Efficacy and safety of glucokinase activators for type 2 diabetes mellitus therapy：a meta-analysis / 中国药房

OBJECTIVE To systematically evaluate the efficacy and safety of glucokinase activators in the treatment of type 2 diabetes mellitus. METHODS PubMed， Cochrane Library， Web of Science， Embase and CNKI databases were searched from the inception to March 2022. Randomized controlled trials about glucokinase activators versus placebo （or other oral hypoglycemic agents） in the treatment of type 2 diabetes were included， data were extracted and meta-analysis was analyzed using RevMan 5.4 software. RESULTS A total of 9 studies with 215 0 patients were included. In terms of hypoglycemic effect， compared with control group， glucokinase activators significantly reduced glycosylated hemoglobin （HbA1c） [MD＝－0.40， 95%CI（－0.53， －0.26）， P＜0.000 01]， fasting blood glucose[MD＝－0.53， 95%CI（－0.85， －0.20）， P＝0.001] and 2 h postprandial blood glucose [MD＝－2.28， 95%CI（－2.68， －1.88）， P＜0.000 01] in diabetic patients. In terms of safety， the incidence of hypoglycemia caused by glucokinase activators was higher than control group on the whole [RR＝1.55， 95%CI（1.20，2.01）， P＝ 0.000 8]. According to the subgroup analysis of organs activated by glucokinase activator， the incidence of hypoglycemia in the pancreas-liver dual activator group [RR＝1.44， 95%CI（1.11，1.89）， P＝0.007] and liver-selective activator group [RR＝2.26， 95%CI（1.02，5.03）， P＝0.05] was higher than that in the control group， the difference was statistically significant. CONCLUSIONS Glucokinase activators can effectively reduce HbA1c， fasting blood glucose and 2 h postprandial blood glucose in patients with type 2 diabetes， but the risk of hypoglycemia remains to be addressed.

Analysis on Hospice Care Cognition Status and Influencing Factors among High School Students in Guangzhou / 中国医学伦理学

【Objective:】 To investigate the cognition, attitude and influencing factors of hospice care among high school students in Guangzhou, and to provide basis for improving the understanding level of hospice care and death education among adolescents. 【Methods:】 A total of 226 questionnaires were collected by convenient sampling and questionnaire survey. The questionnaire covered two parts: basic information of the respondents, cognition and attitude towards hospice care (including four dimensions: basic knowledge of hospice care, knowledge of pain control, attitude and thought of hospice care, and attitude towards hospice care education). Excel software was used to preliminary screen, preprocess and establish database of data. SPSS21.0 was used for statistical analysis. T-test and ANOVA were used for difference analysis, multiple linear regression was used for correlation analysis. 【Results:】 High school students had a basic understanding of hospice care. Among the four dimensions of basic knowledge of hospice care, knowledge of pain control, attitude and thought of hospice care, and attitude towards hospice care education, the cognition of "knowledge of pain control" dimension was the weakest link, and the entry of "attitude and thought of hospice care" had the highest score, which was the strong cognitive link. 【Conclusion:】 The main influencing factors of high school students’ cognition of hospice care were family structure, family residence and whether they have understood hospice care. This paper recommended that schools should add medical humanities education courses related to hospice and death education, and cooperate with hospice care centers to carry out hospice care experience practices. It was also suggested that relevant departments or organizations should make full use of mainstream media, such as online media and WeChat public accounts, to strengthen the popularity and popularization of hospice care education and science popularization from multiple channels and aspects, and improve the level and quality of hospice care education for young people.

Advances in the research of microRNA in Orchidaceae / 生物工程学报

As a class of small non-coding RNAs, microRNA (miRNA) is widely present and plays important regulatory roles in plant growth, development and stress response. Based on the mechanism of miRNAs in plants, we review the identification of miRNAs in some genera of Orchidaceae, the specific functions of several miRNAs and other relevant studies on miRNAs in the last decade, in order to provide a reference for better understanding function and regulatory network of small RNAs in orchids.

Functional magnetic stimulation can improve the urination of persons with urine retention after a spinal cord injury / 中华物理医学与康复杂志

Objective:To observe any effect of functional magnetic stimulation (FMS) of the sacral 3 nerve root on relieving urine retention after a spinal cord injury.Methods:Forty-four patients with neurogenic bladder disorders after a spinal cord injury were divided at random into a 5Hz group ( n=14), a 20Hz group ( n=15), and a sham stimulation group ( n=15). In addition to conventional bladder control training, the 5Hz and 20Hz groups were given 20 minutes of FMS of the sacral 3 nerve root at the appropriate frequency five days a week for 4 weeks. The sham stimulation group was not given any stimulation. A detailed urination diary was kept during the treatment, and before and after the 4 weeks, everyone′s bladder pressure volume was assessed and an electromyogram was recorded. Results:After the treatment those in the 5Hz and 20Hz groups had improved significantly in terms of average bladder capacity, bladder pressure, residual urine volume, daily number of urethral catheterizations, daily micturition frequency, single urine output, H-reflex latency, and the amplitude and incubation period of the F wave. Those in the sham stimulation group showed no consistent improvement in any of these indicators. Moreover, the average residual urine volume, daily urination frequency and H-reflex latency and amplitude of the 20Hz group were significantly better than those of the 5Hz group.Conclusions:Magnetic stimulation of the S3 nerve roots can effectively improve the urination of persons with neurogenic bladder disorders after a spinal cord injury. The preferred frequency is 20Hz.

Simultaneous determination of four kinds of components in Erchen Decoction by UPLC-MS/MS / 国际中医中药杂志

Objective:To develop the UPLC-MS/MS method for the determination of hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid in Erchen Decoction. Methods:The separation was performed on Phenomenex Gemini C18, isocratic elution was carried out with mobile phase consisting of acetonitrile - 2 mmol/L ammonium formate. The mass spectrometer was operated in the positive and negative ionization electrospray (ESI) mode using multiple monitoring (MRM) for analysis of four components. External standard methods fix quantity. The precursor to product ion transitions monitored for hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid were m/z 611.2→303.1, 455.2→407.2, 166.2→148.2 and 821.4→350.9, respectively. Results:Hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid were all analyzed exactly, the linear ranges were 0.010 0-0.400 0, 0.006 3-0.250 0, 0.012 5-0.500 0, 0.002 5-0.100 0 ng, respectively. The r were 0.998 2, 0.998 8, 0.999 4 and 0.999 1, respectively. The recovery rateof the four analytes ranged from 98.45% to 102.60% and the RSD were all below 1.67%. Conclusion:This UPLC-MS/MS method is sensitive, accurate and suitable hwhich could be applied for the determination of hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid in Erchen Decoction.

Time series analysis on the effect of ambient fine particulate matters and temperature interactions on schizophrenia admission in Tongling City of Anhui Province, 2014-2017 / 中华预防医学杂志

Objective@#To explore the effect of ambient fine particulate matters (PM2.5) and temperature interaction on schizophrenia admission.@*Methods@#All admission data were retrieved from the Psychiatric Hospital and Municipal Hospital of TongLing from January 1, 2014 to December 31, 2017. Daily air pollution and meteorological data were collected from the Tongling Environmental Protection Agency and Meteorological Bureau, respectively. A distributed lag non-linear model combined with the generalized additive model were applied to explore the effects of PM2.5, multi-pollutants, and the interaction between temperature and PM2.5 on schizophrenia admission. The stratification of temperature was divided by three criteria. The low temperature layer was defined as <P5 or <P10 or <P20; P5-P95 or P10-P90 or P20-P80 was defined as the middle temperature layer; >P95 or >P90 or >P80 was defined as the high temperature layer.@*Results@#From 2014 to 2017, 6 642 patients were admitted for schizophrenia in Tongling, and the median of PM2.5 and temperature were 47.0 μg/m3 and 17.5 ℃, respectively. The median concentration of PM2.5 (P50) was taken as a reference. When the exposure concentration of PM2.5 was P90, the lagged effect appeared in the first day with RR=1.03 (95%CI: 1.00-1.07) and reached the maximum in the fifth day with RR=1.16 (95%CI: 1.13-1.19). In the multi-pollutant models, it was found that the simultaneous inclusion of PM2.5 and NO2 had higher risk of schizophrenia admission, with the RR=1.18 (95%CI: 1.15-1.22), P<0.001. The risk of schizophrenia admission caused by PM2.5 exposure at high temperature was greatest under the three temperature stratification standards, which were 12.1% (8.5%-15.7%), 9.7% (6.9%-12.6%) and 17.1% (11.6%-22.8%), all P values <0.001.@*Conclusion@#With the increase of PM2.5 concentration, the risk of schizophrenia admission is increased, and the risk effect of PM2.5 is stronger at high temperature.

Clinical application of horizontal transection of the triangular flap for epicanthal plasty / 中华整形外科杂志

Obiective@#To explore the method and clinical effect of epicanthal plasty.@*Methods@#Transverse incision of epicanthus was applied on the horizontal line of the epicanthus to separate and release the orbicularis oculi muscle and the fibrous tissue and moderately remove the abnormal orbicularis oculi muscle. The redundant triangular flap under the incision was removed, and the superficial ligament of epicanthus was sutured and fixed to the dorsal nasal fascia with 1 stitch, so as to achieve correcting the epicanthus.@*Results@#The epicanthus of the 121 patients was corrected after the surgery with their lacrimal caruncle exposed. The appearance of the endocanthion is pleasing, the skin of the endocanthion is smooth, the scar is invisible, and the oculi rimae is lengthened 1 to 3 mm.@*Conclusions@#The operation has achieved a satisfactory effect. Therefore, the horizontal transection to remove the triangular flap is applicable for most epicanthus due to its simplicity and practicality, as well as the invisible scar and simultaneous manipulation with other operations. These features might be significant for a wider clinical application.

High-throughput sequencing analysis of gut microbiota in patients with schizophrenia in the stage of onset and remission / 中国神经精神疾病杂志

Objective To investigate the differences of gut microbiota in patients with schizophrenia between onset and remission. Methods Twelve patients with schizophrenia in the stage of onset were selected as the episode group. Thirteen gender-, age-and BMI-matched patients with schizophrenia during the remission period were selected as the control group. The fecal specimens of the two groups were collected for high-throughput sequencing of the 16S rRNA gene, and the gut microbiota differences between the two groups were analyzed. Results The chao index and ace index of gut microbiota was lower in the episode group than in the control group (t=2.385,P=0.026; t=3.068,P=0.005). The relative abundance of Bacteroides was higher and the relative abundance of Prevotella was lower in the episodes group than in the control group (Z=-2.013, P =0.044; Z=-3.427, P=0.001). The relative abundance of the Prevotella was negatively correlated with the PANSS score (r=-0.577, P=0.003). Conclusion Schizophrenia in the stage of acute episode have altered gut microbiota compared with those in the stage of remission and the gut microbiota is significantly corrected with mental symptoms.

Flexible dilatation combined with topical betamethasone cream in treatment of child phimosis / 中华全科医师杂志

Two hundred and twenty five children aged 4-12 years with phimosis were treated by flexible dilatation combined with topical betamethasone cream from January 2003 to January 2015.Two hundred and eight cases (92.44％) were completely cured and penile edema and urination were returned to normal 7 d after a single operation;while,17 children received 2-3 additional flexible expansion.During follow-up of 2-24 months,221 children achieved the cure standards with an overall cure rate of 98.22％.Flexible dilatation combined with topical betamethasone cream is effective modality for phimosis in children,with less surgical trauma and low complication rate.

The preliminary outcomes of percutaneously looped thread transection in the surgical treatment of carpal tunnel syn-drome / 中华骨科杂志

Objective To study the preliminary effects of percutaneously looped thread transection on the surgical treatment of carpal tunnel syndrome (CTS). Methods A total of 72 cases (103 sides) were treated from January 2012 to Decem?ber 2014 (27 males and 45 females, aged 22-94 years, with an average of 51.3 years). Among all the cases, 21 cases (30 sides) were treated with open decompression and 51 cases (73 sides) were treated with percutaneously looped thread transection. We did the incision in the ulnaris hypothenar pattern, revealed and cut off the transverse carpal ligament to decompress the carpal tunnel in the open surgery. Percutaneously looped thread transection was under the guidance of ultrasound, threading from the deep and shallow transverse carpal ligament, respectively, forming loops to cut off and decompressed the carpal tunnel. We observed the me?dian nerve aspect ratio (the ratio of length to width of the uncinatum median nerve on transverse section) and swelling ratio (the ra?tio of area of median nerve on transverse section of pisiform and distal radius) under ultrasound before, during and 3 months after operation. Telephone follow?up was conducted in postoperative 3 months according to the Boston Carpal Tunnel Questionnaire (BCTQ) to evaluate the symptoms of carpal tunnel syndrome and wrist joint function. Results There were 11 cases lost in the fol?low?up, and 61 cases were followed up for 3 to 27 months, with an average of 11.6 months. The preoperative BCTQ scores of open decompression group and looped thread transection group were 28.5±4.6 and 29.4±5.3, respectively. There was no statistically sig?nificant difference between two groups (t=1.34, P=0.528). The postoperative 3 months BCTQ scores were 16.3±5.7 and 15.7±4.9. There was no statistically significant difference between two groups (t=1.12, P=0.674). The median nerve aspect ratios measured under ultrasound of open decompression group before and 3 months after operation were 3.8 ± 0.7 and 2.6 ± 0.4, respectively. The swelling ratios were 2.3±0.4 and 1.2±0.3. The difference of preoperative and postoperative changes was statistically significant (P<0.05). The median nerve aspect ratios measured under ultrasound of looped thread transection group before and 3 months after op?eration were 3.9±0.6 and 2.7±0.5, respectively. The swelling ratios were 2.1±0.3 and 1.4±0.4. The difference of preoperative and postoperative changes was statistically significant (P<0.05). There were no infection, poor healing, blood vessel and nerve damage after operation in both two groups. Conclusion Percutaneously looped thread transaction under ultrasound for the surgical treat?ment of CTS has less trauma and rapid recovery. It can improve the symptoms of median nerve stimulation, restore the morphology and function of the median nerve and reach the same effects as the open decompression surgery.

Rhytidectomy by multi-method joint application of W incisions in temporal hair line / 中华医学美学美容杂志

Objective To introduce an operative method of rhytidectomy with W-incision and fewer complications for facial rejuvenation.Methods A total of 84 patients were treated with rhytidectomy by multi-methods and followed up from January 2007 to December 2012.The rhytidectomy was done along the temporal hairline edge through the combined procedures,including sharp and blunt separation,liposuction and filling with autologous fat,tighting and fixing the fascial flap of superficial musculoaponeurotic system,as well as the suspension of the zygomatic cheek fiber fat pad.Results Follow-up for 3 moths to 2 years after surgery in 84 patients showed that the wound was healing with good concealment and without complications such as facial nerve injury or local uneven.All the cases achieved good results in facelift with high satisfaction rate after the combined operations.Conclusions This combined rhytidectomy is safe,effective,simple and easy.And it is a good and ideal approach of facial rejuvenation worthy of clinical application.

The application of delayed skin grafting combined traction in severe joint cicatricial contracture / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture.</p><p><b>METHODS</b>At the first stage, the joint cicatricial contracture was released completely with protection of vessels, nerves and tendons. The wound was covered with allogenetic skin or biomaterials. After skin traction for 7-14 days, the joint could reach the extension position. Then the skin graft was performed on the wound. 25 cases were treated from Mar. 2000 to May. 2013.</p><p><b>RESULTS</b>Primary healing was achieved at the second stage in all the cases. The skin graft had a satisfactory color and elasticity. Joint function was normal. All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse, except for one case who didn' t have enough active exercise on shoulder joint.</p><p><b>CONCLUSION</b>Delayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.</p>

Effect of deferasirox on DLL4 expression and angiogenesis in a slender narrow pedicle and random flap in rats / 中华医学美学美容杂志

Objective To investigate the effect of deferasirox on DLL4 expression and angiogenesis in a narrow pedicle and random flap in rats.Methods Twenty SD rats were randomly divided into the deferagirox group and control group.Rats were subjected to deferagirox of 100 mg · kg-1 · d-1 inthe experimental groups,respectively and the same dose saline in the control group for 1 week. In each group,flap were created in the bilateral back of each rats.Ratio of length to width of tissue in the pedicle portion and the flap portion was 1 cm × 1 cm and 3 cm × 3 cm,respectively.The tissue samples were taken from the pedicle and the middle portions of the flap.The DLL4 and CD105 expression was also detected with immunohistochemistry (SABC).Results Compared with control group,whatever in the pedicle portion or the middle portion,there was a significant increase of microvessels marked by CD105 and a significant decrease of flap microvessels stained by DLL4 in the deferagirox group.In both groups,compared with the pedicle portion,there was a significant increase of microvessels marked by CD105 and DLL4 in the the middle portion.Conclusions Deferasirox can in crease the CD105 expression and angiogenesis of the slender narrow pedicle random flap.This process might be related to the inhibition of DLL4 protein expression,which is significant in the notch signaling pathway.

Mimic hypoxia of deferasirox in improving growth of micrangium in a narrow pedicle flap / 中华医学美学美容杂志

Objective To study the function of hypoxia mimics of different exposure time of deferasirox in improving the growth of micrangium in a narrow pedicle flap.Methods Fourty male SD rats were divided into 2 groups:experimental group was fed with deferasirox 100 mg/kg per day from 1d,3d,5d and 7d,respectively,before the surgery of transferring the narrow pedicle flap,while control group just fed with saline.After 7 days,the immunohistochemistry,Western blot and quantitative reverse transcription-PCR (qPCR) were performed to examine the expression of CD34.qPCR was used to examine the expression of HIF-1α,VEGF in order to investigate the regulatory effect of deferasirox in improving the growth of micrangium and the distinction among the different exposed time of deferasirox in the narrow pedicle flap.Results The deferasirox group exhibited a marked improvement in flap healing time,and with the increasing administration time of deferasirox,the expression of MVD,HIF-1α and VEGF was improved in each treated group (P＜0.05).Conclusions Deferasirox can induce HIF-1α secretion and increase CD34 expression,and so deferasirox can protect endothelial cells from hypoxic and ischaemic injury.