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Wilson's disease （WD） is a copper metabolism disorder caused by mutations in the ATP7B gene， with diverse phenotypes and complex pathogenesis. It is one of the few rare diseases that can achieve good clinical efficacy through standardized treatment. Since there are few systematic reviews of this disease， we summarize the pathogenesis and treatment methods of WD from traditional Chinese and western medicine by reviewing the literature related to WD. In western medicine， ATP7B gene mutation is considered as the root cause of WD， which affects copper transport and causes copper metabolism disorders. The excessive copper deposited in the body will result in oxidative stress， defects in mitochondrial function， and cell death. Western medicine treatment of WD relies mainly on drugs， and copper antagonists are the first choice in clinical practice， which are often combined with hepatoprotective and antioxidant therapy. Surgery is a common therapy for the patients with end-stage WD， and gene therapy provides an option for WD patients. According to the traditional Chinese medicine （TCM） theory， WD is rooted in constitutional deficiency and copper accumulation and triggered by dampness-heat accumulation or phlegm combined with stasis. The patient syndrome varies in different stages of the disease， and thus the treatment should be based on syndrome differentiation. The TCM treatment method of nourishing the liver and kidneys and warming the spleen and kidneys can address the root cause. The methods of clearing heat and drying dampness， resolving phlegm and dispelling stasis， and soothing liver and regulating qi movement can be adopted to treat symptoms. On the basis of syndrome differentiation， special prescriptions for the treatment of WD have been formulated， such as Gandou decoction， Gandouling， and Gandou Fumu decoction， which have been widely used in clinical practice. TCM and western medicine have their own advantages and shortcomings. The integrated Chinese and western medicine complementing with each other demonstrates great therapeutic potential. This paper summarizes the pathogenesis and treatment of WD with integrated Chinese and western medicine， aiming to provide a reference for the clinical diagnosis and treatment of this disease.
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Objective To investigate the effect of diosmine on semen quality and sex hormone concentra-tion in patients with spermatovenous ligation.Methods Clinical data were retrospectively collected from January 2019 to January 2022 on patients with varicocele admitted to Department of Urology,General Hospital of Southern Theater Command,divided into a control group and a study group based on whether they had a history of Diosmine use after surgery.Clinical data from both groups were matched using propensity score matching.Sperm quality and sex hormone tests were then compared before surgery,three months after surgery and six months after surgery.Results There were 73 in the control group and 73 in the study group.Both groups were balanced in terms of age,BMI,seminal fluid volume and testosterone(P＞0.05).Sperm motility,forward motility and testosterone were all increased 3 and 6 months after surgery,and sperm malformations,sperm DNA fragment index,follicle stimulating hormone and luteinizing hormone were all reduced significantly(P＜0.05).The results were also better than those in the control group for total sperm motility,forward motility,testosterone,sperm DNA fragment index,follicle stimulating hormone and luteinizing hormone(P＜0.05).Conclusions Diosmine can help to restore semen quality and improve sex hormone concentration in patients with varicocele after Laparoscopic varicocelectomy.
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BACKGROUND:Pretreatment with moxibustion is a preventive treatment in traditional Chinese medicine.Pretreatment with moxibustion at the onset of prodromal symptoms can significantly reduce the symptoms and delay the onset of many diseases,but the exact mechanism remains to be studied. OBJECTIVE:To investigate the mechanism of SIRT1/FoxO3 pathway in moxibustion pretreatment to ameliorate oxidative stress injury in cerebral ischemia-reperfusion model rats. METHODS:Forty-eight Sprague-Dawley rats were randomly divided into sham-operated group,model group,moxibustion pretreatment group,and moxibustion pretreatment+EX527(SIRT1 inhibitor)group,with 12 rats in each group.The moxibustion pretreatment group was given moxibustion with seed-sized moxa cone at Baihui,Dazhui,and Zusanli before modeling,three moxa-cones per acupoint,once a day for 7 days.In the model group,moxibustion pretreatment group and moxibustion pretreatment+EX527 group,the rat model of middle cerebral artery occlusion was made by suturing of the middle cerebral artery 30 minutes after the last moxibustion.After 2 hours of cerebral ischemia,the middle artery suture was removed and the rats were reperfused for 12 hours.In the sham-operated group,only the common carotid artery,internal carotid artery,and external carotid artery were dissected without suturing the middle cerebral artery.In the moxibustion pretreatment+EX527 group,EX527(15 mg/kg)was given intraperitoneally 30 minutes before each moxibustion.After 12 hours of reperfusion,the rats were scored for neurological deficits,and the cerebral infarct volume was calculated by 2,3,5-triphenyltetrazolium chloride staining method.The levels of oxidative stress factors in the infarcted tissues were detected by the kit method,and western-blot method was used to detect the expression levels of SIRT1,FoxO3,p-FoxO3 and brain-derived neurotrophic factor in the ischemic area of the cerebral cortex. RESULTS AND CONCLUSION:After 12 hours of reperfusion,the neurobehavioral score in the model group was significantly higher than that in the sham-operated group(P＜0.01),while the score in the moxibustion pretreatment group was significantly lower than that in the model group(P＜0.01)and moxibustion pretreatment+EX527 group(P＜0.05).There were no obvious infarct foci in the brain tissue of the sham-operated rats,but obvious ischemic foci were observed in the right side of the brain tissue of the rats in the model group(P＜0.01).The right infarct volume in the moxibustion pretreatment group was significantly reduced compared with the model group(P＜0.01),while the right infarct volume in the moxibustion pretreatment+EX527 group was significantly enlarged compared with the moxibustion pretreatment group.After 12 hours of reperfusion,the level of malondialdehyde was significantly elevated(P＜0.01)and the expression of superoxide dismutase was significantly decreased(P＜0.01)in the model group compared with the sham-operated group.The levels of malondialdehyde was significantly decreased(P＜0.01,P＜0.05)and the expression of superoxide dismutase was significantly increased(P＜0.01,P＜0.05)in the moxibustion pretreatment group compared with the model group and the moxibustion pretreatment+EX527 group.Western blot results showed that the expression levels of SIRT1,FoxO3,p-FoxO3,and brain-derived neurotrophic factor proteins were significantly higher in the model group compared with the sham-operated group(P＜0.01);compared with the model group,the expression levels of SIRT1,FoxO3,and brain-derived neurotrophic factor were significantly higher in the moxibustion pretreatment group(P＜0.01),and p-FoxO3 expression was significantly lower(P＜0.01);compared with the moxibustion pretreatment+EX527 group,the expression levels of SIRT1,FoxO3,and brain-derived neurotrophic factor were elevated in the moxibustion pretreatment group(P＜0.05),and no statistically significant difference was found in the p-FoxO3 expression(P＞0.05).To conclude,moxibustion pretreatment can significantly improve neurological function in rats after cerebral ischemia-reperfusion,and the mechanism may be related to the activation of SIRT1/FoxO3 pathway to reduce oxidative stress injury in the rat model of cerebral ischemia-reperfusion.
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BACKGROUND:It was found that moxibustion can inhibit the inflammatory factors in the serum of rats with cerebral ischemia/reperfusion injury,resist oxidative stress,inhibit cell apoptosis,and effectively reduce cerebral ischemia/reperfusion injury. OBJECTIVE:To observe the effects of different moxibustion intervention time on the expression levels of nucleotide binding oligomerization domain-like protein 3 inflammasome(NLRP3),cysteine aspartase(caspase-1),apoptosis-related speck-like protein,exfoliatin-D protein,interleukin-1β and interleukin-18 in rats with cerebral ischemia/reperfusion injury,and to explore its action mechanism. METHODS:SD rats were randomly divided into sham operation group(n=9)and operation group(n=36).The model of focal cerebral ischemia/reperfusion injury was established by middle cerebral artery occlusion in the operation group.After successful modeling,the rats in the operation group were further divided into model group,moxibustion 10-minute group,moxibustion 15-minute group and moxibustion 30-minute group,with 9 rats in each group.Rats in the moxibustion 10-minute,15-minute and 30-minute groups were given moxibustion at"Baihui,Dazhui and Zusanli",respectively,once a day for a total of 7 days.The neurological deficits of rats were evaluated by LONGA method.The cerebral infarction was observed by 2,3,5-triphenyltetrazolium chloride staining.The pathological changes of brain tissue were observed by hematoxylin-eosin staining.The contents of interleukin-1β and interleukin-18 in serum of rats in each group were detected by ELISA.Immunohistochemistry and western blot assay were used to detect the expression levels of NLRP3,caspase-1,apoptosis-related spot-like protein and gasdermin D in the ischemic cortex of rats in each group. RESULTS AND CONCLUSION:Compared with the sham operation group,the neurological deficit score of the model group was significantly increased(P<0.01).Compared with the model group,the neurological deficit score of the moxibustion groups was significantly reduced(P<0.01).Compared with the sham operation group,the infarct volume of the model group was significantly increased(P<0.01).Compared with the model group,the infarct volume of the moxibustion groups was significantly reduced(P<0.01);the infarct volume of the rats was smallest in the moxibustion 30-minute group(P<0.05).Compared with the model group,the contents of inflammatory factors interleukin-1β and interleukin-18 in the serum of rats in the moxibustion groups were decreased(P<0.01).Compared with the moxibustion 10-minute group,the contents of inflammatory factors in the serum of rats in the moxibustion 30-minute group were significantly decreased(P<0.05).Compared with the model group,the expression of NLRP3,apoptosis-related spot-like protein,Caspase-1 and gasdermin D protein in the ischemic cortex of the moxibustion groups was significantly decreased(P<0.01).Compared with the moxibustion 10-minute and 15-minute groups,the expression of protein in the moxibustion 30-minute group was significantly decreased(P<0.05).It is concluded that moxibustion at Baihui,Dazhui and Zusanli can reduce cerebral ischemia/reperfusion injury,among which moxibustion for 30 minutes has the best effect,and its mechanism may be related to the inhibition of pyroptosis mediated by NLRP3/Caspase-1 pathway.
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AIM: To evaluate clinical efficacy and safety of ultrasound cycloplasty(UCP)in the treatment of refractory glaucoma.METHODS:From June 2021 to October 2022, a total of 17 patients(17 eyes)with refractory glaucoma were enrolled in this prospective study, and they all underwent UCP. The patients underwent 6 mo followed-up post-treatment, and the intraocular pressure(IOP), pain grade score, IOP lowering drugs, success rate and occurrence of complications were documented.RESULTS:The IOP was significantly decreased from 51.98±7.80 mmHg before UCP to 32.54±13.21 mmHg at 1 d, 22.38±11.98 mmHg at 1 wk, 22.63±10.78 mmHg at 1 mo, 26.05±9.17 mmHg at 3 mo, and 23.73±9.60 mmHg at 6 mo postoperatively(all P<0.01). The percentage of IOP reduction after treatment was 36.25%, 57.10%, 56.35%, 49.16% and 54.09% at 1 d, 1 wk, 1, 3, and 6 mo, respectively. The pain grade scores were decreased(P<0.01). There was a statistically significant reduction in the use of IOP lowering medications(P=0.008). At 6 mo postoperatively, 2 eyes(12%)were complete success, 11 eyes(65%)were qualified success, and 4 eyes(24%)were failure. The main complication observed was anterior chamber inflammation in 1 eye(6%), foreign body sensation in 2 eyes(12%), subconjunctival hemorrhage in 2 eyes(12%), and conjunctival congestion in 6 eyes(35%). All symptoms spontaneously resolved within 1 wk without requiring any specific treatment. One case of choroidal detachment(6%)occurred on 10 d postoperatively, but recovered after orally treated by prednisone acetate for 1 mo. No other serious complications, such as hyphema, corectopia, synechia or macular edema were reported.CONCLUSION:UCP is safe and efficacious in treating refractory glaucoma, reducing IOP and alleviating ocular pain symptoms, while maintaining a favorable safety profile.
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To explore screening tools for children with autism spectrum disorder (ASD), which are convenient for primary hospitals, it can provide basic data for formulating ASD prevention policies. This was a cross-sectional study by cluster sampling. Huyi District and Xincheng District were extracted for investigation in Xi'an City. From July 2021 to September 2022, all children aged from 3 months to 36 months who live in the two districts were subjected to primary screening. The child care physician used the routine screening tool "warning signs checklist for screening psychological, behavioral and developmental problems of children" and cartoon pictures of "early high-risk warning signs of autism", the children who were positive in the initial screening were referred to the district level maternal and child health hospital for re-screening, and those who were positive in the re-screening were referred to Xi 'an Children's Hospital for diagnosis. The results showed that a total of 17 905 children aged from 3 months to 36 months were initially screened in the two districts, including 10 588 children aged from 18 months to 36 months, 50 children who were positive in the initial screening and 50 children who were re-screened. 23 children (18 boys and 5 girls) were diagnosed with ASD. The prevalence rate of ASD in children was 2.17‰ (95% confidence interval:1.29‰-3.06‰). 42 children were positive for "warning signs checklist" at the preliminary screening, and 19 were confirmed as ASD. 27 children were positive for "cartoon pictures" in the preliminary screening, and 23 were confirmed with ASD. The "cartoon pictures" in the preliminary screening and diagnosis of consistent rate was higher than the "warning signs checklist", two kinds of screening methods comparison were statistically significant difference in the odds of consistent (χ2=11.01, P=0.001). In conclusion, relying on the three-level network of maternal and child health care, it is conducive to the whole process management of screening and diagnosis of children with ASD, and to guide the formulation of prevention policies. The cartoon pictures of "early high-risk warning signs of autism" can assist the identification of children with ASD based on the "warning signs checklist", which is simple, effective and suitable for promotion in the community health care.
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Masculino , Femenino , Humanos , Trastorno del Espectro Autista/epidemiología , Estudios Transversales , Tamizaje Masivo/métodos , Trastorno Autístico , PrevalenciaRESUMEN
To explore screening tools for children with autism spectrum disorder (ASD), which are convenient for primary hospitals, it can provide basic data for formulating ASD prevention policies. This was a cross-sectional study by cluster sampling. Huyi District and Xincheng District were extracted for investigation in Xi'an City. From July 2021 to September 2022, all children aged from 3 months to 36 months who live in the two districts were subjected to primary screening. The child care physician used the routine screening tool "warning signs checklist for screening psychological, behavioral and developmental problems of children" and cartoon pictures of "early high-risk warning signs of autism", the children who were positive in the initial screening were referred to the district level maternal and child health hospital for re-screening, and those who were positive in the re-screening were referred to Xi 'an Children's Hospital for diagnosis. The results showed that a total of 17 905 children aged from 3 months to 36 months were initially screened in the two districts, including 10 588 children aged from 18 months to 36 months, 50 children who were positive in the initial screening and 50 children who were re-screened. 23 children (18 boys and 5 girls) were diagnosed with ASD. The prevalence rate of ASD in children was 2.17‰ (95% confidence interval:1.29‰-3.06‰). 42 children were positive for "warning signs checklist" at the preliminary screening, and 19 were confirmed as ASD. 27 children were positive for "cartoon pictures" in the preliminary screening, and 23 were confirmed with ASD. The "cartoon pictures" in the preliminary screening and diagnosis of consistent rate was higher than the "warning signs checklist", two kinds of screening methods comparison were statistically significant difference in the odds of consistent (χ2=11.01, P=0.001). In conclusion, relying on the three-level network of maternal and child health care, it is conducive to the whole process management of screening and diagnosis of children with ASD, and to guide the formulation of prevention policies. The cartoon pictures of "early high-risk warning signs of autism" can assist the identification of children with ASD based on the "warning signs checklist", which is simple, effective and suitable for promotion in the community health care.
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Masculino , Femenino , Humanos , Trastorno del Espectro Autista/epidemiología , Estudios Transversales , Tamizaje Masivo/métodos , Trastorno Autístico , PrevalenciaRESUMEN
Objective To investigate the effects of microsurgical varicocelectomy on testicular function and sexual function in patients with varicocele.Methods The clinical data of 90 patients with varicocele admitted to our hospital were retrospectively analyzed,and the patients were divided into the laparoscopic group(received laparoscopic varicocelectomy)and the microscopic group(received microsurgical varicocelectomy)according to different surgical methods,with 45 cases in each group.The testicular function and sexual function related indexes including sperm density,normal sperm ratio,rate of sperm motility(grades a+b),forward motility sperm rate,international index of erectile function-5(IIEF-5)score,and the levels of testosterone,follicle-stimulating hormone,luteinizing hormone,and androgen levels before and 6 months after surgery in the two groups were compared.The incidence of complications and recurrence 6 months after surgery in the two groups were counted.Results Compared with those before surgery,the sperm density,forward motility sperm rate,rate of sperm motility(grades a+b),normal sperm ratio,IIEF-5 score,testosterone level,and androgen level 6 months after surgery of patients in the two groups were significantly increased(P<0.05),and the levels of luteinizing hormone and follicle-stimulating hormone were decreased(P<0.05).Compared with the laparoscopic group,the levels of follicle-stimulating hormone and luteinizing hormone,and incidence of complications 6 months after surgery of patients in the microscopic group were decreased(P<0.05),and the levels of testosterone and androgens,and IIEF-5 score 6 months after surgery were increased(P<0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Microsurgical varicocelectomy can improve the testicular function and sexual function of patients with varicocele,with a low incidence of complications.
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Objective@#To analyze the emotional and behavioral problems and associated factors of the only and non only child, and to provide some clues for further monitoring and intervention of psychological and behavioral development among preschool children.@*Methods@#Using a convenience sampling method, a total of 45 065 children enrolled in 153 kindergartens in 23 districts and counties of Chengdu were selected from May to June 2021 to investigate demographic characteristics and children s psycho behavioral development through online questionnaires filled out by their guardians. The Chi square tests were used to analyze whether the differences in abnormality rates of each dimension were statistically significant between the only and non only children. The emotional and behavioral problems of only children and non only children were analyzed by propensity score measurement.@*Results@#The detection rate of abnormal emotional behavior problems in children was 6.10%, including 6.34% in the only child group and 5.84 % in the non only child group. After matching, total difficulty score, and scores of emotional symptoms, conduct problems, hyperactive attention deficit, peer interaction, and social behavior differed between the only child group and the non only child group ( t =9.91, 8.97, 3.91, 15.57, -5.46, 4.08, P <0.01).@*Conclusion@#In terms of the total score of difficulties, emotional symptoms, moral problems, and hyperactivity attention defects, the non only child is better than the only child，but the opposite is true in terms of peer interaction and social behavior. Mental health conditions among the only child should be paid more attention. Whether or not the only child should be taken as an important consideration for preschool children s mental health care.
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In recent years， in order to meet the needs of high-quality development， more and more hospitals have begun to carry out refined drug management. Based on the theory of value chain management， this study analyzed and practiced the refined drug management. First of all， the value chain model of drug management was constructed to clarify the drug management process and classification. Secondly， the current situation and demand of drug management were analyzed to clarify the management needs of procurement， logistics， inventory， distribution and use in the management process. Then， based on the value chain theory， the basic activities and auxiliary activities of drug management were reconstructed and optimized. The performance evaluation suggested that refined drug management based on the value chain theory could improve the efficiency of drug management， provide better services for patients， and help the hospital develop with high quality.
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Objective@#To understand different types of depression and anxiety among primary and secondary school students, as well as their influencing factors, so as to provide a basis for the development of future intervention programs for adolescent mental health.@*Methods@#From December 2022 to February 2023, a self administered questionnaire survey was administered among grades 4 to 6 students and junior school, senior school students in Yixing City using Depression Anxiety and Stress Scale-21 (DASS-21), Insomnia Severity Index (ISI), Family Environment Scale (FES), and modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), Ottawa Self injury Inventory (OSI). A total of 4 180 students were included in the analysis. Different types of depression and anxiety in students and their influencing factors were analyzed by the Chi squaretest and multivariate Logistic regression.@*Results@#The overall prevalence of depression and anxiety among primary and secondary school students were 16.6% and 22.4%, respectively, with 14.0% of depression and anxiety comorbidities. The Logistic regression results showed that, compared to students with low depression-low anxiety, students of depression and anxiety who had parents in conflicts ( OR =3.06), smoked ( OR =3.16), exhibited moderate food addiction ( OR =3.56), and had non suicidal self injury (NSSI) ( OR =2.26) were more likely to be classified as a depression predominant-depression anxiety type. Students of depression and anxiety who consumed alcohol ( OR =2.00), had serious food addiction ( OR =5.44), moderate to severe insomnia ( OR =3.25), and mild insomnia ( OR =1.88) were more likely to be classified as anxiety predominant-depression anxiety type. Students of depression and anxiety with low mood ( OR =10.87), mild food addiction ( OR =2.00), moderate food addiction ( OR =4.32), and severe food addiction ( OR =7.35), mild ( OR =2.96) or moderate to severe ( OR =16.52) insomnia, and NSSI ( OR =4.24) were more likely to be classified as the severe depression anxiety type( P < 0.05 ).@*Conclusions@#There are significant differences between different depression-anxiety types among primary and secondary school students with respect to food addiction, insomnia, NSSI, smoking, and alcohol use. Relevant departments should engage with schools and families to adopt targeted interventions for students to reduce the occurrence of mental health problems.
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【Objective】 To investigate the resource allocation status of blood testing laboratories in 14 blood stations in Gansu Province, explore the impact of differences in basic conditions on the comprehensive testing ability of laboratories, so as to promote the homogenization and standardization of blood screening capacity in blood stations in Gansu and improve blood safety and effectivenes. 【Methods】 An evaluation index system of laboratory resource allocation was constructed and a question-naire was designed. The data of human resources, infrastructure and key equipment of 14 blood stations were collected. The entropy weight -TOPSIS method was used to evaluate and rank the resource allocation of 14 blood stations. 【Results】 In the comprehensive evaluation of blood testing laboratory resource allocation in 14 blood stations in Gansu, the top three were laboratories A, B and I, and the last three were laboratories G, M and J. On the whole, the main issue was unreasonable structure of human resources: most laboratories had unreasonable age structure; except for Laboratory A, there was no personnel with bachelor's degree or above in laboratories; most laboratories had not established a team with intermediate professional titles. In terms of infrastructure, the size of seven laboratories could not meet the needs of modern laboratory testing, and all eight blood stations had no spare nucleic acid laboratories nor a mutual spare laboratory with other blood stations As for the key equipment, 5 laboratories had no automatic blood grouping diagnostic instrument, 5 laboratories only had one set of enzyme immunoassay detection system, 3 laboratories had no spare equipment for the key equipment, which means if the equipment failure could not be repaired in time, the release of results would be affected. 【Conclusion】 There were significant differences in human resources, infrastructure and key equipment of blood testing laboratories in 14 blood stations in Gansu, which had a great impact on laboratory testing capacity and subsequent development. It is suggested that governments at all levels and health administrative departments optimize the input of laboratory resource allocation according to the blood collection volume of blood stations to gradually narrow the differences in resource distribution between different regions, improve the degree of laboratory automation and optimize the personnel structure, so as to build high-quality and efficient blood testing laboratories and ensure the safety of clinical blood use.
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Objective@#To understand the prevalence and influencing factors of scoliosis among primary and middle school students in Shanghai, so as to provide reference for the prevention and control strategies of scoliosis in children and adolescents.@*Methods@#From September to December 2021, a total of 4 531 students from grade four of primary school to grade three of junior high school from 16 primary and middle schools in 4 districts of Shanghai were selected by multi stage stratified cluster sampling to carry out scoliosis screening and questionnaire survey. Independent sample t-test, Chi-squared test, Fisher s exact probability method and nonparametric Mann Whitney U-test were used for statistical analysis, and multivariate Logistic regression was used to analyze the influencing factors of scoliosis.@*Results@#The on the spot detection rate of scoliosis abnormality was 7.4% and the prevalence was 2.2%, mainly for thoracolumbar scoliosis (60.4%) and the scoliosis angle of 10° -<20°(88.1%). The results showed that the detection rate of scoliosis in boys was 1.6% and in girls was 3.3%, with a statistically significant difference ( χ 2=11.84, P < 0.01). There were significant differences in weight and BMI between scoliosis students and students with negative initial screening( t = -3.77, -5.30, P <0.01). And there was a statistically significant difference in the detection rate of scoliosis with different frequency of classroom seating arrangements ( Z =2.02, P <0.05). The results of multivariate Logistic regression showed that the risk of scoliosis in girls was higher than that in boys ( OR =1.87, 95% CI =1.21-2.88). BMI ( OR =0.89, 95% CI =0.83-0.95) and frequency of classroom seating arrangements ( OR =0.49, 95% CI =0.25-0.93) were correlated with lower rate of scoliosis. After stratification by sex, the frequency of classroom seating arrangements ( OR =0.26, 95% CI =0.10-0.67) in boys and the educational stage ( OR =2.35, 95% CI =1.26-4.41) in girls ( P <0.05) was correlated with higher rate of scoliosis, while BMI ( OR =0.86, 95% CI =0.79-0.94) in girls were correlated with lower rate of scoliosis.@*Conclusion@#Regular screening of scoliosis is an effective method for early detection of scoliosis. Girls in junior high school and low BMI should be paid close attention to. According to the occurrence and influencing factors of scoliosis, comprehensive prevention and control based on family, school, society, and other aspects can be carried out.
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Objective: To investigate the relationship between serum lysophosphatidylcholine (LPC) level and the health index of the elderly. Methods: A total of 251 subjects were selected from the 2016 baseline survey of the Yongfu Longevity Cohort in Guangxi Province among whom 66, 63 and 122 were in the young and middle-aged group (≤59 years old), the young group (60-89 years old) and the longevity group (≥90 years old), respectively. Demographic data were collected and related indicators of height, weight, blood pressure and lipid metabolism were measured. The cognitive and physical functions of the elderly were assessed by the results of the simple mental state scale and the daily living activity scale to construct the health index of the elderly. The serum levels of LPC16∶0, LPC18∶0, LPC18∶1 and LPC18∶2 were determined by liquid chromatography-tandem mass spectrometry, and the differences among different ages and health status groups were compared. The logistic regression model was used to analyze the relationship between the serum LPC level and the health index of the elderly. Results: With the increase in age, the proportion of female subjects increased, and the rate of smoking and drinking decreased. BMI, TC, TG, LDL-C, diastolic blood pressure, and the four LPCs levels decreased with the increase of age, and systolic blood pressure levels increased with the increase of age (all P values<0.05). There was no significant difference in HDL-C levels among age groups (P>0.05). With the decline of health status in the elderly, serum levels of LPC16∶0, LPC18∶0, LPC18∶1 and LPC18∶2 showed a downward trend (all P values<0.001). After adjusting for age and gender, only LPC18∶0 was associated with the health status in old age [OR (95%CI): 0.48 (0.25-0.92)]. For every 1 standard deviation (16.87 nmol/L) increase in serum LPC18∶0 concentration, the risk of poor health status in old age decreased by 52%. Conclusion: Serum LPC18∶0 was associated with the health status in old age independent of age and sex.
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Anciano , Persona de Mediana Edad , Humanos , Femenino , Anciano de 80 o más Años , Lisofosfatidilcolinas , Factores de Riesgo , China , Longevidad , Encuestas y Cuestionarios , TriglicéridosRESUMEN
International research on healthy life expectancy (HALE) focuses on inequality of socioeconomic status and individual natural attributes. With the acceleration of population ageing and the increase in average life expectancy, the extension of unhealthy life expectancy and the increase of social and economic burden caused by diseases have gradually attracted the attention of countries around the world. Therefore, the evaluation of disease factors affecting HALE is a meaningful direction in the future. This study introduces the development process and commonly used measurement methods of HALE. According to the definition of health from the Global Burden of Disease Study and World Health Organization, physical and mental diseases such as cardiovascular and cerebrovascular diseases, chronic respiratory diseases, diabetes, malignant tumors and depression were selected to summarize the impact of these diseases and pre-disease states on HALE. It is expected to provide a theoretical basis for the formulation of relevant public health policies and the improvement of quality of life in China.
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Humanos , Esperanza de Vida Saludable , Calidad de Vida , Esperanza de Vida , Causalidad , Clase SocialRESUMEN
Objective: To evaluate the effectiveness of a risk-adapted colorectal cancer screening strategy constructed utilizing genetic and environmental risk score (ERS). Methods: A polygenic risk score (PRS) was constructed based on 20 previously published single nucleotide polymorphisms for colorectal cancer in East Asian populations, using 2 160 samples with MassARRAY test results from a multicenter randomized controlled trial of colorectal cancer screening in China. The ERS was calculated using the Asia-Pacific Colorectal Screening Score system. Logistic regression was used to analyze the association between PRS alone and PRS combined with ERS and colorectal neoplasms risk, respectively. We also designed a risk-adapted screening strategy based on PRS and ERS (high-risk participants undergo a single colonoscopy, low-risk participants undergo an annual fecal immunochemical test, and those with positive results undergo further diagnostic colonoscopy) and compared its effectiveness with the all-acceptance colonoscopy strategy. Results: The high PRS group had a 26% increased risk of colorectal neoplasms compared with the low PRS group (OR=1.26, 95%CI: 1.03-1.54, P=0.026). Participants with the highest PRS and ERS were 3.03 times more likely to develop advanced colorectal neoplasms than those with the lowest score (95%CI: 1.87-4.90, P<0.001). As the risk-adapted screening simulation reached the third round, the detection rate of the PRS combined with ERS strategy was not statistically different from the all-acceptance colonoscopy strategy (8.79% vs. 10.46%, P=0.075) and had a higher positive predictive value (14.11% vs. 10.46%, P<0.001) and lower number of colonoscopies per advanced neoplasms detected (7.1 vs. 9.6, P<0.001). Conclusion: The risk-adapted screening strategy combining PRS and ERS helps achieve population risk stratification and better effectiveness than the traditional colonoscopy-based screening strategy.
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Humanos , Detección Precoz del Cáncer , Factores de Riesgo , Neoplasias Colorrectales/genética , Asia , China/epidemiologíaRESUMEN
Hepatitis E is a viral hepatitis that the hepatitis E virus (HEV) causes. In the early 1980s, the hepatitis E virus was first discovered and identified, and it is one of the important pathogens that cause acute viral hepatitis globally. HEV infection is usually self-limiting, but in some groups of populations, such as pregnant women, patients with chronic liver disease, and the elderly, the prognosis is poor and may result in acute or subacute liver failure or even death. In addition, HEV infection can occur in chronically immunocompromised populations. At present, some regions and countries are not paying enough attention to hepatitis E prevention, diagnosis, and treatment, which suggests that we should study the epidemiology of HEV infection.
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Humanos , Femenino , Embarazo , Anciano , Hepatitis E/epidemiología , Virus de la Hepatitis E/genética , Pronóstico , Fallo Hepático , Complicaciones Infecciosas del EmbarazoRESUMEN
Objective: To investigate the predictive value of glycosylated hemoglobin A1c/apolipoprotein A-1 (HbA1c/ApoA-1) ratio for major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS). Methods: The present study is a retrospective cohort study. ACS patients who were hospitalized and underwent coronary angiography at Beijing Hospital from March 2017 to March 2019 were enrolled. Baseline information such as sex, age, previous history, Gensini score, HbA1c and ApoA-1 were analyzed. Patients were divided into two groups according to presence or absence of MACEs and the difference on HbA1c/ApoA-1 ratio was compared between the two groups. According to the tertiles of HbA1c/ApoA-1 levels, patients were divided into high (5.87-16.12), medium (4.50-5.83) and low (2.11-4.48) HbA1c/ApoA-1 groups. Cox proportional risk model was used to evaluate the differences in MACEs and all-cause mortality among the three groups. Kaplan-Meier survival analysis was used to compare the differences of MACEs between the various HbA1c/ApoA-1 groups. Results: A total of 366 ACS patients were included in this study. The mean age of the patients was (65.9±10.3) years. There were 59 MACEs and 10 all-cause deaths during the mean of (22.3±4.4) months follow-up. After adjusting for age, systolic blood pressure, history of diabetes and Gensini score, the incidence of MACEs was 2.45 times higher in the high HbA1c/ApoA-1 group than in the low HbA1c/ApoA-1 group (95%CI 1.16-5.18, P=0.019). There was no significant difference in all-cause mortality between the high and low HbA1c/ApoA-1 groups (P=1.000). Kaplan-Meier survival analysis showed that patients in the high HbA1c/ApoA-1 group had the highest risk of MACEs, while patients in the low HbA1c/ApoA-1 group had the lowest risk of MACEs (P<0.01). Spearman rank correlation analysis showed that HbA1/ApoA-1 ratio was positively correlated with Gensini score in ACS patients (r=0.274, P<0.01). Conclusion: High HbA1c/ApoA-1 ratio was an independent risk factor for MACEs in ACS patients. Patients with high HbA1c/ApoA-1 ratio had more severe coronary artery disease lesions. HbA1c/ApoA-1 ratio may be used as a potential risk stratification biomarker for ACS patients, it might be useful for the early identification of high-risk population and for predicting the incidence of MACEs among ACS patients.
Asunto(s)
Anciano , Humanos , Persona de Mediana Edad , Síndrome Coronario Agudo/diagnóstico , Apolipoproteína A-I/análisis , Biomarcadores/análisis , Hemoglobina Glucada/análisis , Intervención Coronaria Percutánea , Estudios Retrospectivos , Factores de Riesgo , Valor Predictivo de las PruebasRESUMEN
The correlation between intestinal flora and diseases has become a hot research topic in recent years.Since the incidence of diabetes is closely related to chronic low-grade inflammation and intestinal flora disorders,the intervention of intestinal flora imbalance has become a research focus in the prevention and treatment of diabetes mellitus.Akkermansia muciniphila(A.muciniphila) stands out among the intestinal flora as it can alleviate the diabetes-related symptoms by regulating glucagon-like peptide 1 (GLP-1) level,improving intestinal barrier function,and inhibiting chronic inflammation,which is a potential target for the prevention and treatment of diabetes.The reduction in the abundance of A.muciniphila is a marker for the early diagnosis of diabetes.The available studies have demonstrated that the administration with A.muciniphila alone can significantly attenuate inflammation and other related symptoms of diabetic patients.Moreover,A.muciniphila has good safety and can be tolerated by human body.Therefore,A.muciniphila has the potential to serve as a new species of probiotics for the treatment of diabetes.The clinical measures for treating diabetes,such as metformin,Chinese herbal medicines,and functional diet,have been confirmed to be associated with the increased abundance of A.muciniphila.Among them,Chinese herbal medicines can treat diabetes via multiple targets and pathways in a systemic manner.Studies have reported that A.muciniphila is a potential target of Chinese herbal medicines intervening in diabetes.After the administration of Chinese herbal medicines,the improvement of diabetes-related indicators was positively correlated with the abundance of A.muciniphila.The above evidence provides a new idea for the research on the interaction between Chinese herbal medicines and intestinal flora in the treatment of diabetes.Therefore,this paper reviewed the role of A.muciniphila in diabetes and the correlation between the abundance of A.muciniphila and the administration of Chinese herbal medicines,aiming to provide new measures for the prevention and treatment of diabetes.
Asunto(s)
Humanos , Diabetes Mellitus/prevención & control , Akkermansia , Inflamación , Extractos VegetalesRESUMEN
PURPOSE@#This study aims to elucidate the electrotaxis response of alveolar epithelial cells (AECs) in direct-current electric fields (EFs), explore the impact of EFs on the cell fate of AECs, and lay the foundation for future exploitation of EFs for the treatment of acute lung injury.@*METHODS@#AECs were extracted from rat lung tissues using magnetic-activated cell sorting. To elucidate the electrotaxis responses of AECs, different voltages of EFs (0, 50, 100, and 200 mV/mm) were applied to two types of AECs, respectively. Cell migrations were recorded and trajectories were pooled to better demonstrate cellular activities through graphs. Cell directionality was calculated as the cosine value of the angle formed by the EF vector and cell migration. To further demonstrate the impact of EFs on the pulmonary tissue, the human bronchial epithelial cells transformed with Ad12-SV40 2B (BEAS-2B cells) were obtained and experimented under the same conditions as AECs. To determine the influence on cell fate, cells underwent electric stimulation were collected to perform Western blot analysis.@*RESULTS@#The successful separation and culturing of AECs were confirmed through immunofluorescence staining. Compared with the control, AECs in EFs demonstrated a significant directionality in a voltage-dependent way. In general, type Ⅰ alveolar epithelial cells migrated faster than type Ⅱ alveolar epithelial cells, and under EFs, these two types of cells exhibited different response threshold. For type Ⅱ alveolar epithelial cells, only EFs at 200 mV/mm resulted a significant difference to the velocity, whereas for, EFs at both 100 mV/mm and 200 mV/mm gave rise to a significant difference. Western blotting suggested that EFs led to an increased expression of a AKT and myeloid leukemia 1 and a decreased expression of Bcl-2-associated X protein and Bcl-2-like protein 11.@*CONCLUSION@#EFs could guide and accelerate the directional migration of AECs and exert antiapoptotic effects, which indicated that EFs are important biophysical signals in the re-epithelialization of alveolar epithelium in lung injury.