Based on commonly used acupoints in the clinical acupuncture treatment of functional dyspepsia （FD）， this study systematically analyzes the therapeutic differences and synergistic effects between local and distal point selection. It also examines the suitability of primary acupoint selection for different FD subtypes， postprandial distress syndrome （PDS） and epigastric pain syndrome （EPS）. The findings suggest that a combination of local and distal acupoints may be more appropriate as primary points for PDS， whereas local acupoints alone may be more suitable for EPS. Additionally， the study explores the impact of various factors， such as stimulation techniques， needling order， intensity or stimulation parameters， and depth， on the efficacy of acupuncture. It concludes that the intrinsic properties of acupoints are the primary determinants of therapeutic direction. Other factors mainly influence the magnitude rather than the direction of the effect. Future research may further investigate how different acupoint combinations， local versus distal， affect the treatment outcomes of FD subtypes， providing new insights for clinical acupuncture prescriptions.

Objective:To investigate the feasibility of conducting active surveillance (AS) for low risk papillary thyroid microcarcinoma (PTMC) in China and to examine the factors in association with disease progression during AS.Methods:This study was a prospective observational research conducted from Jun. 2018 to Aug. 2022 at Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine. Seventy-three patients with cytologically confirmed low-risk PTMC were enrolled in this study. They were followed up by ultrasonography, and the observed nodules were re-assessed whether or not to have disease progression. Disease progression was defined as having nodule enlarged more than 3 mm in any of diameters measured on ultrasound, or/and presence of suspicious lymph node metastasis.Results:The median follow-up time was 33 months. At the time of last follow-up, 16 cases (21.9%) exhibited disease progression, including 9 cases (12.3%) with suspicious lymph nodes detected by ultrasound, and 8 cases (11.0%) with lesion enlargement; one case (1.3%) exhibited both situations. The univariate chi-square analysis revealed that young patients (≤45 years old, P=0.041), presence of microcalcifications ( P=0.032), initial larger nodule (diameter greater than 7 mm, P=0.003), and elevated thyroid autoantibody levels ( P=0.008) were associated with disease progression. Multiple regression analysis showed elevated thyroid autoantibodies ( OR=4.311, P=0.030) and initial larger nodule ( OR=6.196, P=0.034) were independent risk factors for PTMC progression,respectively. Conclusions:AS for low-risk PTMC is a feasible and effective. During the observation, ultrasound can reveal suspicious lymph nodes and nodule enlargement, which are crucial indicators for assessing disease progression. Patients with initially larger nodule size and elevated thyroid autoantibody level are more likely to exhibit disease progression and should receive closer attention.

Objective To investigate the effects of long-term occupational exposure to high-frequency noise in specific frequency bands on auditory function of the inner ear,and to evaluate the mechanisms of auditory threshold damages due to high-frequency noise exposure utilizing bone conduction audiometry and acoustic physical models.Methods The study subjects included factory workers and airport ground staff working in high-noise environments for a long period.Two groups(an exposure group and a control group)were established,and the exposure group was further divided into 3 subgroups according to exposure duration:5-9 years,10-14 years,and over 15 years.Bone conduction audiometry was used to assess auditory threshold changes in different frequency bands(4,6,8 kHz),while a sound level meter was employed to record noise exposure intensity.The impact of noise on the cochlea was simulated using an acoustic physical model.Multivariable regression analysis,controlling for confounding factors such as age and gender,was used to further analyze the independent effects of exposure duration and intensity on auditory damage.Results The auditory thresholds of exposure group were significantly higher than those of control group in the high-frequency bands,particularly in 8 kHz frequency band(P＜0.001).With increasing exposure duration,auditory damage in exposure group progressively worsened,and the most significant auditory threshold changes was found in the group exposed for over 15 years.The predictions made by the acoustic physical model closely matched the actual measurements,and the high model fitting degree(R2:0.85-0.90)in the long-term exposure group indicated a strong predictive capability for the cumulative effects of cochlear damage.Conclusion Long-term exposure to high-frequency noise in specific frequency bands results in significant cumulative damage to auditory function of the inner ear.Exposure duration and intensity are the primary independent risk factors.

Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.

Objective To explore the effect of a new organ preservation solution with HOE642 on the apoptosis of the donor lung from a modified lung transplantation model of rabbits.Methods 24 male rabbits were divided into two groups [low potassium dextran (LPD) group and HOE group],established rabbit models for next 2-h reperfusion using LPD solution or new organ preservation solution.Detected the levles of apoptosis index and caspase-3,the expression of Fas/Fas-L and Bcl-2/Bax.Results Compared with LPD group,HOE group revealed significant lower level of apoptosis index and caspase-3 (P＜0.05),lower expression of Fas/Fas-L and Bax,and higher expression of Bcl-2 (P＜0.05).Conclusion The potential donor lung protective mechanism offered by the new organ preservation solution with HOE642 might be the inhibition of apoptosis via both intrinsic and extrinsic pathways.

Objective Application of near-infrared fluorescent thoracoscope in visualizing thoracic sympathetic ganglions,to explore the effectiveness and safety of the technique.Methods Patients received near-infrared fluorescent thoracoscopic surgery was continuously in rolled from September 2015 to September 2016.The patient was infused indocyanine green 5 mg intravenous 24 hours before surgery.The thoracic sympathetic ganglions were observed under white and fluorescence model during surgery.The videos and photos were analyzed and the relationship between sympathetic ganglions and ribs was recorded.Results 31 patients was in rolled,including 12 males and 19 females.The average age was 47 years.The sympathetic ganglion of each patient was well visualized under fluorescence model.The signal to background ratio was 1.67.As we found that 48.8％ ganglions located in the upper edge of lower rib.Besides,26.9％ of T2 ganglions and 23.1％ of T3 ganglions located on the rib.Conclusion Near-infrared fluorescent thoracoscope was effiective and safety to visualize the thoracic sympathetic ganglions.The sympathectomy of palmar hyperhidrosis could be done by near-infrared fluorescent thoracoscope more precisely.

Objective To investigate the current situation of Chinese non-small cell lung cancer( NSCLC) surgical treat-ment in different centers.And to compare the differences of patient characteristics and treatment patterns .Methods Data of 5060 NSCLC patients out of 8387 patients from 14 provinces, 17 third-grade class-A hospitals was obtained .All included pa-tients were stage ⅠtoⅢ, and were treated with curative-intent surgeries during the years of 2013 and 2014.Patient character-istics, preoperative examinations, surgical treatment patterns and pathology et al.were analyzed.Results There were 3204 males and 1856 females.The patients' age was among 19~86(59.7 ±9.11)years old.Mean preoperative FEV1 was(2.23 ± 0.67)L, and mean FEV1/FVC was 81.8%.64.6% patients accompanied with at least one comorbidity.The mean diameter of tumor was(3.28 ±1.94)cm.Duration of surgery was(181.1 ±71.0) minutes.Pathology confirmed 59.8% as adenocarcino-ma, and 30.2% as squamous carcinoma.The ratio of adenocarcinoma/squamous cell carcinoma was 1.03:1 in all male pa-tients.And the ratio is 16.4:1 in female patients.Among all the patients that underwent lobectomies, 50.1% patients under-went micro-invasive surgeries(VATS or mini-incision surgery).The rate of micro-invasive surgery is among 8.3% to 90.2%. The number of lymph nodes stations harvested in lobectomy was 5.9(mean 3.0 -7.4).Mean hospital cost was 53830.8 ( mean 42205-100113 ) yuan.Conclusion The Chinese NSCLC patients who underwent surgeries own unique patient charac-teristics.The baseline characteristics, surgical treatment patterns and hospital cost varied among different centers.

Objective To systematically assess the efficacy and safety of electroacupuncture for trigeminal neuralgia. Method Randomized controlled trials of a electroacupuncture treatment for trigeminal neuralgia were sought by a computer search of CNKI,Wan Fang Data,VIP,CBM,PubMed,EMbas and The Cochrane Library.The retrieval time limit was from March 1996 to March 2016. Two reviewers sifted the literature and extracted data independently according to the inclusion and exclusion criteria andthen assessed the riskofbias of the included literatureusing the Cochrane risk of bias assessment tool.Ameta-analysis was made using RevMan 5.3.Result Finally, 12 articles were included with atotal of 847 subjects.The results ofmeta-analysis showed that the total efficacy rate was higher in the electroacupuncture group than in the control group [OR=4.04,95%CI(2.67, 6.13),P<0.00001].There were no statistically significant differences in the VAS score [MD=﹣0.06,95%CI(﹣0.59, 0.47),P=0.82] and the recurrence rate [OR=0.64,95%CI(0.05,7.45),P=0.54] between the electroacupuncture and control groups.Conclusion The currentlimited evidenceshows that the total efficacy rate fortrigeminal neuralgiais higher in the electroacupuncture group than in the control group.There are no statistically significant differences in the VAS score and the recurrence rate of trigeminal neuralgia between the electroacupuncture and control groups of patients.But the conclusions need more high-qualitytrials for validation owing to the limitation of the sample size of the included studies.

Objective To observe the clinical efficacy of Linda mixture self made by combination of disease with syndrome pattern for treatment of neonatal intrahepatic cholestasis disease caused by Citrin defects (NICCD) and to provide an experience in early diagnosis and treatment of NICCD.Methods The clinical features of 20 patients with NICCD was confirmed by NICCD common genetic loci detection during hospitalization admitted to the Department of Integrated Traditional and Western Medicine in Wuhan Children Hospital from June 2012 to June 2015 were retrospectively analysed.The clinical efficacy of Chinese medicine Linda mixture for treatment of NICCD,before and after treatment,the index changes of liver function and coagulation function were observed and Color Doppler ultrasound was used to detect the situation of hepatosplenomegaly in the patients.Results There were 20 cases all their pathological jaundice occurring within 3 months old,after treatment,15 cases of them obtained clinical recovery and 5 cases were getting better,the average length of stay in hospital was (14.67 ± 1.56) days.After the treatment,the levels of serum total bilirubin (TBil),direct bilirubin (DBil),alanine aminotransferase (ALT),total bile acid (TBA) were markedly lower compared with those before treatment [TBil (μmol/L):64.0 ± 39.5 vs.173.5 ± 54.1,DBil (μmol/L):37.7±24.8 vs.80.9±46.4,ALT (U/L):42.1±25.8 vs.55.0±32.2,TBA (μnol/L):67.5±20.3 vs.195.0±61.3,all P ＜ 0.05],albumin (Alb) and total albumin (GLB) were significantly higher compared with those before treatment [Alb (U/L):37.9 ± 4.7 vs.33.1 ± 4.7,GLB (g/L):17.3 ± 4.0 vs.14.6 ± 2.8,both P ＜ 0.05],activated partial thromboplastin time (AP'TT) of coagulation function was significantly reduced (s:38.2± 8.3 vs.63.1±24.0,P ＜ 0.05).Color Doppler ultrasound examination showed that hepatosplenomegaly was shrunk after treatment [hepatomegaly (cm):2.12 ± 0.70 vs.3.04 ± 0.25,splenomegaly (cm):0.25 ± 0.03 vs.0.58 ± 0.32,both P ＜ 0.05].After 1 month of follow up,the infants' body weights were almost normal,the average increase in weight being (1.01±0.32) kg,the color and frequency of stool were distinctly better compared with those before treatment,the stool color in 15 cases was golden,pale yellow in 5 cases and no one,pottery clay in color.The stool frequencies of 18 cases were kept under 5 times,and fatty diarrhea situation was ameliorated.Conclusion Using Chinese medicine for treatment of NICCD can obtain significant clinical effects.

BACKGROUND:Studies have testified that nano-ultrasound contrast agents have a strong permeability, making it possible to image the targeted tissues outside blood vessels and overcome the limitation that micron contrast agents are only available for the blood pool imaging. OBJECTIVE:To construct the folate-modified nanoparticles targeting breast cancer as ultrasound contrast agents, as wel as to observe their ability to specifical y bind to cel s and imaging effect in vitro. METHODS:Both contrast agents, pegylated lactic acid-glycolic acid copolymer wrapping liquid fluorocarbon formed nanoparticles (mPP/PFOB) and folate modified pegylated lactic acid-glycolic acid wrapping liquid fluorocarbon formed nanoparticles (mPPF/PFOB), were constructed by phacoemulsification-evaporation method. (1)Biocompatibility detection:HFF-1 and MCF-7 cel s in the logarithmic phase were cultivated with various concentrations (0, 0.005, 0.01, 0.02, 0.05, 0.1, 0.2 and 1 g/L) of mPP/PFOB or mPPF/PFOB for 24 hours respectively, and then the cel viability was measured. (2)Targeting ability detection in vitro:HFF-1 and MCF-7 cel s in the logarithmic phase were divided into three groups. Cy5-labled mPP/PFOB and mPPF/PFOB were added into groups A and B, respectively;the cel s in group C were pretreated with folate for 2 hours, and sequential y Cy5-labled mPPF/PFOB was added into group C. Fluorescence intensity was detected by flow cytometry after 0.5 hours of culture. The distribution of contrast agents in cel s was observed using confocal microscopy after 20 minutes of culture. (3)Ultrasound imaging in vitro:there were three groups:saline was as group A;the suspension of saline and mPPF/PFOB nanoparticles was prepared as group B;MCF-7 cel s were resuspended with the mixture of saline and mPPF/PFOB nanoparticles to prepare the suspension of nanoparticles and cel s as group C. In each group, the suspension was added into latex gloves, that were then tightened and immersed in water. Final y, the ultrasound was use to detect the ultrasound imaging effect in vitro. RESULTS AND CONCLUSION:Neither nanoparticles were with significant cytotoxicity. The flow cytometry showed that the mean fluorescence intensity in MCF-7 cel s of group B was significantly higher than that of groups A and C. But there were no significant differences in the mean fluorescence intensity in HFF-1 cel s among the three groups. It was observed that mPPF/PFOB mainly gathered around the MCF-7 cel membrane, while mPP/PFOB randomly distributed in the cytoplasm. After mPPF/PFOB binding to MCF-7 cel s, they could enhance ultrasound echo in vitro. These findings indicate that the targeted nanoparticles mPPF/PFOB have good biocompatibility and can specifical y bind to breast cancer MCF-7 cel s in vitro and enhance the imaging capability.