In response to the Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance， Innovation， and Development of traditional Chinese medicine（TCM） and the spirit of the National Conference on TCM， Chinese Association of Chinese Medicine organized experts in Otorhinolaryngology Head and Neck Surgery of traditional Chinese and western medicine to discuss the clinical advantages of TCM and integrated traditional Chinese and western medicine in the treatment of allergic rhinitis （AR） and they reached a basic consensus. In recent years， the prevalence of AR has been on the rise， threatening the quality of life of patients and giving rise to a heavy burden to both the patients and the society. AR is resulted from immune imbalance rather than reduced immunity or hyperimmunity， and the imbalance is similar to the Yin-yang disharmony in TCM. In the treatment of this disease， western medicine features rapid onset. However， it is cost-intensive and causes severe surgical trauma， and the recurrence is common. TCM boasts diverse methods for AR， which can be used in all stages of this disease. It has advantages in controlling symptoms such as nasal congestion， runny nose， or dysosmia in the attack stage， preventing recurrence in the remission stage， and treating refractory AR or steroid-resistant AR. In particular， acupuncture enjoys a reputation in treatment of AR， which has been supported by evidence-based medicine and recommended by guidelines. While treating local symptoms of AR， TCM regulates the psychosomatic conditions， which facilitates chronic disease management and long-term follow-up. We should integrate the advantages of TCM and western medicine， give full play to the unique nonnegligible and irreplaceable advantages of TCM， formulate a comprehensive diagnosis and treatment scheme for learning and promotion， and summarize the research outcomes to promote the theoretical innovation of TCM on AR from the perspective of integrated traditional Chinese and western medicine.

Objective:To investigate the clinical efficacy of carbomer hemorrhoid gel in the treatment of second-degree internal hemorrhoid bleeding.Methods:A total of 160 anorectal outpatients with second-degree internal hemorrhoid bleeding who received treatment in Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to January 2021 were included in this study. They were randomly divided into an observation group and a control group ( n = 80/group). In the observation group, carbomer hemorrhoid gel was used to plug the anus, while in the control group, a hemorrhoid suppository was used to plug the anus. All patients were treated for 7 days. Clinical efficacy was compared between the two groups. Results:After 4 days of treatment, the bleeding score in the observation group was lower than that in the control group [1(0) point vs. 2(1) points, Z = -6.70, P < 0.05). After 7 days of treatment, the bleeding score in the observation group was significantly lower than that in the control group [0(1) point vs. 1(1) point, Z = -4.73, P < 0.05]. After 4 days of treatment, there was no significant difference in the size score of the hemorrhoids between the two groups ( P > 0.05). After 4 days of treatment, the size score of hemorrhoids in the control group did not differ significantly compared with before treatment ( P > 0.05). After 4 days of treatment, the size score of hemorrhoids in the observation group differed significantly compared with before treatment ( Z = -3.16, P < 0.05). After 7 days of treatment, the size score of the hemorrhoids in the observation group was lower than that in the control group [1(1) point vs. 1(0) point, Z = -4.48, P < 0.05]. The total response rate in the observation group was significantly higher than that in the control group [97.5% (78/80) vs. 75% (60/80), Z = -4.50, P < 0.05]. Conclusion:Carbomer hemorrhoid gel is a new drug used to treat hemorrhoids. It has a new dosage form, has no stimulation to the rectum, and is safe to use. Carbomer hemorrhoid gel is highly effective on second-degree internal hemorrhoid bleeding and deserves clinical popularization.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Objective:To investigate the correlation between heart rate variability (HRV) and the progression of Parkinson's disease (PD).Methods:A total of 78 patients with PD who received treatment at the Second People's Hospital of Lianyungang from January 2020 to May 2022 were included in this study. According to Hoehn-Yahr (H&Y) staging, patients with PD were divided into three subgroups: mild PD group (H&Y stage < 2), moderate PD group (2 ≤ H&Y < 3), and advanced PD group (H&Y ≥ 3). Another 66 healthy people who concurrently underwent physical examinations in the same hospital were included in the control group. A dynamic electrocardiogram examination was performed in each group for HRV analysis. The Spearman test was used to analyze the correlation between HRV parameters, disease course, and H&Y staging.Results:Standard deviation of all sinus R-R intervals during 24 hours (SDNN), root mean square of successive RR interval differences during 24 hours (RMSSD), percentage normal-to-normal interval deviation greater than 50 ms (PNN50%) during 24 hours, high frequency component (HF), and low frequency component (LF) in the PD group were (94.76 ± 21.65), (23.41 ± 8.67), (3.50 ± 4.32), (96.57 ± 53.84), and (124.92 ± 82.43), respectively, which were significantly lower than (115.65 ± 13.31), (32.48 ± 8.08), (5.61 ± 5.25), (109.11 ± 39.51), and (143.95 ± 72.77) in the control group ( Z = -6.17, -6.22, -3.90, -2.14, -2.53, all P < 0.05). Disease duration, H&Y staging, and the LED level in the mild PD, moderate PD, and advanced PD groups showed an upward trend (all P < 0.05). The Mini-Mental State Examination (MMSE) score in the advanced PD group was significantly higher than that in the mild PD group ( P < 0.05). There was no significant difference in MMSE score between the mild and moderate stages and between moderate and advanced stages ( P > 0.05). Both SDNN and LF in the mild PD group were (110.61 ± 18.53) and (192.02 ± 95.98), respectively, which were significantly lower than (91.97 ± 15.23) and (113.29 ± 56.71) in the moderate PD group ( t = 4.18, 3.55, both P < 0.01). SDNN and LF in the advanced PD group were (80.90 ± 21.03) and (68.10 ± 44.86) respectively, which were significantly lower than those in the moderate PD and advanced PD groups ( t = 4.88, 2.23, 5.54, 3.26, all P < 0.05). There were no significant differences in RMSSD, PNN50%, and HF among the mild PD, moderate PD, and advanced PD groups (all P > 0.05). SDNN and LF were negatively correlated with PD course ( r = -0.36, -0.37, both P < 0.05) and H&Y staging ( r = -0.46, -0.49, both P < 0.05). Conclusion:Sympathetic dysfunction in PD patients is closely related to the onset and progression of PD, and it can reflect the severity of the disease.

Objective　To explore the relationship between C-type lectin-like receptor 2 (CLEC-2) on platelet surface and the severity of acute cerebral infarction and cerebral artery stenosis.Methods　Prospectively selected 211 patients with acute cerebral infarction who were hospitalized for the first time as the infarction group,the patients were grouped according to the NIHSS score and cranial MRA examination results on admission,and 105 healthy patients were collected as the control group.Venous blood of all patients was collected for CLEC-2 detection on the day of admission,and the level of CLEC-2 between each group was analyzed.Results　The level of plasma CLEC-2 in the infarction group was significantly higher than that in the control group (P＜0.001).The level of CLEC-2 in the mild,moderate and severe acute cerebral infarction subgroups gradually increased,and the difference between the two groups was statistically significant (P＜0.001).After adjusting for confounding factors,the concentration of CLEC-2 (OR=1.034,95%CI 1.020~1.048,P<0.001) was an independent risk factor for cerebral artery stenosis in patients with acute cerebral infarction.Receiver operating characteristic (ROC) curve analysis showed that the area under the curve for CLEC-2 to predict cerebral artery stenosis was 0.862 (95%CI 0.812~0.912,P<0.001);the best cut-off value was 266.40pg/ml,predicted the sensitivity of cerebral artery stenosis was 80.3%,and the specificity was 80.9%.Conclusion　Elevated levels of CLEC-2 can assess the severity of ACI patients,is an independent risk factor for cerebral artery stenosis,and has certain value in predicting cerebral artery stenosis.

Objective To discuss the clinical value of magnetic resonance diffusion-weighted imaging (MR-DWI) in distinguishing tumor remnants from tumor necrosis of pancreatic carcinoma after cryoablation treatment.Methods Conventional MRI T1WI,T2WI scan,DWI sequence and dynamic enhanced MRI scan were performed in 26 patients with pancreatic carcinoma who were received cryoablation treatment.The changes in MRI signals after cryoablation treatment were recorded.The apparent diffusion coefficient (ADC) values of the normal pancreas,preoperative tumor tissue,postoperative remnants and necrosis tissue were calculated,and the results were compared.The correlation between the ADC values and the size of the tumor was evaluated,and the differences in ADC values among the tumors that had different diameter,location and staging were statistically analyzed.Results Of the 26 patients,complete necrosis of tumor was obtained in 16.The necrotic tumor tissue displayed low-signal on T1WI,high-signal on T2WI and low-signal on DWI,with no enhancement on dynamic enhanced imaging.Active residual tumor tissue was detected in 9 patients,among them the residual tumor diameter ＞5 cm was seen in 7 patients;the residual rate was 34.6％.ADC values of the following tissue,from low to high in order,were preoperative pancreatic tumor tissue (1.022± 0.126)x10-3 mm2/s,postoperative residual tumor tissue (1.130±0.155)x10-3 mm2/s,normal pancreatic tissue (1.924±-0.124)×10-3 mm2/s and postoperative necrosis tissue (2.312-±0.214)×10-3 mm2/s.No statistically significant difference in ADC values existed between preoperative pancreatic tumor tissue and postoperative residual tumor tissue (P=0.452),while statistically significant difference in ADC values existed between normal pancreatic tissue and postoperative necrosis tissue (P＜0.001).The ADC values of pancreatic tumor tissue bore a negative correlation with the tumor size (R=-0.43,P=0.027 2),while the ADC values lacked the relationship to the tumor location as well as to the tumor staging (P=0.738 8 and P=0.089 5 respectively).Conclusion MR-DWI can effectively distinguish the residual tumor tissue from the necrotic tumor tissue of pancreatic carcinoma after cryoablation treatment,which provides reliable basis for further clinical diagnosis and treatment.

Objective:To investigate the mechanisms of TWS119 induced CCR5 expression in hunman γδT cells. Methods:After treatment with various concentrations of TWS119 for 48h, the expression of CCR5 in γδT cells were detected by flow cytometry. The p-STAT3 and GAPDH expression were examined by Western blot analysis. Results: TWS119 could upregulate the expression of CCR5 in dose dependent manner. Western blot analysis revealed that TWS119 inhibit phosphorylation of STAT3,but had no significant impact on GAPDH. In addition, pretreatment of γδT cells with 0. 5 μmol/L STAT3 specific phosphorylation inhibitor Stattic could upregulate the expression of CCR5 and enhance the TWS119 induced CCR5 expression. Conclusion: TWS119 could upregulate CCR5 expression of γδT cells by inhibiting STAT3 phosphorylation in vitro.

Objective To investigate the effectiveness and safety of endovascular coiling and microsurgical clipping for ruptured intracranial aneurysms. Methods Patients w ith ruptured intracranial aneurysm treated w ith endovascular coiling or microsurgical clipping w ere enrol ed retrospectively. The demography, baseline clinical data, outcome, and complications in patients received endovascular coiling and microsurgical clipping w ere compared. Results A total of 85 patients w ith ruptured intracranial aneurysm were enroled, including 40 were treated with microsurgical clipping (surgical clipping group) and 45 were treated w ith endovascular coiling (endovascular coiling group). There w ere no significant differences in the proportions of the patients in male (37.5%vs.40.0%; χ2 =0.056, P=0.813), hypertension (30.0%vs. 33.3%; χ2 =0.109, P=0.742 ), smoking ( 50.0%vs.48.9%; χ2 =0.010, P=0.918 ), drinking (45.0%vs.46.7%; χ2 =0.024, P=0.878), aneurysm site (anterior communicating artery: 50.0%vs. 48.9%;posterior communicating artery:35.0%vs.33.3%; middle cerebral artery:10.0 %vs.11.1%;vertebral artery: 5.0%vs.6.7%; al P>0.05), aneurysm maximum diameter < 10 mm (80.0%vs. 77.8%;χ2 =0.063, P=0.802), Hunt-Hess grade 1-2 (55.0%vs.57.8%; χ2 =0.066, P=0.797), Fisher grade 1-2 ( 60.0%vs.57.8%; χ2 =0.043, P=0.835 ), and time from onset to treatment < 72 h (62.5%vs.64.4%; χ2 =0.035, P=0.853) in the surgical clipping group and endovascular coiling group. There w ere no significant differences in the complete occlusion rate of aneurysms ( 97.5%vs.91.1%;P=0.364) and the good outcome rate (65.0%vs.68.9%; χ2 =0.145, P=0.703) betw een the surgical clipping group and the endovascular coiling group. No patients died in the surgical clipping group and 1 patient died in the endovascular coiling group, and there w as no significant difference ( P=1.000). One patient (2.5%) had cerebral infarction in the surgical clipping group and no patients had cerebral infarction in the endovascular coiling group, and there w as no significant difference ( P=0.471). Conclusions The efficacy and safety of microsurgical clipping are the same as those of endovascular coiling for ruptured intracranial aneurysms.

Objective:To investigate the effect of 2-deoxy-D-glucose (2-DG) on hunmanγδT cells on the expression of CCR5 and killing function in vitro.Methods:UsingγδT medium to cultivate peripheral blood mononuclear cell( PBMCs) in vitro.After co-cultured with various concentrations of 2-DG for 48 h,the expression of CCR5 and killing activities of γδT cells for each group were detected by flow cytometry and CCK-8 methods.Results: 2-DG could not promote the growth of γδT cells with the increase in concentration from 0 μmol/L to 1.0 μmol/L and decreased thereafter.The certain concentration ( 0-2.0 μmol/L ) of 2-DG could upregulate the expression of CCR5 in dose dependent manner.Besides,at 0.5μmol/L and 1.0μmol/L of 2-DG could increase the ex-pression of CD107a and perforin and have no effect on the granzyme B.Conclusion: Human γδT cells isolated from peripheral blood treated with 2-DG could promote the expression of CCR5 and increase the killing activities at certain concentration in vitro.

Objective To analyze the application value of optical coherence tomography (OCT)in the diagnosis of normal tension glaucoma (NTG).Methods 50 NTG patients (92 eyes)were selected as control group, at the same period 50 cases in our hospital physical examination center for the health examination were selected as the observation group.The optic disc and retinal nerve fiber layer thickness were measured by OCT.The disc diameter, disc area,depending on the cup diameter,optic cup area in the optic disc parameters were observed and compared between the two groups.Results The optic disc diameter between the control group and the observation group had no significant difference (t =1.02,P >0.05),the differences among the remaining nine parameters were significant (t =3.11,2.85,5.63,5.21,4.13,3.06,3.10,6.58,4.36,all P <0.05).Conclusion OCT can measure and analyze the optic disc and retinal nerve fiber layer quantitatively,it is reproducible,clinical early diagnosis of NTG is of great significance,it is worth popularization and application.