Aplastic anemia is a rare and life-threatening bone marrow failure that is becoming more common and tends to affect younger individuals.Traditional Chinese medicine has a long history of preventing and treating asthenia and blood syndrome.Its treatment of aplastic anemia involves coordinated regulation through multiple components,targets,and channels.The article classifies and elaborates on the therapeutic effects of traditional Chinese medicine compounds and their components on aplastic anemia.As well as the expression of related factors from three aspects:hematopoietic stem/progenitor cells,the immune system,and bone marrow microenvironmental abnormalities.It also analyzes the frequency and meridian of commonly used drugs in traditional Chinese medicine compounds.Deficiency tonifying drugs were found to be the most frequently used treatment for aplastic anemia,which is consistent with the deficiency-based nature of the disease.The related organs affected are the liver,spleen,and kidney.This paper reviews the mechanism of aplastic anemia and the preventive and therapeutic effects of traditional Chinese medicine.The study is of great significance for the follow-up research on traditional Chinese medicine in improving aplastic anemia.

Objective:To analyze the risk factors associated with future exacerbations in patients with chronic obstructive pulmonary disease (COPD) who have no history of exacerbation in the past year.Methods:COPD patients with no exacerbation history in the past year, registered in the RealDTC study from January 2018 to December 2023, were enrolled. Demographic data, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea questionnaire scores, forced expiratory volume in the first second predicted of percentage (FEV 1%pred), forced expiratory volume in one second (FEV 1) to forced vital capacity (FVC), Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, GOLD groups, and inhaled medication regimens were collected. All patients were followed up for one year, and the number of exacerbations was recorded. Patients were divided into an exacerbation group and a non-exacerbation group based on the occurrence of exacerbations during the follow-up period. Logistic regression analysis was used to screen the influencing factors for exacerbations in COPD patients. Results:A total of 2 901 COPD patients were included, among which 633 patients (21.8%) experienced exacerbations during the follow-up period. Compared with the non-exacerbation group, patients in the exacerbation group were older, with higher CAT and mMRC scores, lower body mass index (BMI), FEV 1%pred, and FEV 1/FVC. The proportions of patients with high school education or above and those using long-acting β 2-agonist (LABA) + long-acting muscarinic antagonist (LAMA) medications were also lower (all P<0.05). Logistic regression analysis showed that age ( OR=1.010, 95% CI: 1.000-1.021), CAT score ≥20 ( OR=1.415, 95% CI: 1.074-1.865), education level of junior high school or below ( OR=1.243, 95% CI: 1.003-1.540), LABA + LAMA inhalation ( OR=0.605, 95% CI: 0.432-0.848), and BMI ( OR=0.969, 95% CI: 0.943-0.995) were independent risk factors for future exacerbations in COPD patients with no exacerbation history in the past year (all P<0.05). Conclusions:The risk of future exacerbations remains high in COPD patients with no exacerbation history in the past year. High CAT scores, low education levels, and low BMI are associated with future exacerbations. Clinicians should pay close attention to the management of such patients and implement appropriate interventions.

Objective:To analyze the risk factors associated with future exacerbations in patients with chronic obstructive pulmonary disease (COPD) who have no history of exacerbation in the past year.Methods:COPD patients with no exacerbation history in the past year, registered in the RealDTC study from January 2018 to December 2023, were enrolled. Demographic data, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea questionnaire scores, forced expiratory volume in the first second predicted of percentage (FEV 1%pred), forced expiratory volume in one second (FEV 1) to forced vital capacity (FVC), Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, GOLD groups, and inhaled medication regimens were collected. All patients were followed up for one year, and the number of exacerbations was recorded. Patients were divided into an exacerbation group and a non-exacerbation group based on the occurrence of exacerbations during the follow-up period. Logistic regression analysis was used to screen the influencing factors for exacerbations in COPD patients. Results:A total of 2 901 COPD patients were included, among which 633 patients (21.8%) experienced exacerbations during the follow-up period. Compared with the non-exacerbation group, patients in the exacerbation group were older, with higher CAT and mMRC scores, lower body mass index (BMI), FEV 1%pred, and FEV 1/FVC. The proportions of patients with high school education or above and those using long-acting β 2-agonist (LABA) + long-acting muscarinic antagonist (LAMA) medications were also lower (all P<0.05). Logistic regression analysis showed that age ( OR=1.010, 95% CI: 1.000-1.021), CAT score ≥20 ( OR=1.415, 95% CI: 1.074-1.865), education level of junior high school or below ( OR=1.243, 95% CI: 1.003-1.540), LABA + LAMA inhalation ( OR=0.605, 95% CI: 0.432-0.848), and BMI ( OR=0.969, 95% CI: 0.943-0.995) were independent risk factors for future exacerbations in COPD patients with no exacerbation history in the past year (all P<0.05). Conclusions:The risk of future exacerbations remains high in COPD patients with no exacerbation history in the past year. High CAT scores, low education levels, and low BMI are associated with future exacerbations. Clinicians should pay close attention to the management of such patients and implement appropriate interventions.

Aplastic anemia is a rare and life-threatening bone marrow failure that is becoming more common and tends to affect younger individuals.Traditional Chinese medicine has a long history of preventing and treating asthenia and blood syndrome.Its treatment of aplastic anemia involves coordinated regulation through multiple components,targets,and channels.The article classifies and elaborates on the therapeutic effects of traditional Chinese medicine compounds and their components on aplastic anemia.As well as the expression of related factors from three aspects:hematopoietic stem/progenitor cells,the immune system,and bone marrow microenvironmental abnormalities.It also analyzes the frequency and meridian of commonly used drugs in traditional Chinese medicine compounds.Deficiency tonifying drugs were found to be the most frequently used treatment for aplastic anemia,which is consistent with the deficiency-based nature of the disease.The related organs affected are the liver,spleen,and kidney.This paper reviews the mechanism of aplastic anemia and the preventive and therapeutic effects of traditional Chinese medicine.The study is of great significance for the follow-up research on traditional Chinese medicine in improving aplastic anemia.

Alzheimer's disease （AD） is one of the most common diseases in the elderly population. Its etiology involves multiple pathogenic factors and pathological links such as abnormal deposition of β amyloid protein （Aβ）， hyperphosphorylation of Tau protein， abnormalities of the cholinergic system， oxidative stress， and inflammatory response. However， its specific pathogenesis has not been clarified， and no specific therapeutic drugs have been found. In recent years， more and more studies have paid attention to the potential of chemical components of traditional Chinese medicine （TCM） in the treatment of AD. However， the diversity and complexity of the chemical components of TCM may have a positive impact on multiple pathological links of AD. Researchers have isolated many active components from TCMs， and the effects of treating AD have been confirmed by modern pharmacological studies. Through literature analysis， this article found that the main chemical components of TCM with anti-AD effects were saponins （31%）， flavonoids （24%）， polysaccharides （20%）， lactones （8%）， alkaloids （7%）， phenols （3%）， and other compounds （7%）. Among them， ginsenoside， notoginsenoside， epimedium flavones， puerarin， baicalein， schisandra polysaccharide， angelica polysaccharide， ganoderma lucidum polysaccharide， pachyman， huperzine A， berberine， andrographolide， curcumin， emodin， and gastrodin have been extensively studied in terms of their anti-AD effects， and their mechanisms of pharmacological action have been involved in many aspects of AD pathogenesis. This article reviews the anti-AD activities and possible mechanisms of chemical components of TCM， so as to provide a reference for the development of new drugs for the prevention and treatment of AD.

Objective To explore the effect of Tianma Gouteng Yin combined with butylphthalein(NBP)on symptom improvement and vascular elasticity in patients with acute cerebral infarction(ACI).Methods Eighty-two ACI patients admitted to Lu'an Hospital of Traditional Chinese Medicine were included in this study,and they were randomly separated into the single group and the combination group,with 41 cases in each group.The single group was given intravenous infusion of NBP sodium chloride injection,and the combination group was given treatment with Tianma Gouteng Yin on the basis of the single group.Cerebrovascular reserve function,endothelial function,neurological function,independent living ability,hemodynamic indicators,vascular elasticity,clinical efficacy and incidence of adverse reactions were compared between the two groups of patients at 1 day after admission(T0)and 14 days after treatment(T1).Results There were no significant differences in cerebrovascular reserve function,endothelial function,National Institutes of Health Stroke Scale(NIHSS)scores,independent living ability scores,hemodynamic indicators and vascular elasticity indicators at T0 between the two groups(P＞0.05).At T1,levels of cerebrovascular reactivity(CVR),nitric oxide(NO),nitric oxide synthase(NOS),large artery elasticity index(C1)and small artery elasticity index(C2)were significantly increased in both groups,and levels were higher in the combined group than those of the single group(P＜0.05).At T1 moment,levels of ET-1,vascular endothelial growth factor(VEGF),NIHSS score,MRS score,red blood cell count,whole blood viscosity,platelet adhesion rate and arterial pressure were reduced in both groups,and levels were lower in the combined group than those of the single group(P＜0.05).The total effective rate was higher in the combination group(80.5%)than that of the single group(46.3%).The overall incidence of adverse reactions was lower in the combined group than that in the single group(P＜0.05).Conclusion Tianma Gouteng Yin combined with NBP can effectively improve the cerebral vascular reserve function,endothelial function and neurological damage in ACI patients,increase vascular elasticity and improve hemodynamic levels.

Objective:To compare the differences in inhaled medication prescriptions among patients with chronic obstructive pulmonary disease (COPD) who visited the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD 2023) one year after its release and the previous year, and to analyze the impact of GOLD 2023 on physician inhaled medication prescriptions.Methods:This study was a cross-sectional study, with data sourced from the RealDTC study. The study subjects were chronic obstructive pulmonary disease patients who visited the respiratory and critical care departments of 13 hospitals in southern China from November 14, 2021 to November 15, 2023. According to the time of patient visits, they are divided into the following two groups: the group 1 year before the release of GOLD 2023 (November 14, 2021 to November 14, 2022), and the group 1 year after the release of GOLD 2023 (November 15, 2022 to November 15, 2023). We collected demographic characteristics, lung function, symptom scores, history of acute exacerbation in the past year, and inhaled medication prescriptions from patients. According to the symptom score of COPD patients in GOLD 2023 and their history of acute exacerbation in the past year, they were divided into three groups: A, B, and E. The treatment status of inhaled drugs in groups A, B, and E before and after the release of GOLD 2023 was compared.Results:There were statistically significant differences in COPD Assessment Test (CAT) scores, Modified Medical Research Council (mMRC) scores, and the number of acute exacerbations in the past year between patients with COPD before and after the release of GOLD 2023 (all P<0.05). Compared with the group one year before the release of GOLD 2023, the proportion of patients in the group one year after the release of GOLD 2023 using long-acting muscarinic antagonists (LAMA) and inhaled corticosteroids (ICS)+ long-acting β2-receptor agonists (LABA) was lower, while the proportion of patients using LABA+ LAMA and ICS+ LABA+ LAMA was higher (all P<0.05). There was no statistically significant difference ( P>0.05) in the proportion of patients in group A using LAMA between the year before and after the release of GOLD 2023. Compared to the year before the release of GOLD 2023, the proportion of patients in group A who prescribed ICS+ LABA was lower, while the proportion of using LABA+ LAMA and ICS+ LABA+ LAMA was higher (all P<0.05); The proportion of patients in group B who prescribed LAMA and ICS+ LABA was lower (all P<0.05), while the proportion of using LABA+ LAMA and ICS+ LABA+ LAMA was higher (all P<0.05); The proportion of patients in group E who prescribed LAMA and ICS+ LABA was lower (all P<0.05), while the proportion of using LABA+ LAMA and ICS+ LABA+ LAMA was higher (all P<0.05). Conclusions:After the release of GOLD 2023, the prescription of ICS+ LAMA in groups A, B, and E decreased, and the prescriptions of LABA+ LAMA and ICS+ LABA+ LAMA increased compared to before; However, in the real world, the compliance of physicians with GOLD 2023 is still not ideal.

Abstract E cigarette has become more and more popular among adolescents, and the awareness and use of e cigarettes among middle and high school students have shown a significant upward trend. E cigarette use is not only harmful to adolescent health, but also may become a gateway to other addictive substances. Individual characteristics, products features, environment and other factors were associated with e cigarette use among adolescents. The purpose of the review is to understand the current status and associated factors of adolescent e cigarette use, so as to provide scientific suggestions for the prevention of e cigarette use among adolescents.

Humans ; SARS-CoV-2 ; COVID-19

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.