Analysis of spatial pattern and influencing factors of private clinics in the main urban area of Guiyang in China from 2021 to 2022 based on multi-source data.

BACKGROUND: Private clinics are important places for residents to obtain daily medical care. However, previous researches mainly focused on public medical institutions but ignored the issue of systematic allocation of social medical resources such as clinics. It is critical to understand the private clinics distribution to analyze the rational allocation of medical resources and the spatial difference. METHODS: Based on the field survey, land census, population density, and economic data from Guiyang, this study analyzes the spatial pattern of private clinics in the main urban area of Guiyang and the influencing factors by using spatial analysis methods such as kernel density, standard deviation ellipses, and geo-detector. RESULTS: The private clinics in the main urban area of Guiyang are characterized by "inner dense, outer sparse dense," showing an overall spatial clustering feature of "four cores and two belts with many points" and "dense inside and sparse outside." Different types of private clinics have distinct spatial distribution characteristics and agglomeration forms. The growth of private clinics is closely linked to the population growth of mountainous cities. The most important factors influencing the spatial pattern of private clinics are residential land factors, followed by traffic factors and population density. The impact of economic, natural, and spatial factors is minimal. When using a geo-detector, the results of multi-factor interaction differ from those of single factors, and factor interactions have greater explanatory power than single factors in clinic distribution. CONCLUSION: This study investigates the geographic distribution and influencing variables of private clinics in typical mountain cities and identifies the causes of the current disparity in the distribution of healthcare resources. It is necessary to gradually develop the primary healthcare system in mountainous cities with legislation, counterpart support, and social resources. While ensuring equal access to health care for low-income people and mobile populations, various medical needs of community members should be fully considered and implemented as soon as possible.

Increased risk of ischemic heart disease and diabetes in inflammatory bowel disease.

BACKGROUND: Previous studies showed inconsistent results regarding associations between inflammatory bowel disease (IBD) and risk of ischemic heart disease (IHD) and diabetes. The present study aimed to make a meta-analysis to assess the risk of IHD and diabetes in IBD. METHODS: We searched for articles published before February 2020 in the databases as follows: PubMed, Web of Science, Medline, EMBASE, and Google Scholar. We computed odds ratio (OR) or relative risk (RR) and 95 % confidence intervals (CI) regarding the association between IBD and risk of IHD or diabetes by using STATA 13.0 software. RESULTS: The present meta-analysis showed that IBD was associated with higher risk of IHD (OR/RR = 1.26, 95 % CI 1.20 to 1.32, I2 = 88.3 %, p < 0.0001). Additionally, both ulcerative colitis (UC) and Crohn's disease (CD) were associated with higher risk of IHD (UC: OR/RR = 1.19, 95 % CI 1.13 to 1.26, I2 = 65.6 %, p = 0.001; CD: OR/RR = 1.33, 95 % CI 1.17 to 1.51, I2 = 89.5 %, p < 0.0001). The study showed that IBD was associated with elevated risk of diabetes (OR/RR = 1.26, 95 % CI 1.03 to 1.53, I2 = 92.1 %, I2 = 92.1 %, p < 0.0001). Additionally, both UC and CD were associated with higher risk of diabetes (UC: OR/RR = 1.33, 95 % CI 1.03 to 1.71, I2 = 93.8 %, p < 0.0001; CD: OR/RR = 1.39, 95 % CI 1.10 to 1.76, I2 = 76.7 %, p = 0.002). CONCLUSION: In conclusion, patients with IBD are at increased risk of IHD and diabetes. Thus, regular monitoring of biomarkers of IHD and blood glucose levels should be considered for the early detection of IHD and diabetes in IBD patients.

The effect of using simethicone with or without N-acetylcysteine before gastroscopy: A meta-analysis and systemic review.

BACKGROUND/AIM: To assess the efficacy and safety of simethicone with or without N-acetylcysteine (NAC) as premedications before gastroscopy. MATERIALS AND METHODS: We searched EMBASE, PubMed, Cochrane library and Web of Science database for randomized clinical controlled trials regarding simethicone ± NAC as oral drinking agents before gastroscopy. Statistical software RevMan5.3 was used for statistical analysis. RESULTS: Ten randomized clinical trials that fulfilled the inclusion criteria were further pooled into a meta-analysis, which included 5,750 patients. The rate of positive findings in simethicone plus NAC group was higher than that in water group (risk ratio [RR] =1.31, 95%CI: 1.12-1.53, P = 0.0006) with high level of evidence. There was no significant difference on the rate of positive findings when comparing simethicone with simethicone plus NAC (RR = 1.02, 95%CI: 0.90-1.16, P = 0.71) and with water (RR = 1.13, 95%CI: 0.82-1.55, P = 0.46), respectively. Simethicone plus NAC showed better total mucosal visibility score than simethicone alone (MD = -0.14 (-0.25, -0.03), P = 0.01) without obvious heterogeneity. Both simethicone plus NAC and simethicone alone offer more benefit than water. The procedure time in simethicone group was shorter than that in water group (MD = -1.23 (-1.51, -0.96), P < 0.00001). Regarding adverse events, there was no significant difference in simethicone and water group (RR = 0.45, 95%CI: 0.2-1.0, P = 0.05, I2 = 0%). CONCLUSIONS: As premedication of gastroscopy, simethicone plus NAC offers more benefit on positive findings and total mucosal visibility score.

MicroRNA-143 enhances chemosensitivity of Quercetin through autophagy inhibition via target GABARAPL1 in gastric cancer cells.

MicroRNAs have emerged as fundamental regulators in gene expression through silencing gene expression at the post-transcriptional and translational levels. In this study, miR-143 expression and biological functions in AGS/MNK28 cell lines was investigated. Results indicated that the expression of miR-143 was significantly down-regulated in cancer tissues and in gastric cancer (GC) cell lines. Target prediction algorithms (Target Scan and miRanda) showed that GABARAPL1 was a potential target gene of miR-143. GABARAPL1, also regarded as autophagy-related protein 8 (Atg8) is a ubiquitin-like protein required for the formation of autophagosomal membranes. Then, several different assays were conducted to detect autophagy in AGS/MNK28 after transfected with miR-143. In the present study, miR-143 was firstly identified as a autophagy inhibitor in GC cells via targeting GABARAPL1. Quercetin is one of the most prominent dietary antioxidants in human diet and lately it is grabbing some serious attention as a potentially powerful cancer fighter. However, the effect of Quercetin was unexpected decreased in GC cells on account of the appearance of Quercetin-induced autophagy. Therefore, applicable autophagy inhibitors might enhance the chemosensitivity of Quercetin. Furthermore, the therapeutic response of Quercetin in the combination of miR-143 was evaluated by MTT, Hochest and western blot, results suggesting that the chemosensitivity of Quercetin was enhanced when in combination with miR-143 in AGS/MNK28 cells. In conclusion, we determined miR-143 as a potent inhibitor of autophagy via targeting GABARAPL1 and miR-143 could improve the efficacy of Quercetin though autophagy inhibition in GC cell lines, thus representing a novel potential therapeutic target for gastric cancer.

Primary hepatic malignant melanoma: a case report.

Primary hepatic malignant melanoma is a very rare disease. In order to provide clues concerning diagnosis, differential diagnosis and pathogenesis of the disease, a case of a 49 year-old female patient with primary hepatic malignant melanoma is presented. B-mode ultrasound and Contrast-enhanced abdominal computerized tomography (CT) examinations revealed that nodules of varying sizes are diffusely distributed in her enlarged liver. Pathological examination revealed that tumor cells with poor differentiation were located in nests with prominent melanin deposition. Immuno-histochemical staining showed that the tumor cells were positive for HMB-45 and S-100 protein. No evidence for primary malignant melanoma of other sites had been found by comprehensive examinations. Therefore, the patient was diagnosed with primary malignant melanoma of liver. Our case showed that primary malignant melanoma of liver is of histological heterogeneity, and immunohistochemical staining may aid in differential diagnosis between it and other hepatic neoplasms.