OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Objective To explore the association between aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio and metabolic syndrome(MS)in elderly hypertensive patients,and to provide reference for early detection and prevention of MS in elderly hypertensive patients.Methods A questionnaire survey and physical examination were conducted among 616 elderly hypertensive patients at community health service centers.Participants were divided into two groups based on MS status:MS group(n=334)and non-MS group(n=282).According to AST/ALT levels,participants were divided into four groups:q1 group(AST/ALT ≤0.88,n=156),q2 group(0.88＜AST/ALT ≤ 1.10,n=155),q3 group(1.10＜AST/ALT ≤ 1.37,n=154),and q4 group(AST/ALT＞1.37,n=151).Blood biochemical parameters including triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),AST,ALT,and blood glucose were measured.The impact of AST/ALT levels on MS was analyzed using a Logistic regression model,while the risk prediction for MS occurrence was evaluated through receiver operating characteristic(ROC)curves.Results MS group showed higher body mass index(BMI),TG,ALT levels,abnormal glucose levels,female proportion,and abdominal obesity rate compared to non-MS group.HDL-C and AST/ALT values of MS group were lower than those in non-MS patients(P＜0.05).Logistic regression analysis revealed that after adjusting for BMI,smoking,alcohol consumption,physical activity,education level,marital status,TG,HDL-C,and glucose levels,both q3 and q4 groups demonstrated reduced MS risk compared to group q1 group(P＜0.05).ROC curve analysis indicated that the area under the curve for AST/ALT in MS was 0.638(P＜0.05).Conclusion The level of AST/ALT was negatively correlated with MS in elderly hypertensive patients,and AST/ALT has certain predictive value for the risk of MS in elderly hypertensive patients.

Objective To observe the clinical efficacy of the combination of umbilical moxibustion and estradiol valerat in patients with thin endometrium.Methods A random number table was used to randomly divide 60 patients with thin endometrium of kidney deficiency and blood stasis type who met the inclusion criteria into an observation group of 30 cases and a control group of 30 cases.The control group took oral estradiol valerate tablets(DELPHARMLille S.A.S.,specification:1 mg/tablet),2 mg/day(bid),continuously for 21 days starting from the 5th day of the menstrual cycle;On the basis of the control group,the observation group was treated with herbal moxibustion on the navel,starting from the 7th day of the menstrual cycle,once a week,with an interval of 5-7 days.No treatment was given during the menstrual cycle,and both groups were treated continuously for three menstrual cycles.Observe the changes in endometrial thickness,Gonen classification of endometrium,uterine artery pulsatility index,resistance index,and traditional Chinese medicine clinical symptom score before and after treatment in two groups of patients.Results After treatment,the endometrial thickness of the two groups of patients increased(P<0.01),while the uterine artery pulsatility index and resistance index decreased compared to before(P<0.01).The total score of traditional Chinese medicine clinical symptoms decreased compared to before treatment(P<0.01).The above indicators were better in the observation group than in the control group(P<0.05).But the endometrial classification between the two groups of patients was no significant difference(P>0.05).Conclusion The combination of umbilical moxibustion and estradiol valerate can effectively promote uterine artery blood flow perfusion in patients with kidney deficiency and blood stasis type thin endometrium,reduce uterine artery pulsatility index and resistance index,increase the thickness of endometrium,and improve the clinical symptom score of traditional Chinese medicine.

Objective To analyze the epidemiology and trends of measles,tuberculosis,pertussis,scarlet fever,influenza,mumps and rubella in Beijing between 2014 and 2023 in order to provide data for prevention and control of related diseases.Methods Data on the incidences of seven respiratory infectious diseases in Beijing between 2014 and 2023 was collected.Descriptive epidemiological methods were employed to analyze their demographic,temporal and spatial distribution.Joinpoint regression analysis was used to assess temporal trends in incidence.Results A total of 1 406 777 cases of seven respiratory infectious diseases were reported in Beijing between 2014 and 2023,which corresponded to an average crude rate of 649.76/100 000 reported annually.The crude rate of incidencewas higher among females than among males,with the most vulnerable age groups being 0-4 years and 5-19 years,and was higher in the six districts than on the outskirts.Most of the respiratory infectious diseases peaked in winter and spring.The annual increase in the incidence of respiratory infectious diseases in Beijing in this period averaged 27.27％,with no statistically significant differences in trends.The incidence rates of measles,tuberculosis,scarlet fever,mumps and rubella decreased significantly while those of pertussis and influenza increased,but with no statistically significant difference.Conclusion The overall incidence of major respiratory infectious diseases in Beijing is increasing.It is recommended that more people get vaccinated,surveillance of such diseases as pertussis and influenza be enhanced,and regional health resources be allocated more effectively,all of which will be critical to subsequent prevention and control of respiratory infectious diseases in Beijing.

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

Objective To observe the clinical efficacy of the combination of umbilical moxibustion and estradiol valerat in patients with thin endometrium.Methods A random number table was used to randomly divide 60 patients with thin endometrium of kidney deficiency and blood stasis type who met the inclusion criteria into an observation group of 30 cases and a control group of 30 cases.The control group took oral estradiol valerate tablets(DELPHARMLille S.A.S.,specification:1 mg/tablet),2 mg/day(bid),continuously for 21 days starting from the 5th day of the menstrual cycle;On the basis of the control group,the observation group was treated with herbal moxibustion on the navel,starting from the 7th day of the menstrual cycle,once a week,with an interval of 5-7 days.No treatment was given during the menstrual cycle,and both groups were treated continuously for three menstrual cycles.Observe the changes in endometrial thickness,Gonen classification of endometrium,uterine artery pulsatility index,resistance index,and traditional Chinese medicine clinical symptom score before and after treatment in two groups of patients.Results After treatment,the endometrial thickness of the two groups of patients increased(P<0.01),while the uterine artery pulsatility index and resistance index decreased compared to before(P<0.01).The total score of traditional Chinese medicine clinical symptoms decreased compared to before treatment(P<0.01).The above indicators were better in the observation group than in the control group(P<0.05).But the endometrial classification between the two groups of patients was no significant difference(P>0.05).Conclusion The combination of umbilical moxibustion and estradiol valerate can effectively promote uterine artery blood flow perfusion in patients with kidney deficiency and blood stasis type thin endometrium,reduce uterine artery pulsatility index and resistance index,increase the thickness of endometrium,and improve the clinical symptom score of traditional Chinese medicine.

Objective To explore the association between aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio and metabolic syndrome(MS)in elderly hypertensive patients,and to provide reference for early detection and prevention of MS in elderly hypertensive patients.Methods A questionnaire survey and physical examination were conducted among 616 elderly hypertensive patients at community health service centers.Participants were divided into two groups based on MS status:MS group(n=334)and non-MS group(n=282).According to AST/ALT levels,participants were divided into four groups:q1 group(AST/ALT ≤0.88,n=156),q2 group(0.88＜AST/ALT ≤ 1.10,n=155),q3 group(1.10＜AST/ALT ≤ 1.37,n=154),and q4 group(AST/ALT＞1.37,n=151).Blood biochemical parameters including triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),AST,ALT,and blood glucose were measured.The impact of AST/ALT levels on MS was analyzed using a Logistic regression model,while the risk prediction for MS occurrence was evaluated through receiver operating characteristic(ROC)curves.Results MS group showed higher body mass index(BMI),TG,ALT levels,abnormal glucose levels,female proportion,and abdominal obesity rate compared to non-MS group.HDL-C and AST/ALT values of MS group were lower than those in non-MS patients(P＜0.05).Logistic regression analysis revealed that after adjusting for BMI,smoking,alcohol consumption,physical activity,education level,marital status,TG,HDL-C,and glucose levels,both q3 and q4 groups demonstrated reduced MS risk compared to group q1 group(P＜0.05).ROC curve analysis indicated that the area under the curve for AST/ALT in MS was 0.638(P＜0.05).Conclusion The level of AST/ALT was negatively correlated with MS in elderly hypertensive patients,and AST/ALT has certain predictive value for the risk of MS in elderly hypertensive patients.

Objective:To investigate the expression differences of miR-200c, miR-19a and miR-155 in gefitinib sensitive and resistant non-small cell lung cancer (NSCLC) patients, and to analyze the effects of miR-200c, miR-19a and miR-155 expression differences on the prognosis of patients.Methods:From August 1, 2015 to August 1, 2019, 80 patients with stage Ⅲ-Ⅳ NSCLC who were treated with gefitinib in the Fourth Affiliated Hospital of Nanjing Medical University were selected as the research objects. Among them, 36 cases were sensitive to gefitinib as the sensitive group, and 44 cases were resistant to gefitinib as the drug-resistant group. The general data, serum levels of miR-200c, miR-19a and miR-155 were compared between the two groups, and the sensitive factors of gefitinib in NSCLC patients and the correlations between serum miR-200c, miR-19a, miR-155 and clinicopathological characteristics of NSCLC patients were explored. The survival of the patients was analyzed.Results:Compared with the drug-resistant group, the number of smoking cases in the sensitive group was less ( χ2=5.541, P=0.019), the number of clinical stage Ⅲ cases was more ( χ2=8.984, P=0.003), the number of well-differentiated cases was more ( χ2=8.673, P=0.003), the number of patients with lymph node metastasis was less ( χ2=6.082, P=0.014), and the levels of serum miR-200c, miR-19a and miR-155 were higher ( t=7.249, P<0.001; t=8.222, P<0.001; t=10.467, P<0.001). Multivariate logistic regression analysis showed that smoking ( OR=0.355, 95% CI: 0.149-0.845, P<0.001), clinical stage ( OR=0.494, 95% CI: 0.274-0.892, P=0.021), degree of differentiation ( OR=6.062, 95% CI: 3.258-11.279, P=0.013), lymph node metastasis ( OR=0.422, 95% CI: 0.245-0.726, P=0.019), the levels of serum miR-200c ( OR=5.521, 95% CI: 3.126-9.752, P<0.001), miR-19a ( OR=5.384, 95% CI: 2.947-9.836, P<0.001) and miR-155 ( OR=5.325, 95% CI: 3.058-9.274, P<0.001) were all influencing factors of gefitinib sensitivity in NSCLC patients. The levels of serum miR-200c, miR-19a and miR-155 were significantly correlated with clinical stage ( t=3.230, P=0.002, r=-0.578; t=3.188, P=0.002, r=-0.612; t=3.123, P=0.003, r=-0.594), degree of differentiation ( t=2.586, P=0.012, r=0.610; t=4.009, P<0.001, r=0.632; t=4.773, P<0.001, r=0.594) and lymph node metastasis ( t=2.902, P=0.005, r=-0.587; t=3.721, P<0.001, r=-0.629; t=3.391, P=0.001, r=-0.614) of NSCLC patients. Compared with the patients with low levels of serum miR-200c, miR-19a and miR-155, the 1-year survival rates of the patients with high levels of serum miR-200c (63.19% vs. 4.37%, χ2=32.562, P<0.001), miR-19a (61.01% vs. 4.75%, χ2=37.807, P<0.001) and miR-155 (57.82% vs. 0, χ2=44.454, P<0.001) were higher, with statistically significant differences. Conclusion:The levels of serum miR-200c, miR-19a and miR-155 are significantly increased in gefitinib-sensitive NSCLC patients, which are important influencing factors of gefitinib sensitivity, and are closely related to clinicopathological characteristics such as clinical stage, differentiation degree and lymph node metastasis of NSCLC patients, and the prognosis is better in patients with high serum levels.

Objective To investigate gender differences of plasma glial cell line-derived neurotro-phic factor (GDNF) levels in patients with major depressive disorder (MDD). Methods MDD subjects (male 20,female 36) and healthy controls (HCs) (male 35,female 45) were divided into four groups by gender. Plasma levels of GDNF were measured and compared in different gender groups. The clinical symp-tom severity of MDD patients was evaluated by 17-item Hamilton Depression Scale (HAMD-17) and Hamil-ton Anxiety Scale (HAMA-17). Results (1)The plasma GDNF level in male patients with major depres-sive disorder (( 1. 55 ± 0. 43 ) pg/ml ) was significantly lower than that in healthy controls (( 1. 86 ± 0. 50)pg/ml,F=4. 64,P=0. 036). There was no significant difference in GDNF level between female de-pression patients((1.62±0.46)pg/ml)) and female healthy control((1. 64±0. 48)pg/ml,F=0. 18,P=0. 672). In HCs,the GDNF level of male was significantly higher than that of female((1. 86±0. 50)pg/ml, (1. 64±0. 48)pg/ml,F=2. 04,P=0. 045). There was no significant difference in GDNF level between male and female patients(P>0. 05). (2) GDNF level in male patients with major depressive disorder was nega-tively correlated with HAMA score(r=-0. 388,P=0. 034). Conclusion The expression of GDNF is affect-ed by sex factors,which may be related to the different pathogenesis of MDD.