Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Hepatocellular carcinoma (HCC) is one of the most common malignancies and is a major cause of cancer-related mortalities worldwide (Forner et al., 2018; He et al., 2023). Sarcopenia is a syndrome characterized by an accelerated loss of skeletal muscle (SM) mass that may be age-related or the result of malnutrition in cancer patients (Cruz-Jentoft and Sayer, 2019). Preoperative sarcopenia in HCC patients treated with hepatectomy or liver transplantation is an independent risk factor for poor survival (Voron et al., 2015; van Vugt et al., 2016). Previous studies have used various criteria to define sarcopenia, including muscle area and density. However, the lack of standardized diagnostic methods for sarcopenia limits their clinical use. In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) renewed a consensus on the definition of sarcopenia: low muscle strength, loss of muscle quantity, and poor physical performance (Cruz-Jentoft et al., 2019). Radiological imaging-based measurement of muscle quantity or mass is most commonly used to evaluate the degree of sarcopenia. The gold standard is to measure the SM and/or psoas muscle (PM) area using abdominal computed tomography (CT) at the third lumbar vertebra (L3), as it is linearly correlated to whole-body SM mass (van Vugt et al., 2016). According to a "North American Expert Opinion Statement on Sarcopenia," SM index (SMI) is the preferred measure of sarcopenia (Carey et al., 2019). The variability between morphometric muscle indexes revealed that they have different clinical relevance and are generally not applicable to broader populations (Esser et al., 2019).
Humans ; Aged ; Sarcopenia/diagnostic imaging* ; Carcinoma, Hepatocellular/diagnostic imaging* ; Muscle, Skeletal/diagnostic imaging* ; Deep Learning ; Prognosis ; Radiomics ; Liver Neoplasms/diagnostic imaging* ; Retrospective Studies

As a kind of traditional Chinese medicine,which has a medicinal site of rhizomes,contains rich active ingredients,mainly including steroidal saponins,flavonoids,phenols,stilbenes,organic acids and other compounds,which together give a wide range of pharmacological effects,including anti-inflammatory,antibacterial,anti-tumor,hypolipidemic,hypoglycemic,and so on.In recent years,with the continuous development of modern science and technology,the research on Smilacis chinae rhizoma has been deepening,and the pharmacological mechanism of its active ingredients has been gradually revealed.This paper reviews the research progress on the active ingredients and pharmacological effects of Smilacis chinae rhizoma over the last few years at home and abroad,in order to provide a scientific basis for further development and utilization of Smilacis chinae rhizoma,and inject new vitality into the modernization and international development of traditional Chinese medicine.

Objective:To analyze and compare the salt iodine content and iodine nutrition status of pregnant women in Ningxia Hui Autonomous Region (Ningxia for short), and to provide basis for formulation of prevention and control measures.Methods:From 2017 to 2020, 100 pregnant women were surveyed each year in 22 counties (cities, districts) in Yinchuan, Shizuishan, Wuzhong, Guyuan and Zhongwei of Ningxia, salt samples and urine samples were collected for salt iodine and urinary iodine detection.Results:Totally 8 807 salt samples were collected, the median salt iodine was 24.6 mg/kg. The qualified rate of iodized salt was 91.59% (7 838/8 558), the coverage rate of iodized salt was 97.17% (8 558/8 807), and the consumption rate of qualified iodized salt was 89.00% (7 838/8 807). The consumption rate of qualified iodized salt increased year by year (χ 2trend = 248.47, P < 0.001). There were statistical differences in salt iodine levels in different years and regions ( H = 259.14, 37.09, P < 0.001). Totally 8 107 urine samples were collected, the median urinary iodine of pregnant women was 165.00 μg/L, which reached the appropriate level. The median and composition of urinary iodine were statistically different in different regions and pregnancies ( H = 28.87, 17.91, P < 0.001; χ 2 = 85.89, 20.59, P < 0.05). Conclusions:The coverage rate of iodized salt among pregnant women in Ningxia is high, and the urinary iodine level is generally in a suitable state. However, for pregnant women at risk of iodine deficiency, special attention should be paid and targeted iodine supplementation measures should be taken.

INTRODUCTION: Oropharyngeal swabs for diagnosis of COVID-19 often induce violent coughing, which can disperse infectious droplets onto providers. Incorrectly doffing personal protective equipment (PPE) increases the risk of transmission. A cheap, single-use variation of the face shield invented by a Singaporean team, SG Shield, aims to reduce this risk. This manikin study aimed to study the efficacy of the SG Shield in combination with standard PPE. METHODS: A person attired in full PPE whose face and chest was lined with grid paper stood in front of an airway manikin in an enclosed room. A small latex balloon containing ultraviolet fluorescent dye was placed in the oral cavity of the manikin and inflated until explosion to simulate a cough. Three study groups were tested: (a) control (no shield), (b) face shield and (c) SG Shield. The primary outcome was droplet dispersion, determined quantitatively by calculating the proportion of grid paper wall squares stained with fluorescent dye. The secondary outcome was the severity of provider contamination. RESULTS: The SG Shield significantly reduced droplet dispersion to 0% compared to the controls (99.0%, P = 0.001). The face shield also significantly reduced droplet contamination but to a lesser extent (80.0%) compared to the control group (P = 0.001). Although the qualitative severity of droplet contamination was significantly lower in both groups compared to the controls, the face shield group had more contamination of the provider's head and neck. CONCLUSION The manikin study showed that the SG Shield significantly reduces droplet dispersion to the swab provider's face and chest.
Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control* ; COVID-19 ; Fluorescent Dyes ; Personal Protective Equipment ; Cough

OBJECTIVE To prepare quercetin-human serum albumin-nanoparticles （Que-HSA-NPs），and to evaluate the in vivo and in vitro inhibitory effects of Que-HSA-NPs on hepatic fibrosis of non-alcoholic steatohepatitis （NASH）. METHODS Que-HSA-NPs were prepared by desolvation-chemical cross-linking method ，their appearance characteristics were observed ，and their particle size ，polydispersity index （PDI），Zeta potential and drug loading were detected. Quercetin （Que）and Que-HSA-NPs were applied to murine HSC-T 6 cells. The effects of them on survival rate of HSC-T 6，mRNA expression of transforming growth factor β（TGF-β），Type Ⅰ collagen α1（COL1A1）and α-smooth muscle actin （α-SMA）were compared. Que and Que-HSA-NPs were applied to mice fed with low methionine and choline deficient high-fat diet. The serum levels of liver injury indexes ，liver pathological characteristics ，mRNA expressions of TGF-β，COL1A1 and α-SMA，protein expression of α-SMA in liver tissue were determined to evaluate the improvement effects of them on hepatic fibrosis of NASH in mice. RESULTS The prepared Que-HSA-NPs was spherical ，the particle size was （172.9±2.2）nm，the PDI was 0.233，the Zeta potential was －29.2 mV，and the drug loading was 2.99％. Que and Que-HSA-NPs were nontoxic to HSC-T 6 at concentrations of 0-250 μg/mL. Both of them could significantly decrease mRNA expressions of TGF-β，COL1A1 and α-SMA，especially Que-HSA-NPs （P＜0.05）. They also could significantly decrease the serum levels of liver inju ry index ，relieve liver injury and down-regulate mRNA expressions of TGF-β，COL1A1 and α-SMA and protein expression of α-SMA， especially Que-HSA-NPs （P＜0.05）. CONCLUSIONS Que- HSA-NPs is successfully prepared ，and confirm that its anti- NASH hepatic fibrosis effect is better than that of Que .

Objective To evaluate the effects of early exercise intervention in patients who have undergone primary isolated valve surgery. Methods Forty patients scheduled for mitral, aortic, and/or tricuspid valve surgery were allocated to receive a supervised exercise intervention consisting of cycling for 3 min/d at the bedside after operation (intervention group, n=20, mean age [49.05±3.728] years) or to receive no exercise intervention (control group, n=20, mean age [47.95 ± 3.214] years). Oxygen saturation (SpO2) was measured by pulse oximetry continuously before and after the 6-minute walk test. Psycho-educational counseling was provided, and patients were assessed using standard patient questionnaires. Results The arterial SpO2 level increased significantly in the intervention group after exercise compared with the control group (P<0.05). Heart rate returned to baseline in the intervention group postoperatively and was significantly lower than that in the control group (P<0.05). Conclusions A small amount of supervised cycling exercise at the bedside is a safe activity that may improve peripheral arterial SpO2 and reduce heart rate to the baseline level following longer distance walk before discharge in patients who have undergone isolated valve surgery.

Objective:To understand the surveillance of iodine deficiency disorders (IDD) in Zhongwei City of Ningxia Hui Autonomous Region after marketization reform of salt industry (2017).Methods:In 2018, Shapotou District, Zhongning County and Haiyuan County of Zhongwei City were divided into five sampling areas according to the location of east, west, south, north and middle. In each area, one township was selected, and three salt sales outlets were selected from each township; at the same time, three supermarkets were selected from the cities and towns of each county (district), and different kinds of salt samples in all sales outlets and supermarkets were tested semi-quantitatively. From 2016 to 2020, Shapotou District, Zhongning County and Haiyuan County of Zhongwei City were divided into five sampling areas according to the location of east, west, south, north and middle. One township was selected from each area, and one primary school was selected from each township, 40 non-boarding students aged 8 - 10 years old (age balanced, half males and half females) were selected from each primary school; at the same time, 20 pregnant women were selected from each township, and salt samples were collected from houses of children and pregnant women to test salt iodine content. From 2018 to 2020, according to the "Ningxia Iodine Deficiency Disorders Surveillance Program (2016 Edition)", random urine samples of children and pregnant women were collected to detect urinary iodine content. In 2018 and 2019, the thyroid volume of children was measured by B-mode ultrasound, and the goiter rate was calculated.Results:In 2018, 13 kinds of salt were supplied in the market of Zhongwei City, a total of 130 salt samples were tested, and 11 samples of non-iodized salt were detected, with a rate of 8.46%. From 2016 to 2020, the consumption rates of qualified iodized salt in Zhongwei City were 90.33% (813/900), 67.89% (611/900), 78.67% (708/900), 91.56% (825/901) and 94.44% (850/900), respectively. From 2018 to 2020, the medians urinary iodine of children aged 8 - 10 years old were 189.33, 195.64, and 222.10 μg/L, and the medians urinary iodine of pregnant women were 158.21, 158.01, and 171.84 μg/L, respectively. In 2018 and 2019, the goiter rates of children aged 8 - 10 years old were 1.75% (7/400) and 0.67% (4/600), respectively.Conclusion:After marketization reform of salt industry, the consumption rates of qualified iodized salt in Zhongwei City decrease in 2017 and 2018, however, children and pregnant women have sufficient iodine nutrition, and the goiter rate of children is controlled at a low level.