combination of acupuncture and moxibustion with other rehabilitation therapies,outcome indicators for acupuncture and moxibustion interven-tions in PSD,and the rules of acupoint selection.In the future,it is essential to strengthen academic exchanges and collaborations across institutions and regions.Greater emphasis should be placed on objective evaluation in-dicators of acupuncture and moxibustion therapies for improving the swallowing function in PSD patients,as well as on optimizing combinations of acupuncture and moxibustion with modern rehabilitation approaches,so as to better guide clinical practice.

Objective:To investigate the epidemiological characteristics, genotypes and genetic evolution of respiratory syncytial virus (RSV) isolated in Shanghai from April 2020 to December 2021, which was a period from the COVID-19 outbreak to the phase of regular epidemic prevention and control.Methods:This retrospective study collected the nasopharyngeal secretions or nasopharyngeal aspirates of children with acute respiratory tract infection (ARTI) admitted to the Shanghai Children′s Hospital from April 2020 to December 2021. PCR-capillary electrophoresis and RT-PCR were used for virus identification and the amplification of the gene fragment of the second hypervariable region of RSV G protein. Homology analysis and phylogenetic analysis were conducted using bioinformatics software. Chi-square test was used to compare the detection rates of RSV. Results:A total of 6 211 samples were collected and 13.62% (846/6 211) of them were positive for RSV. The positive rates of RSV in male and female patients were 14.07% (503/3 574) and 13.01% (343/2 637), respectively, with no significant gender difference (χ 2=1.467, P=0.226). The highest detection rate of RSV was found in children ≤6 months of age, and the rate of RSV infection decreased gradually with age (χ 2=352.942, P<0.001). No RSV-positive specimens were detected from April 2020 to August 2020, after which the detection rate of RSV gradually increased with two epidemic peaks occurring from December 2020 to February 2021 and from August to October 2021. The predominant epidemic subtype was RSV subtype B in 2020 and the first 9 months of 2021, which was gradually replaced by RSV subtype A in the last 3 months of 2021. The 176 strains of RSV subtype A obtained in this study were all ON1 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.20%-99.50%. All of the 250 strains of RSV subtype B were BA9 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.10%-100.00%. Conclusions:From April 2020 to December 2021, with the regular prevention and control of COVID-19, there is a change in the epidemic season of RSV. The prevalent genotypes of RSV subtypes A and B are ON1 and BA9, respectively, and the subtype A gradually replaces subtype B as the most prevalent subtype.

BACKGROUND/OBJECTIVES: Previous research has shown maternal betaine supplementation alleviates fetal-derived hepatic steatosis. Therefore, this study examined the anti-inflammatory effect of maternal betaine intake in offspring mice and its mechanism.MATERIALS/METHODS: Female C57BL/6J mice and their offspring were randomly divided into 3 groups according to the treatment received during gestation and lactation: control diet (CD), fatty liver disease (FLD), and fatty liver disease + 1% betaine (FLD-BET). The FLD group was given a high-fat diet and streptozotocin (HFD + STZ), and the FLD-BET group was treated with HFD + STZ + 1% betaine. After weaning, the offspring mice were given a normal diet for 5 weeks and then dissected to measure the relevant indexes. RESULTS: Compared to the CD group, the offspring mice in the FLD group revealed obvious hepatic steatosis and increased serum levels of alanine aminotransferase, interleukin (IL)-6, and tumor necrosis factor (TNF)-α; maternal betaine supplementation reversed these changes. The hepatic mRNA expression levels of IL-6, IL-18, and Caspase-1 were significantly higher in the FLD group than in the CD group. Maternal betaine supplementation reduced the expression of IL-1β, IL-6, IL-18, and apoptosis-associated speck-like protein containing C-terminal caspase recruitment domain (ASC). Maternal betaine supplementation also reversed the increasing protein expressions of nitric oxide dioxygenase-like receptor family pyrin domain containing 3 (NLRP3), ASC, Caspase-1, IL-1β, and IL-18 in offspring mice exposed to HFD + STZ. Maternal betaine supplementation decreased the homocysteine (Hcy) and s-adenosine homocysteine (SAH) levels significantly in the livers. Furthermore, the hepatic Hcy concentrations showed significant inverse relationships with the mRNA expression of TNF-α, NLRP3, ASC, and IL-18. The hepatic SAH concentration was inversely associated with the IL-1β mRNA expression. CONCLUSIONS The lipotropic and anti-inflammatory effect of maternal betaine supplementation may be associated with the inhibition of NLRP3 inflammasome in the livers of the offspring mice.

Objective:To investigate the effects of persistent isolated hypothyroxinemia in the first and second trimester of pregnancy on complications and adverse outcomes of pregnancy.Methods:A retrospective analysis was conducted in 784 pregnant women including 111 cases of persistent isolated hypothyroxinemia in the first and second trimester of pregnancy and 673 pregnant women with normal thyroid function as control group. All women were registered and delivered in the Department of Obstetrics of our hospital from April 2016 to April 2017. The complications and adverse outcomes of pregnancy in the two groups were analyzed.Results:Age, body weight before pregnancy, body mass index(BMI), 1 h plasma glucose and 2 h plasma glucose during oral glucose tolerance test in persistent isolated hypothyroxinemia group were higher than those in control group( P<0.05), with increased incidence of anemia during pregnancy( P<0.05). However, there were no significant differences in the incidences of gestational diabetes mellitus and gestational hypertension between the two groups( P>0.05). No significant statistical differences were found in macrosomia, stillbirth, neonatal malformation, postpartum hemorrhage, acute delivery, premature delivery, fetal intrauterine development delay, and small full-term infants between the two groups( P>0.05). Logistic regression analysis showed that age( OR=1.1, 95% CI 1.0-1.1, P=0.002) and pre-pregnancy body weight( OR=1.0, 95% CI 1.0-1.1, P=0.046) were risk factors for the occurrence of persistent isolated hypothyroxinemia in the first and second trimesters of pregnancy. Persistent isolated hypothyroxinemia in the first and second trimesters was associated with anemia during pregnancy( OR=1.9, 95% CI 1.1-3.2, P=0.024). Conclusions:Pregnant women who are older and heavier before pregnancy should pay more attention to their thyroid function. Pregnant women with persistent isolated hypothyroxinemia in the first and second trimesters should be concerned for anemia.

ObjectiveTo systematically evaluate the effects of threshold inspiratory muscle training (TIMT) on respiratory function, motor function and quality of life in patients with chronic obstructive pulmonary disease (COPD). MethodsRandomized controlled trials (RCT) about the effects of TIMT on dyspnea, quality of life, motor function and inspiratory muscle strength for COPD patients were retrieved from PubMed, EBSCO, Web of Science, Ovid, Cochrane Library, SinoMed, CNKI, VIP, since establishment to September, 2020. Two researchers independently screened literatures, extracted data and evaluated the methodological quality. A meta-analysis was performed using RevMan 5.3. ResultsA total of 30 RCTs involving 2 060 patients were included. TIMT could obviously improve the maximum inspiratory pressure (MD = 10.68, 95%CI 7.43 to 13.92, P < 0.001), optimize the results of 6-minute Walking Test (MD = 24.62, 95%CI 9.09 to 40.15, P = 0.002), the St George's Respiratory Questionnaire (MD = -3.08, 95%CI -5.84 to -0.33, P = 0.03), the modified Medical Research Council Dyspnea Scale (MD = -0.30, 95%CI -0.52 to -0.07, P = 0.01) and Borg score (MD = -0.84, 95%CI -1.24 to -0.44, P < 0.001). TIMT could also improve the forced expiratory volume in one second (MD = 0.11, 95%CI 0.04 to 0.19, P = 0.003) and the forced expiratory volume in one second in predicted (MD = 3.72, 95%CI 2.62 to 4.82, P < 0.001). There was no significant difference in the COPD Assessment Test (MD = -1.14, 95%CI -2.32 to 0.03, P = 0.06) or forced vital capacity (MD = 0.07, 95%CI -0.12 to 0.25, P = 0.49). ConclusionTIMT can improve the inspiratory muscle strength, alleviate the symptoms of dyspnea, and improve the lung function and the quality of life for COPD patients.

Clinical and endoscopic data of 6 patients with colorectal mucosa associated lymphoid tissue (MALT) lymphoma who were diagnosed by endoscopy in the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2015 to June 2021 were retrospectively analyzed. There were 2 males and 4 females with aged from 62 to 87 years. The lesions were located in rectum in 3 cases, transverse colon in 1 case, sigmoid colon in 1 case, and sigmoid colon and rectum in 1 case. There were 1 case of polyposis type, 2 cases of inflammation type, and 3 cases of submucosal tumor type. The "tree-like appearance (TLA)" found in 5 cases. Endoscopic resection, surgery combined with chemotherapy, Helicobacter pylori eradication and follow-up were performed on 2, 1, 1 and 2 cases, respectively. Five cases had a good prognosis after 21-73 months follow-up, and 1 case had lost to follow-up. No recurrence was found in endoscopic and imaging review. Colorectal MALT lymphoma should be considered when colonoscopy detects a submucosal lesion with TLA sign on the left colon. Endoscopic resection has the potential to be a first-line treatment in the context of early diagnosis.

Tumor-associated macrophages (TAMs), one of the dominating constituents of tumor microenvironment, are important contributors to cancer progression and treatment resistance. Therefore, regulation of TAMs polarization from M2 phenotype towards M1 phenotype has emerged as a new strategy for tumor immunotherapy. Herein, we successfully initiated antitumor immunotherapy by inhibiting TAMs M2 polarization via autophagy intervention with polyethylene glycol-conjugated gold nanoparticles (PEG-AuNPs). PEG-AuNPs suppressed TAMs M2 polarization in both in vitro and in vivo models, elicited antitumor immunotherapy and inhibited subcutaneous tumor growth in mice. As demonstrated by the mRFP-GFP-LC3 assay and analyzing the autophagy-related proteins (LC3, beclin1 and P62), PEG-AuNPs induced autophagic flux inhibition in TAMs, which is attributed to the PEG-AuNPs induced lysosome alkalization and membrane permeabilization. Besides, TAMs were prone to polarize towards M2 phenotype following autophagy activation, whereas inhibition of autophagic flux could reduce the M2 polarization of TAMs. Our results revealed a mechanism underlying PEG-AuNPs induced antitumor immunotherapy, where PEG-AuNPs reduce TAMs M2 polarization via induction of lysosome dysfunction and autophagic flux inhibition. This study elucidated the biological effects of nanomaterials on TAMs polarization and provided insight into harnessing the intrinsic immunomodulation capacity of nanomaterials for effective cancer treatment.