Analysis of Chinese Medical Syndrome Features of Ischemic Stroke Based on Similarity of Symptoms Subgroup / 中国结合医学杂志

OBJECTIVE@#To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients.@*METHODS@#By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup.@*RESULTS@#Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens.@*CONCLUSIONS@#There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.

Expert Consensus on Otorhinolaryngology Head and Neck Diseases Responding Specifically to Traditional Chinese Medicine / 中国实验方剂学杂志

Traditional Chinese medicine （TCM） and western medicine have their respective advantages and limitations in the diagnosis and treatment of common otorhinolaryngology head and neck diseases. Although the integrated TCM and western medicine exhibits definite curative effects， there is no consensus on the otorhinolaryngology head and neck diseases responding specifically to TCM or integrated TCM and western medicine， as well as the diagnosis and treatment schemes. The China Association of Chinese Medicine （CACM） thus organized the otorhinolaryngology head and neck specialists of both TCM and western medicine to discuss the etiology， pathogenesis， and clinical diagnosis and treatment methods of common otorhinolaryngology head and neck diseases with the results of multiple clinical trials taken into account. The acute pharyngitis， chronic pharyngolaryngitis， paraesthesia pharyngis， hysterical aphasia， allergic rhinitis， subjective tinnitus， and otogenic vertigo were confirmed to respond specifically to TCM or integrated TCM and western medicine. Then a mutually agreed diagnosis and treatment scheme and recommendation with integrated TCM and western medicine was formulated as a reference for clinical practice， thus benefiting more patients.

Effect of intranasal acupuncture on the pathology of nasal mucosa in rabbits with allergic rhinitis and related regulatory mechanism of transient receptor potential vanillic acid receptor 1-substance P axis / 解剖学报

Objective To investigate the pathological changes of nasal mucosa by intranasal acupuncture, and to explore the possible signal transduction mechanism through the distribution and expression of transient receptor potential vanillic acid receptor 1 (TRPV1)-substance P (SP) axis in nasal mucosa of experimental allergic rhinitis. Methods An animal model of allergic rhinitis was constructed by ovalbumin and aluminium hydroxide gel treatment. Twenty five New Zealand rabbits were randomly divided into normal group, model group, sham acupuncture group, acupuncture Wai Ying Xiang group and intranasal acupuncture group, with 5 rabbits in each group. To observe the effect of intranasal acupuncture on animal behavior, nasal mucosa pathology, eosinophils (EOS) count and IgE content in arterial blood. In addition, HE staining was used to determine the distribution of EOS in nasal mucosa and immunohistochemistry was used to observe the distribution and expression of TRPV1 and SP in nasal mucosa membrane. Results Compared with the model group, the behavioral score of the sham acupuncture group did not decrease significantly, while the behavioral score of the Wai Ying Xiang acupuncture group and the intranasal acupuncture group showed a downward trend, and the decrease degree of the intranasal acupuncture group was more significant. Compared with the normal group, the eosinophil count in the model group increased slightly (P0.05). HE staining found that eosinophilic distribution increased significantly in the model group and the sham acupuncture group compared with the normal group, and the difference was statistically significant (P<0.05). Compared with the model group, the distribution of eosinophil reduced in the nasal acupuncture group and the Wai Ying Xiang group. The difference was statistically significant (P<0.05 ). Immunohistochemical found that TRPV1 and SP expressed significantly in the nasal mucosa of the model group and the sham acupuncture group compared with the normal group, the difference was statistically significant (P<0.05). Compared with the model group, TRPV1 and SP expression decreased significantly in the intranasal acupuncture group and the external yingxiang group, the difference was statistically significant (P<0.05). Conclusion Intranasal acupuncture can alleviate the nasal symptoms of allergic rhinitis model by reducing the Chemotaxis of eosinophils in nasal mucosa and the content of IgE in serum.

CT observation of retromaxillary posterior ethmoid / 临床耳鼻咽喉头颈外科杂志

To investigate the morphologic characteristics of the retromaxillary posterior ethmoid.A total of 103 outpatients encountered in our hospital during March 2012 and December 2012,who completed paranasal sinus CT examination,were included in this study.Patients had no sinus trauma,surgery or tumor history.Their paranasal sinus CT scans were analyzed from scheduled axial and coronal plane.The incidence and imaging features of the retromaxillary posterior ethmoid were observed.The retromaxillary posterior ethmoid(RMPE)was the posterior ethmoid cell that expanded along the lamina papyracea toward the infraorbital region.RMPE was located behind the posterior wall of the maxillary sinus and under the orbital floor.The occurrence rate of the RMPE was 74.3%.The ethmomaxillary septum is the bony septum the between the maxillary sinus and posterior ethmoid.Anatomical confirmation of RMPE is based mainly on the presence of the ethmomaxillary septum.RMPE is located at the back of ethmomaxillary septum.The sagittal angulation of the ethmomaxillary septum ranged from 22 to 87 degrees,with an average of(50.34±12.10)degrees.The ethmomaxillary septum is important for anatomic recognition of the RMPE.Accurate identification of the RMPE before ESS can help improve the removal of the posterior ethmoid sinus.

Evaluation of a portable device based on peripheral arterial tone in the detection of obstructive sleep apnea / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To assess the accuracy of a wrist-worn device (Watch-PAT 200) in the diagnosis of obstructive sleep apnea syndrome (OSAHS).</p><p><b>METHODS</b>Forty-three adult subjects with suspected OSAHS simultaneously had a standard in-laboratory polysomnogram (PSG) and wore the Watch-PAT 200 during a full-night recording. PSG sleep and respiratory events were scored according to standard criteria. The PSG recordings were blindly manually analyzed, while Watch-PAT data were scored automatically based on the algorithm developed previously.</p><p><b>RESULTS</b>The mean age of the subjects was (42.2 ± 12.2) years (x(-) ± s), and mean body mass index was (28.0 ± 3.9) kg/m(2). Mean PSG apnea hypopnea index (AHI) was (34.9 ± 29.9) events per hour, and mean PAT-AHI was (36.0 ± 29.2) events per hour. There was a significant correlation between PAT AHI and AHI by PSG (r = 0.931, P < 0.01). A Bland-Altman plot of PAT AHI and PSG AHI was also used to assess the accuracy of Watch-PAT 200. At lower levels of AHI, PAT tended to overestimate disease severity, while at higher levels of AHI, Watch-PAT underestimated severity. To assess sensitivity and specificity of Watch-PAT, constructed receiver operator characteristic curves using a variety of AHI threshold values (5, 15 and 30 events per hour). For AHI ≥ 5 events per hour as threshold value, the Watch-PAT diagnosing rate was 93%, and sensitivity as well as specificity were 94.7% and 80.0%. The misdiagnosis rate and missed diagnosis rate were 20.0% and 5.3%. Optimal combinations of sensitivity and specificity for the AHI threshold values (15 and 30 events per hour) were 82.6% and 100.0%, 95.0% and 95.7% respectively.</p><p><b>CONCLUSION</b>The Watch-PAT 200 may offer an accurate, robust, and reliable ambulatory method for the detection of OSAHS, with minimal patient discomfort.</p>