Chronic heart failure （CHF） is the terminal stage of various heart diseases， with high morbidity， mortality， and hospitalization rate. According to the theory of collateral diseases， the core pathogenesis of CHF is blood stasis of collaterals， water retention and stagnation， and pathogen accumulation in collaterals. Accordingly， the treatment should focus on reinforcing healthy Qi to warm Yang， activating blood to dredge collaterals， and excreting water to alleviate edema. On this basis， Qili Qiangxin capsules （QLQX） are created. This prescription can effectively treat chronic heart failure. Modern studies have shown that QLQX contains a variety of pharmacological components such as flavonoids， alkaloids， terpenoids， phenylpropanoids， phenolic acids， and cardiac glycosides. QLQX can improve the cardiac function， inhibit myocardial fibrosis， improve hemodynamics， mitigate inflammation， reduce cardiomyocyte apoptosis， and regulate the nervous system， with mild adverse reactions. This study analyzed the etiology and pathogenesis of CHF based on the theory of collateral diseases， explored the relationship between the prescription and syndrome， and delved into the material basis and mechanism of QLQX in the treatment of CHF， aiming to provide reference for the clinical application and scientific research of QLQX.

As an emerging discipline that combines traditional diagnostic methods with modern scientific technology,micro syndrome differentiation has good prospects for development,but there are some controversies in the research process.Based on ancient and modern literature,this article reviewed the origin and flow of research on micro syndrome differentiation,and summarized the problems to be improved in the process of research on micro syndrome differentiation from three aspects:application of disease type,guiding ideology and micro indicators.Based on this,the article further expounded the new thinking on"near-micro"syndrome differentiation from three aspects:connotation,scope of application,and links to traditional identification and micro-identification,and pointed out that the modern medical detection basis should be incorporated into the field of TCM syndrome differentiation,and at the same time,it should be based on the overall thinking mode of TCM,which would provide a new idea for the development of modern TCM diagnosis technology.

Objective To observe the correlations of subchondral insufficiency fracture(SIF)of medial femoral condyle with medial meniscus injury pattern and medial meniscus extrusion(MME).Methods Data of 36 patients with clinically confirmed unilateral medial femoral condyle SIF were retrospectively analyzed.The patients were divided into low-grade and high-grade groups according to SIF grade.Cartilage injury,medial meniscus injury and MME were compared between groups,and the correlations of SIF grade with cartilage injury,osteonecrosis volume(OV)and MME were analyzed.Cartilage injury grade,OV and MME were compared between groups,and the correlations were explored.Results There were 18 cases in each group.The percentage of cartilage injury grade Ⅲ-Ⅳ,OV and MME value(the distance between the vertical line of medial meniscus and the vertical line of tibial plateau cartilage)in high-grade group were greater than those in low-grade group(all P＜0.05).Significant difference of injury grades of meniscus posterior horn was found between groups(P=0.007).SIF grade was positively correlated with cartilage injury grade,OV and MME value(rs=0.710,0.765,0.540,all P≤0.01).MME value was positively correlated with meniscal injury degree and tear range(rs=0.502,0.520,both P＜0.01).There were 4,19 and 13 cases with 0,1 and 2 grade MME,respectively,and significant differences of cartilage injury grades,OV and MME values were found among different MME grades(all P＜0.05).MME value was positively correlated with cartilage injury grade and OV(rs=0.451,0.579,both P＜0.01).Conclusion In SIF patients,OV and cartilage injury were both correlated with medial meniscus injury pattern and MME.

ObjectiveTo assess the epidemic trend of COVID-19 Omicron and the effectiveness of containment measures in Shanghai by estimating the time-varying reproduction number （R_t）. MethodsBased on the daily reported confirmed cases and asymptomatic infections in Shanghai from February 20 to April 26， 2022， the R package "Epiestim"， which was built by Bayesian framework method， was used to estimate the variation curve of R_t during the epidemic period and to analyze the trend of the epidemic. ResultsIn the early stage of the epidemic， after the implementation of school closure and nuclear acid screening in some communities， R_t continued to fluctuate between 2.000 and 3.000， reaching a peak of 2.740 （95%CI： 2.640‒2.830） on March 21， but began to decline around one week after the city lock-down on April 1. As of April 18， the R_t value in Shanghai was below the threshold of 1.000 for the first time， reaching 0.955 （95%CI： 0.951‒0.961）. ConclusionAfter the implementation of public health measures with increasing strength of containment in Shanghai， the transmission rate gradually decreased， reflecting the effectiveness of the interventions. In the actual prevention and control process， the containment work should not be relaxed in order to keep the R_t below 1.000.

Objective:To compare the effect of a knee-ankle-foot orthosis (KAFO) and a paraplegic walking orthosis (WO) on the walking ability and the physiological cost index (PCI) of persons suffering from AIS A-B spinal cord injury (SCI) at the L 2 level. Methods:Thirty subjects with AIS A-B SCI at L 2, aged 20 to 45, were assigned randomly into a KAFO group ( n=15) or a WO group ( n=15). All received muscle strength, range of motion, standing, balance and weight shifting training and training in the activities of daily life. Electrotherapy and acupuncture were also administered. Both groups underwent 60 minutes of walking training 6 times per week for 12 weeks, wearing either a KAFO or a WO. Step length, gait speed, step frequency, 10-metre walk time, 6-minute walk distance and PCI were compared after 2 and 12 weeks. Results:The average step length, gait speed, step frequency, 10-metre walk time, 6-minute walk distance and PCI of both groups had improved significantly between the 2-week and 12-week evaluations, with significantly greater average improvement among the WO group at both time points.Conclusion:A WO or KAFO facilitates better walking after an AIS A-B spinal cord injury at L 2. Wearing a WO is more effective than wearing a KAFO, on average.

Objective:To analyze the changes in the morbidity and mortality of hepatitis B in China from 1990 to 2017, and provide evidence for prevention and control of hepatitis B.Methods:The reported incidence and death data of hepatitis B from the Data-Center of China Public Health Science and demographic data from the National Bureau of Statistics were used, Excel 2016 was used to establish the databases of reported hepatitis B cases and deaths, respectively. The Joinpoint regression model was used through Joinpoint software 4.8.0.1 to estimate the average annual percent change of annual reported incidence and mortality of hepatitis B in different age groups and provinces in China from 1990 to 2017 in order to further explore the trend of hepatitis B incidence. Software R 3.6.2 was used for statistical analysis and data visualization.Results:A total of 20 793 233 hepatitis B cases were reported from January 1990 to December 2017 in China with average annual reported incidence of 58.19/100 000. The average annual reported incidence appeared highest in age group 25-29 years (119.67/100 000) and the annual reported incidence increased in group aged 45 years and above. Besides, the reported case fatality rate reached the highest in group aged 85 years and above (2.26/1 000). The reported incidence showed increasing trends in 23 provinces ( P<0.05), stable in 7 provinces ( P>0.05), and decreasing in 2 provinces ( P<0.05). Conclusions:The report of hepatitis B was mainly from adult population in China, and the reported incidence of hepatitis B in this population was in increase. In some provinces of the eastern China where immunization measures have been in place and the treatment level is relatively high, the incidence of hepatitis B has been leveled off; the incidences in most provinces in western China are still in increase. Therefore, more targeted prevention and control strategies should be taken in different provinces.

Objective:To evaluate the association between dietary pattern and type 2 diabetes mellitus (T2DM) in local residents aged 40 years and above in Songjiang district of Shanghai.Methods:Data was obtained from the baseline investigation of Shanghai Peak-Plan cohort. According to inclusion and exclusion criteria, we selected people with T2DM as the case group, and people without T2DM as controls, matched with gender, age and alcohol intake status. Dietary patterns were established by factor analysis. Conditional logistic regression model (CLRM) was used to explore the relationship between different dietary patterns and T2DM, as well as the association between multiplicative interactions of dietary patterns and T2DM.Results:We used factor analysis to obtain six dietary patterns: including meat, desserts-coarse cereals, condiment-egg, beverage, cereals-tubers and fruit-vegetable. Data from multivariate condition logistic regression suggested that condiment-egg patterns as ( OR=0.543, 95 %CI: 0.377-0.781), beverage ( OR=0.590, 95 %CI: 0.409-0.852), cereals-tubers ( OR=0.592, 95 %CI: 0.414-0.848), fruit-vegetable ( OR=0.604, 95 %CI: 0.417-0.876) were associated with the reduced risks for T2DM. After analyzing the multiplicative interactions between dietary patterns, there were three interaction items associated with T2DM with statistical significances: the multiplicative interaction between meat pattern and condiments-egg pattern was related with the increased risk for T2MD, and the multiplicative interactions between cereal-tubers pattern, meat pattern between cereal-tubers pattern and fruit-vegetable pattern were related with the reduced risks for T2MD. Conclusions:In the six dietary pattern under study, cereals-tubers pattern undwr studly, fruit-vegetable pattern might be more practical in preventing T2DM. In addition, the dietary pattern with cereals and potatos as the main ingredients, appropriate meat and reduced condiment intake might also play positive roles in reducing the risk for T2DM.

Objective To explore the effect of comprehensive rehabilitation on patients with knee ankylosis and contracture of popliteal fossa after severe burn. Methods 35 patients with severe burn on lower limb (containing the around skin of popliteal fossa) accepted exercise therapy, hydrotherapy, occupation therapy (including pressure therapy), electrotherapy, etc. They were assessed with Functional Independence Measure (FIM), range of motion and muscle strength of knee before and after treatment. Results The scores of FIM, range of motion and muscle strength of knee improved after treatment (P<0.01). Conclusion Comprehensive rehabilitation can improve activities of daily living and function of knee after severe burn.

Objective To explore the effects of gait training with an alternative gait orthosis (AGO) on the neurogenic bladders of patients with spinal cord injury (SCI). Method Twelve patients with complete SCI at the thoracic and lumbar level were trained for 8 weeks on motor and bladder function. After that, specific gait training with an AGO was given for another 8 weeks. American Spinal Injury Association ( ASIA ) sensation and motor function assessments were done before and after the gait training with the AGO, and bladder capacity, residual urine and urine flow rates were also assessed. Results Compared with pre-treatment there was no significant difference in average ASIA senzsation and motor scores after training, but the maximum rate of urine flow, average urine volume and single urination had significantly increased and residual urine volume had significantly decreased. Conclusions Therapeutic gait training with an AGO can improve bladder function after SCI.

Objective To observe the effect of reciprocating gait orthosis on walking ability and activities of daily living (ADL) of patients with C6～T6 spinal cord injury (SCI).Methods 20 cases with C6～T6 SCI and according with type A and type B of ASIA standard received rehabilitation therapy, including training of muscle power, cardiopulmonary function, transferring mobility, ADL, bladder function, etc., before assembling the reciprocating gait orthosis, and additional gait training after fixing orthosis. The timed walking function assessment (6-min walking test and timed 10 meters walking test), gait analysis, Modified Barthel Index (MBI) and Functional Independence Measure (FMI) were used to assess pre- and post-training.Results The ADL ability of all cases improved obviously after equipping reciprocating ambulation orthosis, the walking ability also improved (P＜0.05). The mean timed 10 meters was 99.21±75.24 s, mean 6-min walk test was 41.71±29.38 m. From all patients, 14 cases achieved practicability walking ability, 6 cases achieved domestic walking ability.Conclusion The reciprocating gait orthosis combined with comprehensive rehabilitation therapy has effect on walking ability and ADL of patients with C6～T6 SCI.