BACKGROUND Depression is a common mental-health disorder worldwide.Several studies have demonstrated the effects of gut microbiota-targeting interventions,such as probiotics,prebiotics,synbiotics,and postbiotics(PPSP)...BACKGROUND Depression is a common mental-health disorder worldwide.Several studies have demonstrated the effects of gut microbiota-targeting interventions,such as probiotics,prebiotics,synbiotics,and postbiotics(PPSP),on depression.AIM To assess the potential benefits of PPSP on patients diagnosed with depressive disorder.METHODS A literature search of the PubMed,Web of Science,and Elsevier Science Direct databases for relevant studies published from database inception to March 2024 was performed.Studies that used a randomized controlled trial design and eva-luated differences in depression between PPSP and placebo were included.Depressive symptoms were assessed using a validated scale.Analysis was performed using Review Manager version 5.4(The Cochrane Collaboration,2020).RESULTS Fourteen studies comprising 906 patients with depressive symptoms were included.PPSP improved depression compared with placebo[SMD:-0.39(95%CI:-0.60 to-0.17);P<0.001].PPSP resulted in significant reductions in Hamilton Depression Rating Scale[MD:-1.72(95%CI:-2.57 to-0.88);P<0.001]and Beck Depression Inventory[MD:-2.69(95%CI:-4.67 to-0.71);P<0.001]scores.Sub-analysis confirmed the antidepressant effects of probiotics on depressive symp-toms[SMD:-0.32(95%CI:-0.48 to-0.16);P<0.001],with prebiotics exerting no apparent effect[SMD:-0.08(95%CI:-0.39 to-0.23);P=0.62],and synbiotics exerting statistically significant benefits[SMD:-1.09(95%CI:-1.45 to-0.73);P<0.001].CONCLUSION PPSP effectively alleviates depressive symptoms,and subgroup analysis supports the benefits of probiotics and synbiotics.Nevertheless,evidence supporting the use of PPSP for the treatment of depression remains insufficient.展开更多
BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes o...BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.展开更多
Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) that is characterized by excessive synthesis of parathyroid hormone (PTH) and parathyroid hyperplasia.The prevalence of CKD...Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) that is characterized by excessive synthesis of parathyroid hormone (PTH) and parathyroid hyperplasia.The prevalence of CKD is estimated to be 5-10%, and the burden of CKD-associated diseases is alarmingly high.Despite advances in medical therapy for SHPT, surgical parathyroidectomy remains the definitive therapy for refractory SHPT, which drastically decreases PTH levels and ameliorates symptoms related to severe SHPT.展开更多
Background The global spread of coronavirus disease 2019(COVID-19)continues to threaten human health security,exerting considerable pressure on healthcare systems worldwide.While prognostic models for COVID-19 hospita...Background The global spread of coronavirus disease 2019(COVID-19)continues to threaten human health security,exerting considerable pressure on healthcare systems worldwide.While prognostic models for COVID-19 hospitalized or intensive care patients are currently available,prognostic models developed for large cohorts of thousands of individuals are still lacking.Methods Between February 4 and April 16,2020,we enrolled 3,974 patients admitted with COVID-19 disease in the Wuhan Huo-Shen-Shan Hospital and the Maternal and Child Hospital,Hubei Province,China.(1)Screening of key prognostic factors:A univariate Cox regression analysis was performed on 2,649 patients in the training set,and factors affecting prognosis were initially screened.Subsequently,a random survival forest model was established through machine analysis to further screen for factors that are important for prognosis.Finally,multivariate Cox regression analysis was used to determine the synergy among various factors related to prognosis.(2)Establishment of a scoring system:The nomogram algorithm established a COVID-19 patient death risk assessment scoring system for the nine selected key prognostic factors,calculated the C index,drew calibration curves and drew training set patient survival curves.(3)Verification of the scoring system:The scoring system assessed 1,325 patients in the test set,splitting them into high-and low-risk groups,calculated the C-index,and drew calibration and survival curves.Results The cross-sectional study found that age,clinical classification,sex,pulmonary insufficiency,hypoproteinemia,and four other factors(underlying diseases:blood diseases,malignant tumor;complications:digestive tract bleeding,heart dysfunction)have important significance for the prognosis of the enrolled patients with COVID-19.Herein,we report the discovery of the effects of hypoproteinemia and hematological diseases on the prognosis of COVID-19.Meanwhile,the scoring system established here can effectively evaluate objective scores for the early prognoses of patients with COVID-19 and can divide them into high-and low-risk groups(using a scoring threshold of 117.77,a score below which is considered low risk).The efficacy of the system was better than that of clinical classification using the current COVID-19 guidelines(C indexes,0.95 vs.0.89).Conclusions Age,clinical typing,sex,pulmonary insufficiency,hypoproteinemia,and four other factors were important for COVID-19 survival.Compared with general statistical methods,this method can quickly and accurately screen out the relevant factors affecting prognosis,provide an order of importance,and establish a scoring system based on the nomogram model,which is of great clinical significance.展开更多
To the Editor: Viral hepatitis is a major public health concern worldwide, and hepatitis B virus (HBV), with which two billion people infected globally, has been commonly reported to undergo reactivation during chemot...To the Editor: Viral hepatitis is a major public health concern worldwide, and hepatitis B virus (HBV), with which two billion people infected globally, has been commonly reported to undergo reactivation during chemotherapy for malignancies. Some literatures have reported hepatitis C virus (HCV) reactivationin hematological malignancies.展开更多
文摘BACKGROUND Depression is a common mental-health disorder worldwide.Several studies have demonstrated the effects of gut microbiota-targeting interventions,such as probiotics,prebiotics,synbiotics,and postbiotics(PPSP),on depression.AIM To assess the potential benefits of PPSP on patients diagnosed with depressive disorder.METHODS A literature search of the PubMed,Web of Science,and Elsevier Science Direct databases for relevant studies published from database inception to March 2024 was performed.Studies that used a randomized controlled trial design and eva-luated differences in depression between PPSP and placebo were included.Depressive symptoms were assessed using a validated scale.Analysis was performed using Review Manager version 5.4(The Cochrane Collaboration,2020).RESULTS Fourteen studies comprising 906 patients with depressive symptoms were included.PPSP improved depression compared with placebo[SMD:-0.39(95%CI:-0.60 to-0.17);P<0.001].PPSP resulted in significant reductions in Hamilton Depression Rating Scale[MD:-1.72(95%CI:-2.57 to-0.88);P<0.001]and Beck Depression Inventory[MD:-2.69(95%CI:-4.67 to-0.71);P<0.001]scores.Sub-analysis confirmed the antidepressant effects of probiotics on depressive symp-toms[SMD:-0.32(95%CI:-0.48 to-0.16);P<0.001],with prebiotics exerting no apparent effect[SMD:-0.08(95%CI:-0.39 to-0.23);P=0.62],and synbiotics exerting statistically significant benefits[SMD:-1.09(95%CI:-1.45 to-0.73);P<0.001].CONCLUSION PPSP effectively alleviates depressive symptoms,and subgroup analysis supports the benefits of probiotics and synbiotics.Nevertheless,evidence supporting the use of PPSP for the treatment of depression remains insufficient.
文摘BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.
文摘Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) that is characterized by excessive synthesis of parathyroid hormone (PTH) and parathyroid hyperplasia.The prevalence of CKD is estimated to be 5-10%, and the burden of CKD-associated diseases is alarmingly high.Despite advances in medical therapy for SHPT, surgical parathyroidectomy remains the definitive therapy for refractory SHPT, which drastically decreases PTH levels and ameliorates symptoms related to severe SHPT.
基金supported by National Key Research and Development Program of China(2020YFC2002706).
文摘Background The global spread of coronavirus disease 2019(COVID-19)continues to threaten human health security,exerting considerable pressure on healthcare systems worldwide.While prognostic models for COVID-19 hospitalized or intensive care patients are currently available,prognostic models developed for large cohorts of thousands of individuals are still lacking.Methods Between February 4 and April 16,2020,we enrolled 3,974 patients admitted with COVID-19 disease in the Wuhan Huo-Shen-Shan Hospital and the Maternal and Child Hospital,Hubei Province,China.(1)Screening of key prognostic factors:A univariate Cox regression analysis was performed on 2,649 patients in the training set,and factors affecting prognosis were initially screened.Subsequently,a random survival forest model was established through machine analysis to further screen for factors that are important for prognosis.Finally,multivariate Cox regression analysis was used to determine the synergy among various factors related to prognosis.(2)Establishment of a scoring system:The nomogram algorithm established a COVID-19 patient death risk assessment scoring system for the nine selected key prognostic factors,calculated the C index,drew calibration curves and drew training set patient survival curves.(3)Verification of the scoring system:The scoring system assessed 1,325 patients in the test set,splitting them into high-and low-risk groups,calculated the C-index,and drew calibration and survival curves.Results The cross-sectional study found that age,clinical classification,sex,pulmonary insufficiency,hypoproteinemia,and four other factors(underlying diseases:blood diseases,malignant tumor;complications:digestive tract bleeding,heart dysfunction)have important significance for the prognosis of the enrolled patients with COVID-19.Herein,we report the discovery of the effects of hypoproteinemia and hematological diseases on the prognosis of COVID-19.Meanwhile,the scoring system established here can effectively evaluate objective scores for the early prognoses of patients with COVID-19 and can divide them into high-and low-risk groups(using a scoring threshold of 117.77,a score below which is considered low risk).The efficacy of the system was better than that of clinical classification using the current COVID-19 guidelines(C indexes,0.95 vs.0.89).Conclusions Age,clinical typing,sex,pulmonary insufficiency,hypoproteinemia,and four other factors were important for COVID-19 survival.Compared with general statistical methods,this method can quickly and accurately screen out the relevant factors affecting prognosis,provide an order of importance,and establish a scoring system based on the nomogram model,which is of great clinical significance.
基金This study was supported by the grants from the Graduate Student's Science Innovation Project of Chongqing(No.CYS 16124)National Natural Science Foundation of China (No. 81372851).
文摘To the Editor: Viral hepatitis is a major public health concern worldwide, and hepatitis B virus (HBV), with which two billion people infected globally, has been commonly reported to undergo reactivation during chemotherapy for malignancies. Some literatures have reported hepatitis C virus (HCV) reactivationin hematological malignancies.
