1.Clinical efficacy of escitalopram combined with transcutaneous cervical vagus nerve stimulation therapy for patients with major depressive disorder and its effect on plasma IL-6 and IL-10 levels
Jin LI ; Jinbo SUN ; Di WU ; Wenjun WU ; Runzhu SUN ; Shanshan XUE ; Yapeng CUI ; Huaning WANG ; Yihuan CHEN
Sichuan Mental Health 2025;38(1):7-13
BackgroundInvasive vagus nerve stimulation therapy has been approved for the adjunctive treatment of treatment-resistant depression, which may contribute to the anti-inflammatory properties of vagus nerve stimulation (VNS), whereas the efficacy of non-invasive transcutaneous cervical vagus nerve stimulation (tcVNS) in treating major depressive disorder (MDD) and its impact on plasma inflammatory factors remain unclear. ObjectiveTo observe the effect of escitaloprom combined with tcVNS on the status of depression, anxiety and sleep quality as well as the plasma levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) in MDD patients, in order to provide references for the recovery and treatment of MDD patients. MethodsFrom August 21, 2019 to April 17, 2024, 45 patients who met the diagnostic criteria for MDD in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) were recruited from the psychosomatic outpatient clinic of the First Affiliated Hospital of Air Force Military Medical University. Subjects were divided into study group (n=23) and control group (n=22) using random number table method. All patients were treated with escitalopram. On this basis, study group added a 30-minute tcVNS therapy once a day for 4 weeks. While control group was given corresponding sham stimulation, and the duration of each stimulation lasted 30 seconds. Before and after 4 weeks of treatment, Hamilton Depression Scale-17 item (HAMD-17) was used to assess depressive symptoms, and HAMD-17 anxiety/somatization subfactor and insomnia subfactor were used to assess patients' anxiety/somatization symptoms and sleep quality. Levels of plasma IL-6 and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA). ResultsThe generalized estimating equation model yielded a significant time effect for HAMD-17 total score, anxiety/somatization subfactor score and insomnia subfactor score in both groups (Wald χ2=315.226, 495.481, 82.420, P<0.01). After 4 weeks of treatment, HAMD-17 total score and anxiety/somatization subfactor score of study group were lower than those of control group, with statistically significant differences (Wald χ2=4.967, 32.543, P<0.05 or 0.01), while no statistically significant difference was found in the insomnia subfactor score between two groups (Wald χ2=0.819, P=0.366). Significant time effects were reported on plasma IL-6 and IL-10 levels in both groups (Wald χ2=21.792, 5.242, P<0.05 or 0.01). Compared with baseline data, a reduction in plasma IL-6 levels was detected in both groups (Wald χ2=22.015, 6.803, P<0.01), and an increase in plasma IL-10 levels was reported in study group (Wald χ2=5.118, P=0.024) after 4 weeks of treatment. ConclusionEscitalopram combined with tcVNS therapy is effective in improving depressive symptoms, anxiety/somatization symptoms and sleep quality in patients with MDD. Additionally, it helps reduce plasma IL-6 levels and increase IL-10 levels. [Funded by Shaanxi Provincial Key Research and Development Program-General Project (number, 2023-YBSF-185), www.clinicaltrials.gov number, NCT04037111]
2.Clinical Efficacy of Tongfu Kuanzhong Decoction on Constipation-predominant Irritable Bowel Syndrome and Its Effect on Colonic Dynamics
Junwei LIANG ; Wenjun BAI ; Zu GAO ; Dajuan SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):150-156
ObjectiveTo observe the clinical efficacy of Tongfu Kuanzhong decoction (TFKZ) in the treatment of constipation-predominant irritable bowel syndrome (IBS-C) with spleen deficiency and Qi stagnation and its effects on anorectal manometry and colonic electrical activity parameters. MethodsSixty-four patients with IBS-C of the spleen deficiency and Qi stagnation type were included as research subjects and were randomized into the observation group (thirty-two cases) and control group (thirty-two cases). The control group was orally administered mosapride citrate tablets, and the observation group was orally administered TFKZ. Both groups were treated for 4 weeks. The traditional Chinese medicine (TCM) syndrome scores, patient assessment of constipation symptoms (PAC-SYM) score, general anxiety disorder-7 (GAD-7) score, patient health questionnaire-9(PHQ-9)score, anorectal manometry, and colonic electrical activity parameters were observed before and after treatment in the two groups. ResultsThe total points of TCM syndromes were significantly lower in both groups after treatment (P<0.01) and lower in the observation group (P<0.05). The fecal symptoms, rectal symptoms, abdominal symptoms, and total symptom scores of the patients in both groups were significantly decreased after treatment (P<0.01), and the rectal symptoms, abdominal symptoms, and total symptom scores of the observation group were lower (P<0.05,P<0.01). In both groups, the forced anal residual pressure and the initial rectal sensation threshold decreased after treatment (P<0.05,P<0.01), and forced anal residual pressure in the control group was lower (P<0.01). After treatment, the GAD-7 and PHQ-9 scores of patients in both groups decreased significantly (P<0.01), and the GAD-7 score of the observation group was significantly lower (P<0.01). After treatment, the average wave amplitude at different time points of each lead increased significantly in both groups, compared with that before treatment (P<0.01). The average wave amplitude of each lead of the ascending colon, descending colon, sigmoid colon, and rectum in the observation group at 5 min before the meal and 10 min after the meal, as well as that of the ascending colon and rectum at 20 min and 30 min after the meal, was higher than that of the control group (P<0.05). ConclusionTFKZ is effective in the treatment of IBS-C. Its mechanism may be related to the regulation of colonic function by down-regulating the forced anal residual pressure and the initial rectal sensation threshold and up-regulating the amplitude and frequency of intestinal electrical activity in each intestinal segment of the colon.
3.Association between temperature and injury death and related excess death burden in Hunan Province
Yiqing XU ; Chunliang ZHOU ; Qianlai SUN ; Donghui JIN ; Jianxiong HU ; Guanhao HE ; Wenjun MA ; Zhihong DENG
Journal of Environmental and Occupational Medicine 2025;42(5):528-535
Background Injury poses a serious threat to human health. As global warming continues to intensify, there is an urgent need to explore the impact of temperature changes on injury deaths. However limited research has focused on this issue. Objective To investigate the relationship between daily mean temperature change (Tm) and injury death, as well as to estimate the associated future death burden in Hunan Province. Methods We employed an individual-level, time-stratified case-crossing design to establish a conditional logistic regression model to analyze the exposure-response relationship between daily mean temperature change and injury death in Hunan Province from 2013 to 2018. Consequently, we conducted subgroup analysis of gender, age group, and injury type. Finally, we estimated the excess burden of injury death attributable to temperature changes under a sustainable development path [low emission scenario (SSP1-2.6)], regional competition path [high emission scenario (SSP3-7.0)], or fossil fuel development path [very high emission scenario (SSP5-8.5)]. Results The study collected
4.Pathomechanism and Treatment of Otolith Disorders from the Perspective of "Turbid Pathogen Disturbing Clarity"
Yan KONG ; Zihe KUANG ; Bin WU ; Wenjun SUN
Journal of Traditional Chinese Medicine 2025;66(13):1405-1408
Guided by the theory of turbid pathogen disturbing clarity, this paper holds that the pathogenesis of otolith disorders involves the failure of clear yang to ascend and the internal generation of phlegm-turbidity as the initiating factors. The clinical manifestations are characterized by the intermingling of phlegm and fluid, as well as the disturbance between turbid and clear substances, while the root lies in spleen-kidney deficiency and depletion of primordial qi. Treatment strategies are formulated according to the different stages of the disease: in the acute phase, therapy focuses on warming and resolving phlegm-fluid retention, using a modified combination of Linggui Zhugan Decoction (苓桂术甘汤) and Zexie Decoction (泽泻汤); in the residual phase, the approach shifts to tonifying qi and uplifting clear yang, with a modified combination of Shengxian Decoction (升陷汤) and Shengmai Power (生脉散); in the consolidation phase, therapy aims to tonify the kidney and replenish essence, employing a modified version of Qiju Dihuang Pill (杞菊地黄丸).
5.Application of artificial intelligence and automated scripts in3D printing brachytherapy
Wentai LI ; Jiandong ZHANG ; Zhihe WANG ; Xiaozhen QI ; Yan DING ; Baile ZHANG ; Wenjun MA ; Yao ZHAI ; Weiwei ZHOU ; Yanan SUN ; Xin ZHANG
Chinese Journal of Radiological Health 2025;34(3):419-425
Objective To explore the efficiency improvement in segmenting neural network with the application of Transformer + U-Net artificial intelligence (AI) and modeling with the application of Python scripts in three-dimensional (3D) printing brachytherapy. Methods A Transformer + U-Net AI neural network model was constructed, and Adam optimizer was used to ensure rapid gradient descent. Computed tomography or magnetic resonance imaging data of patients were standardized and processed as self-made data sets. The training set was used to train AI and the optimal result weight parameters were saved. The test set was used to evaluate the AI ability. Python programming language was used to write an automated script to obtain the output segmentation image and convert it to the STL file for import. The source applicator and needle could be automatically modeled. The time of automatic segmentation and modeling and the time of manual segmentation and modeling were entered by two people, and the difference was verified by paired t-test. Results Dice similarity coefficient (DSC), mean intersection over union (MIOU), and Hausdorff distance (HD95) were used for evaluation. DSC was
6.Efficacy of eye transcutaneous electrical acupoint stimulation on preventing the progression of pre-myopic to myopia in children.
Qian LOU ; Furu XU ; Wenjun JIANG ; Yi QU ; Longjiao SUN ; Hongsheng BI
Chinese Acupuncture & Moxibustion 2025;45(2):173-178
OBJECTIVE:
To observe the efficacy and safety of eye transcutaneous electrical acupoint stimulation (Eye-TEAS) on preventing the progression of pre-myopic to myopia in children aged 6-12 years.
METHODS:
A total of 170 pre-myopic children aged 6-12 years were randomly divided into an Eye-TEAS group (85 cases, 3 cases dropped out, 2 cases were eliminated) and a placebo Eye-TEAS group (85 cases, 3 cases dropped out, 2 cases were eliminated). The Eye-TEAS group received Eye-TEAS intervention at bilateral Cuanzhu (BL2), Yuyao (EX-HN4), Sizhukong (TE23), Taiyang (EX-HN5), Sibai (ST2), and Jingming (BL1), with continuous wave at a frequency of 4 Hz and a current of 1-2 mA for 30 min per session. The placebo Eye-TEAS group received sham intervention with the same equipment and procedure, but no electrical stimulation. Both groups received intervention once every other day, at least 3 times a week, for a duration of 20 weeks. After intervention and during the 28-week follow-up period after the intervention completion, the changes in axial length (AL), spherical equivalent refraction (SER), and the incidence of myopia were compared between the two groups. Adherence and safety during the intervention period were also evaluated.
RESULTS:
Compared before intervention, both groups showed an increase in AL after the intervention and during the follow-up (P<0.01). The AL during follow-up was higher than that after the intervention in the two groups (P<0.01). The Eye-TEAS group exhibited a smaller change in AL than the placebo Eye-TEAS group after the intervention and during follow-up (P<0.01, P<0.05). Compared before intervention, both groups showed a decrease in SER after the intervention and during follow-up (P<0.01). The SER during follow-up was lower than that after the intervention in the two groups (P<0.01). The Eye-TEAS group had a higher SER than the placebo Eye-TEAS group after the intervention (P<0.05). The Eye-TEAS group exhibited a smaller change in SER than the placebo Eye-TEAS group after the intervention and during follow-up (P<0.01). The incidence of myopia in the Eye-TEAS group was lower than that in the placebo group during follow-up (20.0% [14/70] vs 34.7% [25/72], P<0.05). Both groups had good adherence, with no adverse events related to the intervention.
CONCLUSION
Eye-TEAS can delay the progression of pre-myopic to myopia in children, and has a high safety profile.
Humans
;
Child
;
Male
;
Female
;
Acupuncture Points
;
Myopia/prevention & control*
;
Transcutaneous Electric Nerve Stimulation
;
Treatment Outcome
;
Disease Progression
7.Intraoperative targeted blood pressure management and dexmedetomidine on composite complications in moderate-to-high risk patients after major abdominal surgery.
Qiongfang WU ; Haifeng WANG ; Meilin LI ; Wenjun HU ; Shuting HE ; Yanling SUN ; Dongliang MU ; Daniel I SESSLER ; Dongxin WANG
Chinese Medical Journal 2025;138(2):240-242
8.Basiliximab is superior to low dose rabbit anti-thymocyte globulin in pediatric kidney transplant recipients: The younger, the better.
Lan ZHU ; Lei ZHANG ; Wenjun SHANG ; Wenhua LIU ; Rula SA ; Zhiliang GUO ; Longshan LIU ; Jinghong TAN ; Hengxi ZHANG ; Yonghua FENG ; Wenyu ZHAO ; Wenqi CONG ; Jianyong WU ; Changxi WANG ; Gang CHEN
Chinese Medical Journal 2025;138(2):225-227
9.Efficacy and safety of secukinumab in Chinese patients with psoriasis: Update of six-year real-world data and a meta-analysis.
He HUANG ; Yaohua ZHANG ; Caihong ZHU ; Zhengwei ZHU ; Yujun SHENG ; Min LI ; Huayang TANG ; Jinping GAO ; Dawei DUAN ; Hequn HUANG ; Weiran LI ; Tingting ZHU ; Yantao DING ; Wenjun WANG ; Yang LI ; Xianfa TANG ; Liangdan SUN ; Yanhua LIANG ; Xuejun ZHANG ; Yong CUI ; Bo ZHANG
Chinese Medical Journal 2025;138(23):3198-3200
10.Analysis of factors related to voice training compliance.
Caipeng LIU ; Jinshan YANG ; Wenjun CHEN ; Xin ZOU ; Yajing WANG ; Yiqing ZHENG ; Faya LIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(7):610-623
Objective:To explore the factors influencing adherence to voice therapy among patients with voice disorders in China. Methods:Patients with voice disorders who visited the Voice Therapy Center at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from February to May 2022 were enrolled in the study. Adherence was assessed using the URICA-Voice scale, while influencing factors were assessed through the Voice Handicap Index(VHI) scale and a general information questionnaire. Correlation analysis was conducted using univariate and multivariate logistic regression analysis. Results:A total of 247 patients were included in the study, comprising 57 males(23.08%) and 190 females(76.92%). The results revealed that: ①Female patients demonstrated higher likelihood of being in the contemplation stage(OR=0.22) compared to males. ②Patients with a monthly family income per capita>6 000 yuan were more likely to be in the contemplation stage than those with<3 000 yuan with an OR = 13.94. ③High vocal-demand occupations increased contemplation stage probability(OR=7.70) compared to moderate-demand occupations. ④Residence within 30-minute commute predicted action/maintenance stages(OR=7.14) versus≥60-minute commute. ⑤Patients whose occupations had high voice demands were more likely to be in the action and maintenance stages than those with average voice demands, with an OR of 16.20. Conclusion:Gender, monthly family income per capita, occupational voice demands, and distance to the hospital significantly impact the URICA-Voice compliance stages of patients. Patients who are female, have higher family income, have occupations with high voice demands, and live closer to the hospital exhibit higher compliance with voice training.
Humans
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Male
;
Female
;
Voice Disorders/therapy*
;
Patient Compliance
;
Voice Training
;
Surveys and Questionnaires
;
China
;
Middle Aged
;
Adult
;
Voice Quality
;
Logistic Models
;
Aged

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