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La presente publicación describe el contexto y los procesos del cambio climático global, sus repercusiones reales o probables en la salud y la forma en que deberían responder las sociedades humanas y sus gobiernos frente a los desastres de olas de calor, dedicando especial atención al sector de la salud

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Objetivo: Cuando las resinas compuestas son expuestas a procesos de envejecimiento naturales en boca, como es el ciclaje térmico, pueden sufrir un deterioro en sus propiedades ópticas. El objetivo de este estudio fue evaluar la influencia del envejecimiento térmico sobre la estabilidad del color de dos resinas compuestas. Materiales y métodos: Se confeccionaron 120 pas- tillas de resinas compuestas, divididas en dos grupos: uno de resina Spectra Smart (n=60) y otro de resina Filtex Z350 XT (n=60). Estas muestras fueron sometidas a distintos regíme- nes de ciclaje térmico de 0, 10.000, 20.000 y 30.000 ciclos con temperaturas de entre 5 ºC +/- 2 ºC y 55 ºC +/- 2 °C. Los parámetros de color CIE L*a*b* de cada muestra se mi- dieron con un espectrofotómetro antes y después del proceso de envejecimiento. Las diferencias de color se calcularon me- diante la fórmula CIELAB (ΔE). Los datos fueron analizados estadísticamente usando la prueba no paramétrica de Kruskal Wallis y de U-Mann Whitney. Resultados: Los distintos regímenes de termociclado produjeron cambios de color estadísticamente significativos en ambos materiales. El material que tuvo menor estabilidad cromática fue Spectra Smart aunque sin diferencias estadísti- camente significativas. Conclusión: El envejecimiento térmico simulado a tres años afecta la estabilidad de color de las muestras, tanto de las resinas Spectra Smart, como de Filtex Z350 XT, sin alcanzar los valores que clínicamente determinarían la necesidad del reemplazo de las restauraciones (AU)

Aim: When composite resins are exposed to natural ag- ing processes in the mouth, such as the thermal cycling, they may suffer a deterioration in their optical properties. The aim of this study was to evaluate the influence of thermal aging on the color stability of two composite resins. Materials and methods: 120 composite resins tablets were made, divided into two groups: one of Spectra Smart res- in (n=60) and another of Filtex Z350 XT resin (n=60). These were subjected to different thermal cycle regimes of 0, 10,000, 20,000 and 30,000 cycles with temperature between 5 °C +/- 2 °C and 60 °C +/- 2 °C. The CIE L*a*b* color parameters of each sample were measured with a spectrophotometer before and after the aging process. Color differences were calculat- ed using the CIELAB formula (ΔE). The data were statisti- cally analyzed using the non-parametric Kruskal Wallis and U-Mann Whitney tests. Results: The different thermocycling regimes produce statistically significant color changes in both materials. The material that had the least chromatic stability was Spectra Smart, although without statistically significant differences. Conclusion: Simulated 3 year thermal aging affects the color stability of the samples, both Spectra Smart resins and Filtex Z350 XT, without reaching the values that would clini- cally determine the need to replace the restorations (AU)

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Resumen (analítico) El cambio climático y el aumento de las olas de calor tienen un impacto negativo en el bienestar subjetivo de niños y jóvenes. Este estudio examinó la experiencia de bienestar en jóvenes chilenos frente a las olas de calor. Utilizando entrevistas y grupos focales, se seleccionaron diez participantes con diferentes trayectorias educativas y niveles de contacto con la naturaleza. Los resultados mostraron que predominaban percepciones negativas del clima y emociones displacenteras como preocupación y desmotivación. Sin embargo, se encontró que aquellos con mayor contacto con la naturaleza experimentaban un mayor bienestar subjetivo. Se concluye que las olas de calor asociadas al cambio climático afectan negativamente la salud mental, pero también se destaca el papel que desempeñan los jóvenes en las acciones de mitigación y adaptación ante el cambio climático.

Abstract (analytical) Climate change and the increasing occurrence of heatwaves have a negative impact on the subjective well-being of children and young people. This study examined the well-being of young Chileans during heatwaves. Using interviews and focus groups, ten participants with a range of educational backgrounds and different levels of contact with nature were selected. The results showed that negative perceptions of the climate and unpleasant emotions such as worry and feeling demotivated were prevalent among young people during heatwaves. However, it was identified that young people who have increased contact with nature experienced higher subjective well-being during these climate conditions. The authors conclude that heatwaves associated with climate change negatively affect young people's mental health. However, the role that young people play in climate mitigation and adaptation actions was also emphasized by participants in the study.

Resumo (analítico) A mudança climática e o aumento das ondas de calor têm um impacto negativo no bem-estar subjetivo de crianças e jovens. Este estudo examinou a experiência de bem-estar de jovens chilenos diante das ondas de calor. Utilizando entrevistas e grupos focais, foram selecionados dez participantes com diferentes trajetórias educacionais e níveis de contato com a natureza. Os resultados mostraram que predominavam percepções negativas do clima e emoções desagradáveis como preocupação e desmotivação. No entanto, descobriu-se que aqueles com maior contato com a natureza experimentavam um maior bem-estar subjetivo. Conclui-se que as ondas de calor associadas à mudança climática afetam negativamente a saúde mental, mas também destaca-se o papel desempenhado pelos jovens nas ações de mitigação e adaptação às mudanças climáticas.

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Cancer is one of the deadliest diseases affecting the health of human beings. With limited therapeutic options available, complementary and alternative medicine has been widely adopted in cancer management and is increasingly becoming accepted by both patients and healthcare workers alike. Chinese medicine characterized by its unique diagnostic and treatment system is the most widely applied complementary and alternative medicine. It emphasizes symptoms and ZHENG (syndrome)-based treatment combined with contemporary disease diagnosis and further stratifies patients into individualized medicine subgroups. As a representative cancer with the highest degree of malignancy, pancreatic cancer is traditionally classified into the "amassment and accumulation". Emerging perspectives define the core pathogenesis of pancreatic cancer as "dampness-heat" and the respective treatment "clearing heat and resolving dampness" has been demonstrated to prolong survival in pancreatic cancer patients, as has been observed in many other cancers. This clinical advantage encourages an exploration of the essence of dampness-heat ZHENG (DHZ) in cancer and investigation into underlying mechanisms of action of herbal formulations against dampness-heat. However, at present, there is a lack of understanding of the molecular characteristics of DHZ in cancer and no standardized and widely accepted animal model to study this core syndrome in vivo. The shortage of animal models limits the ability to uncover the antitumor mechanisms of herbal medicines and to assess the safety profile of the natural products derived from them. This review summarizes the current research on DHZ in cancer in terms of the clinical aspects, molecular landscape, and animal models. This study aims to provide comprehensive insight that can be used for the establishment of a future standardized ZHENG-based cancer animal model.

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BACKGROUND@#There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden.@*METHODS@#Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status.@*RESULTS@#A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status.@*CONCLUSIONS@#Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.

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Abstract Repeatedly frying process of dietary edible oil has a potential role in the generation of free radicals. Therefore, questions have always been raised as to whether, there is an efficient and economical method to reduce the harmful effects of repeated use of frying edible oil. Since hibiscus has been stated to have a wide variety of therapeutic effects, it was important to investigate its properties against harmful effects of free radicals. The current study aspires to find out whether irradiated powder of hibiscus has a protective role against adverse effects of repeated use of frying edible oil. Thirty-five adult male albino rats were equally assigned into five groups. First group"G1" was fed with normal diet as control group, meanwhile, group"G2" the diet mixed with fresh oil, "G3" diet mixed with repeatedly frying oil only, "G4" diet mixed with frying oil treated with hibiscus and "G5" diet mixed with frying oil treated with irradiated hibiscus. Feeding duration was six weeks. Fatty acid analyses of oil as well as peroxide values were determined. Blood and liver samples were collected for biochemical analyses as well as histological study. Repeatedly heated cooked oil has significant increases in peroxide value, acid value, free fatty acid and both conjugated diene and triene compared with repeatedly frying oil treated with hibiscus. Also there are significant increases in cholesterol and triglyceride and impaired in liver functions in "G3"compared with others. In addition, relative to the hibiscus groups, there is a substantial reduction in oxygen consumption in "G3". Both hibiscus as well as irradiated hibiscus attract attention in order to play a vital and economical role against harmful effects of frequent use of frying edible oil on some biological functions but, irradiated hibiscus was more effective.

Resumo O processo de fritura repetida de óleo comestível da dieta tem papel potencial na geração de radicais livres que podem ter efeitos prejudiciais em algumas funções biológicas. Portanto, sempre se questionou se existe uma maneira eficiente e econômica de prevenir ou pelo menos reduzir os efeitos nocivos do uso repetido de óleo comestível para fritar. Como o hibisco tem ampla variedade de efeitos terapêuticos, foi importante investigar suas propriedades como agente antioxidante contra os efeitos nocivos dos radicais livres. O presente estudo pretende descobrir se o pó irradiado de hibisco tem papel protetor contra os efeitos adversos do uso repetido de óleo comestível para fritar. Trinta e cinco ratos albinos machos adultos foram divididos igualmente em cinco grupos. O primeiro grupo "G1" foi alimentado com dieta normal como grupo controle, enquanto o grupo "G2" dieta misturada com óleo fresco, dieta "G3" misturada com óleo de fritura repetida, dieta "G4" misturada com óleo de fritura tratada com hibisco e dieta "G5" misturada com óleo de fritura tratada com hibisco irradiado. A duração da alimentação foi de seis semanas. Foram determinadas as análises de ácidos graxos de óleo, bem como os valores de peróxidos. Amostras de sangue e fígado foram coletadas para análises bioquímicas e estudo histológico. O óleo cozido repetidamente aquecido tem aumentos significativos no valor de peróxido, valor de ácido, ácido graxo livre e dieno e trieno conjugados em comparação com óleo de fritura repetidamente tratado com hibisco. Também há aumentos significativos no colesterol e triglicérides e comprometimento das funções hepáticas no "G3" em comparação com outros. Além disso, em relação aos grupos de hibiscos, há uma redução substancial no consumo de oxigênio no "G3". Tanto o hibisco como o hibisco irradiado chamam atenção por desempenhar papel vital e econômico contra os efeitos nocivos do uso frequente de óleo comestível para fritar em algumas funções biológicas, mas o hibisco irradiado foi mais eficaz.

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Objective: This study aimed to evaluate the optical behavior of pressable lithia-silicate and lithia-zirconia-silicate glass ceramics toward additional heat treatment protocols. Material and Methods: 40 lithia-silicate discs (15mm x 1mm) were heat pressed following the manufacturers' instructions. Discs were divided into four groups (n=10) according to type as follows: two groups of lithia-silicate-glass ceramics; Gp(E) (IPS e.max Press; Ivoclar Vivadent AG), Gp(L) (GC Initial LiSi Press, GC), two lithia-zirconia-silicate pressable glass ceramics; Gp(C) (Celtra Press, Dentsply Sirona) and Gp(A) (VITA Ambria, VITA Zahnfabrik). Each group was subdivided into (n=5): Subgroup(T1): the thermal tempering temperature was set 9% below the pressing temperature, Subgroup(T2): the temperature was set 5% below the pressing temperature. Optical properties: color, translucency parameter (TP), and contrast ratio (CR) were evaluated by spectrophotometer (Aglient Cary 5000 UV-Vis­NIR) after pressing and after thermal tempering. Results: Thermal tempering regardless of temperature resulted in a color shift within the acceptability level as ΔE for Gp(E) (3.18±2) followed by ΔE for Gp(L) (2.47±0.19) by ΔE for Gp(C) (2.26±0.14) and the last ΔE for Gp(A) (1.62±0.13). Subgroup(T2) showed a significantly higher color shift with mean ΔE(2.55±0.63) compared to Subgroup(T1) ΔE(2.35±0.59). There was a statistically significant increase in TP after tempering for all tested groups parallelled with a decrease in CR values. Conclusion: Heat tempering of the tested lithia-silicate pressable ceramics had a significant effect on the optical outcome of these materials, being lithia-zirconia-silicate ceramics more stable and less affected optically than other lithia-silicate-glass ceramics.(AU)

Objetivo: Avaliar o comportamento óptico de cerâmicas pressionáveis de vidro de litia-silicato e litia-zircônia-silicato sob protocolos adicionais de tratamento térmico. Materiais e métodos: 40 discos de litia-silicato (15mm x 1mm) foram prensados a quente conforme instruções dos fabricantes. Material e Métodos: 40 discos de litia-silicato (15mm x 1mm) foram prensados e divididos em quatro grupos (n=10): dois de lithia-silicato-vidro, Gp(E) (IPS e.max Imprensa) e Gp(L) (GC inicial LiSi Press), e dois de vidro prensado de litia-zircônia-silicato, Gp(C) (Celtra Press) e Gp(A) (VITA Ambria). Cada grupo foi subdividido em (n=5): Subgrupo(T1): amostras temperadas a 9% abaixo da temperatura de prensagem, e Subgrupo(T2): a temperatura foi ajustada 5% abaixo da temperatura de prensagem. As propriedades ópticas, incluindo cor, translucidez (TP) e contraste (CR), foram avaliadas com um espectrofotômetro (Aglient Cary 5000 UV-Vis-NIR) após prensagem e temperagem térmica. Resultados: O tratamento térmico resultou em mudança de cor dentro do nível aceitável, com ΔE mais alto para Gp(E) (3,18±2), seguido por Gp(L) (2,47±0,19), Gp(C) (2,26±0,14), e Gp(A) (1,62±0,13). No subgrupo (T2), houve uma mudança de cor mais significativa, com ΔE médio de (2,55±0,63), comparado ao subgrupo (T1) com ΔE médio de (2,35±0,59). Houve aumento significativo na TP e redução nos valores de RC após o tratamento térmico em todos os grupos testados. Conclusão: O tratamento térmico das cerâmicas prensadas de litia-silicato teve um efeito significativo na sua qualidade ótica, com as cerâmicas de litia-zircônia-silicato mostrando-se mais estáveis e menos afetadas visualmente em comparação com outras cerâmicas de litia-silicato-vidro(AU)

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Antecedentes y objetivo: El calor extremo es una amenaza para la salud y la vida, y en el último siglo, las altas temperaturas han aumentado considerablemente. Se espera que estos eventos sean más frecuentes e intensos debido al cambio climático. En este contexto, el Departamento de Gestión del Riesgo en Emergencias y Desastres del Gabinete de la Ministra, requirió una síntesis que responda a cuál es el riesgo de las olas de calor y de altas temperaturas extremas en la salud. Metodología: Se formuló una estrategia de búsqueda en las bases de datos: MEDLINE y EMBASE a través de OVID, en Cochrane Library y en Web of Science utilizando los conceptos High Temperature, Heatwave y Heat illness, con fecha 10 de agosto de 2023. Dos revisores independientes seleccionaron los estudios que repondieran a la pregunta, basándose en criterios de inclusión y exclusión acordados. La extracción de cada artículo la realizó una persona. Para resumir los resultados y valorar la certeza de la evidencia se utilizó la metodología GRADE. Resultados: 1. Se incluyeron en esta síntesis de evidencia 3 revisiones sistemáticas publicadas entre 2014 y 2022, y se obtuvieron los siguientes resultados: 2. Las olas de calor se definen como un periodo de al menos 3 días consecutivos con temperaturas máximas mayores a 35 °C. 3. El umbral de temperatura máxima corresponde a la temperatura que supere el percentil 95 de la serie histórica de temperaturas máximas para un territorio determinado. 4. Las olas de calor podrían: - Aumentar la mortalidad en la población general y en niñas y niños de 0 a 14 años. - Aumentar las enfermedades directamente relacionadas con el calor en la población general (p. ej.: golpes de calor, deshidratación). - Aumentar las consultas de urgencia y hospitalizaciones en niñas/os de 0 a 14 años, por causas renales y directamente relacionadas con el calor. 5. El aumento de la temperatura en 1 °C podría: - Aumentar la tasa de mortalidad y morbilidad por enfermedades cerebrovasculares, cardiovasculares y respiratorias en personas de 65 años y más. - Aumentar la incidencia de enfermedades asociadas al calor en todos los rangos etarios. 6. Se sugiere implementar un sistema local de vigilancia para conocer el efecto del aumento de altas temperaturas extremas en la salud de la población chilena.

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El comercio ambulante de alimentos listos para el consumo ha crecido exponencialmente a nivel mundial. Sin embargo, la falta de condiciones óptimas de preparación y expendio de estos alimentos pueden afectar su inocuidad. El objetivo de este estudio fue evaluar la calidad microbiológica de 19 tipos de alimentos (n= 417), con y sin tratamiento térmico, expendidos en espacios públicos en Cuenca, Ecuador. Según el grupo de alimentos, se analizaron aerobios mesófilos, coliformes/Escherichia coli, mohos y levaduras, Staphylococcus aureus, Salmonella, Listeria spp., Clostridium perfringes y Vibrio parahaemolyticus. Para la identificación y recuento de los microorganismos se aplicaron normativas nacionales y, en casos de ausencia, se adoptaron normas de otros países. Como resultado, el 55,4% de las muestras se consideraron no aptas para el consumo. S. aureus fue el microorganismo patógeno presuntivo de mayor prevalencia (81,7%). El incumplimiento de las normativas fue significativamente mayor entre los alimentos sin tratamiento térmico (54,1%) en comparación con aquellos térmicamente tratados (24%) y los que combinan ingredientes con y sin tratamiento (21,9%) (p<0,001). Se destaca el alto porcentaje de incumplimiento de alimentos sin tratamiento térmico que son manipulados en su preparación, como los jugos. Además, se observó que el tratamiento térmico no garantizó la inocuidad, sugiriendo una posible recontaminación del alimento luego de su preparación hasta su expendio y consumo, por medios ambientales y/o adición de otros ingredientes contaminados. Este estudio recalca la necesidad de acciones concretas con este sector, basados principalmente en capacitación, infraestructura e inclusión, para garantizar la salud de los consumidores.

Street-vending trade in ready-to-eat foods has grown exponentially, worldwide. However, the lack of optimal conditions for the preparation and sale of these foods can affect their safety. The objective of this study was to evaluate the microbiological quality of 19 types of foods (n= 417), with and without heat treatment, sold in public spaces in Cuenca, Ecuador. According to the food group, mesophilic aerobes, coliforms/Escherichia coli, molds and yeasts, Staphylococcus aureus, Salmonella, Listeria spp., Clostridium perfringens, and Vibrio parahaemolyticus were examined. For microorganisms identification and counting, national regulations were applied and, in cases of absence, regulations from other countries were adopted. As a result, 55,4% of the samples were considered inadequate for consumption. S. aureus was the most prevalent presumptive pathogenic microorganism (81.7%). Non-compliance with regulations was significantly higher among foods without heat treatment (54.1%) compared to those heat treated (24%) and those that combine ingredients with and without treatment (21.9%) (p<0.001). The high percentage of non-compliance with foods without heat treatment that is handled for preparation, such as juices, stands out. In addition, it was observed that the heat treatment did not guarantee safety, suggesting possible food recontamination after preparation until sale and consumption, due to environmental means and/or the addition of other contaminated ingredients. This study emphasizes the need for concrete actions in this sector, mainly based on training, infrastructure, and inclusion, to guarantee consumers' health.

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OBJECTIVE@#This study aimed to estimate spatiotemporal variations of global heat-related cardiovascular disease (CVD) burden from 1990 to 2019.@*METHODS@#Data on the burden of heat-related CVD were derived from the Global Burden of Disease Study 2019. Deaths and disability-adjusted life years (DALYs) were used to quantify heat-induced CVD burden. We calculated the age-standardized mortality rate (ASMR) and DALY rate (ASDR) per 100,000 population to compare this burden across regions. Generalized linear models were applied to evaluate estimated annual percentage changes (EAPC) for temporal trends from 1990 to 2019. The correlation between the socio-demographic index (SDI) and age-standardized rate was measured using the Spearman rank test.@*RESULTS@#Heat-induced CVD caused approximately 90 thousand deaths worldwide in 2019. Global ASMR and ASDR of heat-related CVD in 2019 were 1.17 [95% confidence interval ( CI): 0.13-1.98] and 25.59 (95% CI: 2.07-44.17) per 100,000 population, respectively. The burden was significantly increased in middle and low-SDI regions and slightly decreased in high-SDI regions from 1990 to 2019. ASMR showed an upward trend, with the most considerable increase in low-latitude countries. We observed a negative correlation between SDI and EAPC in ASMR ( r s = -0.57, P < 0.01) and ASDR ( r s = -0.59, P < 0.01) among 204 countries.@*CONCLUSION@#Heat-attributable CVD burden substantially increased in most developing countries and tropical regions.

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A multifunctional moxibustion treatment machine is designed and developed to assist the heat-sensitive moxibustion therapy. Through the motion control of the stepping motor by programmable logic controller (PLC), the automatic control is obtained for the acupoint detection of heat-sensitive moxibustion therapy and the manual operation of moxibustion. The skin temperature is monitored in real-time, using infrared non-contact temperature measurement technology. Based on the deviation of the temperature set value and the monitoring one, the distance between the moxibustion device and the exerted region is adjusted automatically by PLC so that the temperature is controlled practically. The multifunctional moxibustion treatment machine based on the heat-sensitive moxibustion therapy is capable of the operation control of mild moxibustion, circling moxibustion, sparrow-pecking moxibustion and along-meridian moxibustion techniques, as well as real-time monitoring of skin temperature. The temperature change curve of this machine is coincident with that obtained by the manual operation of heat-sensitive moxibustion. This multifunctional moxibustion treatment machine assists the delivery of heat-sensitive moxibustion therapy and it is satisfactory in temperature control and precise in operation.

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OBJECTIVE@#To investigate the effects of different manners of heat exposure on thoracic aorta injury in spontaneously hypertensive rats (SHRs) and explore the underlying mechanism.@*METHODS@#Normal 6 to 7-week-old male SHRs were randomized into control group (cage at room temperature), intermittent heat exposure group (SHR-8 group, exposed to 32 ℃ for 8 h daily for 7 days) and SHR-24 group (with continuous exposure to 32 ℃ for 7 days). After the treatments, the pathologies of the thoracic aorta of the rats were observed with HE staining, and the expressions of Beclin1, LC3B and p62 were detected with Western blotting and immunofluorescence assay; TUNEL staining was used to observe cell apoptosis in the thoracic aorta, and the expressions of caspase-3, Bax, and Bcl-2 were detected using Western blotting. The effects of intraperitoneal injections of 3-MA (an autophagy agonist), rapamycin (an autophagy inhibitor) or compound C 30 min before intermittent heat exposure on the expressions of proteins associated with autophagy, apoptosis and the AMPK/mTOR/ULK1 pathway in the aorta were examined with immunohistochemistry.@*RESULTS@#In SHR-8 group, the rats showed incomplete aortic intima with disordered cell distribution and significantly increased expressions of Beclin1, LC3II/LC3I and Bax, lowered expressions of p62 and Bcl-2, and increased apoptotic cells in the thoracic aorta (P < 0.05). Pretreatment with 3-MA obviously inhibited the expressions of autophagy- and apoptosis-related proteins, whereas rapamycin promoted their expressions. Compared with the control group, the rats in SHR-8 group had significantly down-regulated p-mTOR and up-regulated p-AMPK and p-ULK1 expression of in the aorta; Treatment with compound C obviously lowered the expressions of p-AMPK and p-ULK1 and those of LC3B and Beclin1 as well.@*CONCLUSION@#In SHRs, intermittent heat exposure causes significant pathologies and promotes autophagy and apoptosis in the thoracic aorta possibly by activating the AMPK/mTOR/ULK1 pathway.

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Children's fever is often accompanied by food accumulation. Traditional Chinese medicine believes that removing food stagnation while clearing heat of children can effectively avoid heat damage. To systematically evaluate the efficacy of Xiaoer Chiqiao Qingre Granules(XRCQ) in clearing heat and removing food accumulation and explore its potential mechanism, this study combined suckling SD rats fed with high-sugar and high-fat diet with injection of carrageenan to induce rat model of fever and food accumulation. This study provided references for the study on the pharmacodynamics and mechanism of XRCQ. The results showed that XRCQ effectively reduced the rectal temperature of suckling rats, improved the inflammatory environment such as the content of interleukin-1β(IL-1β), interleukin-2(IL-2), interferon-γ(IFN-γ), white blood cells, and monocytes. XRCQ also effectively repaired intestinal injury and enhanced intestinal propulsion function. According to the confirmation of its efficacy of clearing heat, the thermolytic mechanism of XRCQ was further explored by non-targeted and targeted metabolomics methods based on LTQ-Orbitrap MS/MS and UPLC-QQQ-MS/MS. Non-target metabolomics analysis of brain tissue samples was performed by QI software combined with SIMCA-P software, and 22 endogenous metabolites that could be significantly regulated were screened out. MetaboAnalyst pathway enrichment results showed that the intervention mechanism was mainly focused on tyrosine metabolism, tricarboxylic acid cycle, inositol phosphate metabolism, and other pathways. At the same time, the results of targeted metabolomics of brain tissue samples showed that XRCQ changed the vitality of digestive system, and inhibited abnormal energy metabolism and inflammatory response, playing a role in clearing heat and removing food stagnation from multiple levels.

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Objective: To investigate the effect of oxidative stress caused by heat exposure on the blood pressure increase of treadmill rats and the intervention of antioxidants. Methods: In June 2021, Twenty-four healthy SD male rats were randomly divided into four groups: normal temperature feeding, normal temperature treadmill, high temperature treadmill and high temperature treadmill supplementation with vitamin C groups, 6 rats in each group. The rats run on the platform in normal temperature or heat exposure environment for 30 min in the morning and in the afternoon daily, 6 days per week. The daily vitamin C supplement dose of high temperature treadmill supplementation with vitamin C group was 10 mg/kg. BP recordings were done at the end of the week. The rat vascular lipofuscin (LF) was detected by ELISA, the rat serum nitric oxide (NO) was detected by nitrate reductase method, the serum malondialdehyde (MDA) was detected by thibabituric acid method, the serum glutathione peroxidase (GPx) and superoxide dismutase (SOD) were detected by chemiluminescence method, and the serum catalase (CAT) was detected by ammonium molybdate method. The total antioxidant capacity (T-AOC) of serum was measured by iron reduction/antioxidant capacity method, and the content of nuclear erythroid 2-related factor 2 (Nrf2) in vascular tissue was measured by Western blot. The intra-group mean was compared by repeated measurement analysis of variance, and the inter-group mean was compared by single-factor analysis of variance and post-event LSD-t test. Results: Compared with the previous time point, the systolic BP and diastolic BP of the high temperature treadmill group were significantly increased at 7, 14 and 21 d, and decreased at 28 d which were higher than the initial level (P<0.05), and the systolic BP and diastolic BP values at each experimental time point were significantly higher than those of normal temperature treadmill group (P<0.001). The changes of thickening of the artery wall, no smoothing of the endodermis and irregular arrangement of muscle cells in high temperature treadmill group were observed. Compared with the normal temperature treadmill group, the content of MDA in serum, and LF in vascular tissue were significantly increased, the activities of SOD, CAT, T-AOC, the content of NO in serum, and the expression of Nrf2 in vascular tissue were significantly decreased in high temperature treadmill group (P<0.05). Compared with the high temperature treadmill group, the systolic BP and diastolic BP values at 7, 14, 21 and 28 d, the content of serum MDA and LF in vascular tissue were significantly decreased, the activities of CAT and T-AOC, and the expression of Nrf2 in vascular tissue significantly increased (P<0.05), the histopathological changes of the artery wall improved in high temperature treadmill supplementation with vitamin C group. Conclusion: Heat exposure has effect on oxidative stress, which may be related to the increase of BP. Vitamin C as an anti-oxidative enhancer can prevent those negative effects, which could alleviate the pathological changes of vessel intima in heat-exposed rats. And the Nrf2 may be a regulated factor to vascular protection.

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Objective: To study the effect of diurnal temperature range on the number of elderly inpatients with ischemic stroke in Hunan Province. Method: Demographic and disease data, meteorological data, air quality data, population, economic and health resource data of elderly inpatients with ischemic stroke were collected in 122 districts/counties of Hunan Province from January to December 2019. The relationships between the diurnal temperature range and the number of elderly inpatients with ischemic stroke were analyzed by using the distributed lag non-linear model, including the cumulative lag effect of the diurnal temperature range in different seasons, extremely high diurnal temperature range and extremely low diurnal temperature range. Results: In 2019, 152 875 person-times were admitted to the hospital for ischemic stroke in the elderly in Hunan Province. There was a non-linear relationship between the diurnal temperature range and the number of elderly patients with ischemic stroke, with different lag periods. In spring and winter, with the decrease in diurnal temperature range, the risk of admission of elderly patients with ischemic stroke increased (Ptrend<0.001, Ptrend=0.002);in summer, with the increase in diurnal temperature range, the risk of admission of elderly patients with ischemic stroke increased (Ptrend=0.024);in autumn, the change in the diurnal temperature range would not cause a change in admission risk (Ptrend=0.089). Except that the lag effect of the extremely low diurnal temperature range in autumn was not obvious, the lag effect occurred in other seasons under extremely low and extremely high diurnal temperature ranges. Conclusion: The high diurnal temperature range in summer and the low diurnal temperature range in spring and winter will increase the risk of admission of elderly patients with ischemic stroke, and the risk of admission of elderly patients with ischemic stroke will lag under the extremely low and extremely high diurnal temperature ranges in the above three seasons.

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The paper reviews the inheritance, innovation and development of heat-sensitive moxibustion; and explores the path for the clinical development of moxibustion of traditional Chinese medicine moxibustion (TCM). Practice has shown that the laws of clinical research on TCM moxibustion refer to phenomenon discovery, exploration of rules, technological innovation, verification of curative effects, theory sublimation, returning to clinical practice, discipline construction, and experimental research. It is deeply realized that TCM research should be based on clinical practice, originated from classics, focused on theoretical innovation and in serve of clinical practice.

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OBJECTIVE@#To observe the effect of meridian sinew releasing technique on moxibustion sensation of heat-sensitive moxibustion in patients with knee osteoarthritis (KOA).@*METHODS@#A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. In the observation group, on the basis of the meridian sinew releasing technique, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. In the control group, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. The meridian sinew releasing technique was performed for 20 min each time, the moxibustion sensation exploration method was performed for 60 min each time, once a day for 3 days. The excitation rate, latency, duration time and intensity value of moxibustion sensation of heat-sensitive moxibustion were recorded on the 1st, 2nd and 3rd days of exploration in the two groups.@*RESULTS@#The excitation rate on the 3rd day of exploration and total excitation rate in the observation group were higher than the control group (P<0.05). On the 1st, 2nd and 3rd days of exploration, the latency of moxibustion sensation of heat-sensitive moxibustion in the observation group was shorter than the control group (P<0.05), the duration time was longer than the control group (P<0.05), and the intensity value was higher than the control group (P<0.05).@*CONCLUSION@#Meridian sinew releasing technique could improve the excitation rate of moxibustion sensation of heat-sensitive moxibustion in patients with KOA, shorten the latency, prolong the duration time, and improve the intensity value.

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An automatic ash-removal heat-sensitive moxibustion device was developed, which could keep relatively constant temperature of heat-sensitive moxibustion, and realize the automatic ignition and automatic ash removal of moxa sticks during heat-sensitive moxibustion. The automatic ash-removal heat-sensitive moxibustion device comprises a bracket and a moxibustion box fixed on the top of the bracket; the bracket is composed of a base and a movable telescopic arm. This device can solve the problems of temperature instability, moxa ash blocking heat transfer and moxa ash falling during heat-sensitive moxibustion, avoiding the scalding caused by moxa ash falling, and reduce the workload of medical staff.

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Regan Syrup has the effect of clearing heat, releasing exterior, benefiting pharynx and relieving cough, and previous phase Ⅱ clinical trial showed that the efficacy of Regan Syrup high-dose and low-dose groups was better than that of the placebo group, and there was no statistically significant difference in the safety between the three groups. The present study was conducted to further investigate the efficacy and safety of the recommended dose(20 mL) of Regan Syrup in the treatment of common cold(wind-heat syndrome). Patients who met the inclusion and exclusion criteria were selected and divided into the test group(Regan Syrup+Shufeng Jiedu Capsules placebo), positive drug group(Regan Syrup placebo+Shufeng Jiedu Capsules) and placebo group(Regan Syrup placebo+Shufeng Jiedu Capsules placebo) at a 1∶1∶1 using a block randomization method. The course of treatment was 3 days. A total of 119 subjects were included from six study centers, 39 in the test group, 40 in the positive drug group and 40 in the placebo group. The onset time of antipyretic effect was shorter in the test group than in the placebo group(P≤0.01) and the positive drug group, but the difference between the test group and the positive drug group was not significant. The test group was superior to the positive drug group in terms of fever resolution(P<0.05), and had a shorter onset time of fever resolution than the placebo group, but without obvious difference between the two groups. Compared to the positive drug group, the test group had shortened disappearance time of all symptoms(P≤0.000 1). In addition, the test group was better than the positive drug group and the placebo group in relieving symptoms of sore throat and fever(P<0.05), and in terms of clinical efficacy, the recovery rate of common cold(wind-heat syndrome) was improved in the test group compared to that in the placebo group(P<0.05). On the fourth day after treatment, the total TCM syndrome score in both test group and positive drug group was lower than that in the placebo group(P<0.05). There was no significant difference in the incidence of adverse events between three groups and none of them experienced any serious adverse events related to the study drug. The results indicated that Regan Syrup could shorten the onset time of antipyretic effect, reduce the time of fever resolution, alleviate the symptoms such as sore throat and fever caused by wind-heat cold, reduce the total score of Chinese medicine symptoms, and improve the clinical recovery rate with good safety.

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The quality of moxa is an important factor affecting moxibustion therapy, and traditionally, 3-year moxa is considered optimal, although scientific data are lacking. This study focused on 1-year and 3-year moxa from Artemisia stolonifera and A. argyi(leaf-to-moxa ratio of 10∶1) as research objects. Scanning electron microscopy(SEM), Van Soest method, and simultaneous thermal analysis were used to investigate the differences in the combustion heat quality of 1-year and 3-year moxa and their influencing factors. The results showed that the combustion of A. stolonifera moxa exhibited a balanced heat release pattern. The 3-year moxa released a concentrated heat of 9 998.84 mJ·mg~(-1)(accounting for 54% of the total heat release) in the temperature range of 140-302 ℃, with a heat production efficiency of 122 mW·mg~(-1). It further released 7 512.51 mJ·mg~(-1)(accounting for 41% of the total heat release) in the temperature range of 302-519 ℃. The combustion of A. argyi moxa showed a rapid heat release pattern. The 3-year moxa released a heat of 16 695.28 mJ·mg~(-1)(accounting for 70% of the total heat release) in the temperature range of 140-311 ℃, with an instantaneous power output of 218 mW·mg~(-1). It further released 5 996.95 mJ·mg~(-1)(accounting for 25% of the total heat release) in the temperature range of 311-483 ℃. Combustion parameters such as-R_p,-R_v, D_i, C, and D_b indicated that the combustion heat quality of 3-year moxa was superior to that of 1-year moxa. It exhibited greater combustion heat, heat production efficiency, flammability, mild and sustained burning, and higher instantaneous combustion efficiency. This study utilized scientific data to demonstrate that A. stolonifera could be used as excellent moxa, and the quality of 3-year moxa surpassed that of 1-year moxa. The research results provide a scientific basis for the in-depth development of A. stolonifera moxa and the improvement of moxa quality standards.