OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

AIM To investigate the clinical effects of Jinhua Qinggan Granules combined with azithromycin on patients with Mycoplasma pneumoniae pneumonia.METHODS One hundred and three patients were randomly assigned into control group(51 cases)for 1-week intervention of both azithromycin and conventional treatment,and observation group(52 cases)for 1-wee intervention of Jinhua Qinggan Granules,azithromycin and conventional treatment.The changes in clinical effects,remission time for local symptoms(cough,wheezing,fever,pulmonary wet rales),pulmonary function indices(PEF,FEV1,FEV1/FVC),immune function indices(CD4+,CD8+,CD4+/CD8+),NLRP3 inflammatory pathway factors(Caspase-1,IL-1β,IL-18)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05),along with shorter remission time for local symptoms(P＜0.05).After the treatment,the two groups displayed increased pulmonary function indices,CD4+,CD4+/CD8+(P＜0.05),and decreased CD8+,NLRP3 inflammatory pathway factors(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with Mycoplasma pneumoniae pneumonia,Jinhua Qinggan Granules combined with azithromycin can safely and effectively improve clinical symptoms,pulmonary functions and immune functions,whose mechanism may contribute to the regulation of NLRP3 inflammasome pathway expressions.

Background/Aims: Metabolic dysfunction-associated steatohepatitis (MASH) is a significant risk factor for gallstone formation, but mechanisms underlying MASH-related gallstone formation remain unclear. Golgi membrane protein 1 (GOLM1) participates in hepatic cholesterol metabolism and is upregulated in MASH. Here, we aimed to explore the role of GOLM1 in MASH-related gallstone formation. Methods: The UK Biobank cohort was used for etiological analysis. GOLM1 knockout (GOLM1-/-) and wild-type (WT) mice were fed with a high-fat diet (HFD). Livers were excised for histology and immunohistochemistry analysis. Gallbladders were collected to calculate incidence of cholesterol gallstones (CGSs). Biles were collected for biliary lipid analysis. HepG2 cells were used to explore underlying mechanisms. Human liver samples were used for clinical validation. Results: MASH patients had a greater risk of cholelithiasis. All HFD-fed mice developed MASH, and the incidence of gallstones was 16.7% and 75.0% in GOLM1-/- and WT mice, respectively. GOLM1-/- decreased biliary cholesterol concentration and output. In vivo and in vitro assays confirmed that GOLM1 facilitated cholesterol efflux through upregulating ATP binding cassette transporter subfamily G member 5 (ABCG5). Mechanistically, GOLM1 translocated into nucleus to promote osteopontin (OPN) transcription, thus stimulating ABCG5-mediated cholesterol efflux. Moreover, GOLM1 was upregulated by interleukin-1β (IL-1β) in a dose-dependent manner. Finally, we confirmed that IL-1β, GOLM1, OPN, and ABCG5 were enhanced in livers of MASH patients with CGSs. Conclusions In MASH livers, upregulation of GOLM1 by IL-1β increases ABCG5-mediated cholesterol efflux in an OPN-dependent manner, promoting CGS formation. GOLM1 has the potential to be a molecular hub interconnecting MASH and CGSs.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Background/Aims: Metabolic dysfunction-associated steatohepatitis (MASH) is a significant risk factor for gallstone formation, but mechanisms underlying MASH-related gallstone formation remain unclear. Golgi membrane protein 1 (GOLM1) participates in hepatic cholesterol metabolism and is upregulated in MASH. Here, we aimed to explore the role of GOLM1 in MASH-related gallstone formation. Methods: The UK Biobank cohort was used for etiological analysis. GOLM1 knockout (GOLM1-/-) and wild-type (WT) mice were fed with a high-fat diet (HFD). Livers were excised for histology and immunohistochemistry analysis. Gallbladders were collected to calculate incidence of cholesterol gallstones (CGSs). Biles were collected for biliary lipid analysis. HepG2 cells were used to explore underlying mechanisms. Human liver samples were used for clinical validation. Results: MASH patients had a greater risk of cholelithiasis. All HFD-fed mice developed MASH, and the incidence of gallstones was 16.7% and 75.0% in GOLM1-/- and WT mice, respectively. GOLM1-/- decreased biliary cholesterol concentration and output. In vivo and in vitro assays confirmed that GOLM1 facilitated cholesterol efflux through upregulating ATP binding cassette transporter subfamily G member 5 (ABCG5). Mechanistically, GOLM1 translocated into nucleus to promote osteopontin (OPN) transcription, thus stimulating ABCG5-mediated cholesterol efflux. Moreover, GOLM1 was upregulated by interleukin-1β (IL-1β) in a dose-dependent manner. Finally, we confirmed that IL-1β, GOLM1, OPN, and ABCG5 were enhanced in livers of MASH patients with CGSs. Conclusions In MASH livers, upregulation of GOLM1 by IL-1β increases ABCG5-mediated cholesterol efflux in an OPN-dependent manner, promoting CGS formation. GOLM1 has the potential to be a molecular hub interconnecting MASH and CGSs.

Background/Aims: Metabolic dysfunction-associated steatohepatitis (MASH) is a significant risk factor for gallstone formation, but mechanisms underlying MASH-related gallstone formation remain unclear. Golgi membrane protein 1 (GOLM1) participates in hepatic cholesterol metabolism and is upregulated in MASH. Here, we aimed to explore the role of GOLM1 in MASH-related gallstone formation. Methods: The UK Biobank cohort was used for etiological analysis. GOLM1 knockout (GOLM1-/-) and wild-type (WT) mice were fed with a high-fat diet (HFD). Livers were excised for histology and immunohistochemistry analysis. Gallbladders were collected to calculate incidence of cholesterol gallstones (CGSs). Biles were collected for biliary lipid analysis. HepG2 cells were used to explore underlying mechanisms. Human liver samples were used for clinical validation. Results: MASH patients had a greater risk of cholelithiasis. All HFD-fed mice developed MASH, and the incidence of gallstones was 16.7% and 75.0% in GOLM1-/- and WT mice, respectively. GOLM1-/- decreased biliary cholesterol concentration and output. In vivo and in vitro assays confirmed that GOLM1 facilitated cholesterol efflux through upregulating ATP binding cassette transporter subfamily G member 5 (ABCG5). Mechanistically, GOLM1 translocated into nucleus to promote osteopontin (OPN) transcription, thus stimulating ABCG5-mediated cholesterol efflux. Moreover, GOLM1 was upregulated by interleukin-1β (IL-1β) in a dose-dependent manner. Finally, we confirmed that IL-1β, GOLM1, OPN, and ABCG5 were enhanced in livers of MASH patients with CGSs. Conclusions In MASH livers, upregulation of GOLM1 by IL-1β increases ABCG5-mediated cholesterol efflux in an OPN-dependent manner, promoting CGS formation. GOLM1 has the potential to be a molecular hub interconnecting MASH and CGSs.

AIM To investigate the clinical effects of Jinhua Qinggan Granules combined with azithromycin on patients with Mycoplasma pneumoniae pneumonia.METHODS One hundred and three patients were randomly assigned into control group(51 cases)for 1-week intervention of both azithromycin and conventional treatment,and observation group(52 cases)for 1-wee intervention of Jinhua Qinggan Granules,azithromycin and conventional treatment.The changes in clinical effects,remission time for local symptoms(cough,wheezing,fever,pulmonary wet rales),pulmonary function indices(PEF,FEV1,FEV1/FVC),immune function indices(CD4+,CD8+,CD4+/CD8+),NLRP3 inflammatory pathway factors(Caspase-1,IL-1β,IL-18)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05),along with shorter remission time for local symptoms(P＜0.05).After the treatment,the two groups displayed increased pulmonary function indices,CD4+,CD4+/CD8+(P＜0.05),and decreased CD8+,NLRP3 inflammatory pathway factors(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with Mycoplasma pneumoniae pneumonia,Jinhua Qinggan Granules combined with azithromycin can safely and effectively improve clinical symptoms,pulmonary functions and immune functions,whose mechanism may contribute to the regulation of NLRP3 inflammasome pathway expressions.

Objective To evaluate the disinfection quality of gastroscopes and enteroscopes in medical institutions across China,and provide scientific guidance for the disinfection of digestive endoscopes.Methods From 2010 to 2022,relying on the"National Hospital Disinfection and Infection Control Surveillance"project,the disinfection status of gastroscopes and enteroscopes in 184 medical institutions in 30 provinces in China was investigated,clea-ning and disinfection quality of gastroscopes and enteroscopes was analyzed.Results From 2010 to 2022,a total of 6 421 post-disinfection endoscope specimens were collected from 184 medical institutions,including 4 011 gastro-scope specimens and 2 410 enteroscope specimens.From 2010 to 2022,the qualified rate of disinfection of gastro-scopes and enteroscopes in China increased from 87.6％to 97.9％and 75.9％to 95.4％,respectively.The average qualified rate of disinfection of endoscopes in secondary medical institutions was lower than that in tertiary medical institutions(87.5％vs 92.1％).The disinfection efficacy of different kinds of endoscopic disinfectants was also dif-ferent,among which the qualified rate of peracetic acid was the highest(95.6％-95.7％),followed by o-phthalal-dehyde(93.6％-95.0％).The qualified rate of acidic electrolyzed-oxidizing water was low,only 55.0％-85.0％.Conclusion The disinfection quality of gastroscopes and enteroscopes in China has been continuously improved,and it is still necessary to strengthen the surveillance on daily disinfection quality.

Objective To analyze the clinical efficacy of the Qianyang Fengsui Dan(combined with flying needle therapy)in the treatment of kidney-yang deficiency type of insomnia.Methods A retrospective study was conducted to select 82 patients with insomnia admitted to the Department of Traditional Chinese Medicine of Dezhou Hospital of Traditional Chinese Medicine from November 2020 to November 2021,and they were divided into an observation group and a control group according to whether or not they were treated with Qianyang Fengsui Dan combined with flying needle therapy,with 41 cases in each group.The control group was treated with Estazolam,while the observation group was treated with Qianyang Fengsui Dan combined with flying needle therapy on the basis of the treatment of the control group,and the course of treatment was 1 month.The changes of Pittsburgh Sleep Quality Index(PSQI)scores and Epworth Sleepiness Scale(ESS)scores,as well as polysomnographic parameters were observed before and after treatment in the two groups.The changes of γ-aminobutyric acid(GABA),glutamate(GA),substance P(SP),and neuropeptide Y(NPY)levels were compared before and after treatment between the two groups.And followed up for 1 year to compare the incidence of relapce of the two groups of patients.Results(1)The total effective rate was 95.12%(39/41)in the observation group and 63.41%(26/41)in the control group,and the efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,PSQI scores and ESS scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving PSQI scores and ESS scores,and the differences were statistically significant(P＜0.05).(3)After treatment,sleep efficiency,awakening time,sleep latency,REM,and total sleep time were significantly improved in the two groups(P＜0.05),and the observation group was significantly superior to the control group in improving sleep efficiency,awakening time,sleep latency,REM,and total sleep time,and the differences were statistically significant(P＜0.05).(4)After treatment,the serum GABA,GA,SP,and NPY levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the serum GABA,GA,SP,and NPY levels,and the differences were all statistically significant(P＜0.05).(5)After treatment,follow-up for 1 year,the recurrence rate of the observation group was 0,and there were 7 cases of recurrence in the control group,and the recurrence rate of the control group was 17.07%(7/41),and the recurrence rate of the observation group was lower than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion The combination of flying needle therapy and Qianyang Fengsui Dan can effectively relieve insomnia and fatigue in patients with insomnia,reduce daytime drowsiness,regulate the release of blood monoamine neurotransmitters,and reduce the relapse rate,and its efficacy is superior to that of simple western medicine treatment.

Objective To evaluate the disinfection quality of gastroscopes and enteroscopes in medical institutions across China,and provide scientific guidance for the disinfection of digestive endoscopes.Methods From 2010 to 2022,relying on the"National Hospital Disinfection and Infection Control Surveillance"project,the disinfection status of gastroscopes and enteroscopes in 184 medical institutions in 30 provinces in China was investigated,clea-ning and disinfection quality of gastroscopes and enteroscopes was analyzed.Results From 2010 to 2022,a total of 6 421 post-disinfection endoscope specimens were collected from 184 medical institutions,including 4 011 gastro-scope specimens and 2 410 enteroscope specimens.From 2010 to 2022,the qualified rate of disinfection of gastro-scopes and enteroscopes in China increased from 87.6％to 97.9％and 75.9％to 95.4％,respectively.The average qualified rate of disinfection of endoscopes in secondary medical institutions was lower than that in tertiary medical institutions(87.5％vs 92.1％).The disinfection efficacy of different kinds of endoscopic disinfectants was also dif-ferent,among which the qualified rate of peracetic acid was the highest(95.6％-95.7％),followed by o-phthalal-dehyde(93.6％-95.0％).The qualified rate of acidic electrolyzed-oxidizing water was low,only 55.0％-85.0％.Conclusion The disinfection quality of gastroscopes and enteroscopes in China has been continuously improved,and it is still necessary to strengthen the surveillance on daily disinfection quality.