简介：Inthepresentpaper,theauthorputsforwardsixkeypointsforacupuncturetreatmentofdiseases,namely,①carefulexamination,②definitediagnosis,③preciseandappropriateidentificationofsyndromes,④accuratelocationoftheacupoint,⑤flexibleapplicationofneedlingmanipulations,and⑥“Deqi”.Thefirstthreeaspactsarethefoundation,accuratelocationandflexibleneedlingmanipulationsarealsotheprerequisiteforeffectivetreatmentofdiseases.Inaddition,soundtheoreticalbasicknowledgeofbothtraditionalChinesemedicine(TOM)andmodemmedicine,andflexiblyapplyingsuitableneedlingmaneuvers,stimulatingquantityanddurationofneedleretaininginaccordancewiththeconcretestateofdiseaseandthepatient'sconditionsarealsoveryimportantinclinicalpracticeofacupuncture.

简介：LedbyfourgenerationsofleadershipfromlateProf.JIANGSichang(academician,ChineseAcademyofEngineering),Prof.YANGWeiyan(HonoraryPresident,DivisionofOtolaryngologyHeadandNeckSurgery,ChineseMedicalAssociation),Prof.HANDongyi(PresidentElected,DivisionofOtolaryngologyHeadandNeckSurgery,ChineseMedicalAssociation)tonowProf.YANGShiming(President,DivisionofOtolaryngologists,

简介：AbstractMandibular condylar fractures are among the most common facial fractures and some of the most difficult to manage. Opinions about the management of mandibular condylar fractures differ among surgeons. With the implementation of new technology, an increased understanding of fracture management, and better functional and morphological outcomes reported in the literature, open reduction and internal fixation is becoming many surgeons’ preferred choice for the treatment of condylar fractures. Because surgical treatment of such fractures is complex, certain factors must be considered to achieve satisfactory outcomes. In this article, we summarise six key points in the management of mandibular condylar fractures: virtual evaluation of condylar fracture, a suitable surgical approach, good reduction, stable internal fixation, repair of the articular disc, and restoration of the mandibular arch width. We believe that these points will help to improve the prognosis of mandibular condyle fractures.

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简介：AbstractMucormycosis is a lethal human disease caused by fungi of the order Mucorales. Mucormycosis is caused by fungi mainly belonging to the genera Mucor, Rhizopus, and Lichtheimia, all of which belong to the order Mucorales. The number of individuals with mucormycosis-causing disorders has increased in recent years, hence, leading to the spread of mucormycosis. Throughout the coronavirus disease 2019 (COVID-19) pandemic, numerous cases of mucormycosis in COVID-19-infected patients have been reported worldwide, and the illness is now recognized as COVID-19-associated mucormycosis, with most of the cases being reported from India. Immunocompromised patients such as those with bone marrow sickness and uncontrolled diabetes are at a greater risk of developing mucormycosis. Genes, pathways, and other mechanisms have been studied in Mucorales, demonstrating a direct link between virulence and prospective therapeutic and diagnostic targets. This review discusses several proteins such as high-affinity iron permease (FTR1), calcineurin, spore coat protein (CotH), and ADP-ribosylation factors involved in the pathogenesis of mucormycosis that might prove to be viable target(s) for the development of novel diagnostic and therapeutic methods.

简介：AbstractBackground:The End Tuberculosis (TB) Strategy of the World Health Organization highlights the need for patient-centered care and social protection measures that alleviate the financial hardships faced by many TB patients. In China, TB treatments are paid for by earmarked government funds, social health insurance, medical assistance for the poor, and out-of-pocket payments from patients. As part of Phase III of the China-Gates TB project, this paper introduces multi-source financing of TB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB care.Main text:The new financing policies for TB treatment in the three provinces include increased reimbursement for TB outpatient care, linkage of TB treatment with local poverty alleviation programs, and use of local government funds to cover some costs to reduce out-of-pocket expenses. However, there are several challenges in reducing the financial burdens faced by TB patients. First, medical costs must be contained by reducing the profit-maximizing behaviors of hospitals. Second, treatment for TB and multi-drug resistant TB (MDR-TB) is only available at county hospitals and city or provincial hospitals, respectively, and these hospitals have low reimbursement rates and high co-payments. Third, many patients with TB and MDR-TB are at the edge of poverty, and therefore ineligible for medical assistance, which targets extremely poor individuals. In addition, the local governments of less developed provinces often face fiscal difficulties, making it challenging to use of local government funds to provide financial support for TB patients. We suggest that stakeholders at multiple sectors should engage in transparent and responsive communications, coordinate policy developments, and integrate resources to improve the integration of social protection schemes.Conclusions:The Chinese government is examining the establishment of multi-source financing for TB treatment by mobilization of funds from the government and social protection schemes. These efforts require strengthening the cooperation of multiple sectors and improving the accountability of different government agencies. All key stakeholders must take concrete actions in the near future to assure significant progress toward the goal of alleviating the financial burden faced by TB and MDR-TB patients.

简介：Historically,mastcellswereknownasakeycelltypeinvolvedintypeIhypersensitivity.Untillasttwodecades,thiscelltypewasrecognizedtobewidelyinvolvedinanumberofnon-allergicdiseasesincludinginflammatoryboweldisease(IBD).MarkedlyincreasednumbersofmastcellswereobservedinthemucosaoftheileumandcolonofpatientswithIBD,whichwasaccompaniedbygreatchangesofthecontentinmastcellssuchasdramaticallyincreasedexpressionofTNFα,IL-16andsubstanceP.TheevidenceofmastcelldegranulationwasfoundinthewallofintestinefrompatientswithIBDwithimmunohistochemistrytechnique.ThehighlyelevatedhistamineandtryptaselevelsweredetectedinmucosaofpatientswithIBD,stronglysuggestingthatmastcelldegranulationisinvolvedinthepathogenesisofIBD.However,littleisknownoftheactionsofhistamine,tryptase,chymaseandcarboxypeptidaseinIBD.Overthelastdecade,heparinhasbeenusedtotreatIBDinclinicalpractice.Thelowmolecularweightheparin(LMWH)waseffectiveasadjuvanttherapy,andthepatientsshowedgoodclinicalandlaboratoryresponsewithnoseriousadverseeffects.TherolesofPGD2,LTC4,PAFandmastcellcytokinesinIBDwerealsodiscussed.Recently,aseriesofexperimentswithdispersedcolonmastcellssuggestedthereshouldbeatleasttwopathwaysinmanformastcellstoamplifytheirownactivation-degranulationsignalsinanautocrineorparacrinemanner.Thehypothesisisthatmastcellsecretogoguesinducemastcelldegranulation,releasehistamine,thenstimulatetheadjacentmastcellsorpositivelyfeedbacktofurtherstimulateitshostmastcellsthroughH1receptor.Whereasreleasedtryptaseactssimilarlytohistamine,butactivatesmastcellsthroughitsreceptorPAR-2.Theconnectionsbetweencurrentanti-IBDtherapiesorpotentialtherapiesforIBDwithmastcellswerediscussed,implicatingfurtherthatmastcellisakeycelltypethatisinvolvedinthepathogenesisofIBD.Inconclusion,whilepathoge

简介：LongbeforethediscoveryofHelicobacterpylori,thereweremanyexcellentobservationalstudiesthatdocumenteddifferencesinthepatternsofgastroduodenaldisease.Itwasclearthatinthedevelopingworld,gastriculcerandgastriccancerweremorecommonthaninthedevelopedworldwhereduodenalulcerpredominated.Thiscorrelatedwiththedistributionofgastritisinduodenalulcerpatientswheretheinflammationwasantralpredominantwhileingastriculcerpatientsthegastritiswasmoreevenlydistributedthroughthestomach.Gastriculcersusuallyappearedinafairlyrestricteddistributioninthestomachneartheangulusandclosetothetransitionalzonebetweenantrumandbodymucosa.Asasocietydevelopedsothesepatternsofdiseasechanged.

简介：Objective:Toinvestigateimmune-relatedgeneticbackgroundinbilateralsuddensensorineuralhearingloss(SSNHL).Casereportandmethods:Thecaseisa45-year-oldmanpresentingwitha7-yearhistoryofbilateralprofoundSSNHL.Bloodbiochemicaltestingdemonstratedincreasedlevelsoftotalcholesterol(5.88mmol/L).TestsforhepatitisBshowedapositiveantibodyagainstthehepatitisBcoreantigen.ComplementC3wasbelowthenormalvalue,andcomplementC4andIgGwereinthelowerrangeofnormalvalues.CTimagesshowedanormalinnerearandvestibularaqueductbutroundwindowmembranousossificationonbothsides.Atotalnumberof232immuneassociatedgenesweresequencedusingthenextgenerationsequencingtechnique.Results:Mutationsweredetectedin5genes,includingthephosphoinositide3-kinasecatalyticsubunitdelta(PIK3CD),caspaserecruitmentdomain-containingprotein9(CARD9),complementfactorH-related(CFHR2),immunoglobulinlambda-likepolypeptide1Protein(IGLL1),andtransmembranechannel-likegenefamily8(TMC8).InthePIK3CDgene,aC896Tsubstituteinexon7wasdetected.Thismutationcausesprimaryimmunodeficiencyandisanautosomaldominantdisease.Conclusion:ThePIK3CDC896TmutationresponsibleforprimaryimmunodeficiencymaycontributetotheonsetofbilateralSSNHLwithsubsequentrapidprogression.

简介：AbstractBackground:The global prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing. The pathogenesis of NAFLD is multifaceted, and the underlying mechanisms are elusive. We conducted data mining analysis to gain a better insight into the disease and to identify the hub genes associated with the progression of NAFLD.Methods:The dataset GSE49541, containing the profile of 40 samples representing mild stages of NAFLD and 32 samples representing advanced stages of NAFLD, was acquired from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified using the R programming language. The Database for Annotation, Visualization and Integrated Discovery (DAVID) online tool and Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database were used to perform the enrichment analysis and construct protein-protein interaction (PPI) networks, respectively. Subsequently, transcription factor networks and key modules were identified. The hub genes were validated in a mice model of high fat diet (HFD)-induced NAFLD and in cultured HepG2 cells by real-time quantitative PCR.Results:Based on the GSE49541 dataset, 57 DEGs were selected and enriched in chemokine activity and cellular component, including the extracellular region. Twelve transcription factors associated with DEGs were indicated from PPI analysis. Upregulated expression of five hub genes (SOX9, CCL20, CXCL1, CD24, and CHST4), which were identified from the dataset, was also observed in the livers of HFD-induced NAFLD mice and in HepG2 cells exposed to palmitic acid or advanced glycation end products.Conclusion:The hub genes SOX9, CCL20, CXCL1, CD24, and CHST4 are involved in the aggravation of NAFLD. Our results offer new insights into the underlying mechanism of NAFLD progression.

简介：<正>InstituteofOtolaryngologyofChinesePLA(KeyLaboratoryforthePreventionofAcousticTrauma,PLA)KeyLaboratoryofHearingImpairmentScience(ChinesePLAMedicalSchool)MinistryofEducationLedbyfourgenerationsofleadershipfromlateProf.JIANGSichang(academician,ChineseAcademyofEngineering),Prof.YANGWeiyan(HonoraryPresident,DivisionofOtolaryngology

简介：AbstractIn order to effectively implement the Tianjin Biosecurity Guidelines for Codes of Conduct for Scientists, biosecurity awareness-raising and education are essential because if these are not in place scientists will not understand the need for biosecurity codes of conduct. In an effort to assist in the implementation of the guidelines, a small-scale survey was carried out in early 2022 of biosecurity awareness-raising and education projects that have been developed over the last two decades to discover what resources and experience have been accumulated. It is argued that the survey demonstrates that much of what is needed to implement the guidelines effectively has been developed, but that there are specific deficiencies that need to be remedied quickly. In particular, an updated teaching resource covering the core issues related to the Biological and Toxin Weapons Convention (BTWC) and the problem of dual use in scientific research needs to be made widely available and translated into at least the six official United Nations (UN) languages. Additionally, more specialists from the Humanities with expertise in ethics need to become involved in biosecurity awareness-raising and education activities. While advantage should be taken now of the available national, regional and international networks of people involved in related activities, it is suggested that in the longer term cooperation in biosecurity awareness-raising and education will benefit from the development of an equivalent organisation to the International Nuclear Security Education Network (INSEN) organised through the International Atomic Energy Agency (IAEA).

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简介：AbstractObjective:This survey was designed to understand the misconceptions about labor epidurals.Methods:This voluntary and anonymous online survey on wenjuan.com was conducted from September 1st, 2015 to January 1st, 2016 via mainly WeChat groups dedicated to perinatal healthcare providers in China. The questionnaire included items inquiring the knowledge and opinions about labor epidural analgesia related to maternal complications, baby safety, and effect on laboring. Incomplete surveys were excluded from the data analysis. The data was presented as percentages and a Chi-square test or Fisher’s exact test, as appreciate, was used to quantitatively compare the results.Results:A total of 1412 respondents completed surveys with 42.9% (606/1412) of them being anesthesiologists, 35.1% (495/1412) being obstetricians, 11.8% (167/1412) being midwives, 3.7% (52/1412) being labor and delivery nurses, and 6.5% (92/1412) being hospital administrators and unspecified. The study revealed a lack of knowledge in labor pain control. Although 82.4% (1164/1412) of respondents were familiar with labor epidural analgesia, 8.9% (126/1412) did not know how it works, and 1.1% (15/1412) never heard it in a multiple-choice question. The three main groups (anesthesiologists, obstetricians, and midwives/labor and delivery nurses) were chosen for comparisons. Opinions among these three groups concerning five questions in the three main concerns were evaluated using a statistical significance of P<0.05.Conclusion:The results in our survey indicated an urgent need of continuing medical education to multidisciplinary specialties to improve evidence-based medical practices as these misconceptions have existed for over 10 years in the medical professionals. Lack of public awareness fueled by misconceptions related to labor epidural analgesia may be associated with a lack of professional knowledge. Correct knowledge in professionals needs to be disseminated to the public in order to dispel possible misconceptions and rumors about labor epidural analgesia. This would not only enhance patient understanding of their care but also improve maternal, fetal, and neonatal outcomes.

简介：AbstractBackground:Zoonoses are public health threats that cause severe damage worldwide. Zoonoses constitute a key indicator of One Health (OH) and the OH approach is being applied for zoonosis control programmes of zoonotic diseases. In a very recent study, we developed an evaluation system for OH performance through the global OH index (GOHI). This study applied the GOHI to evaluate OH performance for zoonoses in sub-Saharan Africa.Methods:The framework for the OH index on zoonoses (OHIZ) was constructed including five indicators, 15 subindicators and 28 datasets. Publicly available data were referenced to generate the OHIZ database which included both qualitative and quantitative indicators for all sub-Sahara African countries (n = 48). The GOHI algorithm was used to estimate scores for OHIZ. Indicator weights were calculated by adopting the fuzzy analytical hierarchy process.Results:Overall, five indicators associated with weights were generated as follows: source of infection (23.70%), route of transmission (25.31%), targeted population (19.09%), capacity building (16.77%), and outcomes/case studies (15.13%). Following the indicators, a total of 37 sub-Sahara African countries aligned with OHIZ validation, while 11 territories were excluded for unfit or missing data. The OHIZ average score of sub-Saharan Africa was estimated at 53.67/100. The highest score was 71.99 from South Africa, while the lowest score was 40.51 from Benin. It is also worth mentioning that Sub-Sahara African countries had high performance in many subindicators associated with zoonoses, e.g., surveillance and response, vector and reservoir interventions, and natural protected areas, which suggests that this region had a certain capacity in control and prevention or responses to zoonotic events.Conclusions:This study reveals that it is possible to perform OH evaluation for zoonoses in sub-Saharan Africa by OHIZ. Findings from this study provide preliminary research information in advancing knowledge of the evidenced risks to strengthen strategies for effective control of zoonoses and to support the prevention of zoonotic events.

简介：AbstractBackground:Being able to predict with confidence the early onset of type 2 diabetes from a suite of signs and symptoms (features) displayed by potential sufferers is desirable to commence treatment promptly. Late or inconclusive diagnosis can result in more serious health consequences for sufferers and higher costs for health care services in the long run.Methods:A novel integrated methodology is proposed involving correlation, statistical analysis, machine learning, multi-K-fold cross-validation, and confusion matrices to provide a reliable classification of diabetes-positive and -negative individuals from a substantial suite of features. The method also identifies the relative influence of each feature on the diabetes diagnosis and highlights the most important ones. Ten statistical and machine learning methods are utilized to conduct the analysis.Results:A published data set involving 520 individuals (Sylthet Diabetes Hospital, Bangladesh) is modeled revealing that a support vector classifier generates the most accurate early-onset type 2 diabetes status predictions with just 11 misclassifications (2.1% error). Polydipsia and polyuria are among the most influential features, whereas obesity and age are assigned low weights by the prediction models.Conclusion:The proposed methodology can rapidly predict early-onset type 2 diabetes with high confidence while providing valuable insight into the key influential features involved in such predictions.

简介：摘要目的探讨后路全脊柱内镜下微创Key-hole侧块减压髓核摘除术(ACDF)治疗单节段神经根型颈椎病患者的临床效果。方法回顾性分析2016年3月—2018年12月徐州市中心医院40例单节段神经根型颈椎病患者的临床资料，其中男23例、女17例，年龄32～76岁。根据手术方式不同分组，行颈椎前路椎间盘切除椎间融合术(ACDF)20例为开放组，行后路全脊柱内镜下微创Key-hole侧块减压髓核摘除术20例为内镜组。比较两组患者的基线资料，以及手术时间、出血量、切口长度、住院时间、住院费用、术后并发症等；定期随访，比较两组患者术前和术后1、3、6、12个月及末次随访时，颈部及上肢疼痛视觉模拟评分(VAS)、颈椎功能障碍指数(NDI)，末次随访采用Odom标准评定临床疗效。结果两组患者基线资料差异均无统计学意义(P值均>0.01)。与开放组比较，内镜组手术时间短、出血少、切口小、住院时间短、费用低，差异均有统计学意义(t＝3.451、15.844、49.438、6.772、28.311, P值均<0.01)。术后随访12～24个月，开放组术后发生并发症1例，内镜组2例。开放组和内镜组术后1个月VAS分别为(2.90±0.42)、(2.11±0.29)分，NDI评分分别为(21.75±3.85)、(17.60±2.04)分，差异均有统计学意义(t＝6.966、4.260, P值均<0.01)；术前和术后3、6、12个月及末次随访时VAS、NDI评分组间比较，差异均无统计学意义(P值均>0.05)。末次随访根据Odom标准评定临床疗效，内镜组优14例、良4例，开放组患者中优15例、良3例，两组优良率比较差异无统计学意义(Z＝-0.311，P>0.05)。结论后路全脊柱内镜微创Key-hole侧块减压髓核摘除术与传统ACDF开放手术均可获满意临床疗效，但后路全脊柱内镜Key-hole侧块减压髓核摘除术具有创伤小、恢复快、费用少、安全性高等优点，值得临床推广应用。