Influenza poses a significant public health burden with distinct seasonality. In regions with pronounced climatic features like Gansu Province, China, traditional statistical models often fail to capture the nonlinear and lagged effects of meteorological drivers on influenza transmission. A deeper understanding of these complex relationships is essential for improving predictive accuracy. A Random Forest-based nonlinear Granger causality test was employed to systematically identify significant lagged predictive relationships between eight meteorological variables and monthly influenza incidence in Gansu Province (2004–2020). This approach accommodates complex, nonlinear dependencies that linear Granger causality cannot capture. Meteorological features exhibiting significant predictive improvement were selected via Random Forest and combined with influenza autocorrelation features as inputs to an LSTM-Transformer hybrid model. The model was trained using a rigorous time-series split (60%-20%-20%) and evaluated primarily using the Weighted Mean Absolute Percentage Error (WMAPE). Model explainability was assessed using SHapley Additive exPlanations (SHAP). The nonlinear Granger causality test identified significant statistical predictive relationships for all eight meteorological factors. Temperature-related variables exhibited a 6-month lag (improvement rates: 22.56%-23.99%). Precipitation showed a 1-month lag (improvement rate: 19.37%). Sunshine duration displayed a persistent predictive pattern across lags of 1 to 6 months (improvement rates: 15.8%-22.85%). The hybrid model achieved an R² of 0.786 and a WMAPE of 30.19% on the independent test set. SHAP-based explainability analysis ranked sunshine duration lagged by 2 months as the most influential predictor (mean absolute SHAP value = 0.0609), followed by the 6-month rolling mean of minimum temperature (0.0322). Meteorological factors offered important statistical predictive information for influenza incidence in Gansu Province, with sunshine duration exhibiting a persistent predictive pattern across multiple lags. The hybrid model demonstrated robust predictive performance on the independent test set.

Droughts, historically recognized as drivers of societal transformation, have been implicated in the emergence of infectious diseases. While existing research has concentrated on the impact of climate change on infectious diseases outbreaks in modern, industrialized, and urban settings, there is a dearth of epidemiological evidence regarding the historical interplay between drought and disease. Here, we analyze the 1585-1590 extreme drought in Ming Dynasty China to investigate the concurrent development of drought and infectious diseases, as well as the temporal and spatial effects of drought on disease outbreaks. The findings reveal a positive correlation between drought and infectious diseases in both temporal and spatial dimensions, with famine identified as a critical intermediate factor. Drought's influence on famine and disease is both immediate and delayed, with the most significant effects occurring within the same year. Additionally, a north-to-south pattern in the occurrence of drought and infectious diseases is observed, with northern droughts more likely to precipitate disease outbreaks. These insights offer valuable perspectives for future strategies.

Extreme drought events can impact human health, notably triggering epidemics that impose significant global health and economic burdens. Understanding these effects and developing response strategies is crucial. However, there is limited epidemiological evidence on how climate change influenced ancient epidemics before large-scale urbanization and frequent population movements. In this study, we utilized the Reconstructed East Asian Climate Historical Encoded Series (REACHES) climate database and the self-constructed ancient Chinese epidemics database to examine extreme drought events in ancient China from 1784–1787 CE. We analyzed factors like grain prices, population density, and socioeconomic conditions to explore the temporal and spatial mechanism and influence the degree of extreme drought events on epidemics outbreaks. The results show that there is a clear positive link between drought and the spread of epidemics, with a notable one-year lag effect of drought. Drought impacts epidemics directly and indirectly through locust plague, famine, crop failure, and social turmoil, with famine being the most crucial factor. Official disaster management can mitigate epidemics. This study intuitively shows the relationship between extreme drought events and epidemics in ancient China and offering insights into the climate change-epidemic relationship. Placing the conclusions of this paper in a broader context has global implications, providing historical experience for polycrisis and modern challenges.

Background: Seasonal influenza infection is a major challenge in public health. Previous studies have shown that the timing of seasonal influenza epidemics varies with latitude, indicating that meteorological and environmental conditions are involved in the spread of influenza. We sought to investigate the link between the onset of influenza and meteorological factors in Gansu Province, to build an accurate forecasting model. Methods: We conducted time series analysis based on selected weather variables and influenza incidence data from 2006 to 2016 in Gansu Province. First, the cross-correlation function (CCF) was applied to explore the correlation between meteorological variables and influenza incidence. Then, a seasonal autoregressive integrated moving average model with additional covariates (SARIMAX) was performed to fit and predict influenza incidence. Results: After fitting the SARIMAX model, minimum temperature at lag 1 (β = −0.067, P < 0.05, 95% confidence interval: −0.119, −0.015) was negatively associated with loginfluenza incidence. SARIMAX (1, 1, 1) (0, 1, 1)12 with minimum temperature at lag 1 was the optimal model, with good prediction accuracy. Conclusions: Meteorological factors showed different effects on influenza incidence in Gansu Province. Our results verify the idea that climate is an important factor in the spread of influenza. Keywords: influenza; meteorological factor; time series; SARIMAX; Gansu Province

Objective To analyze the trend of influenza in Heilongjiang province by using Seasonal Autoregressive Integrated Moving Average（SARIMA）model, providing a basis for decision-making in influenza prevention and control.Methods Using the data on influenza incidence rate in Heilongjiang province from January 2009 to December 2016,this paper established a prediction model, evaluated the relationship between meteorological elements at different lags and the incidence of influenza, and then incorporated the relevant meteorological elements to improve the prediction accuracy of the model.The data on 2017 were used to evaluate the prediction effect of SARIMA model.Results Wind speed at lag 5（β=0.345,P＜0.05,95% confidence interval: 0.239,0.450）were positively correlated with incidence rate.SARIMA（1,1,1）（0,1,1）12 was the optimal model with wind speed at lag 5.The model had a good fitting effect and good prediction accuracy.Conclusion The change in meteorological elements is related to the incidence rate of influenza in Heilongjiang province.It is feasible to predict the influenza incidence in Heilongjiang province by adopting the SARIMA model incorporating meteorological elements, but the prediction accuracy needs to be further improved.

[目的]研究双相情感障碍患者发病时的运气特征分布特点及差异.[方法]采用回顾性研究方法,以豫南精神卫生中心收治的3 871例双相情感障碍患者住院病案资料为研究对象,采用统计描述、Pearson卡方检验及二分类Logistic回归分析比较躁狂发作与抑郁发作患者发病时间的运气特征差异.[结果]根据Pearson卡方检验结果,躁狂发作与抑郁发作在六步气位与客气分布上无统计学差异.而根据二分类Logistic回归的结果,相较于抑郁发作,躁狂发作的比例在初之气与太阴湿土相合时段以及终之气与少阴君火相合时段升高,在四之气与太阴湿土相合时段降低,差异均有统计学意义(P＜0.05).[结论]双相情感障碍的发病与运气相合特征变化存在一定关联性.该研究对指导双相情感障碍患者预防发病、及时进行具有针对性的治疗具有一定的意义.

该研究以中医传统智慧—五运六气理论为依据,选择香港地区2020年1月18日(首例报告时间)—2021年8月31日COVID-19(corona virus disease 2019)的报告发病数据,及近30年的气象数据[即平均气压(hpa)、平均气温(℃)、最高气温(℃)、最低气温(℃)、平均相对湿度(％)、平均云量(％)、平均风速(km/h)、总雨量(mm)、总日照(h)共9项气象要素的日均值].采用Logistic生长模型和指数平滑预测法,对2021年秋冬季(即9月1日-12月31日,含处暑、白露、秋分、寒露、霜降、立冬、小雪、大雪、冬至共九个节气)的COVID-19发病与气象变化情况进行预测.结果发现:今年秋季的白露节气(9月7日—9月22日)以及冬季的小雪—大雪节气(11月22日—12月20日)为香港地区CO-VID-19可能出现波动的两个时段.其中,脾虚湿胜及阳虚体质的人群尤应加强防护,中医推荐药物、针刺、艾灸、食疗等综合疗法进行早期预防及治疗.

血液透析患者是一个特殊的疾病群体,这个群体如何在透析的道路上走得更稳更远,需要医生的治疗,更离不开患者的自我管理.在充分透析的前提下,经医生指导进行科学饮食、合理运动、预防并发症的发生,并结合中医手段进行养生,使患者的生存质量、健康功能维持在相对满意的状态,即可达到健康养生、带病延年的目的.

The effects of the moon on mental activities remain contentious. Few studies have investigated associations between lunar phases and different types of bipolar disorder (BD) episodes. In the current study, 7,452 patients with BD from three hospitals were enrolled. Patients were divided into two groups on the basis of episode types, and the effects of lunar phase were examined for each type. The cosinor analysis revealed moon-related rhythmicity in admissions for BD in a period of 14.75 days. There were fewer admissions around the new moon and the full moon. There was no significant difference between different groups in acrophase. There was possibly a temporal lag between the onset of BD and hospitalization. Thus, it is too early to draw firm conclusions about the impact of lunar phases on BD. Sleep might be a middle way from moon effect to admissions of BD. These results have implications for future disease prevention strategies and research.

Background and objective Integrated traditional Chinese and western medicine (ITCWM), as a representative type of complex intervention, is commonly used for the treatment of angina pectoris (AP) in clinical practice. However, it is unclear whether the details of ITCWM interventions, such as rationale for selection and design, implementation and potential interactions for different therapies, were adequately reported. Therefore, this study aimed to describe the reporting characteristics and quality in randomized controlled trials (RCTs) of AP with ITCWM interventions. Methods Through a search of 7 electronic databases, we identified RCTs of AP with ITCWM interventions published in both English and Chinese from 1 st Jan 2017 to 6 th Aug 2022. The general characteristics of included studies were summarized, further, the quality of reporting was assessed based on three Checklists, including the CONSORT with 36 items (except for one item 1b about abstract), the CONSORT for abstracts (17 items), and a self-designed ITCWM-related checklist (21 items covering rationale and details of interventions, outcome assessment and analysis). The quality of RCTs published in English and Chinese, as well as journals and dissertations were also compared. Results A total of 451 eligible RCTs were included. For the reporting compliance, the mean score (95% Confidence Interval) of the CONSORT (72 scores in total), CONSORT for abstract (34 scores in total), and ITCWM-related (42 scores in total) checklists was 27.82 (27.44–28.19), 14.17 (13.98–14.37) and 21.06 (20.69–21.43), respectively. More than half items were evaluated as poor quality (reporting rate < 50%) among each Checklist. Moreover, the reporting quality of publications in English journals was higher than that in Chinese journals in terms of the CONSORT items. The reporting of published dissertations was better than that in journal publications regarding both the CONSORT and ITCWM-specific items. Conclusion Although the CONSORT appears to have enhanced the reporting of RCTs in AP, the quality of ITCWM specifics is variable and in need of improvement. Reporting guideline of the ITCWM recommendations should be developed thus to improve their quality.

Sweating is a common physiological and pathological phenomenon in the human body. Pathological sweating is most likely to occur when the balance of Yin and Yang is disturbed and the heart and lungs are out of order. There are many phrases describing sweating in the Yellow Emperor’s Inner Classic, which can be divided into three categories, indicating the state of profuse sweating, the time or cause of sweating, the degree and the prognosis of sweating, all with brief and concise concepts. However, the meaning of “Corporeal Soul（Po） Sweat” has been interpreted differently by medical practitioners throughout the ages, and a unified understanding of its meaning has yet to emerge.The meaning and clinical significance of “Corporeal Soul（Po） Sweat” is discussed in relation to the original text of the Yellow Emperor’s Inner Classic and its understanding and clinical practice by later medical practitioners. “Corporeal Soul Sweat” should be interpreted as a severe degree of sweating, emphasizing the depletion of essence with a poor prognosis. In cases of prolonged sweating or profuse sweating, or even abnormalities of the corporeal soul（Po） such as abnormal limb movements, dulled perception and dysfunction of the organs, the major treatment should be to tonify the essence.

The calculation model is the core content which directly related to the scientificity and accuracy of yunqi theory. However, in modern times, the dividing pattern of annual cycle widely adopted is a five-step model and a sixstep model. The five yun model, with each step of 73.05 days, includes zhuyun and keyun. The six qi model, with each step of 60.875 days, includes zhuqi and keqi. But in fact, when we calculate the yunqi characteristics of each period of annual cycle, there is a disagreement between yun and qi of specific time which has complexity and disadvantages. As a result, the prediction and application of yunqi theory cannot be achieved. However, this model is not the original meaning of the seven chapters of yunqi in Huangdi Neijing, which originated from LIU Wen-shu in the Northern Song dynasty, and inherited from ZHANG Jie-bin in the Ming dynasty. Later, it was regarded as the criterion by doctors, and the yunqi theory in Huangdi Neijing was misunderstood for thousands of years. This paper explains the combined mode of yunqi in Suwen in detail, which based on the contents of seven chapters of yunqi in Huangdi Neijing and the ancient calendar, in order to correct the yunqi theory of Huangdi Neijing in academic circles.

《黄帝内经》"阳化气"理论提示,气从阳化阴精而来,要想体内之气源源不断,首先要保证人体阴阳之气充足,使气化有源,源有所化.仲景根据虚劳病不同的特点,以桂枝汤为基础方,灵活加减,将其广泛应用于各种虚证的治疗.桂枝汤不仅是传统意义上的解表之剂,更重要的是有补益之效,在补肾填精药的基础上加温阳药,可使气化有源,以补脏腑之虚.

本文基于《黄帝内经》运气七篇,通过对其年内历法不同模式的形成、发展及应用进行文献溯源,提出《黄帝内经》运气七篇的历法体系是多元思想影响下的集合.六节气位划分是以天文观测为据,在成熟的阴阳合历基础上,受《周易》"大明终始,六位时成"和《周髀算经》七衡六间图思想共同影响形成的独特历法体系;四季与二十四节气的应用是气象物候观测的实际需求,是在农耕文明影响下运气理论趋向实践的应用体现;五时的划分模式受五行文化思想影响而成,具有浓郁的文化色彩.三者相较,六节气位具有精密的历算系统与规则,理论属性强,在运气理论演算模式中占据主导地位;四季与二十四节气用于实用观象,实践属性多;而五时模式则与五行文化思想一脉相承,是文化渗透的体现.

本研究分析20年来五运六气与气象相关的研究现状,从研究的问题、地域、周期、方法及团队特征等方面进行述评,发现虽然取得了明显进步,但在研究的系统性与规范性方面仍有不足,如研究问题方面,气象因素选择不统一,六气起始点研究结论各执一词,以气象研究评价运气推演角度各异,极端气候研究不足;研究地域选择上缺乏系统化大规模研究,研究周期选择具有随意性,研究方法选择不规范,研究团队间未能优势互补.对不同研究结果缺乏有效评价与整合,在领域内未能建立可推广的研究范式.建议今后应重视研究的方案设计,加强多地域、多学科、多团队等系统整合,针对关键问题建立研究范式,以期更客观准确地揭示运气理论的科学内涵.

目前中医学界多认为胸痹病属于现代医学之冠状动脉粥样硬化性心脏病,但笔者认为,在病位上胸痹应包括心、肺两个脏的疾病;在病机上,二脏有差异,心之病多虚、肺之病多实;在治疗上,二者用药各有侧重,于心则温阳益气通脉、于肺则祛痰化饮理气,一偏补、一重泻.目前中医界对冠状动脉粥样硬化性心脏病治疗偏于活血化瘀疗法,是以泻为主,既非补心,又不属泻肺,实则仅适用于部分冠状动脉粥样硬化性心脏病后期的协同治疗,有以偏概全之嫌,反而易于引发临床冠状动脉粥样硬化性心脏病的治疗进入误区,当仔细甄别.

目的:研究山东地区精神类疾病发病与岁运的关系.方法:对2016年1月1日至2017年12月31日山东省精神卫生中心住院的无明显发病诱因的精神类疾病住院患者4387例的发病岁运进行描述性统计,并通过卡方检验和Logistic逻辑回归分析其差异.结果:精神分裂症、心境障碍和分离性障碍3种精神类疾病均于土运不及之年发病人数最多,发病风险由大到小依次为分离性障碍、心境障碍和精神分裂症.结论:土运不及之年为山东省精神类疾病的高发年份,提示精神类疾病可能以中焦虚损为本质,临床上应重视调理脾胃功能在治疗神志病中的作用.

基于西医学的认知,脑具有感觉、思维、记忆、调控躯体及内脏活动等功能,为人体神机之主.然而《黄帝内经》却明确提出"心主神明",现学界多认为其为哲学模式思维推演下的结果.本团队通过梳理相关内容,发现《黄帝内经》对脑的解剖位置、组织特征以及主司神明的功能已有清晰的认识,而部分篇章之所以将神归属于心,是源于古人在临床实践过程中认识到气血的充盈及通畅与否对脑功能影响较大,基于解剖学心主血脉的认识,即心的功能正常与否对气血是否通畅发挥着至关重要的作用,故将神配属于心,心主血脉为心主神明的理论基础.客观阐释"心主神明"的临床内涵,对于治疗"神"的病变具有重要的指导意义.

关、阖、枢理论出自《黄帝内经》,对其理论内涵的解读历代分歧甚大.本文通过还原其出处经文《灵枢·根结》《素问·阴阳离合论》《素问·皮部论》的成篇背景,提出关、阖、枢应视为经、络、皮部联系系统的功能模式,其中阳经之气受天阳之气的影响而布散于表,开气门而与天气相通,主外之皮肉筋骨;阴经之气受水谷之气充养,回输腑脏.阴阳经又以关、阖、枢的形式气化相通,构成人身内之脏腑、外之皮肉筋骨与外界沟通之门户.《素问·皮部论》补充了内外邪气按三阴三阳关-阖-枢传变的模式,并为用调经刺络法治疗外经病和脏腑病提供理论依据.

Inconsistencies were discovered in the findings regarding the effects of meteorological factors on tuberculosis (TB). This study conducted a systematic review of published studies on the relationship between TB and meteorological factors and used a meta-analysis to investigate the pooled effects in order to provide evidence for future research and policymakers. The literature search was completed by August 3rd, 2021, using three databases: PubMed, Web of Science and Embase. Relative risks (RRs) in included studies were extracted and all effect estimates were combined together using meta-analysis. Subgroup analyses were carried out based on the resolution of exposure time, regional climate, and national income level. A total of eight studies were included after screening for inclusion and exclusion criteria. Our results show that TB risk was positively correlated with precipitation (RR = 1.32, 95% CI: 1.14, 1.51), while temperature (RR = 1.15, 95% CI: 1.00, 1.32), humidity (RR = 1.05, 95% CI: 0.99, 1.10), air pressure (RR = 0.89, 95% CI: 0.69, 1.14) and sunshine duration (RR = 0.95, 95% CI: 0.80, 1.13) all had no statistically significant correlation. Subgroup analysis shows that quarterly measure resolution, low and middle Human Development Index (HDI) level and subtropical climate increase TB risk not only in precipitation, but also in temperature and humidity. Moreover, less heterogeneity was observed in "high and extremely high" HDI areas and subtropical areas than that in other subgroups (I-2 = 0%). Precipitation, a subtropical climate, and a low HDI level are all positive influence factors to tuberculosis. Therefore, residents and public health managers should take precautionary measures ahead of time, especially in extreme weather conditions.