Empathy is one of the basic qualities that modern clinicians need to possess.Although traditional Chinese medicine has no definition for empathy,it does have practical applications.TCM clinical empathy,nurtured by Chinese excellent traditional culture,can be seen in TCM classics and clinical practice of famous doctors of previous generations,and has been inherited in the spiritual thinking of modern colleges and universities of Chinese medicine.However,at present,there is a relative lack of special training courses for"empathy"in Chinese medicine higher education.This paper first briefly describes the connotation,history,and neuroscience mechanism of the concept of"empathy".Secondly,the manifestations and characteristics of"empathy"in the clinical practice of traditional Chinese medicine were sorted out.Finally,we use modern medicine and psychology for reference,and combine the characteristics of traditional Chinese medicine to make suggestions for the cultivation of the ability of"empathy"in clinical Chinese medicine.

Objective:To investigate epidemiological features and trends of genital herpes in Zhejiang province, and to provide scientific evidence for developing control strategies.Methods:Data on reported cases of genital herpes in Zhejiang province between 2011 and 2020 were collected from national notifiable infectious disease surveillance system in China Disease Control and Prevention Information System, and a descriptive epidemiological study was conducted.Results:The reported incidence rate of genital herpes in Zhejiang province between 2011 and 2020 ranged from 4.92 per 100 000 to 6.19 per 100 000, without a significant upward or downward trend (trend χ2 = 0.03, P = 0.959) ; the reported incidence rate in females showed an increasing trend (from 4.50 per 100 000 to 6.02 per 100 000, trend χ2 = 5.13, P = 0.034) , with an average annual increase rate of 3.27%; among all the age groups, the sexually active population aged 20 - 39 years showed a high reported incidence rate of genital herpes, but the incidence rate increased significantly in the groups aged 15 - 19 years and over 50 years, with the average annual increase rates being 8.10%, 9.24%,7.81% and 4.27% in the groups aged 15 - 19 years, 50 - 54 years, 55 - 59 years and over 60 years respectively. The largest proportion of cases was found in farmers (28.38%, 8 779/30 931) , and high average annual increase rates in proportions were observed in healthcare workers, retirees, students, unemployed population and cadres (13.71%, 13.14%, 10.74%, 9.36% and 7.00%, respectively) . The reported incidence rates were high (over 5 per 100 000) in Eastern coastal areas such as Ningbo, Wenzhou, Taizhou, as well as Jinhua city with relatively developed industrial economies in central Zhejiang; the reported incidence rate markedly increased in Hangzhou city, with an average annual increase rate of 5.39%. Conclusions:There was no obvious downward trend in the prevalence of genital herpes in Zhejiang province from 2011 to 2020. Attention should be paid to the prevention and treatment of genital herpes in females, adolescents and the elderly, and the monitoring of herpes simplex virus infections and investigation of infection routes and exposure history should be strengthened.

Objective:To analyze spatiotemporal distribution characteristics of syphilis in Zhejiang province from 2016 to 2020, to explore cluster areas of syphilis cases, and to provide a theoretical basis for accurate prevention and control of syphilis.Methods:Data on reported syphilis cases in Zhejiang province from 2016 to 2020 were collected from the notifiable infectious disease surveillance system in China Disease Control and Prevention Information System. The ArcGIS10.2 software was used as a data management and presentation platform to establish a database for spatial analysis of syphilis in Zhejiang province from 2016 to 2020, and spatial autocorrelation analysis of reported syphilis incidence was conducted. The SaTScan 9.6 software was used for spatiotemporal scanning analysis.Results:A total of 158 420 cases of syphilis were reported in Zhejiang province from 2016 to 2020, and the average annual reported incidence rate was 49.07 per 100 000 in all counties and districts (range: 20.52 per 100 000-124.29 per 100 000) . The overall spatial distribution pattern of syphilis cases in Zhejiang province was characterized by higher reported syphilis incidence in the West area and lower incidence in the middle area. Global autocorrelation analysis showed that all the global Moran′s I indices from 2016 to 2020 were over 0, Z values were over 1.96, and P values were below 0.001, suggesting the spatial clustering of reported syphilis cases. Local autocorrelation analysis showed that there were 2 high-high clustering areas (Tonglu and Chun′an counties in Hangzhou city, Jingning county in Lishui city) , and 1 low-low clustering area (Jindong district, Dongyang and Yongkang county-level cities in Jinhua city) . Local hot-spot analysis with G statistic showed that there were 6 positive hot-spot areas and 8 negative hot-spot areas of syphilis cases in Zhejiang province. SaTScan spatiotemporal scanning analysis revealed 3 clustering areas, mainly distributed in Taizhou and Zhoushan cities along the eastern coast, and some counties and districts in the southwestern mountainous areas. Conclusions:The reported incidence rate of syphilis in Zhejiang province is characterized by spatial clustering. In the future, prevention and control of syphilis should be strengthened in southwestern mountainous areas, eastern islands, and other remote areas as well as areas with poor transportation.

Objective: To assess the implementation of National Leprosy Control Plan (2011-2020) in Zhejiang Province, so as to provide insights into leprosy control. Methods: Leprosy control data were collected from the National Leprosy Management Information System of China, and health administrative sectors, centers for disease control and prevention and professional leprosy control institutions at each level in Zhejiang Province. According to the scheme for the final evaluation of National Leprosy Control Plan (2011-2020), the implementation of 12 indicators in Zhejiang Province in 2020 was investigated, including the current number of leprosy patients, prevalence of leprosy, proportion of training on leprosy control skills, proportion of regular leprosy treatment, proportion of treatment of adverse reactions, annual examination rate of close contacts, proportion of early case identification and awareness of leprosy control knowledge. Results: There were 50 registered leprosy cases in Zhejiang Province by the end of 2020, with a decrease of 50.98% relative to in 2010. The prevalence of leprosy was less than 1/105 in 93 counties (districts) of Zhejiang Province, and the rate of training on leprosy control skills, rate of regular leprosy treatment, rate of treatment of adverse reactions, annual examination rate of close contacts, rate of early case identification were all 100% in Zhejiang Province. There were no new confirmed cases with diagnosis of leprosy having grade 2 deformity or disability, or no new cases with deformity or disability within 2 years following anti-leprosy therapy. In addition, the awareness of leprosy control knowledge was 91.67% among the public and 98.12% among the close contacts. All of the 12 indicators reached the requirements of the National Leprosy Control Plan (2011-2020). Conclusions The implementation of the National Leprosy Control Plan (2011-2020) in Zhejiang Province had achieved the targets defined in the final evaluation of the plan. Intensifying multi-sectoral joint leprosy prevention and control and improving early identification and standardized therapy of leprosy cases are recommended for future leprosy control in Zhejiang Province.

Objective:To analyze the genomic characteristics of H7N9 avian influenza virus in external environment in Huainan city in 2016.Methods:Samples such as poultry feces, cages, table or cutting board, depilator, poultry drinking water and sewage in live poultry markets were collected. PCR positive samples of H7N9 and H9 subtypes ( Ct value ≤30) were selected. RNA was extracted from chicken embryos after isolation and culture. Results:Fourty-six H7N9 subtypes, 71 H9 subtypes and 38 H5 subtypes were detected from 150 environmental samples in Huainan city in 2016. Two H7N9 subtypes were successfully isolated. Genetic evolution analysis showed that the hemagglutinin (HA) and neuraminidase (NA) genes of the two H7N9 strains in Huainan city were in the branch of the Yangtze river delta, while the other six endogenous genes had no obvious regional distribution and clustering. G186V and Q226L of HA receptor site amino acids mutated. NA stem area missed "QISNT" sequence, while R294K and E119V resistance sites showed no variation. PA gene I550L, PB1 gene I368V and PB2 gene I504V were mutated in the polymerase. The N205S and P42S of the NS-1 gene changed to enhance the pathogenicity. M1 gene N30D, T215A, M2 gene S31N drug resistance gene loci mutated.Conclusions:The avian influenza virus was highly prevalent in the live poultry market in Huainan city in 2016. Meanwhile, the ability of the H7N9 subtypes to infect humans has increased. M2 ion channel inhibitor (related to the M2 gene) developed resistance, while NA inhibitors (related to the NA gene) remain susceptible and effective drugs.

Objective:To analyze the genomic characteristics of H9N2 subtype avian influenza virus in external environmental specimens collected in Huainan city from February to April, 2016.Methods:Specimens positive for H9N2 nucleic acid (Ct value≤30) were screened by fluorescent PCR and cultivated in chicken embryos to extract RNA. Eight gene segments were amplified and analyzed with whole genome sequencing. The molecular characteristics of each gene segment of Huainan strains were analyzed. A phylogenetic tree was constructed based on the sequences.Results:The hemagglutinin (HA) and neuramidinase (NA) genes of two Huainan H9N2 avian influenza strains and the human-derived strain A/Anhui-Lujiang/39/2018/H9N2 shared the homology of 98.2%-98.3% and 97.2%-94.9% in nucleotide and 98.9%-98.8% and 99.2%-98.6% in amino acid. The other six endogenous genes were highly homologous to those of the A/Anhui/1/2013/H7N9 and A/Anhui/33163/2016/H5N6 strains. The phylogenetic tree showed that two H9N2 subtype avian influenza strains isolated in Huainan city in 2016 belonged to G57 genotype, and the endogenous genes of two Huainan H7N9 isolates and human-derived A/Anhui/1/2013/ H7N9 and A/Anhui/33163/2016/H5N6 strains were G57-like genotype. Amino acid mutations in the HA protein receptor binding domain including S132D, K138T, T189D, V/A190T and Q226L were detected. The " TEI" sequence was deleted from the NA stem region. Amino acid mutations associated with drug resistance including H274Y, R292K and N294S were not detected in the isolates, but they carried the mutations of I550L in PA gene, I368V in PB1 gene, I504V in PB2 gene, P42S in NS1 gene, N30D and T215A in M1 gene and S31N in M2 gene.Conclusions:The two H9N2 viruses isolated in the live poultry market in Huainan city were highly homologous to the A/Anhui-Lujiang/39/2018/H9N2 strain isolated from humans. The three strains were within the same evolutionary branch and belonged to G57 genotype. The endogenous genes of the two H9N2 viruses could recombine with H7N9 and H5N6 subtype avian influenza viruses that caused human infection. Amino acid mutations in the HA protein receptor binding domain, deleted sequences in the NA stem region and increased polymerase activity strengthened the ability of viruses to infect humans and were related to the drug resistance to M2 ion channel inhibitors (adamantane). The two Huainan H9N2 viruses remained sensitive to NA inhibitors (oseltamivir phosphate).

Objective:To investigate the epidemiological characteristics of syphilis in Zhejiang province and to provide scientific basis for the development of syphilis prevention and control strategies.Methods:A descriptive epidemiological analysis was conducted on the incidence data of syphilis in Zhejiang from 2010 to 2019.Results:During the period, the incidence rate of syphilis decreased from 94.90/100 000 in 2010 to 53.53/100 000 in 2019 with an average decreasing rate of 6.16%. The annual decreases of the incidences of congenital syphilis, primary syphilis and secondary syphilis were all obvious, which were 43.47%, 21.38% and 14.19% respectively. The proportion of latent syphilis cases increased with year. Except for Lishui, the incidences of syphilis in the remaining 10 prefectures showed declining trends. The incidence rates in both men and women showed declining trends with the average rates of 4.80% and 6.45% respectively. The incidence peaks occurred in old men aged ≥60 years and in sexually active women aged 20-34 years, and the syphilis cases in age group ≥60 years increased significantly. The cases were mainly farmers, accounting for 43.00%.Conclusion:The incidence of syphilis in Zhejiang showed a decreasing trend, but the situation remains serious, indicating that the intensity and quality of the comprehensive prevention and control needs to be further strengthened.

The development of TCM acupuncture represents a internationalized and modern trend. A recent study with the title of "Acupuncture for chronic knee pain: a randomized clinical trial" published in Journal of the American Medical Association on October 1st, 2014, which raised doubts on acupuncture efficacy as well as traditional manipulation and acupoint theory, makes some negative impact and challenges on the development of acupuncture. From the view of future development of acupuncture, the potential influence of this research on acupuncture development is proposed, and by combining acupuncture theory, some discussions and doubts on the research design and outcome explanations are made. Additionally, enlightenments of this research on further clinical research are summarized.
Acupuncture Therapy ; Chronic Pain ; therapy ; Female ; Humans ; Low-Level Light Therapy ; Male

BACKGROUND/AIMS: Increasing evidence shows involvement of psychological disorders in functional dyspepsia (FD), but how psychological factors exert their influences upon FD remains largely unclear. The purpose of the present study was to explore the brain-based correlations of psychological factors and FD. METHODS: Based on Fluorine-18-deoxyglucose positron emission tomography-computed tomography, the altered cerebral glycometabolism was investigated in 40 FD patients compared with 20 healthy controls during resting state using statistical parametric mapping software. RESULTS: FD patients exhibited increased glucose metabolism in multiple regions relative to controls (P < 0.001, family-wise error corrected). After controlling for the dyspeptic symptoms, increased aberrations persisted within the insula, anterior cingulate cortex (ACC), middle cingulate cortex (MCC) and middle frontal cortex (midFC), which was related to anxiety and depression score. Interestingly, FD patients without anxiety/depression symptoms also showed increased glycometabolism within the insula, ACC, MCC and midFC. Moreover, FD patients with anxiety/depression symptoms exhibited more significant hypermetabolism within the above 4 sites compared with patients without anxiety/depression symptoms. CONCLUSIONS: Our results suggested that the altered cerebral glycometabolism may be in a vicious cycle of psychological vulnerabilities and increased gastrointestinal symptoms.
Anxiety ; Cerebral Cortex ; Depression ; Dyspepsia* ; Electrons ; Glucose ; Gyrus Cinguli ; Humans ; Metabolism ; Psychology*

By searching the registry information of systematic review regarding acupuncture included before March 31, 2014 in PROSPERO systematic review registry platform, information in the project plan such as care gories of diseases, interventions, research team and the completion status was analyzed to make a comprehensive understanding on registry status of acupuncture systematic review in this platform. As a result, a total of 52 project plans was finally included. The health problem concerned was mainly painrelated diseases, and the interventions were mostly simple acupuncture or combination of acupuncture and moxibustion. The registered plan participated with Chinese team appeared comparatively late, which was featured with fewer independent projects and concentrated research organization, so its scientific research advantage in acupuncture did not present. In conclusion, it is believed that the consciousness on systematic review registry in domestic researchers needs to be improved, and researchers might take good advantages of the PROSPERO platform in the future.
Acupuncture Therapy ; Databases, Factual ; Humans ; Registries ; Review Literature as Topic