This paper systematically analyzed the ancient monographs of acupuncture and moxibustion and comprehensive medical books from pre-Qin to 1911， and extracted the data according to the etiology and pathogenesis， treatment principles and methods， acupoint selection， needling and moxibustion， and taboos of needling and moxibustion. The pathogenesis of migraine in ancient books and documents is summarized as "the causes are diverse， and phlegm-dampness is the majority". For treatment， the features include "needling has a sequence， and the root and the branch should be treated separately" and "focusing on tonifying deficiency and drain excess". It is also obtained of the rich ideas of acupoints selection， extensive application records of moxibustion， unique application of bloodletting therapy and clear explanation of acupuncture and moxibustion taboos. All mentioned above is expected to enrich the ideas and methods of modern migraine treatment and improve the clinical effects.

Objective:To standardize the quantitation of 18F-Florbetapir PET SUV ratio (SUVR) to the Centiloid (CL) scale, and analyze the positive rate of β-amyloid (Aβ) in Chinese Preclinical Alzheimer′s Disease (AD) Study (C-PAS). Methods:11C-Pittsburgh compound B(PIB) and 18F-Florbetapir images from public databases " Standard PIB" and " Florbetapir Calibration" were preprocessed by statistical parametric mapping (SPM) 12, and the transformative formulas from SUVR to CL were derived. Then a total of 942 subjects (357 males, 585 females; age (66.4±8.1) years) from C-PAS who received 18F-Florbetapir PET at the Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University from October 2018 to August 2023 were retrospectively included. CL values were calculated and the Aβ positive rates (CL value≤12, Aβ negative; 12< CL value<30, Aβ subtle pathology; CL value≥30, Aβ positive) of AD, mild cognitive impairment (MCI) and cognitive unimpaired (CU) groups were explored. Data were analyzed by using Kruskal-Wallis rank sum test, Dunn′s test (Bonferroni correction ) and χ2 test. Results:The formula for the 18F-Florbetapir SUVR converted to CL was CL=179.64×SUVR_Florbetapir-186.95. In the C-PAS cohort, the SUVR, CL value, Aβ positive rate (including subtle pathology) of patients with clinically diagnosed AD were 1.29±0.22, 43.97±39.23, 71.80%(140/195), which were 1.04(1.02, 1.14), 1.16(-4.04, 17.14), 28.50%(61/214) for patients with MCI, and 1.04(1.01, 1.08), 0.54(-5.29, 7.69), 15.38%(82/533) for CU subjects, respectively. SUVR, CL value and the ratio of negative, subtle and positive Aβ pathology of the above three groups exhibited statistical differences ( H=148.30, H=148.30, χ2=262.12, all P<0.001). Besides, mixed MCI group exhibited higher CL values ((2.45(-1.54, 46.32) vs -1.58(-6.33, 7.20); H=8.21, P=0.016; z=2.81, P=0.015) and Aβ positive rate (including subtle pathology) (41.18%(14/34) vs 14.64%(6/41); χ2 values: 12.71 and 10.63, both P<0.01), compared to non-amnestic MCI group. The CL values and Aβ positive rates were also increased with age in CU group. Conclusion:This study validates the feasibility of the CL formula with 18F-Florbetapir images and reveals Aβ deposition in C-PAS cohort, which can lay the foundation for multi-center Aβ PET studies in China.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Background: Endoscopic submucosal dissection (ESD) has become the preferred treatment of early colorectal cancer. PDCD4 and autophagy have important clinical significance in the pathogenesis of colorectal cancer. Aims: To explore the expressions and significance of apoptosis factor PDCD4 and autophagy factors LC3Ⅱ and p62 in colorectal cancer. Methods: Fifty-four early colorectal adenocarcinoma patients treated by ESD from Jan. 2015 to Nov. 2020 at Binzhou Medical University Hospital were collected. The expressions of PDCD4, LC3Ⅱ and p62 were detected by immunohistochemistry, and the correlations with clinicopathological factors were analyzed. The differential expression of PDCD4 in pan-cancer was analyzed by bioinformatics analysis. Results: Expression of PDCD4 was associated with the long-diameter of paracancer adenoma (P<0.05), and expressions of LC3Ⅱ and p62 were associated with the long-diameters of adenocarcinoma and paracancer adenoma (P<0.05). The positive expression of PDCD4 in P-NIMM was located in the nucleus, while the positive expression in adenocarcinoma was located in cytoplasm. The nucleus/cytoplasm ratio of PDCD4 was significantly higher in P-NIMM than in P-LGIN, P-HGIN and adenocarcinoma (P<0.05), and the nucleus/cytoplasm ratio of PDCD4 was significantly higher in P-LGIN, P-HGIN than in adenocarcinoma (P<0.05). The positive expression rates of LC3Ⅱ and p62 were significantly higher in adenocarcinoma than in P-NIMM and P-LGIN (P<0.05). In P-LGIN, P-HGIN and adenocarcinoma, the expression of PDCD4 was negatively correlated with the expressions of LC3Ⅱ and p62 (P<0.05). The bioinformatics analysis showed that expression of PDCD4 was significantly reduced in a variety of malignant tumors including colorectal cancer (P<0.05). Conclusions: The inhibition of apoptosis and activation of autophagy may promote the occurrence of colorectal cancer, and its mechanism may be related to the intracellular transposition of PDCD4 that inhibits cell apoptosis and enhances autophagy, and activating cellular autophagy may further accelerate the degradation of PDCD4 and thus reducing its cancer inhibiting effect.

A liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed for the determination of bistrifluron, cyantraniliprole and SYP9080 residues in fruits and vegetables. The analytes were extracted from samples with acetonitrile, and purified by dispersion solid phase extraction using C18 and primary secondary amine (PSA) as solid phase adsorbent, then analyzed by LC-MS/MS. Bistrifluron and SYP9080 were analyzed with negative ion multiple-reaction monitoring (MRM), cyantraniliprole was analyzed with positive ion MRM. The matrix-induced weakening effect was observed in the analysis of cyantraniliprole and SYP9080 in several samples including cucumber, apple and onion, and the weakening extent of the matrix-induced effect depended on the sample properties. But no matrix effect was found in the analysis of bistrifluron in several samples. The interference of matrix was reduced by using the matrix-matched calibration standards curve in the analysis of cyantraniliprole and SYP9080. Bistrifluron could be quantified by an external standard of the matrix-matched calibration standards or the pure solvent calibration standards. The linear range was from 0.2 μg/L to 100 μg/L for bistrifluron, cyantraniliprole and SYP9080 with the good correlation coefficients (r≥0.9990). The recoveries of cucumber, grape, apple and scallion added bistrifluron at 0.005-2 mg/kg were 79.8％-99.9％, with relative standard deviations (RSD) of 3.6％-9.8％. The limits of quantification (S/N=10) were 0.210 μg/kg, 0.160 μg/kg and 0.004 μg/kg, and limits of detection (S/N=3) were 0.064 μg/kg, 0.048 μg/kg and 0.001 μg/kg for bistrifluron, cyantraniliprole and SYP9080, respectively.

Objective:To evaluate the tolerance and safety of Zhengbiguanjie tablets in healthy volunteers to provide the safe dose range for phase II clinical trial. Methods:Totally 36 healthy volunteers were randomly divided into five single dose groups at different doses ranging from 400 mg to 3200 mg per day and two multiple dose groups with 1600 mg and 2400 mg for continuous 7 days. The tol-erance and safety of the tablets were observed. Results: All vital signs were normal in all the volunteers in both single and multiple dose tests. Although some indicators turned into abnormal after the administration, it was not significant for clinical judgment. Neither drug combination nor serious adverse reactions were shown during the trial. However, two mild adverse events occurred and disap-peared later without any treatment. Conclusion:All the volunteers have good tolerance to Zhengbiguanjie tablets. The study proved the safety of Zhengbiguanjie tablets at single and multiple dose.

Objective:To investigate the effect of Operation Maps application on relieving anxiety of patients of the nurses of operation room preoperative visits. Methods:39 cases of operation were randomly divided into the application of operation maps 19 cases and routine visit group 20 cases, regular visiting group received routine preoperative interview content, and on the basis of content, the original application mapping group are visited by nurses carrying atlas album, and according to the related content the nurses explain to patients in the album when they introduce the patients the operating room environment surgery, surgical notes, position, etc. At the same time, the self rating anxiety scale measurement measures the anxiety of patients when they are admitted and after into operation room, and blood pressure, heart rate, pain intensity, the first time getting out of bed, exhaust time, clearing time, and they compare the difference. Results:The anxiety values of the original application mapping group mapping group, systolic blood pressure, heart rate are lower than regular visits group(t=2.28, t=4.756, t=10.28;P<0.05). Intensity of pain after operation in the two groups , get out of bed the first time, exhaust time showed no significant differences(t=3.04, t=3.06, t=2.56;P<0.01). Conclusion:Application of operation atlas of systematic, standardized preoperative visit is an important psychological guidance, and it can reduce the anxiety level of patients and effectively improve the quality of medical operation period.

BACKGROUNDWaldenström macroglobulinemia (WM) is an uncommon lymphoid malignancy. The characteristics and prognosis of WM have never been systematically studied in the East.

METHODSWe analyzed the clinical characteristics and the prognostic factors of 90 Chinese WM patients, and compared them with the Western reports.

RESULTSThe median age was 62 years old with a male-to-female ratio of 3.74. The most common symptoms at diagnosis were fatigue (77.8%) and bleeding (20%), while only 6 patients (6.7%) were asymptomatic. In the univariate analysis, age >62 years, thrombocytopenia, leucopenia, cytopenias ≥ 2, and high risk on the international prognostic scoring system for WM were the adverse risk factors, but only age >62 years and ≥ 2 cytopenias were the independent prognostic factors in the multivariate analysis. Using age <62 years and ≥ 2 cytopenias, three significantly different prognostic groups could been distinguished, with 5-year overall survival of 71.6%, 48.6%, and 17.0% (P < 0.001).

CONCLUSIONDistinct characteristics exist in WM in China compared to the West and we describe a new simple prognostic model for newly diagnosed WM patients.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Waldenstrom Macroglobulinemia ; diagnosis ; mortality

Objective To discuss the promoting effect of humanistic care plus psychological cage on basis of conventional nursing on rehabilitation of patients after breast cancer surgery.Methods 460 cases of breast cancer patients from January 2008 to January 2010 were randomly divided into the control group and the observation group with 230 cases in each group.The control group received routine nursing care after surgery,while for the observation group,in addition to conventional care,they received humanistie care and psychological care.The alleviation degree of psychological barrier and degree of satisfaction of the two groups were compared.Results The alleviation degree of psychological barrier was 62.2% .and was 40.4% in the control group.The patients'satisfaction rate was 95.2% in the observation group,and 71.7% in the control group.the difference Was significant.Conclusions Humanistic care and psychological care can effectively relieve mental disorders of patients,promote their early recovery,also can improve their satisfaction degree with nursing work.

Objective To explore the mechanism of immunomodulatory activity of triptolide on healthy volunteers peripheral blood mononuclear cells (PBMC)-derived plasmacytoid dendritic cells (pDCs). Methods Healthy volunteers-derived pDCs were sorted by flow cytometry, then incubated with triptolide (0, 5, 10, 30 μg/L). After 24 hours, we detected the concentration of IFN-α, IL-6, TNF-α using ELISA. After 5 days, the cultrural cells were collected and analyzed by flow cytometry, light microscope and electron microscope scanning. Results Triptolide-treated pDCs secreted lower level of IFN-α,IL-6 ,TNF-α, triptolide could inhibit pDCs differentiation to DCs which displayed more immature morphology and immunophenotypes than untreated-pDCs. Conclusion Triptolide could decrease the immune function of pDCs, inhibit differentiation and maturation of pDCs.