Objective Preliminary assessment of rabies virus neutralizing activity,safety and immunogenicity of a recombinant human rabies antibody(NM57)compared with human rabies immunoglobulin(HRIG)in Chinese healthy adults.Met...Objective Preliminary assessment of rabies virus neutralizing activity,safety and immunogenicity of a recombinant human rabies antibody(NM57)compared with human rabies immunoglobulin(HRIG)in Chinese healthy adults.Methods Subjects were randomly(1:1:1)allocated to Groups A(20 IU/kg NM57),B(40 IU/kg NM57),or C(20 IU/kg HRIG).One injection was given on the day of enrollment.Blood samples were collected on days-7 to 0(pre-injection),3,7,14,28,and 42.Adverse events(AEs)and serious AEs(SAEs)were recorded over a period of 42 days after injection.Results All 60 subjects developed detectable rabies virus neutralizing antibodies(RVNAs)(>0.05 IU/mL)on days 3,7,14,28,and 42.The RVNA levels peaked on day 3 in all three groups,with a geometric mean concentration(GMC)of 0.2139 IU/mL in Group A,0.3660 IU/mL in Group B,and0.1994 IU/mL in Group C.At each follow-up point,the GMC in Group B was significantly higher than that in Groups A and C.The areas under the antibody concentration curve over 0-14 days and 0-42 days in Group B were significantly larger than those in Groups A and C.Fifteen AEs were reported.Except for one grade 2 myalgia in Group C,the other 14 were all grade 1.No SAEs were observed.Conclusion The rabies virus neutralizing activity of 40 IU/kg NM57 was superior to that of 20 IU/kg NM57 and 20 IU/kg HRIG,and the rabies virus neutralizing activity of 20 IU/kg NM57 and 20 IU/kg HRIG were similar.Safety was comparable between NM57 and HRIG.展开更多
BACKGROUND The increased stroke risk associated with atrial fibrillation(AF)burden exceeding 5 min is a matter of debate.In addition,the potential linear or nonlinear relationship between AF burden and stroke risk has...BACKGROUND The increased stroke risk associated with atrial fibrillation(AF)burden exceeding 5 min is a matter of debate.In addition,the potential linear or nonlinear relationship between AF burden and stroke risk has been largely unexplored.AIM To determine the association between AF burden>5 min and the increased risk of stroke and explore the potential dose-response relationship between these two factors.METHODS Sixteen studies from six databases with 53141 subjects(mean age 65 years)were included.Fifteen studies were observational studies,and one was a randomized controlled trial study.The potential nonlinear dose-response association was characterized using a restricted cubic splines regression model.AF burden for each 1 h and 2 h was associated with an increased risk of stroke.Trial sequential analysis with a random-effect model was used to evaluate the robustness of the evidence from the included 16 studies.RESULTS AF burden>5 min was associated with an increased risk of clinical AF[adjusted risk ratio(RR)=4.18,95%confidence interval(CI):2.26-7.74].However,no association was found with an increased risk of all-cause mortality(adjusted RR=1.55,95%CI:0.87-2.75).Patients with AF burden>5 min had an increased risk of stroke(adjusted RR=2.49,95%CI:1.79-3.47).Moreover,a dose-response analysis showed that the increased stroke risk was paralleled by an increase in AF burden at a rate of 2.0%per hour(Pnonlinear=0.656,RR=1.02,95%CI:1.01-1.03).Trial sequential analysis provided robust evidence of the association between AF burden>5 min and an increased risk of stroke.CONCLUSION AF burden was a significant risk factor for clinical AF and future stroke.A significant linear association was documented between increased AF burden and risk of future stroke.展开更多
Objective:This study is conducted to determine effects of manual acupuncture(MA)in patients with a diagnosis of major depressive disorder(MDD)and comorbid insomnia.Methods:A total of 67 participants who met the inclus...Objective:This study is conducted to determine effects of manual acupuncture(MA)in patients with a diagnosis of major depressive disorder(MDD)and comorbid insomnia.Methods:A total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to a real-MA group(patients=34)and a sham-MA group(patients=33).Patients in the real-MA group were treated on‘Five-shen acupoints’,including Sishencong(四神聪EX-HN 1),Shenting(神庭GV 24),Shendao(神道GV 11),bilateral Benshen(本神GB 13),and bilateral Shenmen(神门HT 7).Though being punctured on the same acupoints,patients in the sham-MA group were treated by a placebo acupuncture approach(Streitberger Placeboneedle).Each group received corresponding interventions every other day,three times a week for total eight weeks.Both polysomnography(PSG)and testing of serum biological markers such as neuropeptide Y(NPY)and substance P(SP)were performed at pre-and post-treatment.Additionally,the global scores of Pittsburgh sleep quality index(PSQI)and the global scores of 17-items Hamilton Depression Rating Scale(HAMD17)were used for assessing the subjective sleep and emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After eight-week treatment,the global scores of PSQI and global scores of HAMD17 declined significantly(both P<0.05)in the real-MA group but not in the sham-MA group(both P>0.05).According to the parameters of PSG,striking decline were observed in sleep latency(SL)and wake after sleep onset(WASO)and striking climb were observed in total sleep time(TST)and sleep efficiency(SE)in the real-MA group after treatment(P<0.05,respectively)but not in the sham-MA group(P>0.05,respectively).Additionally,there were no significant differences in awakening times(ATs)and rapid eyes movement sleep latency(REM-SL)in both two groups after treatment(both P>0.05).Meanwhile,the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions(both P<0.05)while those indicators only slightly fluctuated in the sham-MA group(P>0.05).No serious adverse event was reported in either real-or sham-MA group.Conclusion:(1)MA may be a potential alternative therapy for improving MDD and comorbid insomnia(particularly in extending total sleep time and shortening wake-up duration and sleep latency)via upregulating the expression of NPY and downregulating the expression of SP;more importantly,this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency.(2)There is insufficient evidence to prove that MA can effectively reduce the number of arousals.展开更多
OBJECTIVE:To evaluate the efficacy and safety of acupoint application therapies(AA)for hypertension.METHODS:We searched Pub Med,EMBASE,the Cochrane Center Controlled Trials Register,Chinese National Knowledge Infrastr...OBJECTIVE:To evaluate the efficacy and safety of acupoint application therapies(AA)for hypertension.METHODS:We searched Pub Med,EMBASE,the Cochrane Center Controlled Trials Register,Chinese National Knowledge Infrastructure,Chinese Scientific Journal Database,and Wanfang Med Online Database from their inceptions to October 7,2019.No language restriction was applied.We included randomized clinical trials testing AA against Western Medicine,AA versus placebo,AA combined with Western Medicine versus Western Medicine.Study selection,data extraction,quality assessment,and data analyses were conducted according to the Cochrane standards.RESULTS:Totally 41 trials with 3772 participants were included.The methodological quality of the included trials was evaluated as generally low.AA plus Western Medicine significantly lowered systolic blood pressure(BP)[weighted mean difference(WMD):-10.36,95%confidence intervals(CI):-12.62,-8.10;P<0.00001],diastolic BP(WMD:-5.71,95%CI:-7.30,-4.13;P<0.00001),and total effect[risk ratio(RR):1.23,95%CI:1.15,1.32;P<0.00001].The BP-lowering effect of AA was significantly higher than that of placebo[systolic BP(SBP):-8.05,95%CI:-8.67,-7.43;P<0.00001;diastolic BP(DBP):-6.66,95%CI:-7.31,-6.01,P<0.00001].The total effect also improved significantly from baseline with AA than placebo(RR:10.85,95%CI:4.71,24.98;P<0.00001).Traditional Chinese Medicine symptoms score were significantly reduced by AA compared with Western Medicine(WMD:-1.75,95%CI:-2.52,-0.99;P<0.00001),10 trials reported adverse events,indicating that the safety of SSYX Capsule is still uncertain.CONCLUSIONS:Application therapies may be considered a safe and beneficial for the treatment of hypertension and can reduce BP and improve the total effect.Further well-designed trials are needed to support our conclusions.展开更多
Experimental evidence has demonstrated that environmental hazards can induce neurodegeneration such as Alzheimer's disease(AD)^([1]).The pathogenesis of AD,characterized by a gradual cognitive decline,overproducti...Experimental evidence has demonstrated that environmental hazards can induce neurodegeneration such as Alzheimer's disease(AD)^([1]).The pathogenesis of AD,characterized by a gradual cognitive decline,overproduction ofβ-amyloid(Aβ),and hyperphosphorylated tau in specific brain areas,is considered to involve the interaction of several internal(individual)and external environmental factors.展开更多
Objective:To analyze the characteristics of bacterial flora on the tongue and types of tongue coating between healthy individuals and patients with type 2 diabetes mellitus(T2DM)via detecting 16S rDNA of oral tongue c...Objective:To analyze the characteristics of bacterial flora on the tongue and types of tongue coating between healthy individuals and patients with type 2 diabetes mellitus(T2DM)via detecting 16S rDNA of oral tongue coating microbial group.Methods:A total of 42 patients with T2DM were recruited,including 6 with thin white coating,9 with mirror-like coating,27 with yellow thick coating(YTC),and 28 healthy individuals.The V4 region of 16S rDNA from the tongue coating microbiota was sequenced using the Linux ubuntu sequencing platform,and the structure of bacterial flora in the tongue was analyzed.Treeplot construction,principal coordinates analysis,redundancy analysis,and linear discriminant analysis were conducted using R software to analyze the differences of bacterial flora in the tongue coating in each group.Results:A total of 8131 different operational taxonomic units(OTUs)were obtained via sequencing,of which 719 OTU samples showed significant differences(P<0.05).Comparing OTUs with the 16S rDNA database of known species and annotation of parallel species revealed 16 species with differences at the phylum level,31 at the class level,54 at the order level,88 at the family level,and 161 at the genus level.The dominant bacteria found in patients with T2DM included Lactobacillus,Streptophyta,Chloroplast,Cyanobacteria-Chloroplast,and Bifidobacteriaceae,etc.Dominant bacteria in the control group belonged to Pasteurellales,Pasteurellaceae,Leptotrichiaceae,Lachnoanaerobaculum,and Ignavibacteria among other bacterial families.All samples were clustered into three groups,each group characterized by dominant bacteria.The order of dominant bacteria in group 1 were Prevotella>Neisseria>Veillonella>Streptococcus>Fusobacterium>Leptotrichia and so on.The order of dominant bacteria of group 2 were Neisseria>Prevotella>Fusobacterium>Streptococcus>porphyromonas and so on.The dominant bacteria of group 3 were Prevotella>Fusobacterium>Streptococcus>Neisseria>Leptotrichia>Rothia>Veillonella>porphyromonas>f_Pasteurellaceae>Capnocytophaga>Actinomyces>Alloprevotella and so on.Single factor risk estimation:with group 1 used as the reference(OR=1),the risk of carrying group 2 and group 3 microflora with T2DM increased(OR values were 4.77 and 7.78,respectively).The proportion of group 1 microflora in the control group(25.9%)was higher than that in the T2DM group(5.4%)(χ2=3.873,P=0.049).Compared with group 1 and group 2,group 3 had a significantly dominant microflora structure in YTC group(χ2=7.120,P=0.008).RDA analysis indicated that Neisseria,Fusobacterium,and Prevotella were associated with HbA1c values>10 mmol/L,whereas Rothia,Streptococcus,and Veillonella were more correlated with HbA1c≤10 mmol/L.Conclusion:The incidence of T2DM is related to the imbalance of oral microflora in the human body.The tongue coating flora structure may influence the formation of different tongue coating types in this metabolic condition.Additionally,flora structures of Prevotella,Neisseria,and Fusobacterium were associated with elevated HbA1c.展开更多
Scutellarin(SCU)is a herbal flavonoid glucuronide with multiple pharmacological activities,including antioxidant,anti-inflammation,vascular relaxation,anti-platelet,and myocardial protection.However,the effect of SCU ...Scutellarin(SCU)is a herbal flavonoid glucuronide with multiple pharmacological activities,including antioxidant,anti-inflammation,vascular relaxation,anti-platelet,and myocardial protection.However,the effect of SCU on complete Freund’s adjuvant(CFA)-induced rheumatoid arthritis(RA)had not been studied.In this study,we investigated the beneficial effects of SCU in the CFA-induced RA mice model and the anti-arthritic activity was evaluated by paw edema.Enzyme-linked immunosorbent assay(ELISA)was carried out to evaluate the plasma levels of immunoglobulin(Ig)G,IgE,tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6,receptor activator of nuclear factor-κB ligand(RANKL),and osteoprotegerin(OPG).Histological slides were prepared from the harvested paws of mice to determine the pathological changes in the joints.The proportions of T helper type 1(Th1)and T helper type 2(Th2)cells of CD4+T lymphocyte subsets were analyzed by flow cytometry.The expression of Kelch-like ECHassociated protein 1(Keap1),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)was analyzed using real-time quantitative PCR(RT-qPCR)and western blotting assays.The present study demonstrated that SCU prevented CFA-induced RA,and inhibited the expression of inflammation factors,IgG,IgE,TNF-α,IL-1β,and IL-6.While SCU also reduced the RANKL level,it increased OPG expression in RA mice.The Th1/Th2 ratio was significantly lower in mice treated with SCU.Additionally,HO-1 expression was reduced while the expression of Keap1 and Nrf2 was elevated following SCU treatment.Results provide preliminary evidence to employ SCU in arthritis treatment which might be related to the regulation of Th1/Th2 balance and the Keap1/Nrf2/HO-1 pathway.展开更多
Gestational diabetes mellitus(GDM)is common during pregnancy,with the prevalence reaching as high as 31.0%in some European regions(McIntyre et al.,2019).Dysfunction of the glucose metabolism in pregnancy can influence...Gestational diabetes mellitus(GDM)is common during pregnancy,with the prevalence reaching as high as 31.0%in some European regions(McIntyre et al.,2019).Dysfunction of the glucose metabolism in pregnancy can influence fetal growth via alteration of the intrauterine environment,resulting in an increased risk of abnormal ofispring birth weight(McIntyre et al.,2019).Infants with abnormal birth weight will be foced with increased risks of neonatal complications in the perinatal period and chronic non-communicable diseases in childhood and adulthood(Mitanchez et al.,2015;McIntyre et al.,2019).展开更多
Background:Esophageal injury is a common complication of foreign bodies in the upper gastrointestinal tract,but bilateral pleural effusion or vertebral infection is a rare condition due to a swallowed fishbone.It is c...Background:Esophageal injury is a common complication of foreign bodies in the upper gastrointestinal tract,but bilateral pleural effusion or vertebral infection is a rare condition due to a swallowed fishbone.It is considerably difficult for a physician to diagnose quickly because of incomplete patient history of foreign bodies ingestion and/or insufficient experiences.Patient concerns:We describe the case of a 56-year-old man who was admitted to an emergency medical department owing to a low to moderate fever for 7 days.After a series of examinations,the patient was diagnosed with esophageal perforation(EP)caused by a fishbone that was swallowed half a month ago.Diagnoses:About 12 days after the onset of fever,he was diagnosed with EP based on the gastric endoscopic images combined with histological section and sufficient history of the disease.About 2 months later,the patient has obvious back pain and lack of strength in two legs and was diagnosed with vertebral body infection.Interventions:Antibiotic therapy,multi-disciplinary team(MDT),and surgical intervention had been exerted.Outcomes:It is very fortunate for this patient to have a good prognosis due to a timely diagnosis and proper management.Muscle power has attained level 5.Lessons:Several lessons can be learned from this case;for example,physicians should be alerted to the EP,endoscopic intervention should be prompt,antibiotics should be used regularly,and so on.展开更多
BACKGROUND Chronic skin ulcers are a risk factor for the development of skin tumors.In patients with diabetes,chronic refractory ulcers may also contribute to higher susceptibility to skin tumors.Timely surgical remov...BACKGROUND Chronic skin ulcers are a risk factor for the development of skin tumors.In patients with diabetes,chronic refractory ulcers may also contribute to higher susceptibility to skin tumors.Timely surgical removal of chronic and nonhealing diabetic foot ulcers can effectively prevent progression to squamous cell carcinoma.Such cases may be misdiagnosed owing to currently insufficient clinical evidence.However,in cases of chronic ulcer wounds,it is crucial to enhance clinical awareness regarding their potential progression into malignant lesions.CASE SUMMARY An 84-year-old male patient with diabetes presented with a significantly ulcerated area on his foot.The ulcer had been present to varying degrees since 1996.Between 2012 and July 2019,even after receiving treatments such as herbal medicines or heat clearance and detoxification complete healing of the wound was not achieved.In July 2020,histopathological analysis confirmed a well-differentiated cutaneous squamous cell carcinoma.After the treatments,the ulcer wound healed slowly and did not expand.CONCLUSION Potentially malignant lesions in chronic ulcer wounds should be identified and treated in a timely manner to prevent their progression.展开更多
Objective: to investigate the signs characteristics of x-ray examination of juvenile cervical spondylosis. Methods: 117 cases of juvenile cervical spondylosis treated in our hospital were selected as the research subj...Objective: to investigate the signs characteristics of x-ray examination of juvenile cervical spondylosis. Methods: 117 cases of juvenile cervical spondylosis treated in our hospital were selected as the research subjects, and the study period was from January 2018 to April 2020. The clinical manifestations and X - ray characteristics of cervical spondylosis were observed by TV perspective positioning in patient standup standard such as cervical spine AP展开更多
Introduction:On May 21,2024,an elderly care center in Beijing reported dozens of acute diarrhea cases.The local CDC immediately initiated an epidemiological investigation to identify the outbreak’s etiology and imple...Introduction:On May 21,2024,an elderly care center in Beijing reported dozens of acute diarrhea cases.The local CDC immediately initiated an epidemiological investigation to identify the outbreak’s etiology and implement control measures.Methods:Suspected cases were defined as individuals experiencing diarrhea≥3 times or vomiting within 24 hours at the center during May 19–23,2024.Cases were identified through review of the center’s medical records.Food exposure at breakfast and lunch on May 20 was compared between 24 cases and 70 controls.We interviewed kitchen staff regarding food preparation practices and collected samples for laboratory testing.Results:Investigation identified 77 elderly residents and 21 staff cases,ranging in age from 22 to 99 years,all of whom presented with diarrhea.The epidemic curve exhibited characteristics consistent with a pointsource outbreak.Breakfast and lunch served on May 20 were implicated as suspected exposure meals,with 88%of cases having consumed Chinese hamburgers compared with 51%of controls[odds ratio(OR)=6.6,95%confidence interval(CI):1.7,37.1].The preparation process for the pork filling in Chinese hamburgers involved portioning,blanching for 20 minutes,simmering in spiced broth for 40 minutes,followed by natural cooling.Laboratory analysis confirmed the presence of C.perfringens in 23 patient samples and one Chinese hamburger sample.Conclusions:The outbreak was most likely caused by Chinese hamburgers contaminated with C.perfringens.We recommend comprehensive training for food handlers on proper cooling procedures when preparing Chinese hamburgers.展开更多
Background and Objectives:Irritable bowel syndrome(IBS)stands as a prevalent functional gastrointestinal condition known for causing persistent abdominal pain,changes in bowel patterns,and diminished quality of life.T...Background and Objectives:Irritable bowel syndrome(IBS)stands as a prevalent functional gastrointestinal condition known for causing persistent abdominal pain,changes in bowel patterns,and diminished quality of life.The low fermentable oligosaccharides,disaccharides,monosaccharides,and polyols(FODMAP)diet has emerged as a potential approach to managing IBS through dietary adjustments.To explore how the low FODMAP diet affects symptom relief,nutritional well-being,and overall quality of life in IBS patients when compared to those adhering to a standard diet.Methods and Study Design:A retrospective cohort study was conducted,including patients with IBS categorized into a regular diet group and a low FODMAP diet group.Dietary intake,daily nutrient intake,IBS symptom severity,adverse events,and quality of life were assessed.Results:The low FODMAP diet group demonstrated significantly lower intake of fermentable carbohydrates,including total dietary fiber,fructose,lactose,sorbitol,and total carbohydrates,compared to the regular diet group.Additionally,the low FODMAP diet group exhibited favourable nutritional profiles,reflecting higher intake and utilization of essential nutrients such as vitamin C,iron,calcium,vitamin D,and omega-3 fatty acids.Moreover,significant improvements in symptom severity,adverse event profiles,and quality-of-life scores were observed in the low FODMAP diet group compared to the regular diet group.Conclusions:The Low-FODMAP Diet significantly alters nutrient intake in IBS patients,which may contribute to the observed symptom relief.展开更多
Disseminated tuberculosis(TB)is a severe form of TB associated with high mortality typically occurring in individuals with impaired host defenses.It results from the lymphohematogenous dissemination of Mycobacterium t...Disseminated tuberculosis(TB)is a severe form of TB associated with high mortality typically occurring in individuals with impaired host defenses.It results from the lymphohematogenous dissemination of Mycobacterium tuberculosis from the primary infection site.Diagnosis can be particularly challenging when pulmonary symptoms are absent.We present a case of disseminated TB in a 73-year-old woman who presented with nausea,poor appetite,and low-grade fever.Imaging studies revealed multiple lesions in the lungs,sacroiliac joints,and brain.The nonspecific nature of her initial symptoms,which were inconsistent with the extent of disease involvement,posed significant diagnostic challenges.In this case,metagenomic next-generation sequencing played a pivotal role in confirming the diagnosis of disseminated TB.展开更多
Objective To identify factors that likely contribute to potentially inappropriate prescriptions(PIPs)among older adults in primary care settings,as well as barriers to medicines optimisation and recommended potential ...Objective To identify factors that likely contribute to potentially inappropriate prescriptions(PIPs)among older adults in primary care settings,as well as barriers to medicines optimisation and recommended potential solutions.Design Systematic review.Eligibility criteria Quantitative studies that analysed the factors associated with PIPs among older adults(≥65 years)in primary care settings,and qualitative studies that explored perceived barriers and potential solutions to medicines optimisation for this population.Information sources PubMed,EMBASE,Scopus,CINAHL,PsycINFO,Web of Science,CNKI and Wanfang.Results Of the 13167 studies identified,50 were included(14 qualitative,34 cross-sectional and 2 cohort).Nearly all quantitative studies examined patient-related non-clinical factors(eg,age)and clinical factors(eg,number of medications)and nine studies examined prescriber-related factors(eg,physician age).A greater number of medications were identified as positively associated with PIPs in 25 quantitative studies,and a higher number of comorbidities,physical comorbidities and psychiatric comorbidities were identified as patient-related clinical risk factors for PIPs.However,other factors showed inconsistent associations with the PIPs.Barriers to medicines optimisation emerged within four analytical themes:prescriber related(eg,inadequate knowledge,concerns of adverse consequences,clinical inertia,lack of communication),patient related(eg,limited understanding,patient non-adherence,drug dependency),environment related(eg,lack of integrated care,insufficient investment,time constraints)and technology related(eg,complexity of implementation and inapplicable guidance).Recommended potential solutions were based on each theme of the barriers identified accordingly(eg,prescriber-related factors:incorporating training courses into continuing medical education).Conclusions Older adults with more drugs prescribed and comorbidities may have a greater risk of receiving PIPs in the primary care setting,but it remains unclear whether other factors are related.Barriers to medicines optimisation among primary care older adults comprise multiple factors,and evidence-based and targeted interventions are needed to address these difficulties.PROSPERO registration number CRD42020216258.展开更多
Objective:To assess efficacy of Chinese medicine(CM)on insomnia considering characteristics of treatment based on syndrome differentiation.Methods:A total of 116 participants aged 18 to 65 years with moderate and seve...Objective:To assess efficacy of Chinese medicine(CM)on insomnia considering characteristics of treatment based on syndrome differentiation.Methods:A total of 116 participants aged 18 to 65 years with moderate and severe primary insomnia were randomized to the placebo(n=20)or the CM group(n=96)for a 4-week treatment and a 4-week follow-up.Three CM clinicians independently prescribed treatments for each patient based on syndromes differentiation.The primary outcome was change in total sleep time(TST)from baseline.Secondary endpoints included sleep onset latency(SOL),wake time after sleep onset(WASO),sleep efficiency,Pittsburgh Sleep Quality Index(PSQI)and CM symptoms.Results:The CM group had an average 0.6 h more(95%confidence interval(CI):0.3–0.9,P<0.001)TST and 34.1%(10.3%–58.0%,P=0.005)more patients beyond 0.5 h TST increment than that of the placebo group.PSQI was changed–3.3(–3.8 to–2.7)in the CM group,a–2.0(–3.2 to–0.8,P<0.001)difference from the placebo group.The CM symptom score in the CM group decreased–2.0(–3.3 to–0.7,P=0.003)more than the placebo group.SOL and WASO changes were not significantly different between groups.The analysis of prescriptions by these clinicians revealed blood deficiency and Liver stagnation as the most common syndromes.Prescriptions for these clinicians displayed relative stability,while the herbs varied.All adverse events were mild and were not related to study treatment.Conclusions:CM treatment based on syndrome differentiation can increase TST and improve sleep quality of primary insomnia.It is effective and safe for primary insomnia.In future studies,the long-term efficacy validation and the exploratory of eutherapeutic clinicians'fixed herb formulas should be addressed.(Registration No.NCT01613183).展开更多
Bronchial asthma is a most common and chronic illness which often relapses and has no cure at present Acupuncture has its specific advantage in treating asthma. The author prevented 29 cases of asthma in non-acute sta...Bronchial asthma is a most common and chronic illness which often relapses and has no cure at present Acupuncture has its specific advantage in treating asthma. The author prevented 29 cases of asthma in non-acute stage of attack with plaster on acupoints. Now it is reported as follows.展开更多
The complement system is activated during the development of nonalcoholic fatty liver disease(NAFLD).We aimed to evaluate the causal relationship between serum C3 and C4 levels and NAFLD.After exclusion criteria,a tot...The complement system is activated during the development of nonalcoholic fatty liver disease(NAFLD).We aimed to evaluate the causal relationship between serum C3 and C4 levels and NAFLD.After exclusion criteria,a total of 1600 Chinese Han men from the Fangchenggang Area Male Health and Examination Survey cohort were enrolled in cross-sectional analysis,while 572 participants were included in the longitudinal analysis(average follow-up of 4 years).We performed a bidirectional Mendelian randomization(MR)analysis using two C3-related,eight C4-related and three NAFLD-related gene loci as instrumental variables to evaluate the causal associations between C3,C4,and NAFLD risk in cross-sectional analysis.Per SD increase in C3 levels was significantly associated with higher risk of NAFLD(OR=1.65,95%CI 1.40,1.94)in cross-sectional analysis while C4 was not(OR=1.04,95%CI 0.89,1.21).Longitudinal analysis produced similar results(HR_(C3)=1.20,95%CI 1.02,1.42;HR_(C4)=1.10,95%CI 0.94,1.28).In MR analysis,there were no causal relation-ships for genetically determined C3 levels and NAFLD risk using unweighted or weighted GRS_C3(β_(E_unweighted)=−0.019,95%CI−0.019,−0.019,p=0.202;β_(E_weighted)=−0.019,95%CI−0.019,−0.019,p=0.322).Conversely,serum C3 lev-els were significantly effected by the genetically determined NAFLD(β_(E_unweighted)=0.020,95%CI 0.020,0.020,p=0.004;β_(E_weighted)=0.021,95%CI 0.020,0.021,p=0.004).Neither the direction from C4 to NAFLD nor the one from NAFLD to C4 showed significant association.Our results support that the change in serum C3 levels but not C4 levels might be caused by NAFLD in Chinese Han men.展开更多
Background and Objectives:Frailty has become a public health challenge in China.To investigate the association of foods consumption and physical activity with prefrailty and frailty among older Chinese adults in urban...Background and Objectives:Frailty has become a public health challenge in China.To investigate the association of foods consumption and physical activity with prefrailty and frailty among older Chinese adults in urban communities.Methods and Study Design:In a cross-sectional study from February to July 2023,1183 older adults aged between 65y-88y were enrolled from urban communities in Chongqing and Shandong province,China.Frailty Index(FI)was applied to measure prefrailty and frailty.Partial proportional odds model was used to assess the association between foods consumption,physical activity and prefrailty/frailty.Results:Higher Dietary Diversity Score(DDS),(OR=0.61,95%CI=0.46-0.80;OR=0.47,95%CI=0.28-0.79),Consuming animalbased foods≥2 times/day(OR=0.62,95%CI=0.47-0.82;OR=0.54,95%CI=0.33-0.88),soy products≥2 times/week(OR=0.69,95%CI=0.53-0.89;OR=0.51,95%CI=0.31-0.84),fresh vegetables≥2 times/day(OR=0.42,95%CI=0.31-0.57;OR=0.41,95%CI=0.23-0.72),and nuts≥2 times/week(OR=0.71,95%CI=0.55-0.91;OR=0.52,95%CI=0.32-0.85)was associated with a lower risk of prefrailty and frailty.In addition,higher frequency and longer duration of walking(OR=0.61,95%CI=0.42-0.88;OR=0.63,95%CI=0.48-0.81),exercise(OR=0.48,95%CI=0.35-0.64;OR=0.44,95%CI=0.32-0.61)per week were significantly associated with lower risk of prefrailty.Furthermore,higher frequency and longer duration of walking(OR=0.42,95%CI=0.25-0.72;OR=0.46,95%CI=0.29-0.74),and housework(OR=0.39,95%CI=0.24-0.65;OR=0.57,95%CI=0.34-0.96)per week,were significantly associated with lower frailty.Conclusions:Higher DDS and higher frequency of animal-based foods,soy products,fresh vegetables,and nuts consumption is significantly associated with lower risk of prefrailty and frailty.Additionally,walking and exercising are significantly associated with lower risk of prefrailty,while walking and doing housework is significantly associated with lower frailty.展开更多
Summary What is already known about this topic?Current literature underscores the significance of appropriate physical activity in managing diabetes,primarily utilizing self-reported data.Yet,the impact of objectively...Summary What is already known about this topic?Current literature underscores the significance of appropriate physical activity in managing diabetes,primarily utilizing self-reported data.Yet,the impact of objectively measured physical activity in older diabetic populations remains unclear.What is added by this report?Our research on elderly diabetic patients indicated a correlation between an increased number of daily steps and improved metabolic profiles,as well as a decrease in the incidence of cardiovascular complications.What are the implications for public health practice?Elevated daily step counts may confer significant benefits to elderly individuals with diabetes.The use of devices to monitor these steps could serve as a potent cardiovascular marker,and hold great potential as a screening or intervention tool in community-oriented settings.展开更多
基金supported by 2021 Beijing Key Specialty Program for Major Epidemic Prevention and Control。
文摘Objective Preliminary assessment of rabies virus neutralizing activity,safety and immunogenicity of a recombinant human rabies antibody(NM57)compared with human rabies immunoglobulin(HRIG)in Chinese healthy adults.Methods Subjects were randomly(1:1:1)allocated to Groups A(20 IU/kg NM57),B(40 IU/kg NM57),or C(20 IU/kg HRIG).One injection was given on the day of enrollment.Blood samples were collected on days-7 to 0(pre-injection),3,7,14,28,and 42.Adverse events(AEs)and serious AEs(SAEs)were recorded over a period of 42 days after injection.Results All 60 subjects developed detectable rabies virus neutralizing antibodies(RVNAs)(>0.05 IU/mL)on days 3,7,14,28,and 42.The RVNA levels peaked on day 3 in all three groups,with a geometric mean concentration(GMC)of 0.2139 IU/mL in Group A,0.3660 IU/mL in Group B,and0.1994 IU/mL in Group C.At each follow-up point,the GMC in Group B was significantly higher than that in Groups A and C.The areas under the antibody concentration curve over 0-14 days and 0-42 days in Group B were significantly larger than those in Groups A and C.Fifteen AEs were reported.Except for one grade 2 myalgia in Group C,the other 14 were all grade 1.No SAEs were observed.Conclusion The rabies virus neutralizing activity of 40 IU/kg NM57 was superior to that of 20 IU/kg NM57 and 20 IU/kg HRIG,and the rabies virus neutralizing activity of 20 IU/kg NM57 and 20 IU/kg HRIG were similar.Safety was comparable between NM57 and HRIG.
基金Supported by National Natural Science Foundation of China,No.81673259Natural Science Foundation of Jiangsu Province,China,No.BK20161435.
文摘BACKGROUND The increased stroke risk associated with atrial fibrillation(AF)burden exceeding 5 min is a matter of debate.In addition,the potential linear or nonlinear relationship between AF burden and stroke risk has been largely unexplored.AIM To determine the association between AF burden>5 min and the increased risk of stroke and explore the potential dose-response relationship between these two factors.METHODS Sixteen studies from six databases with 53141 subjects(mean age 65 years)were included.Fifteen studies were observational studies,and one was a randomized controlled trial study.The potential nonlinear dose-response association was characterized using a restricted cubic splines regression model.AF burden for each 1 h and 2 h was associated with an increased risk of stroke.Trial sequential analysis with a random-effect model was used to evaluate the robustness of the evidence from the included 16 studies.RESULTS AF burden>5 min was associated with an increased risk of clinical AF[adjusted risk ratio(RR)=4.18,95%confidence interval(CI):2.26-7.74].However,no association was found with an increased risk of all-cause mortality(adjusted RR=1.55,95%CI:0.87-2.75).Patients with AF burden>5 min had an increased risk of stroke(adjusted RR=2.49,95%CI:1.79-3.47).Moreover,a dose-response analysis showed that the increased stroke risk was paralleled by an increase in AF burden at a rate of 2.0%per hour(Pnonlinear=0.656,RR=1.02,95%CI:1.01-1.03).Trial sequential analysis provided robust evidence of the association between AF burden>5 min and an increased risk of stroke.CONCLUSION AF burden was a significant risk factor for clinical AF and future stroke.A significant linear association was documented between increased AF burden and risk of future stroke.
基金Supported by TCM Science and Technology Innovation Project of Shanghai Health and Family Planning Commission:Mobile internet-based guidance platform of‘Preventive Treatment of Insomnia’(chronic disease management)(No.ZYKC20161016)Special Project for Clinical Research,Shanghai Municipal Health Commission(No.20174Y0009).
文摘Objective:This study is conducted to determine effects of manual acupuncture(MA)in patients with a diagnosis of major depressive disorder(MDD)and comorbid insomnia.Methods:A total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to a real-MA group(patients=34)and a sham-MA group(patients=33).Patients in the real-MA group were treated on‘Five-shen acupoints’,including Sishencong(四神聪EX-HN 1),Shenting(神庭GV 24),Shendao(神道GV 11),bilateral Benshen(本神GB 13),and bilateral Shenmen(神门HT 7).Though being punctured on the same acupoints,patients in the sham-MA group were treated by a placebo acupuncture approach(Streitberger Placeboneedle).Each group received corresponding interventions every other day,three times a week for total eight weeks.Both polysomnography(PSG)and testing of serum biological markers such as neuropeptide Y(NPY)and substance P(SP)were performed at pre-and post-treatment.Additionally,the global scores of Pittsburgh sleep quality index(PSQI)and the global scores of 17-items Hamilton Depression Rating Scale(HAMD17)were used for assessing the subjective sleep and emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After eight-week treatment,the global scores of PSQI and global scores of HAMD17 declined significantly(both P<0.05)in the real-MA group but not in the sham-MA group(both P>0.05).According to the parameters of PSG,striking decline were observed in sleep latency(SL)and wake after sleep onset(WASO)and striking climb were observed in total sleep time(TST)and sleep efficiency(SE)in the real-MA group after treatment(P<0.05,respectively)but not in the sham-MA group(P>0.05,respectively).Additionally,there were no significant differences in awakening times(ATs)and rapid eyes movement sleep latency(REM-SL)in both two groups after treatment(both P>0.05).Meanwhile,the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions(both P<0.05)while those indicators only slightly fluctuated in the sham-MA group(P>0.05).No serious adverse event was reported in either real-or sham-MA group.Conclusion:(1)MA may be a potential alternative therapy for improving MDD and comorbid insomnia(particularly in extending total sleep time and shortening wake-up duration and sleep latency)via upregulating the expression of NPY and downregulating the expression of SP;more importantly,this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency.(2)There is insufficient evidence to prove that MA can effectively reduce the number of arousals.
基金Supported by Beijing Natural Science Foundation(Molecular Mechanisms of Bushen Jiangya Decoction on Hypertensive Renal Damage Based on mi R-21 Induced TGFβ/Smad Signal Pathway 7194277)Key Medical Professional Development Program Fund of Beijing Municipal Hospital Administration(ZYLX201817)。
文摘OBJECTIVE:To evaluate the efficacy and safety of acupoint application therapies(AA)for hypertension.METHODS:We searched Pub Med,EMBASE,the Cochrane Center Controlled Trials Register,Chinese National Knowledge Infrastructure,Chinese Scientific Journal Database,and Wanfang Med Online Database from their inceptions to October 7,2019.No language restriction was applied.We included randomized clinical trials testing AA against Western Medicine,AA versus placebo,AA combined with Western Medicine versus Western Medicine.Study selection,data extraction,quality assessment,and data analyses were conducted according to the Cochrane standards.RESULTS:Totally 41 trials with 3772 participants were included.The methodological quality of the included trials was evaluated as generally low.AA plus Western Medicine significantly lowered systolic blood pressure(BP)[weighted mean difference(WMD):-10.36,95%confidence intervals(CI):-12.62,-8.10;P<0.00001],diastolic BP(WMD:-5.71,95%CI:-7.30,-4.13;P<0.00001),and total effect[risk ratio(RR):1.23,95%CI:1.15,1.32;P<0.00001].The BP-lowering effect of AA was significantly higher than that of placebo[systolic BP(SBP):-8.05,95%CI:-8.67,-7.43;P<0.00001;diastolic BP(DBP):-6.66,95%CI:-7.31,-6.01,P<0.00001].The total effect also improved significantly from baseline with AA than placebo(RR:10.85,95%CI:4.71,24.98;P<0.00001).Traditional Chinese Medicine symptoms score were significantly reduced by AA compared with Western Medicine(WMD:-1.75,95%CI:-2.52,-0.99;P<0.00001),10 trials reported adverse events,indicating that the safety of SSYX Capsule is still uncertain.CONCLUSIONS:Application therapies may be considered a safe and beneficial for the treatment of hypertension and can reduce BP and improve the total effect.Further well-designed trials are needed to support our conclusions.
基金supported by the Shandong Province Higher Education Science and Technology Plan Project[J18KB120]
文摘Experimental evidence has demonstrated that environmental hazards can induce neurodegeneration such as Alzheimer's disease(AD)^([1]).The pathogenesis of AD,characterized by a gradual cognitive decline,overproduction ofβ-amyloid(Aβ),and hyperphosphorylated tau in specific brain areas,is considered to involve the interaction of several internal(individual)and external environmental factors.
文摘Objective:To analyze the characteristics of bacterial flora on the tongue and types of tongue coating between healthy individuals and patients with type 2 diabetes mellitus(T2DM)via detecting 16S rDNA of oral tongue coating microbial group.Methods:A total of 42 patients with T2DM were recruited,including 6 with thin white coating,9 with mirror-like coating,27 with yellow thick coating(YTC),and 28 healthy individuals.The V4 region of 16S rDNA from the tongue coating microbiota was sequenced using the Linux ubuntu sequencing platform,and the structure of bacterial flora in the tongue was analyzed.Treeplot construction,principal coordinates analysis,redundancy analysis,and linear discriminant analysis were conducted using R software to analyze the differences of bacterial flora in the tongue coating in each group.Results:A total of 8131 different operational taxonomic units(OTUs)were obtained via sequencing,of which 719 OTU samples showed significant differences(P<0.05).Comparing OTUs with the 16S rDNA database of known species and annotation of parallel species revealed 16 species with differences at the phylum level,31 at the class level,54 at the order level,88 at the family level,and 161 at the genus level.The dominant bacteria found in patients with T2DM included Lactobacillus,Streptophyta,Chloroplast,Cyanobacteria-Chloroplast,and Bifidobacteriaceae,etc.Dominant bacteria in the control group belonged to Pasteurellales,Pasteurellaceae,Leptotrichiaceae,Lachnoanaerobaculum,and Ignavibacteria among other bacterial families.All samples were clustered into three groups,each group characterized by dominant bacteria.The order of dominant bacteria in group 1 were Prevotella>Neisseria>Veillonella>Streptococcus>Fusobacterium>Leptotrichia and so on.The order of dominant bacteria of group 2 were Neisseria>Prevotella>Fusobacterium>Streptococcus>porphyromonas and so on.The dominant bacteria of group 3 were Prevotella>Fusobacterium>Streptococcus>Neisseria>Leptotrichia>Rothia>Veillonella>porphyromonas>f_Pasteurellaceae>Capnocytophaga>Actinomyces>Alloprevotella and so on.Single factor risk estimation:with group 1 used as the reference(OR=1),the risk of carrying group 2 and group 3 microflora with T2DM increased(OR values were 4.77 and 7.78,respectively).The proportion of group 1 microflora in the control group(25.9%)was higher than that in the T2DM group(5.4%)(χ2=3.873,P=0.049).Compared with group 1 and group 2,group 3 had a significantly dominant microflora structure in YTC group(χ2=7.120,P=0.008).RDA analysis indicated that Neisseria,Fusobacterium,and Prevotella were associated with HbA1c values>10 mmol/L,whereas Rothia,Streptococcus,and Veillonella were more correlated with HbA1c≤10 mmol/L.Conclusion:The incidence of T2DM is related to the imbalance of oral microflora in the human body.The tongue coating flora structure may influence the formation of different tongue coating types in this metabolic condition.Additionally,flora structures of Prevotella,Neisseria,and Fusobacterium were associated with elevated HbA1c.
文摘Scutellarin(SCU)is a herbal flavonoid glucuronide with multiple pharmacological activities,including antioxidant,anti-inflammation,vascular relaxation,anti-platelet,and myocardial protection.However,the effect of SCU on complete Freund’s adjuvant(CFA)-induced rheumatoid arthritis(RA)had not been studied.In this study,we investigated the beneficial effects of SCU in the CFA-induced RA mice model and the anti-arthritic activity was evaluated by paw edema.Enzyme-linked immunosorbent assay(ELISA)was carried out to evaluate the plasma levels of immunoglobulin(Ig)G,IgE,tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6,receptor activator of nuclear factor-κB ligand(RANKL),and osteoprotegerin(OPG).Histological slides were prepared from the harvested paws of mice to determine the pathological changes in the joints.The proportions of T helper type 1(Th1)and T helper type 2(Th2)cells of CD4+T lymphocyte subsets were analyzed by flow cytometry.The expression of Kelch-like ECHassociated protein 1(Keap1),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)was analyzed using real-time quantitative PCR(RT-qPCR)and western blotting assays.The present study demonstrated that SCU prevented CFA-induced RA,and inhibited the expression of inflammation factors,IgG,IgE,TNF-α,IL-1β,and IL-6.While SCU also reduced the RANKL level,it increased OPG expression in RA mice.The Th1/Th2 ratio was significantly lower in mice treated with SCU.Additionally,HO-1 expression was reduced while the expression of Keap1 and Nrf2 was elevated following SCU treatment.Results provide preliminary evidence to employ SCU in arthritis treatment which might be related to the regulation of Th1/Th2 balance and the Keap1/Nrf2/HO-1 pathway.
基金supported by the Key Research and Development Project of Zhejiang Province(No.2018C03010)the Natural Science Foundation of Zhejiang Province(No.LQ20H040005),China。
文摘Gestational diabetes mellitus(GDM)is common during pregnancy,with the prevalence reaching as high as 31.0%in some European regions(McIntyre et al.,2019).Dysfunction of the glucose metabolism in pregnancy can influence fetal growth via alteration of the intrauterine environment,resulting in an increased risk of abnormal ofispring birth weight(McIntyre et al.,2019).Infants with abnormal birth weight will be foced with increased risks of neonatal complications in the perinatal period and chronic non-communicable diseases in childhood and adulthood(Mitanchez et al.,2015;McIntyre et al.,2019).
文摘Background:Esophageal injury is a common complication of foreign bodies in the upper gastrointestinal tract,but bilateral pleural effusion or vertebral infection is a rare condition due to a swallowed fishbone.It is considerably difficult for a physician to diagnose quickly because of incomplete patient history of foreign bodies ingestion and/or insufficient experiences.Patient concerns:We describe the case of a 56-year-old man who was admitted to an emergency medical department owing to a low to moderate fever for 7 days.After a series of examinations,the patient was diagnosed with esophageal perforation(EP)caused by a fishbone that was swallowed half a month ago.Diagnoses:About 12 days after the onset of fever,he was diagnosed with EP based on the gastric endoscopic images combined with histological section and sufficient history of the disease.About 2 months later,the patient has obvious back pain and lack of strength in two legs and was diagnosed with vertebral body infection.Interventions:Antibiotic therapy,multi-disciplinary team(MDT),and surgical intervention had been exerted.Outcomes:It is very fortunate for this patient to have a good prognosis due to a timely diagnosis and proper management.Muscle power has attained level 5.Lessons:Several lessons can be learned from this case;for example,physicians should be alerted to the EP,endoscopic intervention should be prompt,antibiotics should be used regularly,and so on.
基金Supported by Shanghai Science and Technology Commission,National Natural Science Foundation of Shanghai,No.23ZR1460300Shanghai Municipal Science and Technology Commission,Medical Innovation Research Project,No.22Y11922700Shanghai Municipal Health Commission,General Program,No.202240386.
文摘BACKGROUND Chronic skin ulcers are a risk factor for the development of skin tumors.In patients with diabetes,chronic refractory ulcers may also contribute to higher susceptibility to skin tumors.Timely surgical removal of chronic and nonhealing diabetic foot ulcers can effectively prevent progression to squamous cell carcinoma.Such cases may be misdiagnosed owing to currently insufficient clinical evidence.However,in cases of chronic ulcer wounds,it is crucial to enhance clinical awareness regarding their potential progression into malignant lesions.CASE SUMMARY An 84-year-old male patient with diabetes presented with a significantly ulcerated area on his foot.The ulcer had been present to varying degrees since 1996.Between 2012 and July 2019,even after receiving treatments such as herbal medicines or heat clearance and detoxification complete healing of the wound was not achieved.In July 2020,histopathological analysis confirmed a well-differentiated cutaneous squamous cell carcinoma.After the treatments,the ulcer wound healed slowly and did not expand.CONCLUSION Potentially malignant lesions in chronic ulcer wounds should be identified and treated in a timely manner to prevent their progression.
文摘Objective: to investigate the signs characteristics of x-ray examination of juvenile cervical spondylosis. Methods: 117 cases of juvenile cervical spondylosis treated in our hospital were selected as the research subjects, and the study period was from January 2018 to April 2020. The clinical manifestations and X - ray characteristics of cervical spondylosis were observed by TV perspective positioning in patient standup standard such as cervical spine AP
文摘Introduction:On May 21,2024,an elderly care center in Beijing reported dozens of acute diarrhea cases.The local CDC immediately initiated an epidemiological investigation to identify the outbreak’s etiology and implement control measures.Methods:Suspected cases were defined as individuals experiencing diarrhea≥3 times or vomiting within 24 hours at the center during May 19–23,2024.Cases were identified through review of the center’s medical records.Food exposure at breakfast and lunch on May 20 was compared between 24 cases and 70 controls.We interviewed kitchen staff regarding food preparation practices and collected samples for laboratory testing.Results:Investigation identified 77 elderly residents and 21 staff cases,ranging in age from 22 to 99 years,all of whom presented with diarrhea.The epidemic curve exhibited characteristics consistent with a pointsource outbreak.Breakfast and lunch served on May 20 were implicated as suspected exposure meals,with 88%of cases having consumed Chinese hamburgers compared with 51%of controls[odds ratio(OR)=6.6,95%confidence interval(CI):1.7,37.1].The preparation process for the pork filling in Chinese hamburgers involved portioning,blanching for 20 minutes,simmering in spiced broth for 40 minutes,followed by natural cooling.Laboratory analysis confirmed the presence of C.perfringens in 23 patient samples and one Chinese hamburger sample.Conclusions:The outbreak was most likely caused by Chinese hamburgers contaminated with C.perfringens.We recommend comprehensive training for food handlers on proper cooling procedures when preparing Chinese hamburgers.
文摘Background and Objectives:Irritable bowel syndrome(IBS)stands as a prevalent functional gastrointestinal condition known for causing persistent abdominal pain,changes in bowel patterns,and diminished quality of life.The low fermentable oligosaccharides,disaccharides,monosaccharides,and polyols(FODMAP)diet has emerged as a potential approach to managing IBS through dietary adjustments.To explore how the low FODMAP diet affects symptom relief,nutritional well-being,and overall quality of life in IBS patients when compared to those adhering to a standard diet.Methods and Study Design:A retrospective cohort study was conducted,including patients with IBS categorized into a regular diet group and a low FODMAP diet group.Dietary intake,daily nutrient intake,IBS symptom severity,adverse events,and quality of life were assessed.Results:The low FODMAP diet group demonstrated significantly lower intake of fermentable carbohydrates,including total dietary fiber,fructose,lactose,sorbitol,and total carbohydrates,compared to the regular diet group.Additionally,the low FODMAP diet group exhibited favourable nutritional profiles,reflecting higher intake and utilization of essential nutrients such as vitamin C,iron,calcium,vitamin D,and omega-3 fatty acids.Moreover,significant improvements in symptom severity,adverse event profiles,and quality-of-life scores were observed in the low FODMAP diet group compared to the regular diet group.Conclusions:The Low-FODMAP Diet significantly alters nutrient intake in IBS patients,which may contribute to the observed symptom relief.
基金funded by the Incubation Program Project of Beijing Municipal Administration of Hospitals of China(PG2018013)the Education Reform Project of Tsinghua University(ZY01_02).
文摘Disseminated tuberculosis(TB)is a severe form of TB associated with high mortality typically occurring in individuals with impaired host defenses.It results from the lymphohematogenous dissemination of Mycobacterium tuberculosis from the primary infection site.Diagnosis can be particularly challenging when pulmonary symptoms are absent.We present a case of disseminated TB in a 73-year-old woman who presented with nausea,poor appetite,and low-grade fever.Imaging studies revealed multiple lesions in the lungs,sacroiliac joints,and brain.The nonspecific nature of her initial symptoms,which were inconsistent with the extent of disease involvement,posed significant diagnostic challenges.In this case,metagenomic next-generation sequencing played a pivotal role in confirming the diagnosis of disseminated TB.
基金ZX is funded through Scientific Research Fund of Zhejiang Provincial Education Department(Grant ID,Y201941691)YQ is funded through National Natural Science Foundation of China(Grant ID,72004050).
文摘Objective To identify factors that likely contribute to potentially inappropriate prescriptions(PIPs)among older adults in primary care settings,as well as barriers to medicines optimisation and recommended potential solutions.Design Systematic review.Eligibility criteria Quantitative studies that analysed the factors associated with PIPs among older adults(≥65 years)in primary care settings,and qualitative studies that explored perceived barriers and potential solutions to medicines optimisation for this population.Information sources PubMed,EMBASE,Scopus,CINAHL,PsycINFO,Web of Science,CNKI and Wanfang.Results Of the 13167 studies identified,50 were included(14 qualitative,34 cross-sectional and 2 cohort).Nearly all quantitative studies examined patient-related non-clinical factors(eg,age)and clinical factors(eg,number of medications)and nine studies examined prescriber-related factors(eg,physician age).A greater number of medications were identified as positively associated with PIPs in 25 quantitative studies,and a higher number of comorbidities,physical comorbidities and psychiatric comorbidities were identified as patient-related clinical risk factors for PIPs.However,other factors showed inconsistent associations with the PIPs.Barriers to medicines optimisation emerged within four analytical themes:prescriber related(eg,inadequate knowledge,concerns of adverse consequences,clinical inertia,lack of communication),patient related(eg,limited understanding,patient non-adherence,drug dependency),environment related(eg,lack of integrated care,insufficient investment,time constraints)and technology related(eg,complexity of implementation and inapplicable guidance).Recommended potential solutions were based on each theme of the barriers identified accordingly(eg,prescriber-related factors:incorporating training courses into continuing medical education).Conclusions Older adults with more drugs prescribed and comorbidities may have a greater risk of receiving PIPs in the primary care setting,but it remains unclear whether other factors are related.Barriers to medicines optimisation among primary care older adults comprise multiple factors,and evidence-based and targeted interventions are needed to address these difficulties.PROSPERO registration number CRD42020216258.
基金Supported by the National Natural Science Foundation of China(No.81973713 and No.81303149)。
文摘Objective:To assess efficacy of Chinese medicine(CM)on insomnia considering characteristics of treatment based on syndrome differentiation.Methods:A total of 116 participants aged 18 to 65 years with moderate and severe primary insomnia were randomized to the placebo(n=20)or the CM group(n=96)for a 4-week treatment and a 4-week follow-up.Three CM clinicians independently prescribed treatments for each patient based on syndromes differentiation.The primary outcome was change in total sleep time(TST)from baseline.Secondary endpoints included sleep onset latency(SOL),wake time after sleep onset(WASO),sleep efficiency,Pittsburgh Sleep Quality Index(PSQI)and CM symptoms.Results:The CM group had an average 0.6 h more(95%confidence interval(CI):0.3–0.9,P<0.001)TST and 34.1%(10.3%–58.0%,P=0.005)more patients beyond 0.5 h TST increment than that of the placebo group.PSQI was changed–3.3(–3.8 to–2.7)in the CM group,a–2.0(–3.2 to–0.8,P<0.001)difference from the placebo group.The CM symptom score in the CM group decreased–2.0(–3.3 to–0.7,P=0.003)more than the placebo group.SOL and WASO changes were not significantly different between groups.The analysis of prescriptions by these clinicians revealed blood deficiency and Liver stagnation as the most common syndromes.Prescriptions for these clinicians displayed relative stability,while the herbs varied.All adverse events were mild and were not related to study treatment.Conclusions:CM treatment based on syndrome differentiation can increase TST and improve sleep quality of primary insomnia.It is effective and safe for primary insomnia.In future studies,the long-term efficacy validation and the exploratory of eutherapeutic clinicians'fixed herb formulas should be addressed.(Registration No.NCT01613183).
文摘Bronchial asthma is a most common and chronic illness which often relapses and has no cure at present Acupuncture has its specific advantage in treating asthma. The author prevented 29 cases of asthma in non-acute stage of attack with plaster on acupoints. Now it is reported as follows.
基金supported by the Guangxi Natural Science Fund for Innovation Research Team[2017GXNSFGA198003]Key projects of strategic international scientific and technological innovation cooperation of the Chinese Ministry of Science and Technology[2020YFE0201600]Guangxi key Laboratory for Genomic and Personalized Medicine[19-185-33,20-065-33].
文摘The complement system is activated during the development of nonalcoholic fatty liver disease(NAFLD).We aimed to evaluate the causal relationship between serum C3 and C4 levels and NAFLD.After exclusion criteria,a total of 1600 Chinese Han men from the Fangchenggang Area Male Health and Examination Survey cohort were enrolled in cross-sectional analysis,while 572 participants were included in the longitudinal analysis(average follow-up of 4 years).We performed a bidirectional Mendelian randomization(MR)analysis using two C3-related,eight C4-related and three NAFLD-related gene loci as instrumental variables to evaluate the causal associations between C3,C4,and NAFLD risk in cross-sectional analysis.Per SD increase in C3 levels was significantly associated with higher risk of NAFLD(OR=1.65,95%CI 1.40,1.94)in cross-sectional analysis while C4 was not(OR=1.04,95%CI 0.89,1.21).Longitudinal analysis produced similar results(HR_(C3)=1.20,95%CI 1.02,1.42;HR_(C4)=1.10,95%CI 0.94,1.28).In MR analysis,there were no causal relation-ships for genetically determined C3 levels and NAFLD risk using unweighted or weighted GRS_C3(β_(E_unweighted)=−0.019,95%CI−0.019,−0.019,p=0.202;β_(E_weighted)=−0.019,95%CI−0.019,−0.019,p=0.322).Conversely,serum C3 lev-els were significantly effected by the genetically determined NAFLD(β_(E_unweighted)=0.020,95%CI 0.020,0.020,p=0.004;β_(E_weighted)=0.021,95%CI 0.020,0.021,p=0.004).Neither the direction from C4 to NAFLD nor the one from NAFLD to C4 showed significant association.Our results support that the change in serum C3 levels but not C4 levels might be caused by NAFLD in Chinese Han men.
基金financially supported by Beijing Municipal Science and Technology Commission[D181100000218004]Ministry of Finance of People’s Republic of China Program:Public Health Emergency 2023-Nutritional Health and Rational Diets[No.131031107000150007].
文摘Background and Objectives:Frailty has become a public health challenge in China.To investigate the association of foods consumption and physical activity with prefrailty and frailty among older Chinese adults in urban communities.Methods and Study Design:In a cross-sectional study from February to July 2023,1183 older adults aged between 65y-88y were enrolled from urban communities in Chongqing and Shandong province,China.Frailty Index(FI)was applied to measure prefrailty and frailty.Partial proportional odds model was used to assess the association between foods consumption,physical activity and prefrailty/frailty.Results:Higher Dietary Diversity Score(DDS),(OR=0.61,95%CI=0.46-0.80;OR=0.47,95%CI=0.28-0.79),Consuming animalbased foods≥2 times/day(OR=0.62,95%CI=0.47-0.82;OR=0.54,95%CI=0.33-0.88),soy products≥2 times/week(OR=0.69,95%CI=0.53-0.89;OR=0.51,95%CI=0.31-0.84),fresh vegetables≥2 times/day(OR=0.42,95%CI=0.31-0.57;OR=0.41,95%CI=0.23-0.72),and nuts≥2 times/week(OR=0.71,95%CI=0.55-0.91;OR=0.52,95%CI=0.32-0.85)was associated with a lower risk of prefrailty and frailty.In addition,higher frequency and longer duration of walking(OR=0.61,95%CI=0.42-0.88;OR=0.63,95%CI=0.48-0.81),exercise(OR=0.48,95%CI=0.35-0.64;OR=0.44,95%CI=0.32-0.61)per week were significantly associated with lower risk of prefrailty.Furthermore,higher frequency and longer duration of walking(OR=0.42,95%CI=0.25-0.72;OR=0.46,95%CI=0.29-0.74),and housework(OR=0.39,95%CI=0.24-0.65;OR=0.57,95%CI=0.34-0.96)per week,were significantly associated with lower frailty.Conclusions:Higher DDS and higher frequency of animal-based foods,soy products,fresh vegetables,and nuts consumption is significantly associated with lower risk of prefrailty and frailty.Additionally,walking and exercising are significantly associated with lower risk of prefrailty,while walking and doing housework is significantly associated with lower frailty.
文摘Summary What is already known about this topic?Current literature underscores the significance of appropriate physical activity in managing diabetes,primarily utilizing self-reported data.Yet,the impact of objectively measured physical activity in older diabetic populations remains unclear.What is added by this report?Our research on elderly diabetic patients indicated a correlation between an increased number of daily steps and improved metabolic profiles,as well as a decrease in the incidence of cardiovascular complications.What are the implications for public health practice?Elevated daily step counts may confer significant benefits to elderly individuals with diabetes.The use of devices to monitor these steps could serve as a potent cardiovascular marker,and hold great potential as a screening or intervention tool in community-oriented settings.
