BACKGROUND Crohn's disease(CD)frequently leads to intestinal strictures,which pose significant challenges due to their complexity and limited treatment options.While medications can address inflammatory strictures...BACKGROUND Crohn's disease(CD)frequently leads to intestinal strictures,which pose significant challenges due to their complexity and limited treatment options.While medications can address inflammatory strictures,they are largely ineffective for fibrotic and mixed strictures,often necessitating surgical intervention.However,surgery carries considerable risks,including bleeding,infection,anastomotic leaks,and postoperative restricture formation.Endoscopic treatment,particularly endoscopic stricturotomy,offers a minimally invasive alternative that bridges the gap between medication and surgery.AIM To investigate the safety and efficacy of stricturotomy under single-balloon enteroscopy in stricturing CD.METHODS Patients diagnosed with stricturing CD at The First People's Hospital of Changzhou from June 2020 to April 2024 were enrolled and underwent endoscopic stricturotomy(ES).Relevant clinical data of patients were collected retrospectively.Outcomes included success rate,remission time,complications,and follow-up interventions.This observational study was followed up postoperatively to observe patient remission and recurrence rates.RESULTS Seventeen endoscopic strictures were created in 11 patients,achieving a 100%immediate success rate without any serious complications.During the follow-up period,stricture recurrence was observed in two patients,resulting in an endoscopic reintervention rate of 18.2%.Additionally,two patients required subsequent surgical intervention,with a surgical treatment rate of 18.2%.One patient experienced bowel obstruction 18 months post-ES and was successfully managed with conservative treatment without surgical intervention.The remission duration after the initial ES treatment was 10.1±8.2 months,with a median remission time of 10 months.CONCLUSION ES is a safe and effective treatment for CD-related strictures and warrants further clinical promotion and application.展开更多
Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and cl...Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and clinical decisions for MCI patients.Methods: Scottish Intercollegiate Guideline Network(SIGN), National Institute for Health and Clinical Excellence(NICE), American Academy of Neurology(AAN), Registered Nurses Association of Ontario(RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure(CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation(AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews(AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach was used to evaluate the quality of outcomes.Results: Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions(including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4(13%), low for 10(32%), and moderate for 17(55%).Conclusions: Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.展开更多
The cohort study by Li et al provides timely and clinically relevant evidence on the use of recombinant human thrombopoietin(rhTPO)in pediatric allogeneic hematopoietic stem cell transplantation.The authors report enh...The cohort study by Li et al provides timely and clinically relevant evidence on the use of recombinant human thrombopoietin(rhTPO)in pediatric allogeneic hematopoietic stem cell transplantation.The authors report enhanced platelet engraftment and a favorable safety profile,particularly in younger children aged 0-9 years.This age-dependent difference not only highlights the physiological responsiveness of early hematopoietic environments to rhTPO but also raises important questions about tailoring supportive therapies across pediatric age groups.While the findings are promising,the lack of a control group and single-center limitations warrant further multicenter,long-term investigations.Ne-vertheless,the study lays a compelling foundation for integrating rhTPO more broadly into pediatric transplant protocols and for advancing individualized post-transplant care.展开更多
Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia a...Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.展开更多
Five meroterpenoids,rhodonoids K-M(1-2),daurichromene E(3),and grifolins A-B(4-5),together with seven known compounds(6-12),were isolated from Rhododendron anthopogonoides.The chemical structures of these compounds we...Five meroterpenoids,rhodonoids K-M(1-2),daurichromene E(3),and grifolins A-B(4-5),together with seven known compounds(6-12),were isolated from Rhododendron anthopogonoides.The chemical structures of these compounds were elucidated through comprehensive analysis of high-resolution electrospray ionization mass spectrometry(HR-ESI-MS),ultraviolet(UV),infrared spectroscopy(IR),and nuclear magnetic resonance(NMR)data.Their absolute configurations were determined by comparing experimental electronic circular dichroism(ECD)spectra with computed values.Notably,compounds 1 and 3 demonstrated significant inhibitory effects on lipopolysaccharide(LPS)-induced inflammation in RAW264.7 cells.These compounds markedly suppressed the mRNA expressions of inflammatory factors,including interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)while also down-regulating the protein expressions of inducible nitric oxide synthase(iNOS)and cyclooxygenase-2(COX-2).展开更多
[目的]获取与轻度认知功能障碍(MCI)运动干预相关的指南、系统评价或Meta分析,对其进行证据总结与评价,以期为MCI病人相关指南推荐意见的制定提供参考性建议。[方法]计算机检索加拿大安大略注册护士协会(Registered Nurses Association ...[目的]获取与轻度认知功能障碍(MCI)运动干预相关的指南、系统评价或Meta分析,对其进行证据总结与评价,以期为MCI病人相关指南推荐意见的制定提供参考性建议。[方法]计算机检索加拿大安大略注册护士协会(Registered Nurses Association of Ontario,RNAO)、美国神经病协会(American Academy of Neurology,AAN)、英国国家卫生与临床优化研究所(National Institute for Health and Clinical Excellence,NICE)、苏格兰院际指南网(Scottish Intercollegiate Guideline Network,SIGN)、PubMed、Cochrane library、Web of science、CINAHL、CNKI、万方及维普数据库获得相关指南及系统评价,检索时限从2014年1月—2018年2月。采用AMSTAR 2评价工具对文献质量进行评价,必要时应用GRADE工具对证据体进行证据分级,针对指南的质量评价采用AGREEⅡ标准进行评价。[结果]最终纳入1篇指南,12篇系统评价/Meta分析,AMASTA 2评价结果显示,9篇文献为中等质量。GRADE证据质量评价显示,3个证据体证据质量为高质量,11个证据体为中等质量,10个证据体为低质量,3个证据体为极低质量。[结论]运动干预具有较好的疗效,可作为MCI病人的临床辅助治疗措施,但运动干预对MCI病人干预效果系统评价的方法学质量总体不高,其真实效果有待大样本、高质量的研究进一步探讨。展开更多
文摘BACKGROUND Crohn's disease(CD)frequently leads to intestinal strictures,which pose significant challenges due to their complexity and limited treatment options.While medications can address inflammatory strictures,they are largely ineffective for fibrotic and mixed strictures,often necessitating surgical intervention.However,surgery carries considerable risks,including bleeding,infection,anastomotic leaks,and postoperative restricture formation.Endoscopic treatment,particularly endoscopic stricturotomy,offers a minimally invasive alternative that bridges the gap between medication and surgery.AIM To investigate the safety and efficacy of stricturotomy under single-balloon enteroscopy in stricturing CD.METHODS Patients diagnosed with stricturing CD at The First People's Hospital of Changzhou from June 2020 to April 2024 were enrolled and underwent endoscopic stricturotomy(ES).Relevant clinical data of patients were collected retrospectively.Outcomes included success rate,remission time,complications,and follow-up interventions.This observational study was followed up postoperatively to observe patient remission and recurrence rates.RESULTS Seventeen endoscopic strictures were created in 11 patients,achieving a 100%immediate success rate without any serious complications.During the follow-up period,stricture recurrence was observed in two patients,resulting in an endoscopic reintervention rate of 18.2%.Additionally,two patients required subsequent surgical intervention,with a surgical treatment rate of 18.2%.One patient experienced bowel obstruction 18 months post-ES and was successfully managed with conservative treatment without surgical intervention.The remission duration after the initial ES treatment was 10.1±8.2 months,with a median remission time of 10 months.CONCLUSION ES is a safe and effective treatment for CD-related strictures and warrants further clinical promotion and application.
基金supported by Basic Science Research Program through the National Natural Science Foundation of China Youth Program(No.NNSF-81603496)
文摘Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and clinical decisions for MCI patients.Methods: Scottish Intercollegiate Guideline Network(SIGN), National Institute for Health and Clinical Excellence(NICE), American Academy of Neurology(AAN), Registered Nurses Association of Ontario(RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure(CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation(AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews(AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach was used to evaluate the quality of outcomes.Results: Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions(including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4(13%), low for 10(32%), and moderate for 17(55%).Conclusions: Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.
文摘The cohort study by Li et al provides timely and clinically relevant evidence on the use of recombinant human thrombopoietin(rhTPO)in pediatric allogeneic hematopoietic stem cell transplantation.The authors report enhanced platelet engraftment and a favorable safety profile,particularly in younger children aged 0-9 years.This age-dependent difference not only highlights the physiological responsiveness of early hematopoietic environments to rhTPO but also raises important questions about tailoring supportive therapies across pediatric age groups.While the findings are promising,the lack of a control group and single-center limitations warrant further multicenter,long-term investigations.Ne-vertheless,the study lays a compelling foundation for integrating rhTPO more broadly into pediatric transplant protocols and for advancing individualized post-transplant care.
基金supported by the Major Programs of Public Health of the Chinese Ministry of Finance(grant number 131091106000150003)。
文摘Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.
基金supported by the second batch of Bureaulevel Projects of the Xizang Medicine Administration of the Xizang Autonomous Region in 2020(No.JJKT20200024).
文摘Five meroterpenoids,rhodonoids K-M(1-2),daurichromene E(3),and grifolins A-B(4-5),together with seven known compounds(6-12),were isolated from Rhododendron anthopogonoides.The chemical structures of these compounds were elucidated through comprehensive analysis of high-resolution electrospray ionization mass spectrometry(HR-ESI-MS),ultraviolet(UV),infrared spectroscopy(IR),and nuclear magnetic resonance(NMR)data.Their absolute configurations were determined by comparing experimental electronic circular dichroism(ECD)spectra with computed values.Notably,compounds 1 and 3 demonstrated significant inhibitory effects on lipopolysaccharide(LPS)-induced inflammation in RAW264.7 cells.These compounds markedly suppressed the mRNA expressions of inflammatory factors,including interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)while also down-regulating the protein expressions of inducible nitric oxide synthase(iNOS)and cyclooxygenase-2(COX-2).
文摘[目的]获取与轻度认知功能障碍(mild cognitive impairment,MCI)病人或照护者真实体验(患病后、接受某一干预后等)有关的近年来的系统评价或Meta整合,对其进行证据总结,以期为MCI病人相关指南推荐意见的制定提供参考性建议。[方法]在Web of Science、PubMed、CINAHL、Cochrane、中国知网、维普中文科技期刊、万方等中英文数据库进行系统性检索,采用JBI循证卫生保健中心(2008)的评价工具对质性研究原始研究进行质量评价,必要时采用CERQual对证据体进行分级。通过反复阅读最佳证据的内容,提取相应信息。[结果]共纳入2篇质性研究系统评价,该系统评价纳入的原始研究质量均较高,研究表明多数病人或照护者对辅助或改善认知能力相关技术保持积极的态度,但在实际应用时仍有诸多考虑。此外,经CERQual评价后,有中等质量的证据显示,MCI病人对生活呈现新的认识,且对MCI相关的医学知识欠缺深入的了解。[结论]本研究总结MCI病人或照护者真实体验的最佳证据,为临床护理专家或政策制定者提供循证支持。但目前最佳证据的数量及证据力度尚显薄弱,可能对研究结果的诠释带来影响,未来期待更多关于MCI病人或照护者真实体验的质性研究和更高质量的Meta整合。
文摘[目的]获取与轻度认知功能障碍(MCI)运动干预相关的指南、系统评价或Meta分析,对其进行证据总结与评价,以期为MCI病人相关指南推荐意见的制定提供参考性建议。[方法]计算机检索加拿大安大略注册护士协会(Registered Nurses Association of Ontario,RNAO)、美国神经病协会(American Academy of Neurology,AAN)、英国国家卫生与临床优化研究所(National Institute for Health and Clinical Excellence,NICE)、苏格兰院际指南网(Scottish Intercollegiate Guideline Network,SIGN)、PubMed、Cochrane library、Web of science、CINAHL、CNKI、万方及维普数据库获得相关指南及系统评价,检索时限从2014年1月—2018年2月。采用AMSTAR 2评价工具对文献质量进行评价,必要时应用GRADE工具对证据体进行证据分级,针对指南的质量评价采用AGREEⅡ标准进行评价。[结果]最终纳入1篇指南,12篇系统评价/Meta分析,AMASTA 2评价结果显示,9篇文献为中等质量。GRADE证据质量评价显示,3个证据体证据质量为高质量,11个证据体为中等质量,10个证据体为低质量,3个证据体为极低质量。[结论]运动干预具有较好的疗效,可作为MCI病人的临床辅助治疗措施,但运动干预对MCI病人干预效果系统评价的方法学质量总体不高,其真实效果有待大样本、高质量的研究进一步探讨。
