Objective To analyze the efficacy and safety of pramipexole in treating restless legs syndrome (RLS) to different races.Methods A search for randomized,double-blind,and placebocontrolled clinical trials of pramipexole in treating RLS using Pubmed was carried out.A meta-analysis of included clinical trials was performed with Revman 5.2.The efficacy was calculated based on the change of the weighted mean difference (WMD) with International Restless Legs Syndrome Study Group rating scale (IRLS) and the relative risk (RR) of response with Clinical Global Impression-Improvement (CGI-I) scale.Safety was assessed with RR of the adverse event (AE).Subgroup analysis was conducted in the white race subgroup and the yellow race subgroup,separately.Results A total of 6 clinical trials were included in this meta-analysis.The records of patients were pooled.Overall,WMD of the change in IRLS score was-4.72 (Z =6.57,P ＜ 0.01),which was-4.33 in white race subgroup (Z =3.90,P ＜ 0.01) and-4.52 (Z =42.28,P ＜0.01) in yellow race subgroup.Overall RR of response based on CGI-I was 1.64 (Z =10.39,P ＜0.01),which was 1.60 (Z =4.66,P ＜0.01) in white race subgroup,and 1.51 (Z =4.42,P ＜ 0.01) in yellow race subgroup.Overall RR for AE was 1.26 (Z =5.11,P ＜ 0.01),which was 1.26 (Z =2.27,P =0.02) in white race subgroup and 1.36 (Z =2.98,P =0.003) in yellow race subgroup.Conclusion To treat RLS,pramipexole is an effective and safe drug.The results are similar for both the white race and the yellow race.

Purpose To explore the feasibility of low radiation dose combined with lowdose contrast agent in thyroid CT enhanced scan and investigate the benefit of reducing radiation hazard and contrast agent damage to thyroid.Materials and Methods 120 patients assigned for thyroid enhanced CT scan were prospectively and randomly divided into four groups (each group was 30 patients).Group A:radiation dose 120 kV,180 mA,contrast agent dose 1.2 ml/kg;group B:radiation dose 120 kV,180 mA,contrast agent dose 1.0 ml/kg;group C:radiation dose 100 kV,100 mA,contrast agent dose 1.2 ml/kg;group D:radiation dose 100 kV,100 mA,contrast agent dose 1.0 ml/kg.CT values,background sign,background noise of thyroid were measured;signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated;CT dose index of volume (CTDIvol),dose length product (DLP),and the effective dose (ED) were recorded and calculated.The image quality was evaluated and the data was statistically analyzed by two radiologists.Results CT values,background sign and background noise of thyroid,as well as CTDIvol,DLP,ED among four groups were statistical significant (P＜0.05);there was no significant difference in SNR,CNR and image quality scores among four groups (P＞0.05).Conclusion It is beneficial of reducing radiation hazard and side-effect of contrast agent from low radiation dose combined with low-dose contrast agent under the condition of ensuring diagnostic image quality.

There are direct and indirect interactions between gut microbiota and host immune response, which can have a multifaceted impact on host health. Dysbiosis caused by disturbances in the gut microbiota is associated with susceptibility to many diseases, especially immune-related diseases. Based on the research results in recent years, this paper introduced the mechanism of the interaction between gut microbiota and host immunity, and expounded the role of gut microbiota in the occurrence and development of immune-related diseases, including intestinal system diseases such as inflammatory bowel disease and other systemic diseases such as rheumatoid arthritis, and summarized disease treatment strategies targeting gut microbiota. A better understanding of the research progress of gut microbiota and immune-related diseases will help us in the prevention and management of such diseases, and broaden our path to discover disease intervention targets.
Gastrointestinal Microbiome/physiology* ; Humans ; Inflammatory Bowel Diseases ; Intestines

Objective     To evaluate the effect of mediastinal drainage tube placed in the left thoracic cavity after partial resection of the mediastinum pleura in robot-assisted McKeown esophagectomy for esophageal carcinoma, and to compare it with the traditional method of mediastinal drainage tube placed in mediastinum. Methods    We retrospectively analyzed clinical data of 96 patients who underwent robot-assisted McKeown esophagectomy for esophageal carcinoma by the surgeons in the same medical group in our department between July 2018 and March 2021. There were 78 males and 18 females, aged 52-79 years. Left mediastinum pleura around the carcinoma during operation was resected in all patients. Patients were divided into two groups according to the method of mediastinal drainage tube placement: a control group (placed in mediastinum) and an observation group (placed through the mediastinal pleura into the left thoracic cavity with several side ports distributed in the mediastinum). The incidence of left thoracentesis or catheterization after surgery, anastomotic fistula and anastomotic healing time, other complications such as pneumonia and postoperative pain score were also compared between the two groups. Results     There was no statistical difference in baseline data or surgical parameters between the two groups. The percentage of patients in the observation group who needed re-thoracentesis or re-catheterization postoperatively due to massive pleural effusion in the left thoracic cavity was significantly lower than that in the control group (5.6% vs. 21.4%, P=0.020). The incidence of anastomotic leakage (3.7%vs. 7.1%, P=0.651) and the healing time of anastomosis (18.56±4.27 d vs. 24.33±5.48 d, P=0.304) were not statistically different between the two groups, and there was no statistical difference in other complications such as pulmonary infection. Moreover, the postoperative pain score was also similar between the two groups. Conclusion     For patients whose mediastinal pleura is removed partially during robot-assisted McKeown esophagectomy for esophageal carcinoma, placing the drainage tube through the mediastinal pleura into the left thoracic cavity can reduce the risk of left-side thoracentesis or catheterization, which may promote the postoperative recovery of patients.

Objective Incontinence-associated dermatitis(IAD) is a common skin disease, but there is still lack of evidence on which kind of skin proctectant can provide effective prevention and cost reduction. The article aimed to explore the clinical effect and cost-effectiveness of two skin protectants based on structured skin care regimens in the nursing care of incontinent patients and provide evidence for effective prevention of IAD.Methods A total of 124 patients with incontinence were randomly selected and divided into observation group (62 cases) and control group (62 cases). On the basis of the structured skin care program which focused on incontinence management, cleansing and protection, the patients in the observation group were treated with the composite zinc oxide ointment for 7 days, while patients in control group were treated with ostomy powder combined with skin barrier film for 7 days. The main observation indicators were the incidence of IAD and the cost of nursing materials.Results All 62 patients in the observation group completed the study, while in the control group 2 patients fell off because of death and discharge from hospital and 60 patients completed the study. The per-protocol analysis showed that the incidences of IAD in two groups were 6.45% and 20.00%, the intention-to-treat analysis showed 6.45% and 22.58%, and there was significant difference between groups (P<0.05). The nursing cost of the observation group (239.71±48.55) was lower than that of control group (264.35±61.55), and the difference was statistically significant (P<0.05).Conclusion The use of the composite zinc oxide ointment based on a structured skin care regimen can improve the preventive effect of IAD and reducing costs.

Acupuncture Analgesia ; adverse effects ; methods ; Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Middle Aged

ObjectiveThere are few reports on the correlation between blood glucose fluctuation and body mass index(BMI) in patients with type 2 diabetes mellitus (T2DM). This study aims to evaluate the correlation between the two by comparing the differences of glucose fluctuation in T2DM patients with different BMI.MethodsA total of 672 patients with T2DM admitted to the General Hospital of Eastern Theater Command from June 2017 to October 2018 were selected as subjects. They were divided into 4 groups according to the quartile of BMI. The age, height, weight, course of diabetes, hemoglobin, uric acid, glycosylated hemoglobin, HOMA-IR (insulin resistance index) and HOMA-β (islet β cell function index) were collected. The blood glucose of the patients was continuously monitored within 3 days by wearing a continuous glucose monitor (CGMS). The standard deviation of daily blood glucose (SBDG), the mean of daily differences (MODD) and the mean amplitude of glycemic excursion(MAGE) were calculated to analyze the effect of BMI on blood glucose fluctuation.ResultsThe index of blood glucose fluctuation was negatively correlated with BMI, HbA1c and HOMA-β, but positively with HOMA-IR. Compared with the 1st and 2nd quartiles of BMI, the fluctuation level of patients in the 3rd and 4th quartiles was lower. Multivariate logistic regression analysis showed that after adjustment of age, sex, cholesterol, triglyceride and hemoglobin, the risk of hyperglycemia fluctuation in the fourth quartile group was lower than that in the first quartile group (OR=0.594, 95%CI: 1.825~2.062).ConclusionThe fluctuation of blood glucose in patients with higher BMI is lower than that in patients with lower BMI.

BACKGROUND:Pulsed electromagnetic fields,as an important physical therapy,are exactly effective in the treatment of osteoarthritis,but the mechanism has not been fully clarified. OBJECTIVE:To observe the effect of pulsed electromagnetic field on the degeneration of knee joint cartilage in aged rats. METHODS:Eight 6-month-old Sprague-Dawley rats were selected as the young group and were subjected to normal diet with no treatment.Sixteen 22-month-old Sprague-Dawley rats were randomly divided into old group(n=8)and pulsed electromagnetic field group(n=8).The rats in the pulsed electromagnetic field group were subjected to a pulsed electromagnetic field intervention,once a day,5 days per week for continuous 8 weeks.The rats in the old group were given no treatment.All rats were anesthetized and executed after 8 weeks for the detection of relevant indexes. RESULTS AND CONCLUSION:Compared with the young group,serum type Ⅱ collagen C-terminal peptide level was increased in the old group(P<0.05);compared with the old group,serum type Ⅱ collagen C-terminal peptide level was decreased in the pulsed electromagnetic field group(P<0.05).Micro-CT showed that the bone volume fraction,bone mineral density,and number of bone trabeculae decreased(P<0.05)and the trabecular separation increased(P<0.05)in the tibia of rats in the aged group compared with the young group;and the bone volume fraction,bone density,and number of trabeculae increased(P<0.05)and the trabecular separation decreased(P<0.05)in the tibia of rats in the pulsed electromagnetic field group compared with the aged group.The tibial plateau Safranin O-fast green staining showed that the articular cartilage structure of rats in the aged group was disorganized,and the number of chondrocytes was obviously reduced,and the tidal line could not be distinguished.The above results were improved in the pulsed electromagnetic field group.RT-qPCR and western blot assay showed that the mRNA and protein expression levels of matrix metalloproteinase 1,matrix metalloproteinase 13,P53 and P21 in the articular cartilage and subchondral bone of rats were elevated in the aged group compared with the young group(P<0.05)and decreased in the pulsed electromagnetic field group compared with the old group(P<0.05).To conclude,pulsed electromagnetic fields may improve osteoarthritis in aged rats by inhibiting chondrocyte senescence,alleviating articular cartilage degradation and inhibiting subchondral bone osteoporosis through suppressing the expression of P53/P21.

Mood disorders/psychosis have been associated with dysfunctions in the default mode network (DMN). However, the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder (PBD) remain unclear. The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients. Twenty-nine psychotic and 26 non-psychotic PBD patients, as well as 19 age- and sex-matched healthy controls underwent a resting-state functional MRI scan and the data were analyzed by independent component analysis. The DMN component from the fMRI data was extracted for each participant. Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements. The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex, bilateral caudate nucleus, bilateral angular gyri, and left middle temporal gyrus, while non-psychotic PBD was not, suggesting further impairment with the development of psychosis. In summary, we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group. These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.

Key requirements of successful animal behavior research in the laboratory are robustness, objectivity, and high throughput, which apply to both the recording and analysis of behavior. Many automatic methods of monitoring animal behavior meet these requirements. However, they usually depend on high-performing hardware and sophisticated software, which may be expensive. Here, we describe an automatic infrared behavior-monitor (AIBM) system based on an infrared touchscreen frame. Using this, animal positions can be recorded and used for further behavioral analysis by any PC supporting touch events. This system detects animal behavior in real time and gives closed-loop feedback using relatively low computing resources and simple algorithms. The AIBM system automatically records and analyzes multiple types of animal behavior in a highly efficient, unbiased, and low-cost manner.