Houpo Qiwutang originated from the Synopsis of the Golden Chamber， and it consists of seven medicines： Magnoliae Officinalis Cortex， Rhei Radix et Rhizoma， Aurantii Fructus Immaturus， Cinnamomi Ramulus， Zingiberis Rhizoma Recens， Glycyrrhizae Radix et Rhizoma， and Jujubae Fructus. It is a basic formula for the treatment of abdominal fullness. Through the bibliometric method， the historical history， drug base， preparation and dosage， decoction method， and ancient and modern applications of Houpu Qiwu Tang were analyzed by means of textual research. The research finds that Houpu Qiwu Tang has been passed down through the generations in an orderly manner with fewer changes. The drug base of this formula is basically clear， and the base of Magnoliae Officinalis Cortex， Rhei Radix et Rhizoma， Cinnamomi Ramulus， Zingiberis Rhizoma Recens， and Jujubae Fructus is consistent with the 2020 edition of Chinese Pharmacopoeia. The mainstream base of Aurantii Fructus Immaturus is the dried young fruit of Citrus aurantium of Rutaceae family， and the historical mainstream base of Glycyrrhizae Radix et Rhizoma is the dried root of Glycyrrhiza uralensis of Leguminosae family. The modern dosage of this formula is 110.40 g of Magnoliae Officinalis Cortex， 41.40 g of Rhei Radix et Rhizoma， 69 g of Aurantii Fructus Immaturus， 27.60 g of Cinnamomi Ramulus， 69 g of Zingiberis Rhizoma Recens， 41.40 g of Glycyrrhizae Radix et Rhizoma， and 30 g of Jujubae Fructus. In addition， the decoction method is to add 2 000 mL of water with the above seven flavors of the medicine， boil it to 800 mL， and then take 160 mL in a warm state each time. The amount of the medicine taken for each time is 22.08 g of Magnoliae Officinalis Cortex， 8.28 g of Rhei Radix et Rhizoma， 13.80 g of Aurantii Fructus Immaturus， 5.52 g of Cinnamomi Ramulus， 13.80 g of Zingiberis Rhizoma Recens， 8.28 g of Glycyrrhizae Radix et Rhizoma， and 6 g of Jujubae Fructus. The modern application of this formula involves the digestive system， respiratory system， and urinary system. It is more advantageous in digestive system diseases such as early postoperative inflammatory bowel obstruction， functional dyspepsia， gastric pain， functional abdominal distension， and gastric reflux esophagitis. By comprehensively examining the key information of Houpu Qiwu Tang， this paper aims to provide literature support for the development and clinical application of this formula.

Objective To explore the possibility of MR Ti-mapping imaging technology to provide additional indicators for clinical quantitative evaluation of renal function in children with renal insufficiency.Methods A total of 13 children with renal insufficiency diagnosed and underwent renal function MRI examination were selected(renal insufficiency group),and 23 children with normal renal function were included as the control group.The difference of renal cortex T1 value between the control group and the renal insuffi-ciency group was compared,and the correlation between renal cortex T1 value and biochemical indexes such as serum creatinine(SCr)and cystatin C(CysC)in the renal insufficiency group was analyzed.Results There was significant difference in T1 value of renal cortex between the renal insufficiency group and the control group(P＜0.01).The correlation between T1 value of renal cortex and SCr and CysC in renal insufficiency group was higher(r=0.75,P＜0.01;r=0.68,P＜0.01).Conclusion MR T1-mapping technol-ogy can non-invasively monitor the renal function status of children with renal insufficiency,and has a suggestive value for clinical quantitative evaluation of renal function in children.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective: To evaluate the efficacy and safety of hybutimibe monotherapy or in combination with atorvastatin in the treatment of primary hypercholesterolemia. Methods: This was a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial of patients with untreated primary hypercholesterolemia from 41 centers in China between August 2015 and April 2019. Patients were randomly assigned, at a ratio of 1∶1∶1∶1∶1∶1, to the atorvastatin 10 mg group (group A), hybutimibe 20 mg group (group B), hybutimibe 20 mg plus atorvastatin 10 mg group (group C), hybutimibe 10 mg group (group D), hybutimibe 10 mg plus atorvastatin 10 mg group (group E), and placebo group (group F). After a dietary run-in period for at least 4 weeks, all patients were administered orally once a day according to their groups. The treatment period was 12 weeks after the first dose of the study drug, and efficacy and safety were evaluated at weeks 2, 4, 8, and 12. After the treatment period, patients voluntarily entered the long-term safety evaluation period and continued the assigned treatment (those in group F were randomly assigned to group B or D), with 40 weeks' observation. The primary endpoint was the percent change in low density lipoprotein cholesterol (LDL-C) from baseline at week 12. Secondary endpoints included the percent changes in high density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (Apo B) at week 12 and changes of the four above-mentioned lipid indicators at weeks 18, 24, 38, and 52. Safety was evaluated during the whole treatment period. Results: Totally, 727 patients were included in the treatment period with a mean age of (55.0±9.3) years old, including 253 males. No statistical differences were observed among the groups in demographics, comorbidities, and baseline blood lipid levels. At week 12, the percent changes in LDL-C were significantly different among groups A to F (all P<0.01). Compared to atorvastatin alone, hybutimibe combined with atorvastatin could further improve LDL-C, TG, and Apo B (all P<0.05). Furthermore, there was no significant difference in percent changes in LDL-C at week 12 between group C and group E (P=0.991 7). During the long-term evaluation period, there were intergroup statistical differences in changes of LDL-C, TG and Apo B at 18, 24, 38, and 52 weeks from baseline among the statins group (group A), hybutimibe group (groups B, D, and F), and combination group (groups C and E) (all P<0.01), with the best effect observed in the combination group. The incidence of adverse events was 64.2% in the statins group, 61.7% in the hybutimibe group, and 71.0% in the combination group during the long-term evaluation period. No treatment-related serious adverse events or adverse events leading to death occurred during the 52-week study period. Conclusions: Hybutimibe combined with atorvastatin showed confirmatory efficacy in patients with untreated primary hypercholesterolemia, which could further enhance the efficacy on the basis of atorvastatin monotherapy, with a good overall safety profile.
Male ; Humans ; Middle Aged ; Atorvastatin/therapeutic use* ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use* ; Hypercholesterolemia/drug therapy* ; Cholesterol, LDL/therapeutic use* ; Anticholesteremic Agents/therapeutic use* ; Treatment Outcome ; Triglycerides ; Apolipoproteins B/therapeutic use* ; Double-Blind Method ; Pyrroles/therapeutic use*

Low-carbohydrate diet is becoming popular recently. It requires carbohydrate intake lower than 130 g/d(or <26% of total energy intake) while fat and protein intake are not defined. Low-carbohydrate diet contributes to better glycemic control in patients with type 1 diabetes: lowering HbA 1C and glycemic variability, and improving time in range(TIR). Low-carbohydrate diet reduces insulin dosage in type 1 diabetic patients and does not increase the risks of hypoglycemia and diabetic ketoacidosis. This review summarized the research evidence of low-carbohydrate diet to explore the role and safety in disease management.

Objective To investigate the effects of CeO2 NP subacute exposure on body weight,organ structures,and redox indicators in male mice.Methods Thirty-five male ICR mice were randomly divided into five groups with seven mice in each group.Normal control and CeO2 NP(100,500,1000 and 5000 μg/kg)groups were included.Mice were injected with CeO2 NPs intraperitoneally every other day for 28 days.Results Compared with the control group,no significant difference was found in weight gain(P>0.05),but significant differences were observed in the liver coefficient,epididymal coefficient,and sperm survival rate(P<0.01).In the 5000 μg/kg group,CeO2 NPs were deposited in the liver and spleen,and granuloma was found SOD and GSH-Px activities in serum of the 100 μg/kg group were increased,while MDA content was decreased,which indicated the antioxidant effect of CeO2 NPs.With the increase in dose,oxidative stress induced by CeO2 NPs was enhanced.Conclusions Low-dose-CeO2 NPs are safe and exert an antioxidant effect.With the increase in dose,the toxicity of CeO2 NPs also increases gradually.

Objective:To analyze the vascular distribution of palmar digital arteries in syndactyly through color Doppler ultrasound angiography and make the classification according to the level of artery bifurcation points, discusse its clinical significance.Methods:A retrospective analysis was performed for the data of children with congenital and digital malformations admitted to Wuxi Ninth People’s Hospital from January 2017 to December 2022. Preoperative vascular ultrasonography of the hand was performed to locate the bifurcation point of the common palmar digital artery in the digital webbed area. The vascular conditions were classified according to the distance between the bifurcation point and the 1/3 point of the proximal phalangeal as the reference, such as normal type (<0 mm), mild reduction type (0-5 mm), moderate decrease type (6-10 mm), and severe reduction type (>10 mm), absent type (only 1 artery between the fingers). The total variation of the bifurcation point of the common palmar digital artery in the children, as well as the proportion of different vascular condition subtypes were recorded. According to the classification of blood vessels, the corresponding operation plan was made. The positioning accuracy of color Doppler ultrasound angiography was evaluated based on the gold standard of common palmar digital artery bifurcation points detected during operation. Complications such as postoperative infection, flap necrosis, finger vasospasm and the morphology of finger web at the last follow-up were observed. Descriptive statistical analysis was used.Results:A total of 123 children with 181 finger webs were enrolled, including 72 males and 51 females, aged 10-28 months. There were 55 cases of simple type, 36 cases of complex type (bone) and 32 cases of Poland syndrome. Color Doppler ultrasound angiography showed that the total variation rate of the common palmar digital arterial bifurcation point was 24.3% (44/181), of which 11.6% (21/181) were mildly reduced type, 8.3% (15/181) were moderately reduced type, 3.3% (6/181) were severe reduced type, and 1.1% (2/181) were absent type. The vascular variation rates of simple syndactyly, bony syndactyly, and Poland syndrome were 0 (0/55), 19.5% (7/36), and 41.1% (37/90), respectively. Compared with the actual situation during surgery, the positioning accuracy of color Doppler ultrasound angiography was 100%. All pediatric surgeries were successfully completed, and the flaps and skin grafts survived smoothly. There were no postoperative complications such as infection, vascular crisis, or finger necrosis. All patients were followed up for 6 to 27 months, with an average of 13.5 months. At the last follow-up, the depth, width, and slope of the fingerwebs were all close to normal.Conclusion:Congenital syndactyly has a high variation rate at the bifurcation point of the common palmar digital artery, and bony syndactyly and Poland syndrome refer to the need to improve preoperative vascular evaluation. Color Doppler ultrasound angiography has the advantages of no radiation, high sensitivity and low price, and the vascular typing based on color Doppler can improve the reliable basis for the formulation of clinical surgical plans.

Objective:To evaluate the effect of comprehensive intervention model based on key persons in entertainment venues on the incidence of AIDS-related high-risk behaviors in male sex workers (MSW). Data from this study thus can be used to provide compelling evidence for the wider implementation of the intervention model.Methods:In this randomized controlled trial, MSW were recruited and followed-up from May to December, 2021 in entertainment venues in Wuxi, Jiangsu Province, with an estimated sample size of 320. The MSW in the intervention group were provided with comprehensive interventions via key persons in entertainment venues compared with the control group receiving routine interventions. The effect of the intervention model was assessed by comparing the behavioral differences between these two groups and in the intervention group before and after intervention.Results:A total of 330 MSW were recruited at baseline survey, in which 168 were divided into intervention group and 162 into control group. There was no significant difference in socio-demographic characteristics between two groups (all P>0.05). After intervention for 6 months, the rate of consistent condom use in commercial homosexual activities in the intervention group was 79.5% (101/127), higher than 63.2% (74/117) in the control group, and in the intervention group, 90.1% (73/81) of MSW used condom consistently in heterosexual activities, higher than in the control group (59.6%, 59/99) . Compared with 30.8% (36/117) of MSW with drug abuse history in the control group, a lower proportion of 9.4% (12/127) was observed in the intervention group. Differences in all of aforementioned variables were significant (all P<0.05). After intervention, the incidence of group sex was 3.9% (5/127) in the intervention group and 9.4% (11/117) in the control group, the incidence of anal sex post-alcohol consumption was 40.2% (51/127) in the intervention group and 32.5% (38/117) in control group, the differences were not significant (all P>0.05). Conclusions:The intervention model based on key persons in entertainment venues could promote consistent condom use in MSW in both commercial homosexual and heterosexual activities and help them reduce drug abuse, but had no significant effect on decreasing group sex and anal sex after alcohol consumption. It is crucial to improve the intervention model according to the specific characteristics of MSW in order to enhance the effects of comprehensive intervention.

Objective:To analyze the vascular distribution of palmar digital arteries in syndactyly through color Doppler ultrasound angiography and make the classification according to the level of artery bifurcation points, discusse its clinical significance.Methods:A retrospective analysis was performed for the data of children with congenital and digital malformations admitted to Wuxi Ninth People’s Hospital from January 2017 to December 2022. Preoperative vascular ultrasonography of the hand was performed to locate the bifurcation point of the common palmar digital artery in the digital webbed area. The vascular conditions were classified according to the distance between the bifurcation point and the 1/3 point of the proximal phalangeal as the reference, such as normal type (<0 mm), mild reduction type (0-5 mm), moderate decrease type (6-10 mm), and severe reduction type (>10 mm), absent type (only 1 artery between the fingers). The total variation of the bifurcation point of the common palmar digital artery in the children, as well as the proportion of different vascular condition subtypes were recorded. According to the classification of blood vessels, the corresponding operation plan was made. The positioning accuracy of color Doppler ultrasound angiography was evaluated based on the gold standard of common palmar digital artery bifurcation points detected during operation. Complications such as postoperative infection, flap necrosis, finger vasospasm and the morphology of finger web at the last follow-up were observed. Descriptive statistical analysis was used.Results:A total of 123 children with 181 finger webs were enrolled, including 72 males and 51 females, aged 10-28 months. There were 55 cases of simple type, 36 cases of complex type (bone) and 32 cases of Poland syndrome. Color Doppler ultrasound angiography showed that the total variation rate of the common palmar digital arterial bifurcation point was 24.3% (44/181), of which 11.6% (21/181) were mildly reduced type, 8.3% (15/181) were moderately reduced type, 3.3% (6/181) were severe reduced type, and 1.1% (2/181) were absent type. The vascular variation rates of simple syndactyly, bony syndactyly, and Poland syndrome were 0 (0/55), 19.5% (7/36), and 41.1% (37/90), respectively. Compared with the actual situation during surgery, the positioning accuracy of color Doppler ultrasound angiography was 100%. All pediatric surgeries were successfully completed, and the flaps and skin grafts survived smoothly. There were no postoperative complications such as infection, vascular crisis, or finger necrosis. All patients were followed up for 6 to 27 months, with an average of 13.5 months. At the last follow-up, the depth, width, and slope of the fingerwebs were all close to normal.Conclusion:Congenital syndactyly has a high variation rate at the bifurcation point of the common palmar digital artery, and bony syndactyly and Poland syndrome refer to the need to improve preoperative vascular evaluation. Color Doppler ultrasound angiography has the advantages of no radiation, high sensitivity and low price, and the vascular typing based on color Doppler can improve the reliable basis for the formulation of clinical surgical plans.

OBJECTIVE: To observe the effect of acupuncture-moxibustion on negative emotions and plasma tryptophan (Trip)-kynurenine (Kyn) metabolism in the patients with Crohn's disease (CD) at the mild and moderate active stage. METHODS: A total of 66 CD patients were randomized into an observation group (33 cases, 1 case dropped off) and a control group (33 cases, 2 cases dropped off). In the observation group, acupuncture was applied in combination with moxibustion. In the control group, the sham-acupuncture was used in combination with sham-moxibustion. In both of the observation group and the control group, acupuncture was applied to Zhongwan (CV 12), Shangjuxu (ST 37), Sanyinjiao (SP 6), Gongsun (SP 4), Hegu (LI 4), Quchi (LI 11), Taixi (KI 3) and Taichong (LR 3), and moxibustion was applied to Tianshu (ST 25) and Zusanli (ST 36). The treatment was given once every two days, 3 times a week, totally for 12 weeks. Separately, before and after treatment, the score of the hospital anxiety-depression scale (HADS) and the score of intestinal core symptoms (degree of abdominal pain and frequency of diarrhea) were observed in the patients of the two groups. The concentration of plasma indoleamine 2,3-dioxygenase 1 (IDO1) and the ratios of Kyn/Trp, QuinA/Kyn, KynA/Kyn and KynA/QuinA were compared between the two groups. RESULTS: Compared with before treatment, the scores of HADS-A and HADS-D in the observation group and the score of HADS-A in the control group were all reduced after treatment ( CONCLUSION Acupuncture and moxibustion relieve the negative emotions of anxiety and depression in CD patients at mild and moderate active stage, which is probably related to the regulation of plasma Trp-Kyn metabolic pathway.
Acupuncture Points ; Acupuncture Therapy ; Crohn Disease/therapy* ; Emotions ; Humans ; Moxibustion ; Plasma ; Treatment Outcome ; Tryptophan