Bruton’s tyrosine kinase inhibitors(BTKis)have revolutionized the treatment of B-cell lymphomas.However,safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy.A...Bruton’s tyrosine kinase inhibitors(BTKis)have revolutionized the treatment of B-cell lymphomas.However,safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy.A comprehensive and systematic expert consensus from a pharmacological perspective is lacking for safety issues associated with BTKi treatment.A multidisciplinary consensus working group was established,comprising 35 members from the fields of hematology,cardiovascular disease,cardio-oncology,clinical pharmacy,and evidencebased medicine.This evidence-based expert consensus was formulated using an evidence-based approach and the Delphi method.The Joanna Briggs Institute Critical Appraisal(JBI)tool and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach were used to rate the quality of evidence and grade the strength of recommendations,respectively.This consensus provides practical recommendations for BTKis medication based on nine aspects within three domains,including the management of common adverse drug events such as bleeding,cardiovascular events,and hematological toxicity,as well as the management of drug-drug interactions and guidance for special populations.This multidisciplinary expert consensus could contribute to promoting a multi-dimensional,comprehensive and standardized management of BTKis.展开更多
Sepsis is a life-threatening inflammatory syndrome with high morbidity and mortality rates.However,options for sepsis are still limited to general treatment in intensive care units(ICUs),and effective therapies that i...Sepsis is a life-threatening inflammatory syndrome with high morbidity and mortality rates.However,options for sepsis are still limited to general treatment in intensive care units(ICUs),and effective therapies that improve sepsis survival are required.Immune disturbances play a vital role in the pathology of sepsis and are associated with protracted inflammation,susceptibility to infections,and death.Therefore,many investigators have focused on the potential benefits of immunomodulation therapy for sepsis.Electroacupuncture(EA)has been practiced in clinics for many years and has shown advantages in treating infectious diseases.Over the last few decades,our understanding of the efficacy and mechanisms of EA in sepsis has undergone considerable developments.We searched the literature regarding“CNKI,Wan Fang Data,VIP Database,PubMed,and Ingenta Connect”from 2010 to 2023,using the keywords“sepsis”“septic”and“electroacupuncture”and 336 sources were searched.Finally,we included 82 studies that targeted the immune system to determine EA’s anti-inflammatory and immunomodulatory effects on sepsis.In this review,we found that EA has clinical benefits in relieving septic inflammation,improving immune function,and attenuating related multi-organ injury through several mechanisms,such as activation of the cholinergic anti-inflammatory pathway(CAP),vagaladrenal axis,inhibition of the nuclear factor Kappa-B(NF-κB)signaling pathway,signal transducers and activators of transcription(STAT)signaling pathway,and improvement of immune cell function.Therefore,EA may be a promising complementary therapy for sepsis treatment.We also expect these data will contribute to further studies on EA in sepsis.展开更多
Objective: To confirm whether self-administered AVNA treatment is effective in improving emotional distressunder the COVID-19 pandemic.Methods: A smartphone-based online, randomized, controlled trial was designed from...Objective: To confirm whether self-administered AVNA treatment is effective in improving emotional distressunder the COVID-19 pandemic.Methods: A smartphone-based online, randomized, controlled trial was designed from 26 February 2020 to 28April 2020 in four study sites, including Wuhan, Beijing, Shenyang, and Guangzhou of China. Local residentswho had considerable emotional distress with a score of the Hospital Anxiety and Depression Scale (HADS) ≥9 were recruited. Participants were randomly assigned to three times of AVNA (n = 191) per day, in morning,around noon, and in evening or usual care (UC, n = 215) once daily for 14 days. The primary outcome was theresponse rate, which was the proportion of participants whose Hospital Anxiety and Depression Scale (HADS)score reduced from baseline by ≥ 50%. The assessment was conducted at baseline, 3 days, and 14 days.Results: The AVNA group had a markedly higher response rate than the UC group at 3 days (35.6% vs. 24.9%,P = 0.02) and at 14 days (70.7% vs. 60.6%, P = 0.02). The AVNA group showed significantly greater reductionin scores of HADS at the two measurement points and BAI at 3 days (P ≤ 0.03), with average respective effectsize of 0.217 and 0.195. Participants with AVNA spent less time falling asleep and rated their sleep qualitybeing remarkably higher than those with UC at endpoint.Conclusion: During COVID-19 pandemic period, treatment with self-administrated AVNA was more effectivethan UC in reducing emotional distress of isolated populations. These findings support self-administered AVNAas a treatment option for patients with emotional distress under the COVID-19 pandemic or other emergentevents.展开更多
Infectious diseases such as coronavirus disease 2019(COVID-19)continue to pose significant global health challenges.Effective management of reinfection risks depends on sustained levels of binding and neutralizing ant...Infectious diseases such as coronavirus disease 2019(COVID-19)continue to pose significant global health challenges.Effective management of reinfection risks depends on sustained levels of binding and neutralizing antibodies.However,conventional methods—such as enzyme-linked immunosorbent assays(ELISA)and virus neutralization tests(VNT)—are limited by complex workflows,long assay durations,and high sample volume requirements,making them less suit-able for routine,decentralized,or time-sensitive surveillance.This study presents a custom-developed tip optofluidic immunoassay(TOI)platform that enables rapid,multiplexed antibody profiling using only 1 mL offingertip blood.The system integrates batch-fabricated microfluidic immunoreactors with a portable chemiluminescent imaging station,completing both binding and neutralization capability assessments within 40 min.TOI achieves a broad dynamic range(3–4 orders of magnitude),high signal-to-noise ratio(10,000),and excellent sensitivity for immunoglobulin G(IgG)detection.A renovated version of the rapid in vitro inhibition assay(RIVIA)is incorporated to evaluate neutralizing an-tibodies against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with greater speed and cost-effi-ciency.In clinical studies,TOI successfully quantified antibody protection against multiple variants,identifying individ-uals with broad-spectrum immunity to both wild-type and XBB strains.With its high-precision,rapid turnaround,and minimal sample requirement,TOI offers a valuable tool for decentralized immune surveillance and personalized immu-nization strategy development.展开更多
Chinese ancient medical scientists have long focused on the internal and external contacts between acupoints on the surface of the body and the viscera.The Miraculous Pivot(it is one of the earliest medical classics i...Chinese ancient medical scientists have long focused on the internal and external contacts between acupoints on the surface of the body and the viscera.The Miraculous Pivot(it is one of the earliest medical classics in China)stated,“Twelve regular channels belong to the zang-fu organs internally,and connect to the extremities and joints externally.”Traditional Chinese medicine considers acupoints as defined areas where the Qi of viscera and meridians are transfused.These include the reaction points of visceral diseases on the body surface as well as the acupuncture trigger points that promote the flow of Qi and blood,and regulate visceral function.Chinese ancient medical scientists classified the specificity of the main acupoints in the body based on the meridian doctrine,which has been instructing clinical application for about 2000 years.Laws on the domino effect of acupoints have mainly focused on conclusions to clinical experiences.Indications of some acupoints exceed the practical paradigm since the excessive extension occurred during theory derivation.The current research direction on acupuncture focuses on three aspects:the effectiveness of acupuncture and moxibustion;the relevances and associations between meridians and viscera;and the physical and chemical properties and relevant physical basis of acupoints.The relevance between meridians and viscera is the central theory in the meridian doctrine,and acupoints are regarded as an important link in the relationship between meridians and viscera.Specific relationships between acupoints and target organs exist.Stimulating different acupoints on the body surface can help deal with different diseases,especially visceral diseases.In addition,acupoints have a dual function of reflecting and treating visceral diseases.There is no systemic research available on acupoint specificity,despite current knowledge and clinical experiences,which results in a weak foundation for acupuncture theory.This study focuses on the relevance and associations between meridians and viscera.A summary of the mechanisms of acupuncture regulating visceral sensation and mobility and the specific relationships between acupoints and their target organs are presented in this review.展开更多
Comorbid depression and anxiety causes serious psychological and physiological damage for older people.This study aimed to identify heterogeneous classes of comorbid depression and anxiety(CDA)among older people in Ch...Comorbid depression and anxiety causes serious psychological and physiological damage for older people.This study aimed to identify heterogeneous classes of comorbid depression and anxiety(CDA)among older people in China and to ascertain predictors of latent class membership.Cross-sectional data of 10,919 cases were extracted from the Chinese Longitudinal Healthy Longevity Survey.Latent profile analysis(LPA)was used to identify symptom patterns of comorbid depression(measured by the 10-item Center for Epidemiologic Studies Depression Scale)and anxiety(measured by the Generalized Anxiety Disorder 7-item Scale).Multinomial logistic regressions following bivariate analyses were used to explore the relationship between the derived classes and individual-and social-level factors.Four patterns of CDA were identified:low symptoms of depression and anxiety(30.52%;n=3333),mild depression only(53.26%;n=5815),moderate depression and anxiety(13.82%;n=1509),and severe depression and anxiety(2.40%;n=262).Older people who are male,suffer from multimorbidity,and lack a healthy lifestyle are more likely to have problematic symptom profiles.While intimate relationships with partners and children significantly predicted CDA patterns,the effects of sibling relationships,daily life,and emotional support from the community were insignificant.LPA identified four distinct CDA patterns among a representative sample of older Chinese people.While restless sleep,lack of positive emotions,uselessness,and weak concentration are salient across all profiles,“difficult to relax”is prominent in profiles high in anxiety.In addition to individual-level variables,social-level factors,especially intimate relationships with partners and children rather than general links to siblings or the community,have unneglectable impacts on whether and to what extent older Chinese adults suffer from CDA in the cultural context of relationism,patriarchy,and filial piety.展开更多
基金supported by the National Natural Science Foundation of China(NSFC)(No.72074005 and No.72304007)the special fund of the National Clinical Key Specialty Construction Program,P.R.China(2023).
文摘Bruton’s tyrosine kinase inhibitors(BTKis)have revolutionized the treatment of B-cell lymphomas.However,safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy.A comprehensive and systematic expert consensus from a pharmacological perspective is lacking for safety issues associated with BTKi treatment.A multidisciplinary consensus working group was established,comprising 35 members from the fields of hematology,cardiovascular disease,cardio-oncology,clinical pharmacy,and evidencebased medicine.This evidence-based expert consensus was formulated using an evidence-based approach and the Delphi method.The Joanna Briggs Institute Critical Appraisal(JBI)tool and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach were used to rate the quality of evidence and grade the strength of recommendations,respectively.This consensus provides practical recommendations for BTKis medication based on nine aspects within three domains,including the management of common adverse drug events such as bleeding,cardiovascular events,and hematological toxicity,as well as the management of drug-drug interactions and guidance for special populations.This multidisciplinary expert consensus could contribute to promoting a multi-dimensional,comprehensive and standardized management of BTKis.
基金funded by the National Key Research and Development Program(2022YFC3500704)the National Natural Science Foundation of China(82174500,82004491).
文摘Sepsis is a life-threatening inflammatory syndrome with high morbidity and mortality rates.However,options for sepsis are still limited to general treatment in intensive care units(ICUs),and effective therapies that improve sepsis survival are required.Immune disturbances play a vital role in the pathology of sepsis and are associated with protracted inflammation,susceptibility to infections,and death.Therefore,many investigators have focused on the potential benefits of immunomodulation therapy for sepsis.Electroacupuncture(EA)has been practiced in clinics for many years and has shown advantages in treating infectious diseases.Over the last few decades,our understanding of the efficacy and mechanisms of EA in sepsis has undergone considerable developments.We searched the literature regarding“CNKI,Wan Fang Data,VIP Database,PubMed,and Ingenta Connect”from 2010 to 2023,using the keywords“sepsis”“septic”and“electroacupuncture”and 336 sources were searched.Finally,we included 82 studies that targeted the immune system to determine EA’s anti-inflammatory and immunomodulatory effects on sepsis.In this review,we found that EA has clinical benefits in relieving septic inflammation,improving immune function,and attenuating related multi-organ injury through several mechanisms,such as activation of the cholinergic anti-inflammatory pathway(CAP),vagaladrenal axis,inhibition of the nuclear factor Kappa-B(NF-κB)signaling pathway,signal transducers and activators of transcription(STAT)signaling pathway,and improvement of immune cell function.Therefore,EA may be a promising complementary therapy for sepsis treatment.We also expect these data will contribute to further studies on EA in sepsis.
基金the National Key R&D Program of China(No.2018YFC1705800 and No.2018YFC1705801)the Fundamental Research Funds for the Central public welfare research institutes(No.ZZ202017009)General Research Fund(GRF)of Research Grant Council of HKSAR(No.17115017).
文摘Objective: To confirm whether self-administered AVNA treatment is effective in improving emotional distressunder the COVID-19 pandemic.Methods: A smartphone-based online, randomized, controlled trial was designed from 26 February 2020 to 28April 2020 in four study sites, including Wuhan, Beijing, Shenyang, and Guangzhou of China. Local residentswho had considerable emotional distress with a score of the Hospital Anxiety and Depression Scale (HADS) ≥9 were recruited. Participants were randomly assigned to three times of AVNA (n = 191) per day, in morning,around noon, and in evening or usual care (UC, n = 215) once daily for 14 days. The primary outcome was theresponse rate, which was the proportion of participants whose Hospital Anxiety and Depression Scale (HADS)score reduced from baseline by ≥ 50%. The assessment was conducted at baseline, 3 days, and 14 days.Results: The AVNA group had a markedly higher response rate than the UC group at 3 days (35.6% vs. 24.9%,P = 0.02) and at 14 days (70.7% vs. 60.6%, P = 0.02). The AVNA group showed significantly greater reductionin scores of HADS at the two measurement points and BAI at 3 days (P ≤ 0.03), with average respective effectsize of 0.217 and 0.195. Participants with AVNA spent less time falling asleep and rated their sleep qualitybeing remarkably higher than those with UC at endpoint.Conclusion: During COVID-19 pandemic period, treatment with self-administrated AVNA was more effectivethan UC in reducing emotional distress of isolated populations. These findings support self-administered AVNAas a treatment option for patients with emotional distress under the COVID-19 pandemic or other emergentevents.
基金supported by the Outstanding Young Innovator Fund,Shenzhen Institute of Advanced Technology,Chinese Academy of Sciences(to X.T.)the State Key Laboratory of Biomedical Imaging Science and System+5 种基金Shenzhen Basic Research Project of Natural Science Foundation(JCYJ20230808105701004 to Y.C.)Shenzhen Science and Technology Innovations Committee(JSGGZD20220822095200001 to H.Y.)National Science Foundation of China(32270937 to F.Y.)Ministry of Science and Technology of China(2021D0102 to Y.C.)Guangdong Basic and Applied Basic Research Foundation(2025A1515012136 to H.L.)Medicine Plus Program of Shenzhen University(2024YG015 to Y.C.).
文摘Infectious diseases such as coronavirus disease 2019(COVID-19)continue to pose significant global health challenges.Effective management of reinfection risks depends on sustained levels of binding and neutralizing antibodies.However,conventional methods—such as enzyme-linked immunosorbent assays(ELISA)and virus neutralization tests(VNT)—are limited by complex workflows,long assay durations,and high sample volume requirements,making them less suit-able for routine,decentralized,or time-sensitive surveillance.This study presents a custom-developed tip optofluidic immunoassay(TOI)platform that enables rapid,multiplexed antibody profiling using only 1 mL offingertip blood.The system integrates batch-fabricated microfluidic immunoreactors with a portable chemiluminescent imaging station,completing both binding and neutralization capability assessments within 40 min.TOI achieves a broad dynamic range(3–4 orders of magnitude),high signal-to-noise ratio(10,000),and excellent sensitivity for immunoglobulin G(IgG)detection.A renovated version of the rapid in vitro inhibition assay(RIVIA)is incorporated to evaluate neutralizing an-tibodies against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with greater speed and cost-effi-ciency.In clinical studies,TOI successfully quantified antibody protection against multiple variants,identifying individ-uals with broad-spectrum immunity to both wild-type and XBB strains.With its high-precision,rapid turnaround,and minimal sample requirement,TOI offers a valuable tool for decentralized immune surveillance and personalized immu-nization strategy development.
基金supported by grants from the National Basic Research Program of China(973 Project)(2011CB505200)the National Natural Science Foundation of China(Grant Nos.30472133,30772830).
文摘Chinese ancient medical scientists have long focused on the internal and external contacts between acupoints on the surface of the body and the viscera.The Miraculous Pivot(it is one of the earliest medical classics in China)stated,“Twelve regular channels belong to the zang-fu organs internally,and connect to the extremities and joints externally.”Traditional Chinese medicine considers acupoints as defined areas where the Qi of viscera and meridians are transfused.These include the reaction points of visceral diseases on the body surface as well as the acupuncture trigger points that promote the flow of Qi and blood,and regulate visceral function.Chinese ancient medical scientists classified the specificity of the main acupoints in the body based on the meridian doctrine,which has been instructing clinical application for about 2000 years.Laws on the domino effect of acupoints have mainly focused on conclusions to clinical experiences.Indications of some acupoints exceed the practical paradigm since the excessive extension occurred during theory derivation.The current research direction on acupuncture focuses on three aspects:the effectiveness of acupuncture and moxibustion;the relevances and associations between meridians and viscera;and the physical and chemical properties and relevant physical basis of acupoints.The relevance between meridians and viscera is the central theory in the meridian doctrine,and acupoints are regarded as an important link in the relationship between meridians and viscera.Specific relationships between acupoints and target organs exist.Stimulating different acupoints on the body surface can help deal with different diseases,especially visceral diseases.In addition,acupoints have a dual function of reflecting and treating visceral diseases.There is no systemic research available on acupoint specificity,despite current knowledge and clinical experiences,which results in a weak foundation for acupuncture theory.This study focuses on the relevance and associations between meridians and viscera.A summary of the mechanisms of acupuncture regulating visceral sensation and mobility and the specific relationships between acupoints and their target organs are presented in this review.
基金Southeast University Zhishan Young Scholars Support ProgramFoundation for Graduate Researchand Practice Innovation Program of Jiangsu Province,Grant/Award Number:KYCX21_0066。
文摘Comorbid depression and anxiety causes serious psychological and physiological damage for older people.This study aimed to identify heterogeneous classes of comorbid depression and anxiety(CDA)among older people in China and to ascertain predictors of latent class membership.Cross-sectional data of 10,919 cases were extracted from the Chinese Longitudinal Healthy Longevity Survey.Latent profile analysis(LPA)was used to identify symptom patterns of comorbid depression(measured by the 10-item Center for Epidemiologic Studies Depression Scale)and anxiety(measured by the Generalized Anxiety Disorder 7-item Scale).Multinomial logistic regressions following bivariate analyses were used to explore the relationship between the derived classes and individual-and social-level factors.Four patterns of CDA were identified:low symptoms of depression and anxiety(30.52%;n=3333),mild depression only(53.26%;n=5815),moderate depression and anxiety(13.82%;n=1509),and severe depression and anxiety(2.40%;n=262).Older people who are male,suffer from multimorbidity,and lack a healthy lifestyle are more likely to have problematic symptom profiles.While intimate relationships with partners and children significantly predicted CDA patterns,the effects of sibling relationships,daily life,and emotional support from the community were insignificant.LPA identified four distinct CDA patterns among a representative sample of older Chinese people.While restless sleep,lack of positive emotions,uselessness,and weak concentration are salient across all profiles,“difficult to relax”is prominent in profiles high in anxiety.In addition to individual-level variables,social-level factors,especially intimate relationships with partners and children rather than general links to siblings or the community,have unneglectable impacts on whether and to what extent older Chinese adults suffer from CDA in the cultural context of relationism,patriarchy,and filial piety.
