OBJECTIVE: To observe the effects of acupoint catgut embedding (ACE) on gut microbiota and fecal short-chain fatty acids (SCFAs) levels in patients with Parkinson's disease (PD) with constipation. METHODS: A total of 80 PD patients with constipation were randomly divided into an observation group and a control group, 40 cases in each group. Additionally, 40 healthy individuals were recruited as a healthy control group. The control group received conventional Western medical treatment for PD combined with polyethylene glycol (PEG), once daily for eight weeks. The observation group received additional ACE treatment at bilateral Tianshu (ST25), Zusanli (ST36), and Shangjuxu (ST37), once every two weeks for eight weeks. The healthy control group received no intervention. The spontaneous bowel movements (SBMs) per week and patient assessment of constipation quality of life (PAC-QOL) scores were assessed at baseline and after treatment in the two groups. Fecal samples were collected at the end of treatment for the observation and the control groups and at baseline for the healthy control group. Gut microbiota composition and diversity were analyzed using 16S rRNA method, and SCFA levels were measured using high-performance liquid chromatography (HPLC). RESULTS: Compared before treatment, the observation group showed a significant increase in SBMs (P<0.01), and PAC-QOL scores including physical discomfort, psychosocial discomfort, worry and concern, and total score were significantly reduced (P<0.01) after treatment; the control group also showed a reduction in PAC-QOL total score after treatment (P<0.01). After treatment, the observation group had significantly more SBMs (P<0.01), and lower PAC-QOL physical discomfort, psychosocial discomfort, worry and concern scores, and total score (P<0.01), and higher PAC-QOL satisfaction score (P<0.01) than the control group. Compared with the healthy control group, the control group showed decreased Chao1 and Ace indices (P<0.01). Compared with the healthy control group, the relative abundance of Prevotella and Roseburia was increased (P<0.05), while that of Enterobacter and Ruminococcus torques (six species in total) was decreased (P<0.05) in the control group. Compared with the control group, the observation group had increased relative abundance of Dialister, Parabacteroides, and Ruminococcus torques (P<0.05), and decreased relative abundance of Prevotella and Eubacterium ruminantium (P<0.05). Compared with the healthy control group, the control group had increased fecal SCFA levels (P<0.05); compared with the control group, the observation group had reduced fecal SCFA levels (P<0.05). Compared with the healthy control group, acetic acid, propionic acid, and butyric acid levels were elevated in the control group (P<0.05); compared with the control group, acetic acid, propionic acid, and butyric acid levels were decreased in the observation group (P<0.05). CONCLUSION ACE could increase spontaneous bowel movements and improve the quality of life in PD patients with constipation, which may be related to the regulation of gut microbiota composition and SCFA levels.
Humans ; Constipation/metabolism* ; Male ; Gastrointestinal Microbiome ; Acupuncture Points ; Female ; Middle Aged ; Parkinson Disease/complications* ; Aged ; Fatty Acids, Volatile/metabolism* ; Catgut ; Feces/microbiology* ; Acupuncture Therapy ; Quality of Life ; Adult

Objective To investigate the effectiveness and safety of combining Omalizumab with compound glycyrrhetinic acid glycoside in the management of chronic urticaria that exhibits poor response to antihistamine therapy.Methods 92 patients with chronic urticaria who were treated with H1 antihistamines and still had symp-toms from February 2022 to February 2024 in the hospital were selected as the study subjects.The study partici-pants were randomly assigned to either the observation group,consisting of 46 cases,or the control group,also comprising 46 cases,using a random number table method.The control group received subcutaneous injection of omalizumab for treatment.The observation group was treated with oral compound glycyrrhizin tablets on the basis of the control group.After 24 weeks of treatment,compare the efficacy,adverse reactions,Urticaria Activity Score over 7 days(UAS7),Dermatology Life Quality Index(DLQI),Immunoglobulin(Ig)E,and High Sensitivity C-reactive protein(hs CRP)between the two groups,and record the recurrence rate.Results After treatment,the UAS7,DLQI,IgE and hs-CRP of both groups of patients decreased compared to before treatment,and the observation group demonstrated lower results compared to the control group(P<0.05).After treatment,the overall effectiveness rate in the observation group exceeded that of the control group(P<0.05),and the recurrence rate was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of drugs(P>0.05).Conclusion The combination therapy of omali-zumab and compound glycyrrhetinic acid glycoside in the treatment of chronic urticaria patients with low response to antihistamines helps reduce IgE expression,improve treatment effectiveness,lower recurrence rates,and does not increase adverse drug reactions.

Objective To investigate the effectiveness and safety of combining Omalizumab with compound glycyrrhetinic acid glycoside in the management of chronic urticaria that exhibits poor response to antihistamine therapy.Methods 92 patients with chronic urticaria who were treated with H1 antihistamines and still had symp-toms from February 2022 to February 2024 in the hospital were selected as the study subjects.The study partici-pants were randomly assigned to either the observation group,consisting of 46 cases,or the control group,also comprising 46 cases,using a random number table method.The control group received subcutaneous injection of omalizumab for treatment.The observation group was treated with oral compound glycyrrhizin tablets on the basis of the control group.After 24 weeks of treatment,compare the efficacy,adverse reactions,Urticaria Activity Score over 7 days(UAS7),Dermatology Life Quality Index(DLQI),Immunoglobulin(Ig)E,and High Sensitivity C-reactive protein(hs CRP)between the two groups,and record the recurrence rate.Results After treatment,the UAS7,DLQI,IgE and hs-CRP of both groups of patients decreased compared to before treatment,and the observation group demonstrated lower results compared to the control group(P<0.05).After treatment,the overall effectiveness rate in the observation group exceeded that of the control group(P<0.05),and the recurrence rate was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of drugs(P>0.05).Conclusion The combination therapy of omali-zumab and compound glycyrrhetinic acid glycoside in the treatment of chronic urticaria patients with low response to antihistamines helps reduce IgE expression,improve treatment effectiveness,lower recurrence rates,and does not increase adverse drug reactions.

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.

Objective:To evaluate changes in operational effectiveness after the implementation of ambulatory surgical management in pars plana vitrectomy (PPV).Methods:A retrospective clinical study. 17 528 surgeries in 10 895 eyes of 10 895 patients who underwent minimally invasive PPV on an ambulatory and/or inpatient basis at Tianjin Medical University Eye Hospital from August 2015 to June 2023 were included in this study. Among them, 5 346 eyes in 5 346 cases were male; 5 549 eyes in 5 549 cases were female. The age ranged from 0 to 95 years, with the mean age of (57.74±13.15) years. 6 381 surgeries in 3 615 eyes from August 2015 to December 2018 (the initial period of day surgery) were used as the control group; 11 147 surgeries in 7 280 eyes from January 2019 to June 2023 (the expanded period of day surgery) were used as the observation group. According to the management mode of ambulatory surgery, the observation group was subdivided into the decentralized management group (January 2019 to December 2020) and the centralized management group (January 2021 to June 2023), with 2 905 and 4 375 eyes and 4 646 and 6 501 surgeries, respectively. Changes in the percentage of day surgery, average hospitalization days, and average unplanned reoperation rate were compared. The Mann-Whitney U test was used to compare numerical variables between groups; the chi-square test or Fisher's exact test was used to compare categorical variables. Results:The number of cases of daytime PPV performed in the observation group and control group was 7 852 (70.44%, 7 852/11 147) and 24 (0.38%, 24/6 381) cases, respectively, and the average hospitalization days were 1 (1) and 5 (3) d. Compared with the control group, the observation group had a significantly higher percentage of day surgery ( χ2=8 051.01) and a considerably lower mean hospitalization day ( Z=4 536 844.50), and the differences were statistically significant ( P<0.000 1). The mean hospitalization days in the decentralized and centralized management groups were 2 (3) and 1 (0) d, respectively, and unplanned reoperations were 34 (0.73%, 34/4 646) and 171 (2.63%, 171/6 501) eyes, respectively. Compared with the decentralized management group, average hospitalization days was significantly lower ( Z=1 436.94) and unplanned reoperation rate was significantly higher ( χ2=54.10) were significantly lower in the centralized management group, both of which were statistically significant ( P<0.000 1). Conclusion:PPV ambulatory management model can significantly reduce the average hospitalization day, but also results in higher rates of unplanned reoperations.

Objective:To construct model of risk factors for follicular thyroid carcinoma.Methods:Clinical, ultrasound, and pathological data of 196 patients with single thyroid follicular neoplasm who underwent initial surgical treatment at the First Affiliated Hospital of Nanjing Medical University from Apr 2018 to Oct 2023 were collected as a training cohort. The clinical, ultrasound, and pathological data of 48 patients with the same condition at the Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine were used as a validation cohort.Results:Among the training cohort, 63 cases (32.1%) were diagnosed with follicular thyroid carcinoma. Univariate analysis showed that patients with higher preoperative thyroglobulin levels [390.1(106.7-500.0)ng/ml vs. 42.6(27.7-139.2)ng/ml, Z=-5.612, P<0.001], solid internal structure on ultrasound (81.0% vs. 54.1%, χ2=13.154, P<0.001), low internal echogenicity (68.3% vs.15.0%, χ2=55.507, P<0.001), irregular tumor morphology (39.7% vs.3.0%, χ2=45.612, P<0.001), uneven tumor margins (20.6% vs. 1.5%, χ2=19.515, P<0.001), internal tumor calcification (52.4% vs.16.5%, χ2=27.201, P<0.001), absence of acoustic halo or the acoustic halo is uneven in thickness (85.7% vs. 24.8%, χ2=64.235, P<0.001), and uneven echogenicity of solid tumor portions (74.6% vs. 19.5%, χ2=55.437, P<0.001) were characteristics of follicular thyroid carcinoma. Multivariate logistic analysis demonstrated that preoperative serum thyroglobulin levels ( OR=1.001, 95% CI: 1.000-1.002, P=0.046), solid internal echogenicity of the tumor ( OR=4.967, 95% CI: 1.602-15.405, P=0.006), tumor with calcification ( OR=4.238,95% CI:1.550-11.588, P=0.005), absence of halo around the tumor ( OR=4.225,95% CI:1.353-13.192, P=0.013), uneven thickness of the halo ( OR=21.240, 95% CI: 3.242-139.160, P=0.001), and uneven echogenicity of solid tumor portions ( OR=4.580, 95% CI: 1.678-12.505, P=0.003) were independent risk factors for follicular thyroid carcinoma . A nomogram model was constructed based on these variables, and the ROC curve showed AUC values of 0.931. Conclusion:Higher preoperative serum thyroglobulin levels, solid internal echogenicity of the tumor, tumor with calcification, absence of halo around the tumor, uneven thickness of the halo, and uneven echogenicity of solid tumor portions are independent risk factors for follicular thyroid carcinoma.

Objective:To construct model of risk factors for follicular thyroid carcinoma.Methods:Clinical, ultrasound, and pathological data of 196 patients with single thyroid follicular neoplasm who underwent initial surgical treatment at the First Affiliated Hospital of Nanjing Medical University from Apr 2018 to Oct 2023 were collected as a training cohort. The clinical, ultrasound, and pathological data of 48 patients with the same condition at the Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine were used as a validation cohort.Results:Among the training cohort, 63 cases (32.1%) were diagnosed with follicular thyroid carcinoma. Univariate analysis showed that patients with higher preoperative thyroglobulin levels [390.1(106.7-500.0)ng/ml vs. 42.6(27.7-139.2)ng/ml, Z=-5.612, P<0.001], solid internal structure on ultrasound (81.0% vs. 54.1%, χ2=13.154, P<0.001), low internal echogenicity (68.3% vs.15.0%, χ2=55.507, P<0.001), irregular tumor morphology (39.7% vs.3.0%, χ2=45.612, P<0.001), uneven tumor margins (20.6% vs. 1.5%, χ2=19.515, P<0.001), internal tumor calcification (52.4% vs.16.5%, χ2=27.201, P<0.001), absence of acoustic halo or the acoustic halo is uneven in thickness (85.7% vs. 24.8%, χ2=64.235, P<0.001), and uneven echogenicity of solid tumor portions (74.6% vs. 19.5%, χ2=55.437, P<0.001) were characteristics of follicular thyroid carcinoma. Multivariate logistic analysis demonstrated that preoperative serum thyroglobulin levels ( OR=1.001, 95% CI: 1.000-1.002, P=0.046), solid internal echogenicity of the tumor ( OR=4.967, 95% CI: 1.602-15.405, P=0.006), tumor with calcification ( OR=4.238,95% CI:1.550-11.588, P=0.005), absence of halo around the tumor ( OR=4.225,95% CI:1.353-13.192, P=0.013), uneven thickness of the halo ( OR=21.240, 95% CI: 3.242-139.160, P=0.001), and uneven echogenicity of solid tumor portions ( OR=4.580, 95% CI: 1.678-12.505, P=0.003) were independent risk factors for follicular thyroid carcinoma . A nomogram model was constructed based on these variables, and the ROC curve showed AUC values of 0.931. Conclusion:Higher preoperative serum thyroglobulin levels, solid internal echogenicity of the tumor, tumor with calcification, absence of halo around the tumor, uneven thickness of the halo, and uneven echogenicity of solid tumor portions are independent risk factors for follicular thyroid carcinoma.

Objective:To investigate the prevalence and risk factors of tessellation fundus (TF) among Tianjin Medical University students with different refractive statuses.Methods:A cross-sectional study. From September to December 2019, 346 students from Tianjin Medical University were randomly selected and underwent slit-lamp examination, non-cycloplegic auto-refraction, subjective refraction, best-corrected visual acuity, ocular biometric measurement, and non-dilation fundus photography. The differences in the prevalence of TF in basic characteristics and ocular biometric parameters were compared. Based on the equivalent spherical (SE), refractive status was divided into the non-myopia group (SE>-0.50 D) and the myopia group (SE≤-0.50 D). The myopia group was further divided into mild myopia group (-3.00 D26 mm group. The logistic regression was used to analyze the risk factors affecting TF. Trend tests were performed for each risk factor and TF.Results:Of the 346 subjects, 324 (93.6%, 324/346) were myopia, of whom 73 (21.1%, 73/346), 167 (48.3%, 167/346), and 84 (24.3%, 84/346) were mild myopia, moderate myopia, and high myopia, respectively; 22 (6.4%, 22/346) were non-myopia. There were 294 (85.0%, 294/346) students with TF in the macula, including 9 (40.91%, 9/22), 58 (79.45%, 58/73), 145 (86.83%, 145/167), and 82 (97.62%, 82/84) in non-myopia, low myopia, moderate myopia, and high myopia group, respectively; 52 (15.0%, 52/346) students were without TF in the macula. There were statistically significant gender differences ( χ2=4.47), SE ( t=6.29), AL ( t=-8.29), anterior chamber depth ( Z=-2.62), lens thickness ( Z=-2.23), and average corneal radius ( Z=-3.58) between students with and without TF in the macula ( P<0.05). Spherical equivalent and axial length were independent risk factors for TF and its severity ( P≤0.001). With an increasing degree of myopia, and increasing axial length, the risk of TF increased ( P for trend<0.001). Conclusions:The prevalence of TF is 85.0% among Tianjin Medical University students. TF is detected in the fundus of no myopia, mild myopia, moderate myopia and high myopia. The degree of myopia is higher, the AL is longer, the possibility of TF is higher.

Objective:To quantify any correlation between the severity of spinal curvature of an adolescent with idiopathic scoliosis and their cardiopulmonary exercise endurance.Methods:The cardiopulmonary exercise test (CPET) results and the full-length spinal X-rays in a standing position of 64 adolescents with idiopathic scoliosis were reviewed retrospectively. Independent t-tests were used to compare the two datasets obtained from those with left or right thoracic scoliosis. The correlation between the Cobb angle and cardiopulmonary exercise endurance was analyzed using Pearson correlation coefficients, multiple factor linear regression and two-stage linear regression.Results:After adjusting for gender, age, height and weight, the multiple linear regression analysis showed that the Cobb angle was significantly negatively correlated with maximum tidal volume (β=-0.013) and significantly positively correlated with the rate of respiration (β=0.421). The relationship between the Cobb angle and cardiopulmonary exercise endurance was non-linear. With a Cobb angle > 34°, a 1° increase reduces cardiopulmonary exercise endurance by a factor of 1.4 on average. At smaller Cobb angles the corresponding increase is about 0.87 times.Conclusions:The Cobb angle is a negative predictor of ventilation during exercise among adolescents with idiopathic scoliosis. The more severe a patient′s spinal curvature, the lower the cardiopulmonary exercise endurance is likely to be.

Objective:To observe the effect of bone morphogenetic protein 4 (BMP4) on the proliferation and migration of human retinal microvascular endothelial cells (hRMEC) under oxidative stress.Methods:The hRMEC cultured in vitro were divided into control group, 4-hydroxynonenal (HNE) treatment group (4-HNE group), 4-HNE+BMP4 group (BMP4 group). Cell culture medium of 4-HNE treatment group was added with 10 μmmol/L 4-HNE; cell culture of BMP4 group was cultured with 10 μmmol/L 4-HNE, and after stimulation for 6 h, 100 ng/ml recombinant human BMP4 was added. The effects of 4-HNE and BMP4 on hRMEC viability was detected by thiazole blue colorimetric method. The effects of 4-HNE and BMP4 on cell migration was determined by cell scratch test. The relative expression of BMP4 mRNA in the cells of the control group and 4-HNE treatment group and the mRNA expression of the control group, the fibronectin (FN) of BMP4 group, laminin (Laminin), α-smooth muscle contractile protein (α-SMA), and collagen type Ⅰ (Collagen Ⅰ), vascular endothelial growth factor (VEGF), and connective tissue growth factor (CTGF) were detected by real-time quantitative polymerase chain reaction (qRT-PCR). Western blot was used to detect the relative expression of BMP4 protein in the control group and 4-HNE group. The control group and 4-HNE group were compared by t test. Results:Compared with the control group, cell viability ( t=12.73, 16.26, P=0.000 2, <0.000 1), cell migration rate ( t=28.17, 37.48, P<0.000 1, <0.000 1) in 4-HNE group and BMP4 group were significantly increased, and the difference was statistically significant; the relative expression of BMP4 mRNA and protein in the 4-HNE group was significantly increased, and the difference was statistically significant ( t=16.36, 69.35, P=0.000 1, <0.000 1). The qRT-PCR test results showed that compared with the control group, the relative expression of VEGF, FN, Laminin, α-SMA, Collagen Ⅰ, and CTGF mRNA in the cells of the BMP4 group was significantly increased, and the difference was statistically significant ( t=10.61, 17.00, 14.85, 7.78, 12.02, 10.61, P=0.0004, <0.000 1, 0.000 1, 0.001 5, 0.000 1, 0.000 4). Conclusion:BMP4 can induce the proliferation and migration of hRMEC; it can also regulate the expression of angiogenesis factors and fibrosis-related factors in hRMEC.