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INTRODUCTION@#The aim was to study the prevalence of burnout among various groups of healthcare professionals in Singapore.@*METHODS@#An anonymous online survey questionnaire was conducted using the Maslach Burnout Inventory - Human Services to measure three categories of burnout: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA) from July 2019 to January 2020 in a healthcare cluster in Singapore.@*RESULTS@#The survey was completed by 6,048 healthcare professionals out of a target survey population of 15,000 (response rate 40.3%). The study revealed 37.8% of respondents had high EE score ≥27, 29.7% of respondents had high DP score ≥10, and 55.3% of respondents had low PA score ≤33. Respondents with either high EE score or high DP score constituted 43.9% (n=2,654). The Allied Health group had the highest mean EE score, which was significantly higher than those of Medical, Nursing and Non-clinical groups (P<0.05). The Medical group had the highest mean DP score and this was significantly higher than the Nursing, Allied Health and Non-clinical groups (P<0.05). The Non-clinical group had the lowest PA, which was significantly lower than the Medical, Nursing and Allied Health groups (P<0.005).@*CONCLUSION@#There was high prevalence of burnout among healthcare professionals in Singapore, especially the allied health professionals. There were significant differences in the 3 categories of burnout (EE, DP and PA) among the different groups of healthcare professionals. There is an urgent need to address the high burnout rate.
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Burnout, Professional/psychology , Delivery of Health Care , Health Personnel/psychology , Humans , Prevalence , Singapore/epidemiology , Surveys and QuestionnairesABSTRACT
Objective@#To analyze household determinants of adolescents non suicidal self injury(NSSI), and to provide scientific basis for NSSI intervention amogn adolescents.@*Methods@#Using stratified random cluster sampling method, 15 623 middle school students aged 11-20 were selected from Heilongjiang, Anhui, Hubei, Yunnan, and Guangdong provinces, and non suicidal self injury and related household determinants were investigated by questionnaire.@*Results@#The survey showed that 28.8% of people who had NSSI in the past year accounted;among them,17.6% had 1-4 times(occasional self injury) and 11.2% had 5 times or more(repeated self injury) univariate results showed that whether they were an only child, family type, educational level of the main caregiver, family rearing style, family monthly income per capita, and whether there was a family history of mental illness was associated with adolescents NSSI ( χ 2=6.30-12.16, P <0.05); multivariate Logistic regression analysis showed that whether one child or family parenting style is still significantly related to occasional NSSI( OR =1.11,1.34, P <0.05)after controlling for gender, age, grade, ethnicity, emotional control, resilience, loneliness and social support; whether it is an only child, educational level of the main caregiver and family parenting style are still significantly related to repeated NSSI ( OR =1.19，0.69，1.57， P <0.05); stratified analysis by region shows that the influencing factors of NSSI in adolescents in each region are different.@*Conclusion@#Family factors such as the only child and the education level of the main caregiver may be related to the occurrence of adolescents NSSI, but there are regional differences in the family impact of NSSI.
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Objective:To establish the ultra-performance liquid chromatography （UPLC） fingerprints of Artemisiae Argyi Folium and Artemisiae Argyi Folium processed with four excipients， and quantitatively analyze the 8 phenolic acids and flavonoids contained in them， in order to explore the quality evaluation method of Artemisiae Argyi Folium processed with four excipients. Method:UPLC was used with Shim-pack XR-ODS C<sub>18</sub> column （2.0 mm×75 mm， 2.2 µm）， mobile phase of acetonitrile （A） -0.2% formic acid aqueous solution （B） for gradient elution （0-1 min， 10%A； 1-2 min， 10%-15%A； 2-17 min， 15%-18%A； 17-24 min， 18%-28%A； 24-36 min， 28%-38%A； 36-41 min， 38%-60%A； 41-45 min， 60%-100%A）， detection wavelength of 330 nm and flow rate of 0.2 mL·min<sup>-1</sup>. The UPLC fingerprints of Artemisiae Argyi Folium before and after processing were established， and analyzed by chemometrics. Contents of 5-caffeoylquinic acid， 3-caffeoylquinic acid， 4-caffeoylquinic acid， 3，4-dicaffeoylquinic acid， 3，5-dicaffeoylquinic acid， 4，5-dicaffeoylquinic acid， jaceosidin and epuatilin in the decoction pieces were determined. Result:The fingerprints of Artemisiae Argyi Folium before and after processing were established， and the UPLC characteristic chromatograms of Artemisiae Argyi Folium before and after processing had good consistency， and the similarity was >0.94. Compared with Artemisiae Argyi Folium， the contents of 3-caffeoylquinic acid and 3，4-dicaffeoylquinic acid had no significant change after processing， the contents of jaceosidin and epuatilin decreased after processing， while the contents of 5-caffeoylquinic acid， 4-caffeoylquinic acid and 4，5-dicaffeoylquinic acid increased significantly （<italic>P<</italic>0.01）， their average increasing rates were 32.50%， 66.83%， 29.39%， respectively. And content of 3，5-dicaffeoylquinic acid was significantly decreased （<italic>P<</italic>0.01） ， and the average reduction rate was 51.25%. Conclusion:The contents of chemical components in Artemisiae Argyi Folium and Artemisiae Argyi Folium processed with four excipients have changed to a certain extent. Among them， 5-caffeoylquinic acid， 3，5-dicaffeoylquinic acid， 4-caffeoylquinic acid and 4，5-dicaffeoylquinic acid can be used as the key indicators for quality evaluation of Artemisiae Argyi Folium before and after processing.
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Objective To explore the potential targets and synergistic mechanisms of Kushen Decoction for the treatment of cryptosporidiosis using network pharmacology and molecular docking methods. Methods The main active ingredients of Kushen Decoction were captured from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TC-MSP) and the Universal Protein Resource (UniProt) database, and the potential targets were predicted. In addition, the active ingredients of Kushen Decoction that were not included in the TCMSP database were retrieved in CNKI, WanFang Data, CBM, PubMed and Web of Science databases, and the target genes of all supplemented active ingredients were predicted using the online TargetNet database. Network construction and analysis were performed using the Cytoscape software, and cryptosporidiosis-related targets were retrieved in the Comparative Toxicogenomics Database and GeneCards database. The protein-protein interaction (PPI) network was created using the STRING database, and the DAVID database was used for GO enrichment and KEGG pathway analyses. The tissue distribution of key targets was investigated using the BioGPS database, and the AutoDockTools software was employed to verify the molecular docking results. Results A total of 38 active ingredients of Kushen Decoction were screened, and the core ingredients included quercetin, (+)-14α-hydroxymatrine and apigenin. A total of 831 targets of Kushen Decoction and 512 cryptosporidiosis-related targets were predicted, and PPI network analysis revealed 69 key targets, including AKT1, TNF and IL-6. There were 303 biological processes, 46 molecular functions and 29 cellular components involved in the treatment of cryptosporidiosis with Kushen Decoction, and 13 KEGG pathways played a therapeutic role in the synergistic mechanisms of multiple targets, such as Toll-like receptor (TLR), nuclear factor kappa B(NF)-κB, nucleotide binding oligomerization domain like receptor (NLR) signal pathways. The core targets were mainly distributed in the hematologic and immune systems. Molecular docking analysis showed that the binding energy between active ingredients and key targets were all less than 0 kJ/mol, indicating the strong binding of ligands to receptors. Conclusions The active ingredients of Kushen Decoction, such as quercetin, (+)-14α-hydroxymatrine and apigenin, may act on targets like AKT1, TNF, IL-6 to modulate TLR, NLR and NF-κB signaling pathways to play a synergistic role in the treatment of cryptosporidiosis in the hematologic and immune system.
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OBJECTIVE@#To investigate the mechanistic basis for the attenuation of bone degeneration by edible bird's nest (EBN) in ovariectomized rats.@*METHODS@#Forty-two female Sprage-Dawley rats were randomized into 7 groups (6 in each group). The ovariectomized (OVX) and OVX + 6%, 3%, and 1.5% EBN and OVX +estrogen groups were given standard rat chow alone, standard rat chow +6%, 3%, and 1.5% EBN, or standard rat chow +estrogen therapy (0.2mg/kg per day), respectively. The sham-operation group was surgically opened without removing the ovaries. The control group did not have any surgical intervention. After 12 weeks of intervention, blood samples were taken for serum estrogen, osteocalcin, and osteoprotegerin, as well as the measurement of magnesium, calcium abd zinc concentrations. While femurs were removed from the surrounding muscles to measure bone mass density using the X-ray edge detection technique, then collected for histology and estrogen receptor (ER) immunohistochemistry.@*RESULTS@#Ovariectomy altered serum estrogen levels resulting in increased food intake and weight gain, while estrogen and EBN supplementation attenuated these changes. Ovariectomy also reduced bone ER expression and density, and the production of osteopcalcin and osteorotegerin, which are important pro-osteoplastic hormones that promote bone mineraliztion and density. Conversely, estrogen and EBN increased serum estrogen levels leading to increased bone ER expression, pro-osteoplastic hormone production and bone density (all P<0.05).@*CONCLUSION@#EBN could be used as a safe alternative to hormone replacement therapys for managing menopausal complications like bone degeneration.
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To introduce the historical origin of five element acupuncture and its development after returning to China, including the domestic inheritance mode, the clinical application, the establishment and operation of the Society of Five Element Acupuncture. This paper analyzed the challenges and opportunities faced by the development of five element acupuncture in China, which provides reference for the further development and expansion of the five element acupuncture.
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Acupuncture Therapy , China , MoxibustionABSTRACT
Objective:To provide the basis for integration of Traditional Chinese Medicine (TCM) and medical care in cities by taking the elderly care workers in Pudong New District of Shanghai as a sample, investigate the current situation of cognition, training demand and willing to supply among them, promote training of TCM and medical care.Methods:From May to July 2019, nine long-term care facilities were conveniently selected around traditional Chinese medicine hospital Y in Pudong New Area, Shanghai, and 134 elderly care workers were randomly surveyed to understand the basic situation of the characteristics of traditional Chinese medicine services. Awareness, training demand and willing to supply are statistically analyzed using χ2 test to analyze their influencing factors. Results:A total of 134 elderly care workers in nine long-term care facilities were investigated by convenient method, only 37.3% (50/134) didn′t know about Traditional Chinese Medicine Characteristic Services, but 71.6% (96/134) need training. There were significant differences in the scores of cognition of the elderly care workers between different gender, age, education level, working experiences ( χ2 values were 9.512-28.057,respectively, all P<0.05), There were significant differences in the scores of training demand of the elderly care workers between different gender, age, education level ( χ2 values were 10.425, 10.569, 13.088,respectively,all P<0.05). Among the Chinese medical items, In the training needs, the daily rhythm of daily life (3.82±0.67), the classification, characteristics and efficacy of food (3.38±0.73), the common used traditional Chinese medicine (3.23±0.84), the relationship between emotion and health (3.32±0.65), exercise and health care method (3.47±0.58), acupoint massage (3.50±0.72) in the traditional Chinese appropriate technique has higher score. In terms of willing to supply, cupping in suitable techniques of Chinese medicine (3.31±0.79) had the highest score, other items with higher scores were similar to training needs. Conclusions:The awareness of the traditional Chinese medicine service of the elderly workers needs to be improved. It is necessary to strengthen the training and promotion of key projects such as daily health care, diet care, acupoint massage, sports health care, etc, and increase the training of Chinese medicine professionals. Strengthen and increase the participation rate of integrated medical, medical and nursing services.
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ObjectiveTo explore the applicability of semi-quantitative comprehensive index method in occupational health risk assessment in domestic waste incineration industry. MethodsThe flue gas purification system in a domestic waste incineration plant was selected as the study subject. The risk assessment of chemical hazards were conducted using semi-quantitative comprehensive index method in the “Guidelines for occupational health risk assessment of chemicals in the workplace” （GBZ/T 298—2017）. ResultsThe occupational health risk levels of hydrogen chloride， sulfur dioxide and activated carbon were low while using flue gas purification system， while the risk levels of lead and lead compounds， cadmium and cadmium compounds， ammonia and sodium hydroxide were medium. ConclusionThe assessment results of semi-quantitative comprehensive index method are basically consistent with the current situation of occupational health risk of flue gas purification system in a domestic waste incineration plant， which can provide the basis for enterprises to take occupational health risk control measures.
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ObjectiveTo explore the applicability of semi-quantitative comprehensive index method in occupational health risk assessment in domestic waste incineration industry. MethodsThe flue gas purification system in a domestic waste incineration plant was selected as the study subject. The risk assessment of chemical hazards were conducted using semi-quantitative comprehensive index method in the “Guidelines for occupational health risk assessment of chemicals in the workplace” （GBZ/T 298—2017）. ResultsThe occupational health risk levels of hydrogen chloride， sulfur dioxide and activated carbon were low while using flue gas purification system， while the risk levels of lead and lead compounds， cadmium and cadmium compounds， ammonia and sodium hydroxide were medium. ConclusionThe assessment results of semi-quantitative comprehensive index method are basically consistent with the current situation of occupational health risk of flue gas purification system in a domestic waste incineration plant， which can provide the basis for enterprises to take occupational health risk control measures.
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Objective:To study the quality evaluation method of Cyperi Rhizoma processed with four excipients. Method:Ultra-performance liquid chromatography （UPLC） fingerprints of raw products and processed products with four excipients of Cyperi Rhizoma were established， and the changes of chemical components in the fingerprints before and after processing were compared by chemometric analysis. The mobile phase was consisted of methanol （A）-water （B） for gradient elution （0-10 min， 5%-40%A； 10-30 min， 40%-70%A； 30-40 min， 70%A） at a flow rate of 0.3 mL·min<sup>-1</sup>. The injection volume was 3 μL， the column temperature was 35 ℃， and the detection wavelength was 280 nm. The content changes of main index components in Cyperi Rhizoma before and after processing were compared by UPLC. The mobile phase was methanol-water （75∶25） and the detection wavelength was 242 nm. Result:Processing with four excipients had a significant impact on the overall characteristics of chemical components in the fingerprint of Cyperi Rhizoma. A total of 28 characteristic peaks were identified in fingerprints of the raw and processed products. Among them， peaks 1， 2 and 4 were specific peaks of the processed products， peak 5 was characteristic peak of the raw products. Peak 2 was identified as 5-hydroxymethylfurfural， peak 24 as cyperenone and peak 27 as <italic>α</italic>-cyperone. The 5-hydroxymethylfurfural produced by the processing with four excipients came from rice vinegar， rice wine and Maillard reaction of polysaccharides in Cyperi Rhizoma. The results of determination showed that there was no significant difference in the content of cyperenone after processing， but the content of <italic>α</italic>-cyperone decreased significantly. Conclusion:In the process of Cyperi Rhizoma processed with four excipients， there are new components produced by structural transformation， which are accompanied by changes in the content of index components. In this study， the quality of raw and processed products of Cyperi Rhizoma can be rapidly and effectively evaluated from qualitative and quantitative aspects.
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Objective:To investigate the effective constituents and mechanism of Tingli Dazao Xiefeitang for the treatment of heart failure through network pharmacology and high resolution mass spectrometry technique as well as molecular docking technique. Method:Chemical components and potential targets in Descurainiae Semen Lepidii Semen and Jujubae Fructus were searched by referring to literature and BATMAN-TCM database. The disease targets were searched in GeneCards database with ''heart failure'' as the key word. STRING platform was used to construct protein-protein interaction（PPI） network based on common targets of drugs and disease. The network topology was analyzed by using Cytoscape 3.7.2 software to obtain the core targets eventually. Kyoto encyclopedia of genes and genomes（KEGG） enrichment analysis of the core targets was conducted through DAVID database to draw a network of “herb-compound-target-pathway”. Based on the results of the network pharmacology research above，high resolution mass spectrometry was used to analyze the decoction and confirm the selected active components. AutoDock 4.2.6 software was used for molecular docking verification of key active components and related targets. Result:A total of 85 components were obtained in Descurainiae Semen Lepidii Semen，and 49 components were obtained in Fructus Ziziphi Jujubae. A total of 1 078 drug targets and 1 549 disease targets were identified. After PPI analysis and network topology analysis，23 core targets and 33 active components were obtained，involving 19 signaling pathways （<italic>P</italic><0.05）. Mass spectrometry analysis results indicated that 18 components such as isovanillic acid，descuraininA and kaempferol-7-<italic>O-β-D</italic>-glucopyranoside were confirmed in decoction. Molecular docking analysis results indicated that 6 core components （degree value top 6），such as isovanillic acid，descurainin A and kaempferol-7-<italic>O-β-D</italic>-glucopyranoside，had good binding activity with silent information regulatory factor 1（SIRT1），interleukin（IL）1B，protein kinase B<italic>α</italic>（AKT1） and tumor necrosis factor（TNF）. The compound recipe for heart failure mainly involved mitogen-activated protein kinase（MAPK），hypoxia inducible factor-1（HIF-1），Mammalian target of rapamycin（mTOR） and other signaling pathways. Conclusion:This study preliminarily investigated the effective constituents and mechanism of Tingli Dazao Xiefeitang in the treatment of heart failure. It can provide references for the precise clinical medication and screening of quality control markers，as well as the discovery of active components in the treatment of heart failure.
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OBJECTIVE: To explore the distribution characteristics of single nucleotide polymorphism(SNP) rs7072793 and rs3118470 in the 5′ flanking region of(cluster of differentiation 25, CD25) gene in Han males in the naturally high radiation background area(HBRA). METHODS: A random sampling method was used to select 48 and 51 healthy Han males from Tangkou town(HBRA group) in Yangjiang City and Hengpo town(control group) in Enping City, respectively, as the study subjects. The molecular mass array method was used to classify the genotype of the SNP sites rs7072793 and rs3118470 of CD25 gene in these subjects. The distribution difference of the alleles and genotypes was analyzed in individuals of these two groups. The allele frequency of HBRA population was compared with the distribution data of different populations in the Human Genome Project.RESULTS: The distribution of allele frequencies of rs7072793 and rs3118470 in both groups were consistent with the H-W equilibrium law of genetics(all P>0.05). In the HBRA group, variant allele C(58.3%) and genotype TC(50.0%) were dominant at rs7072793, wild-type allele T(55.2%) and genotype TC(56.2%) were dominant at rs3118470. There was no significant difference in the allele and genotype distributions between these two groups(all P>0.05). There was a difference of rs7072793 in the HBRA group compared to that of African and European populations, and rs3118470 in the HBRA group compared with the allele distribution frequencies in Africa, Europe and America populations(all P<0.05). CONCLUSION: In the male population of Han nationality in Yangjiang HBRA area, the alleles of rs7072793 and rs3118470 in the 5′ flanking region of CD25 gene were mainly C and T, respectively, and the genotypes were mainly TC. These two loci may have high genetic variability.
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An UPLC-MS/MS method was developed to simultaneously determine complanatoside A and complanatoside B in rat plasma with rutin as the internal standard and applied to examine the effect of salt-processing on pharmacokinetics of these two flavonoid glycosides. The pharmacokinetic parameters were estimated using DAS 3.2.6 and subjected to independent sample t-test with SPSS 23.0. No significant difference in T_(max) of complanatoside B was observed between the raw and processed groups; however, in the processed group, C_(max) and AUC_(0-12 h) of complanatoside B increased obviously(P<0.05), while MRT_(0-12 h) decreased from(3.34±0.44) h to(1.81±0.36) h(P<0.05). C_(max) [(14.72±11.13) μg·L~(-1)] and MRT_(0-24) [(3.93±0.26) h] of complanatoside A in the raw group were statistically different from those [(35.64±21.99) μg·L~(-1),(1.43±0.24) h] in the processed group(P<0.05). As a result, salt-processing can facilitate the in vivo adsorption and accelerate the excretion of complanatoside A and complanatoside B.
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Animals , Astragalus Plant , Chromatography, High Pressure Liquid , Chromatography, Liquid , Glycosides , Rats , Semen , Tandem Mass SpectrometryABSTRACT
The present study analyzed the current Chinese medicinal health products and Chinese patent medicines effective in boosting memory,aiming at providing references for the formulation and development of memory-boosting health products. The information on memory-boosting health products published by the Department of Special Food Safety Supervision and Management,the State Administration for Market Regulation( SAMR) was collected and the Chinese patent medicines on DRUGDATAEXPY were searched. Microsoft Excel and the TCMISS were used to statistically analyze the characteristics of formulations. A total of 212 memory-boosting health products were obtained from SAMR,including 83 ones containing Chinese medicinal materials. Twelve Chinese herbal medicines showed a usage frequency ≥ 8,with 151 times in use. In DRUGDATAEXPY,258 similar Chinese patent medicines were collected.Twelve Chinese herbal medicines showed a usage frequency ≥ 58,with 907 times in use. Through unsupervised hierarchical entropybased clustering of the above-mentioned Chinese medicinal health products and Chinese patent medicines separately,5 and 12 new formulas were obtained. The selection of Chinese herbal medicines for the new formulas was consistent with the principles of traditional Chinese medicine( TCM) theories,i. e.,tonifying kidney and marrow,benefiting Qi,nourishing Yin,resolving phlegm,and eliminating stasis. According to TCM theories,syndrome differentiation of the users was conducted,and the formulas were designed following the correspondence of syndromes with formulas and Chinese herbal medicines. This study is expected to provide new ideas and methods for the development of Chinese medicinal health products and accurately guide practical applications to exert the advantages of TCM in health care based on syndrome differentiation and improve the effect of Chinese medicinal health products.
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China , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Nonprescription Drugs , SyndromeABSTRACT
Objective:To examine the correlations of microRNA-34c(miR-34c) expression in the peripheral blood with the onset of diabetic foot ulcer(DFU)and diabetic foot osteomyelitis(DFO)in patients with type 2 diabetes mellitus(T2DM).Methods:Sixty newly-diagnosed T2DM patients without DFU(T2DM group), 112 T2DM patients with DFU(DFU group), and 60 healthy controls with normal glucose tolerance(NC group)were included. The 112 T2DM patients with DFU were further divided into DFO( n=64)and NDFO( n=48)groups. The levels of miR-34c were determined by quantitative real-time PCR, while clinical features and risk factors of DFU and DFO were explored. Results:A significant increase in the expression level of miR-34c in peripheral blood was observed in T2DM group compared with NC group[2.99(1.45-6.22) vs 1.01(0.89-1.52), P<0.05], and a markedly increased miR-34c expression level was noted in DFU group compared with T2DM group [9.65(6.15-18.63) vs 2.99(1.45-6.22), P<0.01]. Additionally, the expression level of miR-34c in peripheral blood significantly increased in DFO group compared to NDFO group [13.46(8.89-19.11) vs 6.02(5.93-14.72), P<0.01]. Moreover, there was a positive correlation between the expression level of miR-34c in peripheral blood and the amputation rate in patients in DFU group( P=0.030), and a negative correlation in the expression level of miR-34c( P=0.025)with healing rate of DFU after eight weeks. The multivariate logistic regression analysis confirmed that a high expression of miR-34c was an independent risk factor for DFU and DFO( OR=3.52, 4.13; both P<0.01). Conclusion:An increased expression of miR-34c in peripheral blood of T2DM patients might be closely related to the occurrence, development, and prognosis of DFU and DFO.
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Objective:To investigate the therapeutic efficacy of Golimumab in the treatment of children with refractory juvenile dermatomyositis(JDM).Methods:The clinical data of a child diagnosed with JDM in the Department of Allergy, Immunology and Rheumatology of Guangzhou Women and Children′s Medical Center in February 2019 were collected.The treatment effect was studied and literature review was conducted.Results:The patient was a 7-year-old boy with subacute onset of the disease.The illness protracted, and main manifestations included skin rashes, limb weakness, and swallowing dysfunction.Physical examination showed heliotropic rashes, Gottron papules, positive Gower, proximal limb muscle strength grade Ⅲ-Ⅳ, distal limb muscle strength grade Ⅳ, and a choking cough when swallowing fluid food.Laboratory tests revealed alanine aminotransferase (ALT) of 36 U/L, aspartate aminotransferase (AST) of 115 U/L, alkaline phosphatase of 69 U/L, lactate dehydrogenase of 941 U/L, creatine kinase of 974 U/L, hypersensitive C-reactive protein of 26 mg/L and an erythrocyte sedimentation rate (ESR) of 52 mm/1 h. Antinuclear antibody spectra were negative.Electromyography suggested myogenic damage.Thigh magnetic resonance imaging indicated diffuse abnormal signal shadows in the subcutaneous fat, muscles and muscle spaces of both hips, thighs and knee joints.The child was diagnosed with JDM, and given standardized treatment of Methylprednisolone, intravenous immunoglobulin, Methotrexate and Hydroxychloroquine sulfate.However, after the treatment, the facial rashes were still red, proximal limb muscle strength and swallowing dysfunction did not improve, the choking cough symptom still existed, and a Cushing face appeared.Recheck results showed ALT of 24 U/L, AST of 32 U/L, alkaline phosphatase of 56 U/L, lactate dehydrogenase of 216 U/L, creatine kinase of 527 U/L, hypersensitive C-reactive protein of 8 mg/L and an ESR of 15 mm/1 h. Refractory JDM was considered.After negotiating with the patient′s family members, they agreed to treat the patient with Golimumab 50 mg by subcutaneous injection once a month.Then tapered prednisone gradually, stopped Hydroxychloroquine sulfate tablets and continued to give the patient oral Methotrexate.After two doses of Golimumab 50 mg, proximal limb muscle strength and swallowing function improved markedly.After the third subcutaneous injection of Golimumab, proximal limb muscle strength improved to grade Ⅳ-Ⅴ, and he was able to go up and down stairs, squat and stand up after squatting.Besides, dysphagia and the choking cough disappeared, and skin rashes improved.Recheck results suggested a normal ESR and creatine kinase levels.Magnetic resonance imaging of thighs indicated no muscle inflammation.Conclusions:Golimumab works well in the treatment of refractory JDM and can effectively improve muscle strength.Therefore, it can be used as a treatment option for refractory JDM.
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Clinically, patients with IgA nephropathy often have symptoms of sore throat or discomfort in the pharynx, which needs to be paid attention to. Traditional Chinese Medicine has certain effect in the treatment of IgA nephropathy, starting from the pharynx.There are many commonly used herbal medicines that could relieve wind, clear heat, detoxify the body and relieve sore-thoat, such as platycodon grandiflorum, dandelion, burdock and other herbs, and pecking treatment could be added to increase the curative effect.
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Objective:To understand the risk characteristics of high-risk population of chronic disease in Shanghai， and provide theoretical basis for screening management and health intervention. Methods:The data from the 2013 Shanghai Non-communicable and Chronic Diseases Surveillance was used for analysis. People （aged 35 and over） who had no diagnosis of hypertension， diabetes and dyslipidemia but met the criteria for high-risk groups of chronic diseases were included in the study. Finally， 3 682 participants were included. Results:In this high-risk population， 62.90% of the subjects has total serum cholesterol level of 5.2-6.2 mmol/L， 35.88% had blood pressure level of （130-139）/（85-89） mmHg， 30.50% had abdominal obesity， 27.68% were current smokers， and 8.75% had fasting blood glucose level of 6.1-7.0 mmol/L. Among the different risk characteristics， the detection rate of smoking risk in men was higher than that in women （64.51% vs. 1.49%）. On the contrary， the detection rate of waist circumference and serum total cholesterol risk in women was higher than that in men （34.90% vs. 24.31% and 72.30% vs. 49.67%， respectively）. The differences were statistically significant （P<0.05）. The detection rates of the five high-risk characteristics were not the same in all age groups. The detection rate of blood pressure risk was relatively low， and the cholesterol risk was relatively high in the highly educated population. The blood pressure risk was the highest among agricultural practitioners （42.26%）. The detection rate of smoking risk was the highest in rural areas （31.45%）， and the risk of cholesterol was the highest in urban areas （68.54%）. The differences were statistically significant （P<0.05）. Among the high-risk groups of chronic diseases in Shanghai， the distribution of high-risk characteristics in genders， ages， and occupational types were not the same and the differences were statistically significant （P<0.05）. Conclusions:The level of risk characteristics among high-risk groups of chronic diseases in Shanghai is relatively high. Relevant departments should carry out targeted health interventions for different populations to reduce the level of risk factors in high-risk groups of chronic diseases and control the potential risk of chronic diseases.
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Objective:To understand the epidemiological characteristics of high-risk population of hypertension in Shanghai， and to provide references for health management and targeted lifestyle intervention of the high-risk population in community. Methods:The data from the 2013 Shanghai Non-communicable and Chronic Diseases Surveillance were used. The subjects who met the criteria of high-risk population of hypertension were included， and 11 753 subjects were finally identified， to analyze the distribution and level of risk characteristics. Result:Among six high-risk characteristics of hypertension， the detection rate of high salt in diet was the highest （55.3%）， followed by overweight/obesity （44.0%）， family history of hypertension （41.6%）， and blood pressure level of （130-139）/（85-89） mmHg （31.7%）. The detection rate of excessive drinking was the lowest （5.0%）. The percentage of population with one or two high-risk characteristics was higher than that with three or more high-risk characteristics （76.9% vs. 23.1%）. Systolic blood pressure， diastolic blood pressure， fasting plasma glucose level， and body mass index in the male high-risk group were higher than those in the female group， and the differences were statistically significant （P<0.05）. Systolic blood pressure， diastolic blood pressure， fasting plasma glucose level， body mass index and daily salt intake were different between different age groups， educational level and occupational types （P<0.05）. Systolic blood pressure， diastolic blood pressure， body mass index and daily salt intake were significantly different among high-risk groups with different marital status （P<0.05）. The daily salt intake and systolic blood pressure levels of high-risk population in different areas were significantly different （P<0.05）. Conclusion:We should identify high-risk groups of hypertension as early as possible and actively carry out community health management and targeted lifestyle interventions. The focus should be on the groups and individuals with high-risk characteristics such as dietary high salt and overweight/obesity， male， middle-aged and low-educated groups. In this way， we can reduce the level of high-risk characteristics， prevent and delay the occurrence of hypertension.
ABSTRACT
Kaempferiae Parviflorae Rhizoma is the dried rhizome of Kaempferia parviflora in Zingiberaceae. It is originated and widely distributed in Thailand and other tropical and subtropical regions, where it has been used as food and medicine for thousands of years. K. parviflora is also planted in Yunnan and other places of China, but its traditional Chinese medicine properties are not clear, which greatly limits its compatibility with traditional Chinese medicines. In this article, the English and Chinese literatures of K. parviflora were searched from Web of Science, PubMed, Scopus, CNKI, Wanfang, and VIP databases for research and analysis. The medicinal properties of K. parviflora were preliminarily discussed based on the theory of traditional Chinese medicine under the guidance of clinical application and research literatures. The traditional Chinese medicine properties of K. parviflora were inferred as follows: flat, acrid, sweet. The channel tropisms of K. parviflora included kidney, spleen, stomach, and liver. The function of K. parviflora included tonifying kidney to strengthen essence, tonifying Qi and invigorating spleen, soothing liver and relieving depression. K. parviflora was clinically applied for the diseases such as syndrome of kidney essence deficiency, sex apathy, deficiency of spleen Qi, lassitude and asthenia, a weary spirit, obesity, diabetes, liver Qi stagnation, depression, and restless. The equivalent of dry power is 1.5 g·d~(-1) and the equivalent of decoction is 1.5-6 g·d~(-1). The determination of traditional Chinese medicine properties of K. parviflora has indeed laid a theoretical foundation for its application in the field of traditional Chinese medicine and enriched traditional Chinese medicine resources.