1.Development of Patient Self-Reported Core Outcome Set in Community Studies on Heat-Sensitive Moxibustion for Primary Hypertension
Jianyu YOU ; Shuqing LI ; Guihua DENG ; Xu ZHOU
Journal of Traditional Chinese Medicine 2025;66(1):34-41
ObjectiveTo establish the self-reported core outcome set (COS) for patients with an example of a community study on heat-sensitive moxibustion for primary hypertension (PH), to provide a reference for the selection of effectiveness evaluation indicators in community study on heat-sensitive moxibustion. MethodsA systematic literature search was conducted to collect outcomes used in randomized controlled trials and systematic review of heat-sensitive moxibustion for PH (Jan 2021), and additional outcomes were added through patient and expert questionnaires (Feb 2021) to create a pool of outcome entries. A multidisciplinary expert Delphi survey was conducted to screen outcomes applicable to patient self-reporting (Apr 2021), and the importance of outcome indicators was rated on a 5-Point Likert Scale. Finally, patient self-reported COS was determined through a consensus conference (June 2021). ResultsA pool of patient self-reported indicators in the community study of heat-sensitive moxibustion treatment for PH was generated by standardizing and combining the outcome indicators based on the results of the literature search and the questionnaire survey, which consisted of totally 100 measurement tools or contents, excluding 51 indicators or measurement tools required measurement by specialized physicians or hospital equipment, and 49 items were retained to enter the initial list of indicator entries. For the first round of Delphi survey, the mean score for expert familiarity was 0.819, the mean score for basis of judgment was 0.710, and the expert authority coefficient was 0.765, with a total of 21 indicator measurement tools or contents deleted (significance score ≤ 75 or coefficient of variation > 0.25), 28 retained, and 3 new expert-added indicator entries added. In the second round of Delphi survey, the average score for expert familiarity was 0.859, the average score for basis for judgment was 0.763, and the expert authority coefficient was 0.811, with a total of 11 indicator measurement tools or contents deleted and 20 retained involving 5 domains. Following an expert consensus meeting, 8 outcome indicators were finalized for inclusion in the patient self-reported COS, including 6 indicators of effectiveness evaluation such as quality-of-life scores, blood pressure, traditional Chinese medicine symptom scores, cost-benefit, cardiovascular and cerebrovascular events, and adverse reactions/events, and 2 indicators of factors influencing effectiveness such as sensation of heat-sensitive moxibustion, and adherence. ConclusionIn this study, we initially established a criteria for evaluating the effectiveness in the community study on heat-sensitive moxibustion by constructing patient self-reported COS in the community study on heat-sensitive moxibustion for PH, which can provide a scientific research paradigm for the subsequent development of the community study on heat-sensitive moxibustion.
2.Research progress in the relationship between Alzheimer's disease and blood-brain barrier
The Journal of Practical Medicine 2024;40(11):1602-1606
Numerous studies have confirmed that Alzheimer's disease is a disorder related to dysfunction of blood brain barrier(BBB).How to improve the physiological function of BBB by restoring its structural integ-rity,and then improve the outcome and prognosis of AD will certainly bring new perspectives and opportunities for the prevention and treatment of this chronic disease.In this article,we review the research progress on AD from three aspects including the structural and functional changes of BBB and its pathogenesis,biomarkers and thera-peutic targets.
3.Differential Analysis of Erythrocyte Flexibility of PbK173 Artemisinin-sensitive Strains
Hongying ZHOU ; Wenhui XU ; Miyi YANG ; Hang SHI ; Lanfang LI ; Guihua YU ; Canghai LI ; Huajing WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):95-103
ObjectiveTo detect the flexibility differences of Plasmodium berghei K173 (PbK173)-infected red blood cells with varying degrees of sensitivity to artemisinin-based drugs and to preliminarily explore the underlying mechanisms of the differences. MethodA total of 102 specific-pathogen-free (SPF) male C57BL/6 mice were randomly divided into three groups, with 30 mice each in the control group and PbK173-resistant (PbK173-R) group, and 42 mice in the PbK173-sensitive (PbK173-S) group. Except for the control group, the rest groups were vaccinated with 1×107 PbK173-S/PbK173-R infected red blood cells to establish a mouse malaria model. During the administration and recovery periods (control group, PbK173-R/PbK173-S), dihydroartemisinin (DHA, 40 mg·kg-1) and malaridine (MD, 6 mg·kg-1) were administered continuously for four days. Peripheral blood was taken from the PbK173-S/PbK173-R groups with an infection rate equal to or greater than 20%. Peripheral blood and each organ were taken on the first day at the end of administration (dosing period) and on the fifth day at the end of administration (recovery period), and blood parameters and organ indices of each group were examined. The osmotic fragility of peripheral blood red blood cells in each group was detected using the red blood cell osmotic fragility test. Western blot was applied to determine the levels of Piezo1 and Band3 proteins in the red blood cell membrane. ResultDuring the administration and recovery periods, there were no significant differences between the PbK173-S MD group and the DHA group. During the administration period, there were no significant differences in hematological parameters between PbK173-S and PbK173-R in the MD group. However, during the recovery period, the red blood cell count, hemoglobin concentration and hematocrit of the PbK173-R group were significantly higher than those of the PbK173-S group (P<0.05) in the MD group. Compared with that of the control group, the osmotic fragility of the PbK173-S/PbK173-R groups was significantly enhanced (P<0.01), and the osmotic fragility of the PbK173-S group was significantly stronger than that of the PbK173-R group (P<0.01). The osmotic fragility of red blood cells in the PbK173-S group during the administration period was significantly stronger than that in the control group and PbK173-R group during the administration period (P<0.01). The osmotic fragility of red blood cells in the PbK173-R group during the recovery period was significantly higher than that in the control group during the administration period and the PbK173-S group during the recovery period (P<0.05). Compared with those in the control group, the Piezo1 protein and Band3 protein in the red blood cell membrane of the PbK173-S group were significantly reduced (P<0.01). Compared with those in the PbK173-R group, the Piezo1 protein and Band 3 protein in the red blood cell membrane of the PbK173-S group were significantly reduced. ConclusionThe flexibility of PbK173-infected red blood cells with different sensitivities to artemisinins differed. Plasmodium-infected red blood cells significantly reduced the levels of Piezo1 and Band3 proteins in the red blood cell membrane, and the erythrocyte flexibility exhibited a decreasing trend in the following order: normal group, PbK173-R group, and PbK173-S group.
4.Researches related to pain in Parkinson's disease:a bibliometrics analysis
Mengyuan CHEN ; Qiuqin WANG ; Yuchen XU ; Jie LIU ; Xinyue ZHANG ; Juping CHEN ; Guihua XU
Chinese Journal of Rehabilitation Theory and Practice 2024;30(7):797-803
Objective To analyze the hotspots and frontiers of researches related to pain in Parkinson's disease. Methods The literatures on pain in Parkinson's disease were retrieved from CNKI,VIP,Wanfang data,CBM and Web of Science Core Collection from inception to November,2023,and were analyzed with CiteSpace 6.1.R6. Results A total of 926 literatures were included with 293 in Chinese and 633 in English,respectively.Chinese high-fre-quency keywords were quality of life,sleep disorders and depression,while English high-frequency keywords were nonmotor symptom,quality of life and levodopa.The latest bursting word in Chinese was pathogenesis,while the latest bursting words in English were exercise and management. Conclusion Number of researches related to pain in Parkinson's disease is gradually rising,and the characteristics,patho-genesis,quality of life,rehabilitation interventions and clinical efficacy have become research hotspots.The mechanism of pain in Parkinson's disease and rehabilitation management program will be the main research top-ics in the future.
5.Analysis of clinical characteristics of food allergy in children
Guihua YU ; Ning YANG ; Mingyue GU ; Xiaojuan SHI ; Jing ZHAO ; Ran SU ; Mengli CHEN ; Youning XU ; Meiyan WANG ; Ting ZHOU
China Modern Doctor 2024;62(27):70-74
Objective To investigate the food allergy situation of children in Changping District of Beijing,and to explore the influence of allergic family history,gender and mode of delivery on food allergy in children,the distribution of food allergy in different age groups,the types of food allergy that are easy to cause in this area,and the comorbidities of food allergy.Methods A total of 515 children aged 0 to 14 years who were admitted to the general pediatric outpatient and emergency department and inpatient of Beijing Changping Hospital from April to November 2023.Using immunoblotting to detect specific immunoglobulin E in the serum of pediatric patients,and using SPSS 26.0 statistical software to perform binomial tests on gender and delivery mode non parameters;Using custom Excel functions to statistically analyze the family history of allergies,the number of people in different age groups,and the frequency of allergic foods in each group;Use a self-made mini program to statistically analyze the combination of comorbid allergic diseases.Results ① The number of male children with food allergies(306 cases)was higher than that of female children(209 cases),and the difference was statistically significant(P<0.05).(2)There were 109 cases of pediatric patients with parents who had no history of allergic diseases,accounting for 21.17%of the total cases;There were a total of 406 cases where at least one parent had a family history of allergies,accounting for 78.83%of the total cases.Among them,228 cases(44.27%)had one parent with a history of allergies,and 178 cases(34.56%)had both parents with a history of allergies.③ Among 515 children with positive food allergens,there were 10 cases(1.94%)in infancy,37 cases(7.19%)in early childhood,235 cases(45.63%)in preschool,192 cases(37.28%)in school age,and 41 cases(7.96%)in adolescence.The highest positivity rate for food allergens is in milk(444 times),followed by egg white(70 times),cashew nuts(57 times),crab(37 times),beef(26 times),mango(24 times),shrimp(21 times),pineapple(6 times),and shellfish(1 time).Milk protein is the most common allergen in all age groups.(4)Among 515 children with food allergies,399 cases were single food allergies,accounting for 77.47%;116 cases of multiple food allergies(2 or more types of food allergies),accounting for 22.53%.⑤ The most common comorbidity of food allergies is food allergy related gastrointestinal diseases combined with allergic rhinitis,with a total of 267 cases;Secondly,there were 192 cases of allergic rhinitis combined with chronic cough,and 124 cases of food allergy related gastrointestinal diseases combined with chronic cough.Conclusion Milk is the main allergen of food allergy in people of age 14 and under,and gastrointestinal symptoms are the most common in children with food allergy.
6.Rethinking the scope of lymphadenectomy after neoadjuvant immunotherapy for locally advanced gastric cancer
Lisheng CHEN ; Feng XU ; Xi YANG ; Guihua WANG
Chinese Journal of Gastrointestinal Surgery 2024;27(7):672-677
Radical gastrectomy is the core of comprehensive treatment for patients with locally advanced gastric cancer,while reasonable and standardized lymphadenectomy is the key to radical gastrectomy.With the continuous development of treatment methods and therapeutic drugs for advanced gastric cancer, it is worth exploring whether the scope of lymphadenectomy needs to be changed. Neoadjuvant immunotherapy has brought a new breakthrough for locally advanced gastric cancer, increased pathological complete response rate, reduced clinical stage of tumors, and increased radical surgical resection rate, but it has not brought long-term benefits to patients. Lymph nodes play an important role in human anti-tumor immune response, and some basic studies suggest that preserving some normal lymph nodes may be more helpful to enhance the efficacy of immunotherapy. Thus, in the era of immunotherapy, the extent of lymph node dissection for locally advanced gastric cancer needs to balance continuous drug benefits, patient quality of life, and survival benefits, awaiting further high-quality clinical research for determination. Questions such as how to differentiate between normal and metastatic lymph nodes, how to rationally preserve normal lymph nodes, and whether preserving partial lymph node function can lead to greater benefits for patients from immunotherapy warrant further exploration.
7.Rethinking the scope of lymphadenectomy after neoadjuvant immunotherapy for locally advanced gastric cancer
Lisheng CHEN ; Feng XU ; Xi YANG ; Guihua WANG
Chinese Journal of Gastrointestinal Surgery 2024;27(7):672-677
Radical gastrectomy is the core of comprehensive treatment for patients with locally advanced gastric cancer,while reasonable and standardized lymphadenectomy is the key to radical gastrectomy.With the continuous development of treatment methods and therapeutic drugs for advanced gastric cancer, it is worth exploring whether the scope of lymphadenectomy needs to be changed. Neoadjuvant immunotherapy has brought a new breakthrough for locally advanced gastric cancer, increased pathological complete response rate, reduced clinical stage of tumors, and increased radical surgical resection rate, but it has not brought long-term benefits to patients. Lymph nodes play an important role in human anti-tumor immune response, and some basic studies suggest that preserving some normal lymph nodes may be more helpful to enhance the efficacy of immunotherapy. Thus, in the era of immunotherapy, the extent of lymph node dissection for locally advanced gastric cancer needs to balance continuous drug benefits, patient quality of life, and survival benefits, awaiting further high-quality clinical research for determination. Questions such as how to differentiate between normal and metastatic lymph nodes, how to rationally preserve normal lymph nodes, and whether preserving partial lymph node function can lead to greater benefits for patients from immunotherapy warrant further exploration.
8.Feasibility study on integrated imaging of portal vein and hepatic vein with"three low-contrast agents"combined with energy spectrum CT technology
Jingjing WU ; Lunqing PU ; Guihua LI ; Zhengyang GAO ; Taisong TANG ; Junhong BI ; Yali PENG ; Xi YANG ; Haoran XU
Journal of Practical Radiology 2024;40(7):1175-1178
Objective To explore the feasibility of integrated imaging of portal vein and hepatic vein with"three low-contrast agents"combined with energy spectrum CT technology.Methods A total of 100 patients with enhanced abdominal CT scans were selected.The patients were randomly divided into two groups.The patients of experimental group(n=50)were injected with the isotonic con-trast agent iodixanol(320 mg I/mL)at a flow rate of 3 mL/s and a total volume of 1.2 mL/kg,and underwent energy spectrum CT scan in the portal venous phase.The patients of control group(n=50)were injected with the sub-hypertonic contrast agent iohexol(350 mg I/mL)at a flow rate of 5 mL/s and a total volume of 1.5 mL/kg,and underwent conventional multi-phase spiral CT enhancement scan.The image quality and radiation dose of portal vein and hepatic vein were compared between the two groups.Results The CT value of main portal vein in the experimental group was higher than that in the control group,and the difference was statistically sig-nificant(P<0.05).There was no statistical significance in main portal vein contrast-to-noise ratio(CNR),main portal vein signal-to-noise ratio(SNR),hepatic vein CT value,and hepatic vein CNR between the two groups(P>0.05).The SNR and image standard deviation(SD)of the hepatic vein in the control group were better than those in the experimental group(P<0.05).There was no statistical significance in the subjective scores of portal vein and hepatic vein between the two groups(P>0.05).The volume CT dose index(CTDIvol),dose length product(DLP),and effective dose(ED)of the portal venous phase spectrum CT scan in the experimental group were lower than those of the conventional single-phase spiral CT scan in the control group(P<0.05).Conclusion"Three low-contrast agents"combined with energy spectrum CT technology can realize integrated imaging of portal vein and hepatic vein in late portal vein,and can reduce radiation dose.
9.Comparison of central corneal thickness measured by different devices in myopic patients
Lan YANG ; Yumei HE ; Fang ZHAO ; Yuan HAN ; Guihua XIA ; Man XU
Chinese Journal of Experimental Ophthalmology 2024;42(9):814-819
Objective:To compare the correlation and consistency of central corneal thickness (CCT) measured by four different instruments, specular microscope SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT.Methods:A diagnostic test study was performed.A total of 50 right eyes of 50 consecutive outpatients who planned to undergo corneal refractive surgery at Hanyang Aier Eye Hospital from January to May 2022 were included.CCT was measured with the specular microscope SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT, respectively.The differences of CCT measurements by the four instruments were compared.The correlation and consistency between the CCT values was analyzed by Pearson linear analysis and Bland-Altman test, respectively.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Hanyang Aier Eye Hospital (No.HYEYE20221229JM).Written informed consent was obtained from each subject.Results:The mean CCT values measured by SP-1P, IOLMaster 700, Pentacam HR and RTVue XR-OCT were (522.68±30.08), (544.06±32.85), (541.00±31.75) and (528.86±31.60)μm, respectively, with a statistically significant overall difference ( F=5.09, P=0.002).CCT measurements obtained with SP-1P were lower than those obtained with IOLMaster 700 and Pentacam HR, while the IOLMaster 700 measurements were higher than those of RTVue XR-OCT, showing statistically significant differences (all at P<0.05).Pearson correlation analysis revealed significant positive correlations of CCT measurements between SP-1P and IOLMaster 700, SP-1P and Pentacam HR, SP-1P and RTVue XR-OCT, IOLMaster 700 and Pentacam HR, IOLMaster 700 and RTVue XR-OCT, Pentacam HR and RTVue XR-OCT ( r=0.988, 0.980, 0.988, 0.981, 0.982, 0.973; all at P<0.01).Bland-Altman consistency analysis showed that the 95% limits of agreement (95% LoA) for CCT measurements between SP-1P and RTVue XR-OCT, IOLMaster 700 and Pentacam HR were -16.46-6.14 and -10.56-14.48 μm, respectively, with 3(6%) and 2(4%) data points outside the 95% LoA, respectively.The mean difference lines for the CCT measurements were close to 0, indicating good consistency and clinically acceptable differences without statistical significance. Conclusions:CCT values measured with specular microscope SP-1P and RTVue XR-OCT, as well as those measured with IOLMaster and Pentacam HR, are relatively close in patients with low to moderate myopia, show good consistency and can therefore be considered interchangeable.
10.The role of myocardial work parameters in early identification of myocardial injury in neonatal asphyxia
Xinlu HU ; Guihua WU ; Qiuqin XU ; Huiyun CHEN ; Cui HOU ; Bin SUN ; Bing HAN ; Tao PAN
Chinese Journal of Neonatology 2023;38(8):471-477
Objective:To study the role of myocardial work parameters in early identification of myocardial injury in neonatal asphyxia.Methods:From July 2020 to December 2021, neonates diagnosed with mild neonatal asphyxia admitted to the Department of Neonatology of our hospital within 24 h after birth were prospectively enrolled into the asphyxia group. Neonates without asphyxia during the same period were selected as the control group and matched with the asphyxia group for gender, gestational age and birth weight at a ratio of 1:1~1:2. The asphyxia group was subgrouped into preterm asphyxia group and term asphyxia group. All neonates received echocardiography within 24 h after birth. Multiple parameters were measured including M-mode, two-dimensional image, Doppler image, global longitudinal strain (GLS) and myocardial work parameters [global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE)]. The level of serum N-terminal pro brain natriuretic peptide (NT-proBNP) was recorded in the asphyxia group. The data were compared between the asphyxia group and the control group. Correlations between myocardial work parameters and other parameters were analyzed.Results:A total of 33 cases were in the asphyxia group and 43 cases were in the control group. The preterm asphyxia group (18 cases) showed significantly lower GWI and GCW than the preterm control group (18 cases) [GWI: (702±153) mmHg vs. (879±205) mmHg, GCW: (1 016±221) mmHg vs. (1 200±271) mmHg] ( P<0.05). No differences existed in GLS, GWW and GWE. The term asphyxia group (15 cases) showed significantly lower GWW than the term control group (25 cases) [45.0 (30.0, 65.0) mmHg vs. 71.0 (35.5,85.5) mmHg] ( P<0.05). No differences existed in GLS, GWI, GCW and GWE. GWI was negatively correlated with serum NT-proBNP level ( r=-0.327, P<0.05). Conclusions:GWI and GCW may indicate myocardial injury in preterm neonates with mild asphyxia.

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