Association between Traditional Chinese medicine and a lower risk of dementia in patients with major depression: A case-control study.

ETHNOPHARMACOLOGICAL RELEVANCE: Major depression is an important risk factor for dementia. Traditional Chinese medicine (TCM) can alleviate the symptoms of major depression. However, it is unclear whether TCM decreases the risk of dementia in patients with major depression. Therefore, in this nationwide case-control study, we aimed to evaluate the association between TCM and the risk of dementia. MATERIALS AND METHODS: We included 31,981 major depression patients with dementia from the National Dementia Database as the case group, and 4391 major depression patients without dementia from a one-million random sample database as the control group. We matched age (plus or minus two years), sex, and year of depression diagnosis based on a 1:4 ratio. RESULT: There were 11,724 and 2931 patients in the case and control groups, respectively. Based on a conditional logistic regression analysis, the TCM groups exhibited significantly lower odds ratios with a 95% confidence interval of 0.83 (0.74-0.91). TCM treatment for more than 90 days, dispersing Qi, and activating blood circulation resulted in lower dementia risk with the following odds ratios and 95% confidence intervals: 0.60 (0.56-0.68), 0.87 (0.74-1.08), and 0.66 (0.49-0.81). CONCLUSION: The results suggest that TCM is associated with lower dementia risk in major depression patients.

The Impact of the Postpartum "Doing-the-Month" Practice on Human Milk Microbiota: A Pilot Study in Taiwan.

Human milk microorganisms could benefit the healthy development of the immune system in infants. In Asia, the practice of "doing-the-month" indicates a month-long period of postpartum recuperation for new mothers. This is composed of cultural practices, traditional beliefs, behavioral, dietary, and herbal therapies. In this pilot study, we evaluated the effect of "doing-the-month" on the human milk microbiota using a molecular approach. We collected two "doing-the-month" milk groups from randomly recruited mothers who had completed their "doing-the-month" program in either postpartum care center A (milk-PCA, n = 14) or postpartum care center B (milk-PCB, n = 27) for 20 to 30 days. As for the control group, milk samples were selected from postpartum mothers (milk-H, n = 46), who did not conduct the "doing-the-month" program. We found that the "doing-the-month" milk samples were associated with more diverse and unique milk microbiota and that these samples were also linked with more abundant Lactobacillus (milk-PCB) and prevalent Bifidobacteria (milk-PCA and milk-PCB). In addition, the milk samples from "doing-the-month" mothers could be enriched with more Archaea bacterial members, but the "non-doing-the-month" milk samples were enriched with more common skin-, oral-, and environmental-related bacterial members. This study highlights the impact maternal practices may have on the milk microbiome. More research is needed to investigate the effects this may have on infant immune health.

Characteristics of Traditional Chinese Medicine Use for Carpal Tunnel Syndrome.

Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder and an occupational disease caused by repeated exercise or overuse of the hand. We investigated the characteristics of traditional Chinese medicine (TCM) use by practitioners in CTS patients, including demographic variables, socioeconomic status, previous medical conditions, health care use, and hospital characteristics for TCM health care. This cross-sectional study identified 25,965 patients newly diagnosed with CTS based on the first medical diagnosis recorded between 1999 and 2013 in the nationwide representative insurance database of Taiwan. The date of initial CTS diagnosis in outpatient data was defined as the index date, and four patients were excluded because of missing gender-related information. Patients who used TCM care as the first option at their diagnosis were classified as TCM users (n = 677; 2.61%), and all others were TCM non-users (n = 25,288; 97.4%). In the all variables-adjusted model, female patients had an adjusted odds ratio (OR; 95% CI) of TCM use of 1.35 (1.11-1.66). National Health Insurance (NHI) registration was associated with higher odds ratios of TCM use in central, southern, and eastern Taiwan than in northern Taiwan (ORs = 1.43, 1.86, and 1.82, respectively). NHI registration was associated with higher odds ratios of TCM use in rural cities than in urban cities (OR (95% CI) = 1.33 (1.02-1.72)). The TCM group had a 20% less likelihood of exhibiting symptoms, signs, and ill-defined conditions and injury and poisoning. The TCM group had a 56% lower likelihood of having diseases of the musculoskeletal system and connective tissue. Multi-level model outcomes were similar to the results of the all variables-adjusted model, except for the NHI registration outcome in rural and urban cities (OR [95% CI] = 1.33 [0.98-1.81]). Significant associations between the number of TCM visits and TCM use were observed in all logistic regression models. The study presented key demographic characteristics, health care use, and medical conditions associated with TCM use for CTS. Previous experience of TCM use may affect the use of TCM for CTS treatment. This information provides a reference for the allocations of relevant medical resources and health care providers.

The in vivo antinociceptive and µ-opioid receptor activating effects of the combination of N-phenyl-2',4'-dimethyl-4,5'-bi-1,3-thiazol-2-amines and naloxone.

Morphine is widely used for the treatment of severe pain. This analgesic effect is mediated principally by the activation of µ-opioid receptors (MOR). However, prolonged activation of MOR also results in tolerance, dependence, addiction, constipation, nausea, sedation, and respiratory depression. To address this problem, we sought alternative ways to activate MOR - either by use of novel ligands, or via a novel activation mechanism. To this end, a series of compounds were screened using a sensitive CHO-K1/MOR/Gα15 cell-based FLIPR® calcium high-throughput screening (HTS) assay, and the bithiazole compound 5a was identified as being able activate MOR in combination with naloxone. Structural modifications of 5a resulted in the discovery of lead compound 5j, which could effectively activate MOR in combination with the MOR antagonist naloxone or naltrexone. In vivo, naloxone in combination with 100 mg/kg of compound 5j elicited antinociception in a mouse tail-flick model with an ED50 of 17.5 ±â€¯4 mg/kg. These results strongly suggest that the mechanism by which the 5j/naloxone combination activates MOR is worthy of further study, as its discovery has the potential to yield an entirely novel class of analgesics.

Traditional Chinese Medical Care and Incidence of Stroke in Elderly Patients Treated with Antidiabetic Medications.

OBJECTIVES: Experimental research has shown that herbal and traditional Chinese medicines (TCM) may serve as complements to Western medicine treatments in the control of blood glucose and cardiovascular complications, but population-based studies are limited. We investigated the association between TCM use and subsequent risk of stroke in older patients with diabetes. STUDY DESIGN: The database used in this cohort study contained longitudinal medical claims for one million subjects randomly selected among beneficiaries of a universal health care program in Taiwan. We identified a cohort of patients with diabetes aged 65 years and older who initiated anti-diabetic medications from 2000 to 2012. Patients who had at least two TCM outpatient visits after their initiation of anti-diabetic medications were considered TCM users. MAIN OUTCOME MEASURES: The incidence of stroke was measured until 2013. Cox regression models with TCM use as a time-dependent variable were used to calculate the adjusted hazard ratios (HRs) comparing TCM use with no use. RESULTS: Over the 13-year period, 17,015 patients were identified; 4912 (28.9%) of them were TCM users. The incidence of stroke during the follow-up (per 1000 person-years) was 22.8 in TCM users and 25.7 in non-users. TCM users had an adjusted HR of 0.93 for the incidence of ischemic stroke (95% confidence interval [CI] 0.83, 1.04) and of 0.89 for developing hemorrhagic stroke (95% CI 0.66, 1.19), compared with non-users. CONCLUSIONS: In this study, in older patients receiving Western medicine treatments for diabetes, TCM use was not associated with an increased risk of developing ischemic stroke and hemorrhagic stroke.

Personal, Psychosocial and Environmental Factors Related to Sick Building Syndrome in Official Employees of Taiwan.

Sick building syndrome (SBS) is a combination of symptoms that can be attributed to exposure to specific building conditions. The present study recruited 389 participants aged 20-65 years from 87 offices of 16 institutions to examine if personal factors, work-related psychosocial stress, and work environments, were associated with five groups of SBS symptoms, including symptoms for eyes, upper respiratory tract, lower respiratory tract, skin, and non-specific systems. Indoor environmental conditions were monitored. Data were analyzed using multivariate logistic regression (MLR) analyses and were reported as adjusted Odds Ratios (aOR). SBS symptoms for eyes were associated with older age, sensitivity to tobacco, and low indoor air flow. Upper respiratory symptoms were related to smoking, low social support, longer work days, and dry air. High indoor air flow was associated with reduced upper respiratory symptoms (aOR = 0.29; 95% confidence interval (CI) = 0.13-0.67). Lower respiratory symptoms were associated with high work pressure, longer work hours, chemical exposure, migraine, and exposure to new interior painting. Recent interior painting exposure was associated with a high estimated relative risk of low respiratory symptoms (aOR = 20.6; 95% CI = 2.96-143). Smoking, longer work days, low indoor air flow, indoor dryness, and volatile organics exposure, were associated with other non-specified symptoms including headache, tiredness, difficulty concentrating, anger, and dizziness. In conclusion, there are various SBS symptoms associated with different personal characteristics, psychosocial, and environmental factors. Psychosocial factors had stronger relationships with lower respiratory symptoms than with other types of SBS symptoms. Good ventilation could reduce risk factors and may relieve SBS symptoms.