ObjectiveTo evaluate the efficacy and safety of Xihuang Pill/Capsule （西黄丸/胶囊， XP/XC） as an adjuvant to radiotherapy and/or chemotherapy in the treatment of malignant digestive tract tumors. MethodsA systematic search was conducted in the China Biomedical Literature Database， China National Knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform， VIP Database， PubMed， Web of Science， Embase， and Cochrane Library for randomized controlled trials （RCTs） published before March 6， 2024， regarding the use of XP/XC in clinical adjuvant treatment of malignant digestive tract tumors. The methodological quality of the included studies was assessed using the risk of bias assessment tool. RevMan 5.4 was used to perform a Meta-analysis on 1-year survival rate， 2-year survival rate， clinical efficacy， including objective response rate and disease control rate， Karnofsky Performance Status （KPS） score， immune markers （CD3⁺， CD4⁺， CD8⁺， and CD4⁺/CD8⁺ ratio）， and adverse event rates （incidence of gastrointestinal reactions and bone marrow suppression）. ResultsThirteen RCTs involving 962 patients were included， with 527 patients in the experimental group and 435 patients in the control group. Meta-analysis results showed that the experimental group had better outcomes than the control group in terms of 2-year survival rate ［RR = 0.49， 95% CI （0.31， 0.78）］， objective response rate ［RR = 0.68， 95% CI （0.60， 0.77）］， disease control rate ［RR = 0.85， 95% CI （0.80， 0.91）］， and immune markers CD3⁺ ［MD = -7.99， 95% CI （-9.12， -6.86）］， CD4⁺ ［MD = -5.42， 95% CI （-7.11， -3.74）］， and CD4⁺/CD8⁺ ratio ［MD = -0.26， 95% CI （-0.32， -0.20）］ （P＜0.05）. However， no statistically significant differences were found between the experimental and control groups in terms of 1-year survival rate ［RR = 0.91， 95% CI （0.73， 1.14）］， KPS ［MD = -3.73， 95% CI （-8.67， 1.21）］， CD8⁺ ［MD = -0.53， 95% CI （-1.45， 0.39）］， incidence of gastrointestinal reactions ［RR = 0.82， 95% CI （0.46， 1.46）］， and incidence of bone marrow suppression ［RR = 0.93， 95% CI （0.72， 1.20）］ （P＞0.05）. ConclusionCompared with radiotherapy/chemotherapy alone， the combination of XP/XC with radiotherapy/chemotherapy can effectively improve clinical efficacy and 2-year survival rate， enhance immune function， and achieve similar adverse event rates as radiotherapy/chemotherapy alone in patients with malignant digestive tract tumors.

BACKGROUND: Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS: This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS: During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037). CONCLUSIONS Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
Humans ; Male ; Female ; Prospective Studies ; Middle Aged ; Aged ; Vascular Diseases/etiology* ; Risk Factors ; China/epidemiology* ; Adult ; Proportional Hazards Models ; Cerebrovascular Disorders/epidemiology* ; East Asian People

BACKGROUND: The American Heart Association recently released a new cardiovascular health (CVH) metric, Life's Essential 8 (LE8), for health promotion. However, the association between LE8 scores and the risk of chronic kidney disease (CKD) remains uncertain. We aimed to explore the association of LE8 scores with new-onset CKD and examine whether socioeconomic deprivation and genetic risk modify this association. METHODS: A total of 286,908 participants from UK Biobank and without prior CKD were included between 2006 and 2010. CVH was categorized using LE8 scores: low (LE8 scores <50), moderate (LE8 scores ≥50 but <80), and high (LE8 scores ≥80). The study outcome was new-onset CKD, ascertained by data linkage with primary care, hospital inpatient, and death data. Cox proportional hazard regression models were used to investigate the association between CVH categories and new-onset CKD. RESULTS: During a median follow-up of 12.5 years, 8857 (3.1%) participants developed new-onset CKD. Compared to the low CVH group, the moderate (adjusted hazards ratio [HR], 0.50; 95% confidence interval [CI]: 0.47-0.53) and high CVH (adjusted HR, 0.31; 95% CI: 0.27-0.34) groups had a significantly lower risk of developing new-onset CKD. The population-attributable risk associated with high vs. intermediate or low CVH scores was 40.3%. Participants who were least deprived ( vs.  most deprived; adjusted HR, 0.75; 95% CI: 0.71-0.79) and with low genetic risk of CKD ( vs.  high genetic risk; adjusted HR, 0.89; 95% CI: 0.85-0.94) had a significantly lower risk of developing new-onset CKD. However, socioeconomic deprivation and genetic risks of CKD did not significantly modify the relationship between LE8 scores and new-onset CKD (both P -interaction >0.05). CONCLUSION Achieving a higher LE8 score was associated with a lower risk of developing new-onset CKD, regardless of socioeconomic deprivation and genetic risks of CKD.
Humans ; Renal Insufficiency, Chronic/epidemiology* ; Male ; Female ; Middle Aged ; Genetic Predisposition to Disease/genetics* ; Aged ; Risk Factors ; Adult ; Proportional Hazards Models ; Socioeconomic Factors

BACKGROUND: Pulmonary arterial hypertension (PAH) presents a significant health burden in Asia and remains a critical challenge. This study aims to delineate the PAH burden in Asia from 1990 to 2021. METHODS: Using the latest data from the Global Burden of Disease 2021, we evaluated and analyzed the distributions and patterns of PAH disease burden among various age groups, sexes, regions, and countries in Asia. Additionally, we examined the associations between PAH disease burden and key health system indicators, including the socio-demographic index (SDI) and the universal health coverage (UHC) index. RESULTS: In 2021, there were 25,989 new PAH cases, 103,382 existing cases, 13,909 PAH-associated deaths, and 385,755 DALYs attributed to PAH in Asia, which accounted for approximately 60% of global PAH cases. The age-standardized rates (ASRs) for prevalence and deaths were 2.05 (95% uncertainty interval [UI]: 1.66-2.52) per 100,000 population and 0.31 (95% UI: 0.23-0.38) per 100,000 population, respectively. From 1990 to 2021, Asia reported the lowest ASRs for PAH prevalence but the highest ASRs for deaths compared to other continents. While the ASRs for prevalence increased slightly, ASRs for mortality and DALYs decreased over time. This increasing burden of PAH was primarily driven by population growth and aging. The burden was especially pronounced among individuals aged ≥60 years and <9 years, who collectively accounted for the majority of deaths and DALYs. Moreover, higher SDI and UHC levels were linked to reduced incidence, but higher prevalence rates. CONCLUSIONS Although progress has been made in reducing PAH-related mortality and DALYs, the disease continues to impose a substantial burden in Asia, particularly among older adults and young children. Region-specific health policies should focus on improving early diagnosis, expanding access to treatment, and effectively addressing the growing PAH burden in the region.
Humans ; Global Burden of Disease ; Male ; Female ; Middle Aged ; Adult ; Asia/epidemiology* ; Prevalence ; Aged ; Pulmonary Arterial Hypertension/mortality* ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Hypertension, Pulmonary/epidemiology*

BACKGROUND: The potential impact of pre-existing coronary artery stenosis (CAS) on right ventricular (RV) function during acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and RV dysfunction in patients with acute PE. METHODS: In this multicenter, case-control study, 89 cases and 176 controls matched for age were enrolled at three study centers (Peking Union Medical College Hospital, Fuwai Hospital, and the Second Affiliated Hospital of Harbin Medical University) from January 2016 to December 2020. The cases were patients with acute PE with CAS, and the controls were patients with acute PE without CAS. Coronary artery assessment was performed using coronary computed tomographic angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression analysis was used to evaluate the association between CAS and RV dysfunction. RESULTS: The percentages of RV dysfunction (19.1% [17/89] vs. 44.6% [78/176], P <0.001) and elevated systolic pulmonary artery pressure (sPAP) (19.3% [17/89] vs. 39.5% [68/176], P = 0.001) were significantly lower in the case group than those in the control group. In the multivariable logistic regression model, CAS was independently and negatively associated with RV dysfunction (adjusted odds ratio [OR]: 0.367; 95% confidence interval [CI]: 0.185-0.728; P = 0.004), and elevated sPAP (OR: 0.490; 95% CI: 0.252-0.980; P = 0.035), respectively. CONCLUSIONS Pre-existing CAS was significantly and negatively associated with RV dysfunction and elevated sPAP in patients with acute PE. This finding provides new insights into RV dysfunction in patients with acute PE with pre-existing CAS.
Humans ; Pulmonary Embolism/complications* ; Case-Control Studies ; Male ; Ventricular Dysfunction, Right/physiopathology* ; Female ; Middle Aged ; Aged ; Coronary Stenosis/complications* ; Logistic Models ; Adult

This study aims to explore whether Guzheng playing training has a positive impact on the brain functional state of children with Autism Spectrum Disorder (ASD) based on power spectral and sample entropy analyses. Eight ASD participants were selected to undergo four months of Guzheng playing training, with one month as a training cycle. Electroencephalogram (EEG) signals and behavioral data were collected for comparative analysis. The results showed that after Guzheng playing training, the relative power of the alpha band in the occipital lobe of ASD children increased, and the relative power of the theta band in the parietal lobe decreased. The differences compared with typically developing (TD) children were narrowed. Moreover, some channels exhibited a gradual increase or decrease in power with the extended training period. Meanwhile, the sample entropy parameter also showed a similar upward trend, which was consistent with the behavioral data representation. The study shows that Guzheng training can enhance the brain function of ASD patients, with better effects from longer training. Guzheng playing training could be used as a daily intervention for autism.
Humans ; Electroencephalography ; Entropy ; Music Therapy ; Child ; Brain/physiopathology* ; Autism Spectrum Disorder/therapy* ; Male ; Female ; Autistic Disorder/therapy*

Non-alcoholic fatty liver disease (NAFLD), as a metabolic disease, has shown a constant upward trend in prevalence among the people in recent years. In addition to changing lifestyles and conventional drug treatment, bariatric surgery, represented by Roux-en-Y gastric bypass surgery and sleeve gastrectomy, has gradually become one of the treatment options for NAFLD. However, the mechanism of bariatric surgery in treating NAFLD remains to be studied. The "multiple-hit theory", which has gradually been recognized in recent years, believes that NAFLD is formed by the combined effect of multiple mechanisms such as insulin resistance, bile acid metabolism pathway, and intestinal flora. Based on relevant literatures and clinical practices, the authors explore the relevant mechanisms of bariatric surgery for direct or indirect treatment of NAFLD.

Objective To investigate the image quality,radiation dose and contrast medium(CM)intake in coronary computed tomography angiography(CCTA)of overweight patients based on wide-detector using different tube voltages and CM of different concentrations.Methods A total of 150 overweight patients[body mass index(BMI)≥ 25 kg/m2]who underwent CCTA were divided into three groups according to scan protocols:group A(120 kVp,370 mg I/mL CM),group B(100 kVp,350 mg I/mL CM),and group C(80 kVp,320 mg I/mL CM),with each group had 50 patients.The mean CT value,mean signal-to-noise ratio(SNR),mean contrast-to-noise ratio(CNR),figure of merit(FOM)of all images were measured and calculated.Images were assessed using a 5-point scale by two radiologists.The volume CT dose index(CTDIvol)and dose length product(DLP)of each patient were recorded and the effective dose(ED)was calculated.The total iodine intake values of patients in three groups were calculated.The above data were statistically analyzed by one-way ANOVA.Results The mean CT value,mean SNR,mean CNR,and mean subjective score of groups B and C were significantly higher than those of group A(P＜0.001),but there was no significant difference between groups B and C(P＞0.05).The FOM value of groups B and C was significantly higher than that of group A(P＜0.001),and the FOM value of group B was significantly lower than that of group C(P＜0.001).The total iodine intake values of groups B and C was significantly lower than that of group A(P＜0.001).The ED and total iodine intake values in groups B and C were 30.34％,68.53％and 10.22％,16.85％lower than those in group A,respectively(P＜0.001).Conclusion Under the premise of ensuring image quality,the lower tube voltage and lower concentration of CM based on wide-detector allows for significant reduction in radiation dose and total iodine intake in CCTA for overweight patients compared to routine scan protocols.

Objective:To explore the pattern of pulmonary vascular remodeling in patients with chronic obstructive pulmonary disease (COPD) using artificial intelligence technology based on chest CT images.Methods:This was a cross-sectional study. The clinical and imaging data of 257 patients with stable COPD who underwent chest high resolution CT (HRCT) and pulmonary function tests (PFT) from January 2018 to October 2022 at Shanxi Bethune Hospital were retrospectively analyzed. In addition, 28 healthy individuals with normal HRCT and PFT were collected in the same period as a control group. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading criteria, COPD patients were classified into 31 cases of GOLD 1, 116 cases of GOLD 2, 82 cases of GOLD 3, and 28 cases of GOLD 4. FACT digital lung software was used to automatically segment the pulmonary arteries and pulmonary veins of all the cases, and to calculate the relevant pulmonary vascular parameters, including total lung volume (TLV), vessel volumes at all levels [cross-sectional area less than 5 mm 2 (CSA <5), between 5 and 10 mm 2 (CSA 5-10), and more than 10 mm 2 (CSA >10)], number of vascular branches, and vascular density (pulmonary vascular volume/TLV). Percentage of emphysema (%LAA) and pulmonary artery diameter/aortic diameter (PAD/AD) were calculated for all cases. ANOVA or Kruskal-Wallis H test was used for multiple intergroup comparisons, and LSD test or Bonferroni correction was used for within-group pairwise comparisons. Spearman correlation test was conducted to examine the relationship between CT pulmonary vascular parameters and pulmonary function parameters, as well as %LAA, in both the control group and the COPD group. Results:Differences in age, body mass index, pulmonary function parameters, %LAA and PAD/AD were statistically significant among the 5 groups ( P<0.001). Differences in overall pulmonary vascular density parameters were statistically significant among the 5 groups ( P<0.05). Differences in pulmonary arterial density parameters among the 5 groups with CSA <5, CSA 5-10, and CSA >10 were statistically significant ( P<0.05). The pulmonary arterial density values of GOLD 1 CSA <5, CSA 5-10 and CSA >10 were higher than those of the control group, and then showed a decreasing trend with the increase of COPD severity. The differences in pulmonary venous density parameters among the 5 groups with CSA< 5, CSA 5-10, and CSA >10 were statistically significant ( P<0.001), and the CSA 5-10 pulmonary venous density was higher in GOLD 1 patients than in the control group, and the remaining pulmonary venous densities showed a gradual decreasing trend with the increase in the severity of COPD. The number of arterial and venous vascular branches/TLV tended to decrease in the control group, GOLD 1, GOLD 2, GOLD 3, and GOLD 4 patients ( P<0.001). Pulmonary vascular density parameters were positively correlated with all PFT parameters ( r=0.138-0.510, P<0.05), and negatively correlated with %LAA ( r=-0.340--0.671, P<0.001); PAD/AD was negatively correlated with PFT parameters ( r=-0.208--0.286, P<0.001) and positively correlated with %LAA ( r=0.131, P<0.05). Conclusion:Various pulmonary vascular density parameters can be quantitatively analyzed by artificial intelligence technology based on chest CT images, which can reveal the changing pattern of pulmonary vascular remodeling in COPD patients.