By sorting out the literature related to constitution and referring to the concept and method of "element"， many ancient and modern theories of constitution are deconstructed into multi-dimensional "constitution elements". These constitution elements are divided into two levels： basic and derivative. The basic level is the most basic element of constitution， including zang-fu organs/body and material. The zang-fu organs/body dimension focuses on the fixed functional units in the human body， and the material dimension focuses on the rheology functional units of human body. The derivative level is the secondary physiological or psychological state in life activities， including emotion and qi transformation. The emotional dimension focuses on the state of human psychological activities， and the qi transformation dimension focuses on the state of human physiological activities in cold， heat， dampness， and dryness. Based on this， we can further study the influence of factors such as age， gender， region， and social class， on the combination rule of "constitution element"， so as to form a more comprehensive classification program of constitution.

Objective To systematically evaluate the incidence rate of low-level viremia(LLV)in chronic hepatitis B(CHB)patients and related influencing factors,and to provide evidence-based medicine evidence for effective intervention and prevention of LLV in clinical practice.Methods This study was conducted according to the PRISMA guideline,with a PROSPERO registration number of CRD42023455304.CNKI,Wanfang Data,VIP,SinoMed,PubMed,Embase,Web of Science,and the Cochrane library were searched for observational studies on LLV and related influencing factors in CHB patients published up to July 21,2023.Stata 16.0 software was used to perform the meta-analysis.Results A total of 12 articles were included,with a total sample size of 3408 cases,among whom there were 1181 patients with LLV.The meta-analysis showed that the incidence rate of LLV was 32.8%(95%confidence interval[CI]:27.6%—38.3%)in treatment-experienced CHB patients.High HBsAg quantification(odds ratio[OR]=2.107,95%CI:1.782—2.491,P<0.001),positive HBeAg(OR=3.258,95%CI:2.629—4.038,P<0.001),high HBV DNA level at baseline(OR=1.286,95%CI:1.157—1.430,P<0.001),and history of entecavir treatment(OR=3.089,95%CI:1.880—5.074,P<0.001)were risk factors for LLV;duration of antiviral therapy≥3 years(OR=0.175,95%CI:0.093—0.331,P<0.001)and high alanine aminotransferase level at baseline(OR=0.985,95%CI:0.978—0.992,P<0.001)were protective factors against LLV.The sensitivity analysis showed no significant change in effective value,suggesting that the results of the meta-analysis were relatively stable.The funnel plot of the studies included was basically symmetrical,and the results of the Egger's test and the Begg's test suggested that there was no obvious publication bias in the articles included.Conclusion Clinicians should guide decision making based on the influencing factors for LLV and related clinical evidence,so as to reduce long-term clinical risks and avoid adverse outcomes.

Objective To analyze and study the prescriptions of Chief Physician Chang Yalin for treating breast hyperplasia patients in the outpatient department,explores and summarizes the medication patterns for treating breast hyperplasia,and provides reference and dialectical medication ideas for clinical treatment of breast hyperplasia by using data mining technology.Methods Collect the prescriptions of Dr.Chang Yalin for treating breast hyperplasia patients at the Outpatient Department of Jiuquan Traditional Chinese Medicine Hospital from January 1,2017 to December 31,2022.After induction and organization,establish a data table,use Excel 2019 to statistically analyze the drug frequency and gender,taste,and meridian.Use SPSS Modoler 18.0 software April algorithm to analyze the association rules of the drugs,and use SPSS Statistics for cluster analysis.Results A total of 184 prescriptions were included,covering 140 types of traditional Chinese medicine,with a total frequency of use of 4059 times.Among them,Cornus officinalis,dried ginger,roasted licorice,Poria cocos,and jujube are commonly used drugs for the treatment of breast hyperplasia.The top three types of Chinese medicine that are commonly used are tonifying deficiency,warming internal medicine,and relieving external symptoms.The medicinal properties are mainly warm and mild;The medicinal taste is characterized by sweetness,bitterness,and bitterness;The main meridians of drugs are spleen,lung,and heart meridians.Association rule analysis shows that roasted licorice white peony,poria cocos,licorice,and cornus flesh white peony,jujube,and ginger are equivalent.Classify commonly used drugs into 4 categories using Euclidean distance clustering and segmentation with 5.Conclusion Dr.Chang Yalin has always implemented the core idea of treating breast hyperplasia through the coordination of liver and spleen,the simultaneous application of attack and tonifying,and the simultaneous treatment of phlegm and blood stasis.In terms of the combination of latent drugs,the main focus is on tonifying qi and spleen,tonifying yin/blood and regulating liver,and resolving stasis/resolving phlegm and dispersing stagnation.In terms of the combination of"cold phlegm"and"blood stasis and toxin",as well as the combination of"eighteen contraindications"and"nineteen contraindications",his principles and methods are more distinctive and worthy of further research and promotion.

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

In order to improve the success rate of supraclavicular deep venous catheterization and reduce mechanical complications, we present an auxillary maneuver in regard to supraclavicular subclavian catheterization basing on the relatively fixed anatomy of subclavian vein and its adjacent surroundings, furthermore, we revised the standardized procedure of supraclavicular subclavian catheterization. The maneuver is summarized in the shape of verses (verses: thumb navigation is well designed according to anatomy. Needle penetrated into vein should be parallel to coronal plane. Fine needle in position should be immobilized. Is it difficult for parallel puncture? Pressure determination is required when needle is in place. It is critical to distinguish which vessel has been inserted. Guidewire is advanced smoothly. Check blood return after expansion of skin and catheterization.). For teaching convenience, verses are considered to be more concise and memorable, as well as applicable to clinical practice, in order to provide some help for clinical teaching.

OBJECTIVE: To evaluate the clinical application of magnetic resonance imaging( MRI) in diagnosis of lung large shadow in coal workers' pneumoconiosis( CWP). METHODS: Twenty-five CWP patients with lung large shadow( 39 lesions) were selected as CWP group by using the judgment sampling method,and 34 cases( 34 lesions),including 21 cases of lung cancer( lung cancer subgroup) and 13 cases of lung mass( lung mass subgroup),were selected as control group. Routine MRI examinations was performed on these three groups of patients. T1 weighted imaging( T1 WI),T2 weighted imaging( T2 WI) and frequency pre-saturation inversion recovery( SPIR) imagings were performed to analyze the differences of MRI images. RESULTS: Large shadow lesions in patients with CWP showed slightly lower signal,equal signal and equal lower signal in T2 WI and SPIR,accounting for 97. 4%(38/39) and 94. 9%(37/39) respectively. Those show slightly higher signal accounted for 2. 6%(1/39) and 5. 1%(2/39),respectively. The proportions of lung large shadows showed slightly higher signal of CWP group at T2 WI and SPIR were lower than those in the control group( 2. 6% vs88. 2%,5. 1% vs 91. 2%,P < 0. 01),the lung cancer subgroup(2. 6% vs 95. 2%,5. 1% vs 95. 2%,P < 0. 01) and lung mass subgroup( 2. 6% vs 76. 9%,5. 1% vs 84. 6%,P < 0. 01). CONCLUSION: MRI has good specificity in identifying characteristics of lesion of CWP large lung shadow. The main manifestations are slightly lower signal,equal signal and equal lower signal on T2 WI and SPIR

OBJECTIVE:To observe the effects of Gegenqinlian colon positioning tablet(GGQLJC)on colon tissue PPAR-γ, NF-κB p65 protein expressions of model rabbits with damp-heat type ulcerative colitis(UC). METHODS:56 rabbits were random-ly divided into normal group(normal saline),model group(normal saline),sulfasalazine tablet(SASP)group(positive control, 0.300 g/kg),Gegenqinlian tablet (GGQL) group (0.225 g/kg) and GGQLJC high-dose,medium-dose,low-dose groups (1.036, 0.518,0.259 g/kg),8 in each group. Except for normal group,rabbits in other groups were cultured for damp-heat-type UC mod-el,intragastrically administrated in the second day of last administration,once a day,for 14 d. Disease activity index(DAI),co-lonic mucosal damage index (CMDI),histological damage (TDI) were scored;colon,spleen and thymus indexes were deter-mined;PPAR-γ,NF-κB p65 protein expressions in colon tissue were detected. RESULTS:Compared with normal group,DAI, CMDI,TDI scores and spleen index,colon index,NF-κB p65 protein level in colon tissue in model group were significantly in-creased(P<0.01);thymus index,PPAR-γprotein level in colon tissue were significantly reduced(P<0.01). Compared with mod-el group,above-mentioned indexes in each administration group were significantly improved (P<0.05 or P<0.01). Compared with GGQL group,DAI and TDI scores,spleen index,colon index,NF-κB p65 protein level in colon tissue in SASP group, GGQLJC high-dose,medium-dose groups were significantly decreased (P<0.05);PPAR-γ protein level in colon tissue in SASP group,GGQLJC high-dose,medium-dose groups were significantly increased (P<0.05 or P<0.01). CONCLUSIONS:GGQLJC has certain improvement effects on model rabbits with damp-heat type UC,which is superior to GGQL. The mechanism may be re-lated to increasing PPAR-γprotein level and decreasing NF-κB p65 protein level in colon tissue.

Objective To examine the sleep status and relevant psychosocial factors in patients with colorectal cancer before surgery and improve their sleep quality. Methods A cross?sectional survey method was used. Participants were 107 cases of patients with colorectal cancer from the Department of Anorectal Surgery in The First Hospital ,which is affiliated with China Medical University. The Athens insomnia scale(AIS),Ham?ilton depression scale(HAMD),Hamilton anxiety scale(HAMA),perceived social support scale(PSSS),self?esteem scale(SES),medical cop?ing questionnaire(MCMQ),memorial University of Newfoundland scale of happiness(MUNSH),Eysenck personality questionnaire(EPQ),and Wong?Baker face scale were used to assess preoperative sleep in patients with colorectal cancer and related psychosocial factors. Results Among the 107 cases,there were 24 cases of insomnia,with an insomnia incidence of 22.43%. No statistical differences were found in demographic charac?teristics and clinical characteristics(P>0.05). According to the degree of insomnia,there were significant differences between groups(P<0.05) for depression,anxiety,social support,avoidance,yield,happiness,and EPQ?N. Before the surgery,the degree of depression,anxiety,and EPQ?P had a significant positive effect on the degree of insomnia (P< 0.05). Conclusion The degree of insomnia before surgery in patients with colorectal cancer is closely associated with depression,anxiety,coping styles,social support,and personality characteristics.

Through a search of literatures related to sleep disorders in children with cancer in abroad, the occurrence and influencing factors,evaluation and intervention methods of sleep disorders in cancer children were summarized,which aimed to provide instructions and references for further study at home.

BACKGROUND:Flexible intramedulary nailing and external fixation for pediatric femoral shaft fractures are two common methods in the clinic. It remains controversial which fixation methods are better. OBJECTIVE:To systematicaly evaluate the therapeutic effects of flexible intramedulary nailing and external fixation for pediatric femoral shaft fractures. METHODS: A computer-based search was performed on PubMed, Embase, Medline, and Cochrane library for literatures on clinical controled trials of flexible intramedulary nailing and external fixation for pediatric femoral shaft fractures published before November 25, 2014. Literature language was not limited. The age of subjects was from 3 to 15 years. Modified Jadad was utilized to assess methodological quality of the included studies. Meta-analysis was carried out using Stata 12.0 software. RESULTS AND CONCLUSION:Six papers involving 237 patients were included. Meta-analysis results showed that compared with external fixation, a low incidence of overal complications [relative risk (RR)=0.30, 95% confidence interval (CI): 0.19-0.46;P < 0.001] and pin-hole infection (RR=0.286, 95%CI: 0.13-0.61;P= 0.001), but a high risk of needle tail irritation (RR=1.86, 95%CI: 1.35-2.56;P < 0.001) were found folowing flexible intramedulary nailing. No significant differences in other complications were found between the two groups. These results confirm that compared with external fixation, elastic intramedulary nail has fewer complications and faster fracture healing. Elastic intramedulary nail is recommended for single pediatric femoral shaft fractures. However, external fixation is a better option for high energy injury of lower limbs, multiple trauma or severely soft tissue injury.