Professor Wei-hua ZHANG’s clinical experience in treatment of primary dysmenorrhea with warming-unblocking needling method

The professor Wei-hua ZHANG’s experiences in treatment of primary dysmenorrhea with"warmingunblocking needling method"was introduced in this paper.Prof.Zhang believes that obstruction is the crucial in pathogenesis of primary dysmenorrhea no matter of the excess or the deficiency syndrome.Warming and unblocking principle is the essential in treatment.Hence,an unique therapeutic method is innovated,named warming-unblocking needling method,including three-layer and two-direction warming needling technique at Sanyinjiao(三阴交SP6),two-layer rotating warming-unblocking technique at Zhongji(中极CV3)and one-layer and two-direction warming needling technique at Ciliao(次髎BL32).In this set of needling procedure,acupoint is viewed as a three-dimensional hierarchical structure.A layered and multidirectional needling technique is adopted at main acupoints to enhance the sensations of diqi and to generate heat effect in the local.Additionally,moxibustion is combined to intensify warming and unblocking effect.Simultaneously,the supplementary acupoints are used in response to symptoms.All of the acupoints coordinately warm up the uterus,promote meridian circulation and stop pain.Hence,this therapeutic method achieves relatively excellent effect and deserves to be promoted in practice.

Cat scratch disease in children with nocturnal fever:A case report

BACKGROUND Cat scratch disease(CSD)is the most common human infection caused by Barto-nella henselae(B.henselae).The main manifestation is self-limited lymphaden-opathy that primarily affects adolescents,and typically resolves without treat-ment within 2-4 months.However,individuals with compromised immune systems or immunodeficiency require specific antibacterial therapy following diagnosis.Due to its low incidence,nonspecific clinical manifestations,and diagnostic limitations,this condition often poses challenges for clinicians in terms of missed diagnoses and misdiagnoses.CASE SUMMARY The child was ultimately diagnosed with CSD.The primary manifestations included nocturnal fever,enlargement of lymph nodes in the neck,axilla and groin,and suspected brucellosis;however,both brucellosis tests conducted during the course of the illness yielded negative results.Bone marrow cytology indicated stimulated proliferation.Lymph node biopsy indicated hyperplasia of lymphoid tissue in the cervical lymph nodes(right),with combined immunohisto-chemical findings indicating reactive hyperplasia.Immunohistochemical analysis revealed CD20 B(+),CD3 T(+),BCL-6(+),and BCL-2(-).CD21 FDC networks were present and Ki67 expression in the germinal center was~80%.Blood next-generation sequencing indicated B.henselae sequence number was 3.Serological test results demonstrated positive antibody response to B.henselae IgG(+),B.henselae IgM(+),Bartonella quintana(B.quintana)IgG(-)and B.quintana IgM(-),and the final diagnosis was CSD.CONCLUSION In patients presenting with fever at night and swollen lymph nodes of unknown origin,CSD should be considered.

Cardiac amyloidosis presenting as pulmonary arterial hypertension:A case report

BACKGROUND Pulmonary hypertension is a rare cardiopulmonary disease,with an insidious onset that usually worsens rapidly.Amyloid light chain(AL)amyloidosis is a rare systemic disease caused by extracellular deposition of pathologic,insoluble,and proteinaceous fibrils in organs and tissues;however,it is difficult to diagnose given its varied and nonspecific symptoms.To date,rare cases of amyloidosis with pulmonary hypertension have been reported.Of note,the optimal treatments for cardiac amyloidosis complicated with pulmonary hypertension remain unclear.CASE SUMMARY We report a case of a 51-year-old woman who presented with progressively worsening dyspnea.Transthoracic echocardiography indicated severe pulmonary hypertension.Twenty-seven months after first admission,the patient returned with symptoms of progressive heart failure.A myocardial tissue sample stained with Congo red was positive,and the patient was ultimately diagnosed with AL amyloidosis with cardiac involvement.CONCLUSION Although pulmonary hypertension may be idiopathic,it is frequently associated with other conditions.In rare cases,pulmonary hypertension can be a complication of AL amyloidosis,which should be seriously considered in any adult presenting with nonspecific signs or symptoms of cardiac distress.

Study on the operational safety of high-speed trains exposed to stochastic winds

The characteristic wind curve （CWC） was com- monly used in the previous work to evaluate the operational safety of the high-speed trains exposed to crosswinds. How- ever, the CWC only provide the dividing line between safety state and failure state of high-speed trains, which can not evaluate the risk of derailment of high-speed trains when ex- posed to natural winds. In the present paper, a more realistic approach taking into account the stochastic characteristics of natural winds is proposed, which can give a reasonable and effective assessment of the operational safety of high-speed trains under stochastic winds. In this approach, the longitudi- nal and lateral components of stochastic winds are simulated based on the Cooper theory and harmonic superposition. An algorithm is set up for calculating the unsteady aerody- namic forces （moments） of the high-speed trains exposed to stochastic winds. A multi-body dynamic model of the rail vehicle is established to compute the vehicle system dynamic response subjected to the unsteady aerodynamic forces （mo- ments） input. Then the statistical method is used to get the mean characteristic wind curve （MCWC） and spread range of the high-speed trains exposed to stochastic winds. It is found that the CWC provided by the previous analyticalmethod produces over-conservative limits. The methodol- ogy proposed in the present paper can provide more signif- icant reference for the safety operation of high-speed trains exposed to stochastic winds.

Elevated Arsenic Exposure Is Associated with an Increased Risk of Chronic Hepatitis B Virus Infection： NHANES （2003-2014） in U.S. Adults

Studies concerning the association between arsenic exposure and hepatitis B virus （HBV） infection have been lacking. The present study aimed to examine the association between total urinary arsenic （TUA） and infection ofHBV. A total of 5186 participants from National Health and Nutrition Examination Survey （NHANES） 2003-2014 were included in the analysis. We used logistic regression to evaluate the association. We defined two measures of TUA. TUA1 was the sum of arsenous acid, arsenicacid, monomethylarsonic acid and dimethylarsenic acid. TUA2 was defined as TUA minus arsenobetaine and arsenocholine. The results showed that the weighted overall prevalence of HBV infection was 6.08%. For NHANES 2003-2014, the medians （interquartile range） of TUA1 and TUA2 were 5.60 μg/L （3.97-8.09 μg/L） and 4.91 μg/L （2.36-9.11 μg/L）, respectively. Comparing the highest quartile to the lowest quartile after multivariable adjustment showed that the odds ratios （ORs） and 95% confidence intervals （CIs） for TUA1 and TUA2 were 2.44 （1.40-4.27） and 2.84 （1.60-5.05）, respectively. In conclusion, elevated urinary arsenic was associated with the risk of HBV infection. Further studies, especially prospective studies, are needed to confirm the causal relationship between arsenic exposure and HBV infection.

Fatigue characteristics and microcosmic mechanism of Al-Si-Mg alloys under multiaxial proportional loadings

With the increasing use of Al-Si-Mg alloys in the automotive industry,the fatigue performance of Al-Si-Mg alloy has become a major concern with regard to their reliability.The fatigue characteristics and microcosmic mechanism of an Al-Si-Mg alloy under multiaxial proportional loadings were investigated in this research.As low cycle fatigue life and material strengthening behavior are closely related,the effect of equivalent strain amplitude on the multiaxial fatigue properties was analyzed.Fatigue tests were conducted to determine the influence of equivalent strain amplitude on the multiaxial proportional fatigue properties.The fatigue life exhibits a stable behavior under multiaxial proportional loadings.The dislocation structures of the Al-Si-Mg alloy were observed by transmission electron microscopy（TEM）.The dislocation structure evolution of the Al-Si-Mg alloy under multiaxial proportional loadings during low cycle fatigue develops step by step by increasing fatigue cycles.Simultaneously,the dislocation structure changes with the change in equivalent strain amplitude under multiaxial proportional loadings.The experimental evidence indicates that the multiaxial fatigue behavior and life are strongly dependent on the microstructure of the material,which is caused by multiaxial proportional loadings.

Changes of Nerve Growth Factor in Amniotic Fluid and Correlation with Ventriculomegaly

Objective To detect the change of nerve growth factor (NGF) level in human amniotic fluid during gestation, and to explore the relationship between this change and fetal ventriculo-megaly (VM). Methods The studied subjects (collected from 2004 to 2007) were divided into four groups, including the second-trimester pregnancy group (n=113), third-trimester pregnancy group (n=110), fetal cerebral VM group (n=12), and healthy control group (n=12) which matched with the VM group in gestational weeks. The amniotic fluid specimens were obtained during amniocentesis or cesarean section. The NGF levels in amniotic fluid were detected with en-zyme-linked immunosorbent assay. Results A significantly negative correlation was found between gestational age and the NGF level in amniotic fluid (r= 0.6149, P<0.0001). The NGF level in patients with fetal VM was significantly lower than that in healthy controls (33.95±29.24 pg/mL vs. 64.73±16.21 pg/mL, P=0.024). Conclusion NGF levels in amniotic fluid may be a sensitive marker for fetal VM.

特殊整平剂甲基橙在通孔电镀铜的应用(英文)

甲基橙具有两种基团,可以同时起到加速和抑制作用,可作为特殊的整平剂应用与通孔电镀铜实验中。通过分子动力学模拟和量子化学计算来表征甲基橙在通孔电镀铜中的作用,结果表明甲基橙可以很好地吸附在阴极表面并抑制铜的电沉积。通过恒电流测试和循环伏安测试结果显示,甲基橙由于同时具有磺酸基的去极化和其分子结构部分的极化作用,形成协同分子内对铜加速还原和阻碍传质的竞争效应,所以几乎不影响电位。在板厚孔径为10:1的通孔电镀铜实验中,仅以甲基橙和环氧乙烷和环氧丙烷嵌段共聚物作为添加剂,TP值可达到92.34%。

An unusual case of aggressive systemic mastocytosis mimicking hepatic cirrhosis

Hepatic involvement in aggressive systemic mastocytosis(ASM) is relatively common, and the main clinical features of this disease include hepatomegaly, portal hypertension, ascites, and fibrosis. Cirrhosis is a rare ASM symptom. We report an ASM case that initially mimicked cirrhosis based on clinical and radiographic analyses. The portal tract was expanded by mononuclear inflammatory cells, and an increase in collagen amount was observed in routine histological sections of the biopsied liver. A diagnosis of systemic mastocytosis(SM) was made after ancillary tests for mast cells using bone marrow aspirates. Extensive involvement of the liver and gastrointestinal tract was observed. Clinicians and pathologists need to consider ASM as a diagnosis or differential diagnosis in a clinical case of cirrhosis with unknown etiology. The diagnosis can be confirmed or disregarded by immunohistochemical staining and molecular analysis.

Endoscopic clipping for the secondary prophylaxis of bleeding gastric varices in a patient with cirrhosis:A case report

BACKGROUND Bleeding from gastroesophageal varices(GOV)is a serious complication in patients with liver cirrhosis,carrying a very high mortality rate.For secondary prophylaxis against initial and recurrent bleeding,endoscopic therapy is a critical intervention.Endoscopic variceal clipping for secondary prophylaxis in adult GOV has not been reported.CASE SUMMARY A 66-year-old man with cirrhosis was admitted to our hospital complaining of asthenia and hematochezia for 1 wk.His hemoglobin level and red blood cell counts were significantly decreased,and his fecal occult blood test was positive.An enhanced computed tomography of the abdomen showed GOV.The patient was diagnosed with hepatitis B cirrhosis-related GOV bleeding.A series of palliative treatments were administered,resulting in significant clinical improvement.Subsequently,an endoscopic examination revealed severe gastric fundal varices,prompting endoscopic variceal clipping.There were no further episodes of gastrointestinal bleeding.The GOV improved significantly on follow-up imaging and was confirmed as improved on endoscopy at the 5th post-operative month.CONCLUSION Our results suggest that endoscopic clipping is an inexpensive,safe,easy,effective,and tolerable method for the secondary prophylaxis of bleeding from gastric type 2 GOV.However,additional research is indicated to confirm its longterm safety and efficacy.

Pediatric acute myeloid leukemia patients with i(17)(q10)mimicking acute promyelocytic leukemia:Two case reports

BACKGROUND Chromosome i(17)(q10)abnormality is mainly associated with chronic myeloid leukemia(CML),myelodysplastic syndrome/myeloproliferative tumors(MDS/MPD),and acute myeloid leukemia(AML).The role of i(17)(q10)in AML is still unknown,the differences between AML and acute promyelocytic leukemia(APL)-like AML with i(17)(q10)need more research.This study aimed to investigate the clinical characteristics and laboratory evidence of 2 AML cases with i(17)(q10),similar to APL phenotype.CASE SUMMARY Both pediatric patients were males;case 1 had newly diagnosed AML,and case 2 showed relapsed tumor after 1 year of drug withdrawal.Bone marrow cell morphology,chromosome karyotype analysis,Fully-instrumented submersible housing test,immunological assays,molecular biological methods,and blood tumor panoramic gene test were performed.All-trans retinoic acid(ATRA)combined with arsenic acid(As2O3)were used in the first course of treatment.Bone marrow was dominated by abnormal promyelocytic granulocytes.Karyotype test revealed i(17)(q10)isochromosome.Immunological phenotype mainly included positive expressions of CD9,CD13,CD33,and CD38.Case 1 suffered intracranial hemorrhage after re-chemotherapy and died on D162.For case 2,on D145 and D265,bone marrow promyelocytic granulocytes accounted for 2%.Flow cytometric residual lesion detection showed no abnormal immunophenotype cells.The copy number of WT1 gene in two cases were 1087 and 1010,respectively,and the expression rates were 55.29% and 59.5%,respectively.CONCLUSION ATRA,As2O3,and chemotherapy may be ineffective in treating APL-like AML with i(17)(q10)but without t(15;17)and PML-RARA fusion gene.

Adrenocorticotropic hormone combined with magnesium sulfate therapy for infantile epileptic spasms syndrome:a real-world study

Background Infantile epileptic spasms syndrome(IESS)is a serious disease in infants,and it usually evolves to other epilepsy types or syndromes,especially refractory or super-refractory focal epilepsies.Although adrenocorticotropic hormone(ACTH)is one of the first-line and effective treatment plans for IESS,it has serious side effects and is not sufficiently effective.Methods A retrospective study of the clinical outcomes of ACTH combined with magnesium sulfate(MgSO4)therapy for IESS in two hospital centers was conducted.The major outcome of the single and combined treatment was evaluated by changes in seizure frequency and improvements in hypsarrhythmia electroencephalography(EEG).To reduce the confounding bias between the two groups,we used SPSS for the propensity score matching(PSM)analysis.Results We initially recruited 1205 IESS patients from two Chinese hospitals and treated them with ACTH combined with MgSO4 and ACTH alone.Only 1005 patients were enrolled in the treatment(ACTH combined with MgSO4:744,ACTH:261),and both treatment plans had a more than 55%response rate.However,compared to patients treated with ACTH alone,those patients treated with ACTH combined with MgSO4 had better performance in terms of the seizure frequency and hypsarrhythmia EEG.After PSM,the two groups also showed significant differences in responder rate[70.8%(95%confidence interval,CI)=66.7%–74.8%)vs.53.8%(95%CI=47.4%–60.2%),P<0.001],seizure frequency(P<0.001)and hypsarrhythmia EEG resolution(P<0.001).Notably,multivariate analysis revealed that the lead time to treatment and the number of antiseizure medications taken before treatment were two factors that may affect the clinical outcome.Patients with less than 3 months of lead time responded to the treatment much better than those with>3 months(P<0.05).In addition,the overall incidence of adverse reactions in the ACTH combined with MgSO4 group was much lower than that in the ACTH group(31.4%vs.63.1%,P<0.001).During the treatment,only infection(P=0.045)and hypertension(P=0.025)were significantly different between the two groups,and no baby died.Conclusion Our findings support that ACTH combined with MgSO4 is a more effective short-term treatment protocol for patients with IESS than ACTH alone,especially for those patients with short lead times to treatment.

Selectivin:A nematicide from parasitic nematodes-specifically activated chemical

The latest study published in Nature by Andrew R.Burns,Peter J.Roy and co-authors is highlighted in this paper,they investigated a series of novel nematicidal compounds,including Selectivin-A and Selectivin-E,and explored their mechanism of action.Experiments have displayed that the Selectivin compound is inactive to human cells,fish,fungi,insects and even beneficial nematodes.In the exploration of its mechanism of action,it was found that the mechanism of action of Selectivin is different with those of commercial nematocides:Selectivin needs to be activated by biotin produced by nematodes,after that they can be transformed into compounds with high nematicidal activity.This proves that the family of Selectivin compounds has the advantages of high selectivity and environmental friendliness,and their mechanism of action is completely new,proposing a completely new path for the development of new nematicides.

Recent advances in the natural products-based lead discovery for new agrochemicals

Crops will be harmed by fungi,pests and weeds during their growth.In the past half century,scientists have conducted in-depth research on natural products extracted from microorganisms,plants or animals,and used natural products and their derivatives as the lead for pesticides discovery.Natural product pesticides have the advantages of easy degradation in the environment,selective control and safety to non-target organisms.This review summarizes the studies on natural products pesticides in recent years,including natural products of chemical modification and biosynthesis,mainly fungicides,herbicides,insecticides and acaricides.We classify natural products according to their active fragments,and discuss their effects on the control of agricultural fungi,pests and weeds.Ultimately,we found that lead discovery based on natural products has great advantages in pesticide development.

AI-driven drug discovery from natural products

The latest review published in Nature Reviews Drug Discovery by Michael W.Mullowney and co-authors focuses on the use of artificial intelligence techniques,specifically machine learning,in natural product drug discovery.The authors discussed various applications of AI in this field,such as genome and metabolome mining,structural characterization of natural products,and predicting targets and biological activities of these compounds.They also highlighted the challenges associated with creating and managing large datasets for training algorithms,as well as strategies to address these obstacles.Additionally,the authors examine common pitfalls in algorithm training and offer suggestions for avoiding them.

Multi-objective optimization design method of the high-speed train head

With the continuous improvement of the train speed, the dynamic environment of trains turns out to be aerodynamic domination. Solving the aerodynamic problems has become one of the key factors of the high-speed train head design. Given that the aerodynamic drag is a significant factor that restrains train speed and energy conservation, reducing the aerodynamic drag is thus an important consideration of the high-speed train head design. However, the reduction of the aerodynamic drag may increase other aerodynamic forces (moments), possibly deteriorating the operational safety of the train. The multi-objective optimization design method of the high-speed train head was proposed in this paper, and the aerodynamic drag and load reduction factor were set to be optimization objectives. The automatic multi-objective optimization design of the high-speed train head can be achieved by integrating a series of procedures into the multi-objective optimization algorithm, such as the establishment of 3D parametric model, the aerodynamic mesh generation, the calculation of the flow field around the train, and the vehicle system dynamics. The correlation between the optimization objectives and optimization variables was analyzed to obtain the most important optimization variables, and a further analysis of the nonlinear relationship between the key optimization variables and the optimization objectives was obtained. After optimization, the aerodynamic drag of optimized train was reduced by up to 4.15%, and the load reduction factor was reduced by up to 1.72%.

Dynamic performance of a pantograph-catenary system with the consideration of the appearance characteristics of contact surfaces

In this paper,a modeling method for a pantograph-catenary system is put forward to investigate the dynamic contact behavior in space,taking into consideration of the appearance characteristics of the contact surfaces of the pantograph and catenary.The dynamic performance of the pantograph-catenary system,including contact forces,accelerations,and the corresponding spectra,is analyzed.Furthermore,with the modeling method,the influences of contact wire irregularity and the vibration caused by the front pantograph on the rear pantograph for a pantograph-catenary system with double pantographs are investigated.The results show that the appearance characteristics of the contact surfaces play an important role in the dynamic contact behavior.The appearance characteristics should be considered to reasonably evaluate the dynamic performance of the pantograph-catenary system.

A numerical approach to the interaction between airflow and a high-speed train subjected to crosswind

Aerodynamic forces and dynamic performances of railway vehicles are coupled and affected by each other. On the one hand, aerodynamic forces change the displacements of a train. On the other hand, displacements affect aerodynamic forces. Based on vehicle-track coupling dynamics and aerodynamics, a numerical approach to the interaction between airflow and a high-speed train is presented in this paper. Aerodynamic forces and dynamic performances of a high-speed train subjected to crosswind were numerically simulated. Results showed that the interaction between airflow and a high-speed train has a significant influence on displacements and aerodynamic forces of the head coach. Therefore, it is necessary to consider the interaction between airflow and a high-speed train subjected to crosswind.

Kāiqiàotōngluòacupuncture combined with repetitive transcranial magnetic stimulation for the treatment of hand dysfunction after stroke

Objective:To observe the clinical improvement of Kāiqiàotōngluò(induce resuscitation and remove obstruction in meridians)acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)in patients with hand dysfunction after stroke,and to provide evidence for its extensive application in the future.Methods:Sixty patients with the problem of hand dysfunction were divided into the observation group and the control group randomly.The two groups of patients were treated with the basic treatment,the observation group received Kdiqiaotongluo acupuncture combined with rTMS,and the control group only received the rTMS treatment.Broetz hand function scale,hemiplegic hand function grading,and modified Barthel index were used to evaluate the hand function of the patients in two groups before and after treatment.Results:After treatment,Broetz score of the patients in observation group and control group were significantly lower than that before treatment,and Broetz score of the patients in observation group was lower than that of control group(all P<0.05);As for the hemiplegic hand function grading,24 cases in the observation group improved,the improvement rate was 80.0%,and 8 cases in the control group improved,the improvement rate was only 26.7%.The improvement rate of observation group was significantly better than that of control group(P<0.01);the Barthel index scores of the observation group and the control group were significantly improved after treatment,and the observation group was better than the control group(both P<0.05).Conclusion:The Kāiqiàotōngluòacupuncture combined with rTMS can improve the hand dysfunction of patients after stroke,and it is worthy of clinical application.

Clinical research of atlantoaxial instability treated with the combination of ulna-tibia needling therapy and“point-to-surface”tuina manipulation

Objective:To observe the clinical therapeutic effect on atlantoaxial instability treated with the combination of ulna-tibia needling therapy and"point-to-surface"tuina manipulation.Methods:A total of 64 outpatients diagnosed as atlantoaxial instability were collected and randomized into a control group and an observation group,32 cases in each one.In the control group,flunarizine hydrochloride capsules were used for oral administration.In the observation group,the combined treatment of ulna-tibia needling therapy and"point-to-surface"tuina manipulation was adopted.The ulnatibia needling therapy was exerted at the cutaneous region of hand taiyang meridian on the ulnar region(from carpal joint to elbow joint)on both sides.The"point-to-surface"tuina manipulation included"onepoint and two-surface"technique,"upper-to-lower pressing"method and"lifting-trembling"method.The treatment was provided once daily,consecutively for 5 times.The scores of neck symptoms and physical signs,atlantoaxial axle separation degree and clinical therapeutic results were taken as the observation indicators to evaluate the treatment effect.Results:After treatment,the curative rate and the total effective rate in the observation group were all higher significantly than the control group(all P<0.01).The scores of clinical symptoms and physical signs were statistically different in the self-comparison of each group before and after treatment(all P<0.05).After treatment,the scores of clinical symptoms and physical signs,the excellence rate of atlantoaxial axle separation and the effective rate in the observation group were all significantly better than those of the control group(all P<0.01).Conclusion:The combination of ulna-tibia needling therapy and"point-to-surface"tuina manipulation achieves the better clinical therapeutic effect as compared with flunarizine hydrochloride.