Objective To make a systematical review of the safety and efifcacy of Etomidate plus Fentanyl-class drugs and Propofol plus Fentanyl-class drugs in older patients undergoing gastroscopy. Methods We searched the Cochrane library, PubMed, Embase, China Biology Medicine (CBM), CNKI, VIP, Wanfang Database for all randomized controlled trials (RCTs) about the efifcacy of Etomidate plus Fentanyl-class drugs(Fentanyl, Sufentanil, remifentanil) in older patients undergoing gastroscopy. The quality of the studies was evaluated by the method recommended by the Jadad scale. Meta-analysis was conducted using the Cochrane Collaboration’s RevMan 5.3 software. Results 11 RCTs involving 1 535 patients were analyzed. Meta-analysis showed that patients in the Etomidate group had a lower heart rate [Weighted Mean Difference (WMD)=2.25, 95%CI(0.93, 3.56), P=0.001] and mean arterial pressure [WMD=9.09, 95%CI (7.60, 10.57), P=0.000] lfuctuation than whose of the Propofol group.The hypoxemia occurrence [O^R=0.46, 95%CI (0.32, 0.65), P=0.000] in Etomidate group is also lower than which of the Propofol group. For side effects aspects, the risk of apnea[O^R=0.26, 95%CI(0.15, 0.48), P=0.000] and injection pain [O^R=0.02, 95%CI (0.01, 0.05), P=0.000] in the Etomidate group is much lower than the Propofol group ,while the myoclonus [O^R=8.14, 95%CI (4.18, 15.87), P=0.000], nausea and vomiting [O^R=3.44, 95%CI (2.03, 5.84), P=0.000] were more incidental than the Propofol group. Conclusion Etomidate plus Fentanyl-class drugs can effectively maintain circulatory system for the old undergoing painless gastroscopy, demonstrated to be a safe and valid anesthesia method.

Objective:To establish a automatic headspace gas chromatography-mass spectrometry (HS/GC-MS) method for the determination of 14 volatile organic compounds in urine.Methods:In September 2022, 10 ml urine sample was taken into a 20 ml headspace bottle, balanced for 30 min at 65 ℃, and then detected by HS/GC-MS and quantified by external standard method.Results:The 14 volatile organic compounds showed good linearity at 0.2-8.0 μg/L and 0.1-4.0 μg/L, with correlation coefficients ranging from 0.9956-0.9999. The recoveries were 79.8%-113.1% with relative standard deviations 0.05%-0.27% when three different concentration levels were added. Detection limit was 0.03-0.05 μg/L.Conclusion:The method is simple and convenient, and the recovery and precision meet the requirements. It can be used for the determination of common volatile organic compounds in urine.

Objective:To establish a automatic headspace gas chromatography-mass spectrometry (HS/GC-MS) method for the determination of 14 volatile organic compounds in urine.Methods:In September 2022, 10 ml urine sample was taken into a 20 ml headspace bottle, balanced for 30 min at 65 ℃, and then detected by HS/GC-MS and quantified by external standard method.Results:The 14 volatile organic compounds showed good linearity at 0.2-8.0 μg/L and 0.1-4.0 μg/L, with correlation coefficients ranging from 0.9956-0.9999. The recoveries were 79.8%-113.1% with relative standard deviations 0.05%-0.27% when three different concentration levels were added. Detection limit was 0.03-0.05 μg/L.Conclusion:The method is simple and convenient, and the recovery and precision meet the requirements. It can be used for the determination of common volatile organic compounds in urine.

Objective:To investigate the clinical effect of amiodarone on patients with atrial fibrillation after heart valve replacement, and to provide reference basis for improving the efficacy of patients with atrial fibrillation after heart valve replacement.Methods:The PubMed, Web of Science, WILEY medical and nursing discipline database, Cochrane Library, CNKI, Wanfang database, VIP database and China Biology Medicine disc were searched by computer. Randomized controlled trials (RCTs) about amiodarone treating patients with atrial fibrillation after heart valve replacement were searched from the establishment of the database to 24th September , 2019. After two people's independent literature screening and literature quality evaluation, relevant data were extracted and quantitative comprehensive analysis was conducted with Revman 5.3 software.Results:A total of 7 articles were included, including 6 Chinese articles and 1 English article. There were 710 patients in total, including 363 cases in the experimental group and 347 cases in the control group. Quantitative synthesis was performed with Revman 5.3 software, and the results showed that amiodarone treatment for atrial fibrillation after valve replacement could improve the recovery rate of atrial fibrillation ( RR=1.36, 95% CI: 1.20-1.54, P<0.05) . The rate of sinus rhythm maintenance was increased ( RR=1.41, 95% CI: 1.16-1.72, P=0.002) , the ICU monitoring time was shortened ( MD=-1.09, 95% CI: -1.32--0.86, P<0.05) , and the total days in hospital was reduced ( MD=-3.92, 95% CI: -4.25--3.59, P<0.05) . Conclusions:Amiodarone treatment for atrial fibrillation after valve replacement can improve the recovery rate of atrial fibrillation and the rate of sinus rhythm maintenance, reduce the ICU monitoring time and the total days in hospital, which is worthy of clinical application.

OBJECTIVE：To reappraise systematic review/Meta-analysis （SRs/MAs）of the efficacy and safety of glucagon-like peptide 1（GLP-1）receptor agonist in the treatment of type 2 diabetes mellitus （T2DM），and to provide evidence-based reference for clinical use of these drugs in the treatment of T 2DM. METHODS ：Retireved from Cochrane library ，PubMed，Embase，CBM， Wanfang database and CNKI ，systematic review/Me ta-analysis about GLP- 1 receptor agonist in the treatment of T 2DM were collected during the inception to Dec. 2019. After data extraction of literatures met inclusion and exclusion criteria ，GRADE system was used to evaluate the quality of evidence included in the study ，and the evidence of efficacy and safety outcome indexes were summarized. RESULTS ：Finally 31 literatures were included ，involving 91 outcome indexes ，and GRADE evidence quality was medium，among which 4（4.4％）were very-low-quality ，33（36.3％）were low-quality ，45（49.5％）were medium-quality ，and 9 （9.9％）were high-quality outcome indicators. The results of evidence summary showed that GLP- 1 receptor agonists were better than or similar to placebo and other oral hypoglycemic drugs ， better than dipeptidyl peptidase 4 （DPP-4） inhibitors in . reducing the level of HbA 1c；better than or similar to placebo ， JDZX2015240） better than other oral hypoglycemic agents and DPP- 4 2276299207@qq.com inhibitors in reducing the level of fasting glucose ；similar to DDP-4 inhibitors，higher than or similar to placebo ，lower than other oral hypoglycemic dru gs in the incidence of hypoglycemia；higher than other oral hypoglycemic drugs ，placebo and DPP- 4 inhibitors in the incidence of diarrhea and nausea ； higher than other oral hypoglycemic drugs and placebo in the incidence of vomiting. CONCLUSIONS ：The evidence quality of systematic review/Meta-analysis about GLP- 1 receptor agonist in the treatment of T 2DM are moderate. These drugs have good clinical efficacy in the treatment of T 2DM，but their safety are not as good as placebo or other oral hypoglycemic drugs.

Bone diseases, such as osteoporosis and osteoarthritis, have emerged as pressing public health concerns requiring immediate attention and resolution. Cellular therapy and tissue engineering techniques are among the most promising therapeutic approaches for such conditions. Human induced pluripotent stem cells (hiPSCs) possess remarkable capacity for indefinite self-renewal in vitro and the ability to differentiate into all somatic cell types originating from the three germ layers, thereby making them a promising source of osteoblasts. Consequently, it is crucial to establish a well-delineated system for osteogenic differentiation of hiPSCs in vitro, with the aim to generate osteoblast-like cells that conform to clinical application standards. Numerous research teams have achieved substantial advancements in both the direct osteogenic differentiation of hiPSCs and the indirect pathway via mesenchymal stem cells. In this article, we provide a comprehensive review of these two osteogenic differentiation pathways and their current applications, with the aim of serving as a valuable reference for bone regeneration technologies. Current research efforts have relied on embryoid body formation and monolayer induction methods utilizing biomaterials to develop a system that facilitates in vitro culture and osteogenic differentiation of hiPSCs. However, the existing research is primarily constrained by unclear system components and low efficiency. Therefore, the development of a stepwise and three-dimensional induction system based on stringent regulation by specific compounds is a primary research direction for the future.

Objective:To learn about the changes of the condition of coal-burning-borne endemic arsenism, the use of improved stoves and the formation of health-related behaviors in Shaanxi Province, and evaluate the effect of prevention and control measures.Methods:From 2015 to 2020, according to the "Implementation Plan for Monitoring Coal-burning-borne Endemic Arsenism in Shaanxi Province", regular field surveys were carried out in 4 natural villages, 2 counties in Ankang City and Hanzhong City, Shaanxi Province, to learn about the basic prevention and control situation in the monitoring village. Using the simple random sampling method, 10 families in each village were selected to investigate the use of stoves and the formation of health-related behaviors, and 5 of these families were selected to collect coal samples for arsenic content determination in accordance with the "Determination of Arsenic in Coal" (GB/T 3058-2008). According to the "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015), the condition of the people exposed to high arsenic coal in the monitoring village was investigated. Urine samples of 30 adult patients (half males and half females) with arsenic poisoning were collected, the content of arsenic in urine was determined by the "Urine-Determination of Arsenic-Silver Diethyldithiocarbamate-Triethanolamine-Spectrophotometric Method" (WS/T 28-1996).Results:A total of 240 households were monitored in the past 6 years, and the quality conformance and correct utilization rates of improved stoves in the households monitored in the disease areas remained at 100.00% in 2018 - 2020. The utilization rate of clean energy increased from 75.00% (30/40) in 2015 to 100.00% (40/40) in 2018 - 2020 (χ 2trend = 25.5, P < 0.001). The 73.75% (177/240) of households using a variety of clean energy. From 2018 to 2020, the correct drying, storage and pre-processing washing rates of corn and pepper continued to reach 100.00% (40/40). The arsenic content of coal ( n = 120) in the disease areas was (118.09 ± 57.91) mg/kg, ranging from 16.70 to 280.94 mg/kg. The detection rate of arsenic poisoning decreased from 6.34% (231/3 646) in 2015 to 2.90% (109/3 754) in 2020 (χ 2trend = 121.8, P < 0.001), and no skin cancer or Bowen's disease was detected. The geometric mean of arsenic content in urine ( n = 720) was 0.038 1 mg/L, ranging from 0.000 5 to 0.312 9 mg/L. Conclusions:The condition of coal-burning-borne endemic arsenism areas in Shaanxi Province has reached the national elimination standard. The quality and correct utilization rate of improved stoves and the rate of using clean energy have increased. The healthy-related behaviors the people in the endemic areas have been basically formed. The prevention and control work has achieved good results.

Objective:To learn about the monitoring indicators and patient management in coal-burning-borne endemic arsenic poisoning areas in Shaanxi Province, and provide a basis for consolidating and improving the prevention and control achievements.Methods:From March to December 2023, in accordance with the requirements of the "Notice of the Office of Shaanxi Provincial Health Commission on Issuing of the Monitoring Plan for Key Endemic Diseases Such as Kashin-Beck Disease" and "The Monitoring Plan for Endemic Fluorosis and Arsenic Poisoning in Shaanxi Province", a basic situation investigation was conducted in the affected villages of all counties (districts) with coal-burning-borne endemic arsenic poisoning in Shaanxi Province, and on-site visits were conducted to check the management of high arsenic coal mines. Using the simple random sampling method, 30 families in each village were selected to investigate the use of stoves and the formation of health-related behaviors. A survey on arsenic poisoning was carried out among all populations in the affected villages. According to the requirements of the provincial monitoring program, 720 people were randomly selected from 12 affected villages in 3 monitoring counties to measure their urinary arsenic level. The determination was based on the "Guidelines for the Safety of Urinary Arsenic in Population" (WS/T 665-2019). The evaluation for elimination of disease areas was carried out in accordance with the "National Health Commission Issued the Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 edition)".Results:A total of 2 cities, 8 counties (districts), 99 townships, and 1 414 affected villages were monitored. All 53 high arsenic coal mines had stopped mining. The rate of qualified improved stoves was 99.97%; the correct utilization rate of qualified improved stoves, and the correct drying rate of corn and chili peppers provided for human consumption in the affected villages were 100.00%. A total of 2 064 138 people were examined, and 2 682 cases of arsenic poisoning were detected, all of whom were historical patients. There were no new cases of arsenic poisoning or skin cancer. There were currently 2 682 arsenic poisoning patients who had received family doctor contract services and implemented follow-up management. The geometric mean of urinary arsenic was 0.016 7 mg/L, which was lower than the safety guideline value for human urinary arsenic (0.032 mg/L).Conclusions:The monitoring indicators in the coal-burning-borne endemic arsenic poisoning areas in Shaanxi Province have reached the elimination standards. In the future, we should continue to strengthen the management of high arsenic coal mines, implement comprehensive prevention and control measures mainly focused on furnace and stove renovation and health promotion, and do a good job in patient management to continuously consolidate and improve the prevention and control achievements.

Colorectal cancer （CRC）， a most common malignant tumor of the digestive tract， is often manifested by abdominal pain， changes in stool quality， blood in the stool， and weight loss， with rising morbidity and mortality year by year. The onset and development of CRC involve a variety of mechanisms， in which tumor microenvironment （TME） and tumor-associated macrophages （TAMs） have received increasing attention. TAMs influence the tumor development via immune escape and angiogenesis promotion and are associated with the prognosis of tumors. In recent years， traditional Chinese medicine （TCM） has been widely researched and applied in the treatment of cancers. Studies have discovered that TCM mainly exerts the therapeutic effects on CRC by inhibiting the proliferation， metastasis， and angiogenesis， promoting the apoptosis， and inducing autophagy of tumor cells and boosting the immune function. TCM as an effective treatment approach can regulate TAMs to inhibit tumor growth. Moreover， the active components and targets of TCM can be taken as new research directions of immunotherapy. This review describes TAMs and their roles in CRC progression and summarizes the molecular targets and mechanisms of different active components， compound prescriptions， and novel preparations of TCM against CRC， aiming to provide a mechanism reference for the clinical treatment of CRC with TCM and give new insights into the in-depth research on the prevention and treatment of CRC-related diseases with TCM.

Recent studies have shown that the chemokine receptor CXCR3 and its ligand CXCL10 in the dorsal root ganglion mediate itch in experimental allergic contact dermatitis (ACD). CXCR3 in the spinal cord also contributes to the maintenance of neuropathic pain. However, whether spinal CXCR3 is involved in acute or chronic itch remains unclear. Here, we report that Cxcr3 mice showed normal scratching in acute itch models but reduced scratching in chronic itch models of dry skin and ACD. In contrast, both formalin-induced acute pain and complete Freund's adjuvant-induced chronic inflammatory pain were reduced in Cxcr3 mice. In addition, the expression of CXCR3 and CXCL10 was increased in the spinal cord in the dry skin model induced by acetone and diethyl ether followed by water (AEW). Intrathecal injection of a CXCR3 antagonist alleviated AEW-induced itch. Furthermore, touch-elicited itch (alloknesis) after compound 48/80 or AEW treatment was suppressed in Cxcr3 mice. Finally, AEW-induced astrocyte activation was inhibited in Cxcr3 mice. Taken together, these data suggest that spinal CXCR3 mediates chronic itch and alloknesis, and targeting CXCR3 may provide effective treatment for chronic pruritus.
Acetamides ; therapeutic use ; Animals ; Chemokine CXCL10 ; metabolism ; Chloroquine ; toxicity ; Chronic Disease ; Cyclopropanes ; adverse effects ; Dehydration ; complications ; Dinitrofluorobenzene ; adverse effects ; Disease Models, Animal ; Formaldehyde ; toxicity ; Freund's Adjuvant ; toxicity ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Motor Activity ; drug effects ; Pain ; chemically induced ; Pruritus ; chemically induced ; pathology ; Pyrimidines ; therapeutic use ; Receptors, CXCR3 ; antagonists & inhibitors ; genetics ; metabolism ; Skin ; pathology ; Spinal Cord ; drug effects ; metabolism ; pathology ; Time Factors ; p-Methoxy-N-methylphenethylamine ; toxicity