BACKGROUND:Monounsaturated fatty acids are mostly recognized as a fatty acid with beneficial effects on human health,and some studies have suggested that they may contribute to non-inflammatory pain at multiple sites in the body.OBJECTIVE:To investigate the effect of monounsaturated fatty acids on the incidence of low back pain and all-cause mortality,thereby providing potential biomarkers and intervention strategies for low back pain management and prevention.METHODS:A Mendelian randomization method was used to analyze the potential association of monounsaturated fatty acids on the incidence of low back pain and all-cause mortality in conjunction with large sample data from the National Health and Nutrition Examination Survey(NHANES)database.Results were validated and sensitivity analyzed using multiple statistical models(e.g.,inverse variance weighting,MR-Egger regression,simple median,weighted median,and weighted median)to enhance the reliability of causal inferences.In the NHANES study,multivariate Cox proportional risk regression models were used to assess the independent predictive values of different fatty acid ratios and to control for confounders.Potential nonlinear relationships between monounsaturated fatty acids and all-cause mortality were assessed using Kaplan-Meier curves,log-rank tests,and restricted cubic spline curves.RESULTS AND CONCLUSION:Elevated monounsaturated fatty acids have been found to be associated with a significantly higher risk of low back pain,suggesting an unfavorable effect of this fatty acid.Also,monounsaturated fatty acids may increase all-cause mortality in patients with low back pain.This provides new insights into the potential effects of monounsaturated fatty acids on low back pain and all-cause mortality,and provides a scientific basis for nutritional interventions for low back pain.The results support the use of dietary modification as one of the strategies for the prevention and management of low back pain in the European population,but further studies are needed to explore the specific biological mechanisms and potential for clinical application,thereby improving guidance for the prevention and treatment of diseases in China.

Atrial fibrillation is a prevalent rapid arrhythmia.Patients often develop kinesiophobia and avoidance behaviors due to reduced exercise tolerance and recurrent episodes of atrial fibrillation symptoms,which adversely affect cardiac rehabilitation outcomes.This study reviewed the definition,occurrence mechanisms,assessment tools,influencing factors,and intervention measures of kinesio-phobia in patients with atrial fibrillation,aiming to provide references for implementing nursing prac-tices and promoting exercise rehabilitation in these patients.

Objective To retrospectively assess the clinical efficacy of acupuncture at the Huiyin point combined with Qingdu wash solution in the treatment of high-risk HPV infection.Methods A total of 264 patients who were initially diagnosed with high-risk HPV infection at the University City Gynecology Department of Guang-dong Provincial Hospital of Traditional Chinese Medicine between January 2022 and June 2024 were enrolled in the study.These patients were divided into two groups based on predefined inclusion and exclusion criteria.The ob-servation group included 134 patients who received acupuncture at the Huiyin acupoint combined with Qingdu wash solution,while the control group consisted of 130 patients who did not receive any intervention.The treatment pe-riod lasted for three months,during which the short-term clinical efficacy and safety profile were evaluated.Results The HR-HPV clearance rates in the observation group at 3 months and 6 months were 61.9%and 65.7%,respectively,which were significantly higher than those in the control group(16.9%and 21.5%),and the differences between the two groups were statistically significant(P<0.001).Following a three-month treatment regimen,the rate of HR-HPV positive-to-negative conversion in the observation group was significantly higher than that in the control group,with a statistically significant intergroup difference(P<0.001).The improvement in tra-ditional Chinese medicine(TCM)-related symptoms was also significantly better in the observation group compared to the control group(P<0.05).During the follow-up period,no cases of recurrence were observed in the observa-tion group,whereas the recurrence rate in the control group was 1.5%.Furthermore,no adverse reactions were re-ported in the observation group throughout the treatment period.Conclusion Acupuncture at the Huiyin point,when combined with Qingdu wash solution,can enhance the therapeutic outcomes of high-risk HPV infection and demonstrates a favorable safety profile.

Objective To retrospectively assess the clinical efficacy of acupuncture at the Huiyin point combined with Qingdu wash solution in the treatment of high-risk HPV infection.Methods A total of 264 patients who were initially diagnosed with high-risk HPV infection at the University City Gynecology Department of Guang-dong Provincial Hospital of Traditional Chinese Medicine between January 2022 and June 2024 were enrolled in the study.These patients were divided into two groups based on predefined inclusion and exclusion criteria.The ob-servation group included 134 patients who received acupuncture at the Huiyin acupoint combined with Qingdu wash solution,while the control group consisted of 130 patients who did not receive any intervention.The treatment pe-riod lasted for three months,during which the short-term clinical efficacy and safety profile were evaluated.Results The HR-HPV clearance rates in the observation group at 3 months and 6 months were 61.9%and 65.7%,respectively,which were significantly higher than those in the control group(16.9%and 21.5%),and the differences between the two groups were statistically significant(P<0.001).Following a three-month treatment regimen,the rate of HR-HPV positive-to-negative conversion in the observation group was significantly higher than that in the control group,with a statistically significant intergroup difference(P<0.001).The improvement in tra-ditional Chinese medicine(TCM)-related symptoms was also significantly better in the observation group compared to the control group(P<0.05).During the follow-up period,no cases of recurrence were observed in the observa-tion group,whereas the recurrence rate in the control group was 1.5%.Furthermore,no adverse reactions were re-ported in the observation group throughout the treatment period.Conclusion Acupuncture at the Huiyin point,when combined with Qingdu wash solution,can enhance the therapeutic outcomes of high-risk HPV infection and demonstrates a favorable safety profile.

Objective:To design a vest-type breast dressing bra and explore its application effect in the external application of traditional Chinese medicine therapy for patients with granulomatous lobular mastitis(GLM).Methods:A randomized controlled study was conducted, utilizing convenience sampling to select female patients with 122 GLM who underwent their first topical medication treatment in the Breast Department of Guangdong Provincial Hospital of Traditional Chinese Medicine between January and May 2023. The patients were divided into a control group and an observation group, with 61 patients in each, using a random number table. Following medication application, patients in the control group used a regular sports bra to secure the medication, while patients in the observation group used a custom-designed vest-style breast medication bra for the same purpose. Three hours after the intervention, comparisons were made between the two groups in terms of the incidence of medication detachment, medication displacement, clothing contamination, patient satisfaction, and safety.Results:Both groups of patients completed the study. The age of the observation group was (32.18 ± 5.50) years old, while the age of the control group was (33.66 ± 5.20) years old. Three hours after the intervention, the incidence of medication detachment, medication displacement, clothing contamination in the observation group were 3.28% (2/61), 6.56% (4/61), and 8.20% (5/61), which were lower than those in the control group with 18.03% (11/61), 26.23% (16/61), and 67.21% (41/61), respectively. The differences were statistically significant ( χ2=6.97, 8.61, 45.23; all P<0.05). The satisfaction level of patients towards the bra in the observation group was (4.43 ± 0.85) points, higher than that of the control group (3.85 ± 1.08) points, with a statistically significant difference ( t=3.30, P<0.05). The incidence rates of skin allergic reactions were 3.28%(2/61) and 4.92%(3/61) in the observation group and the control group, respectively, with no statistically significant difference ( P>0.05). Conclusions:The vest-type breast dressing bra designed in this study can properly secure the medicinal paste, reduce the rate of medication detachment, medication displacement, clothing contamination, and enhance patient satisfaction. It facilitates the external application of traditional Chinese medicine for patients with GLM and is worthy of clinical promotion.

OBJECTIVE To deeply explore the in vivo pharmacodynamic substance basis of Zhigancao Decoction,a classic tradi-tional Chinese medicine formula,and provide scientific evidence for its rational application and development in modern clinical practice.METHODS Wistar rats were treated with 12.15 g·kg-1 Zhigancao Decoction by gavage.Rat plasma samples were collect-ed at 10 time points(5,15,30,60,120,240,360,480,600 and 720 min after administration)and rat heart(atrial and ventricu-lar)tissue samples were collected at 12 h after administration.Components in the plasma and heart samples were qualitatively identi-fied by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF/MS),and the distri-bution characteristics of Zhigancao Decoction in vivo were analyzed.At the same time,the time-concentration curve of the prototype components and metabolites in Zhigancao Decoction was drawn to observe the changes of blood drug concentration.RESULTS A total of 11 prototype components(Ajugol,Nicotiflorin,Isoschaftoside,4-Hydroxycinnamic acid,Rehmapicrogenin,4-Hydroxybenzoic acid,4′,7-Dihydroxyflavone,Calycosin,3′,4′,7-Trihydroxyflavone,Pinellic acid,Truxillic acid)and 7 metabolites were identified from the plasma samples of Zhigancao Decoction,mainly including flavonoids(flavonoids glycosides),organic acids,and iridoid glyco-sides,etc.Additionally,6 prototype components(Ajugol,Isoschaftoside,Rehmapicrogenin,4′,7-Dihydroxyflavone,Liquiritigenin,3′,4′,7-Trihydroxyflavone)and 3 metabolites were identified from the cardiac samples(the atrium and the ventricle showed the same results).The metabolic pathways mainly involved Phase Ⅰ metabolism and glucuronidation.CONCLUSION The prototype compo-nents and metabolites in plasma and heart tissue of Zhigancao Decoction is preliminarily determined,providing a reference for analyzing the active components of Zhigancao Decoction in heart tissue.

Objective:To design a vest-type breast dressing bra and explore its application effect in the external application of traditional Chinese medicine therapy for patients with granulomatous lobular mastitis(GLM).Methods:A randomized controlled study was conducted, utilizing convenience sampling to select female patients with 122 GLM who underwent their first topical medication treatment in the Breast Department of Guangdong Provincial Hospital of Traditional Chinese Medicine between January and May 2023. The patients were divided into a control group and an observation group, with 61 patients in each, using a random number table. Following medication application, patients in the control group used a regular sports bra to secure the medication, while patients in the observation group used a custom-designed vest-style breast medication bra for the same purpose. Three hours after the intervention, comparisons were made between the two groups in terms of the incidence of medication detachment, medication displacement, clothing contamination, patient satisfaction, and safety.Results:Both groups of patients completed the study. The age of the observation group was (32.18 ± 5.50) years old, while the age of the control group was (33.66 ± 5.20) years old. Three hours after the intervention, the incidence of medication detachment, medication displacement, clothing contamination in the observation group were 3.28% (2/61), 6.56% (4/61), and 8.20% (5/61), which were lower than those in the control group with 18.03% (11/61), 26.23% (16/61), and 67.21% (41/61), respectively. The differences were statistically significant ( χ2=6.97, 8.61, 45.23; all P<0.05). The satisfaction level of patients towards the bra in the observation group was (4.43 ± 0.85) points, higher than that of the control group (3.85 ± 1.08) points, with a statistically significant difference ( t=3.30, P<0.05). The incidence rates of skin allergic reactions were 3.28%(2/61) and 4.92%(3/61) in the observation group and the control group, respectively, with no statistically significant difference ( P>0.05). Conclusions:The vest-type breast dressing bra designed in this study can properly secure the medicinal paste, reduce the rate of medication detachment, medication displacement, clothing contamination, and enhance patient satisfaction. It facilitates the external application of traditional Chinese medicine for patients with GLM and is worthy of clinical promotion.

OBJECTIVE To deeply explore the in vivo pharmacodynamic substance basis of Zhigancao Decoction,a classic tradi-tional Chinese medicine formula,and provide scientific evidence for its rational application and development in modern clinical practice.METHODS Wistar rats were treated with 12.15 g·kg-1 Zhigancao Decoction by gavage.Rat plasma samples were collect-ed at 10 time points(5,15,30,60,120,240,360,480,600 and 720 min after administration)and rat heart(atrial and ventricu-lar)tissue samples were collected at 12 h after administration.Components in the plasma and heart samples were qualitatively identi-fied by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF/MS),and the distri-bution characteristics of Zhigancao Decoction in vivo were analyzed.At the same time,the time-concentration curve of the prototype components and metabolites in Zhigancao Decoction was drawn to observe the changes of blood drug concentration.RESULTS A total of 11 prototype components(Ajugol,Nicotiflorin,Isoschaftoside,4-Hydroxycinnamic acid,Rehmapicrogenin,4-Hydroxybenzoic acid,4′,7-Dihydroxyflavone,Calycosin,3′,4′,7-Trihydroxyflavone,Pinellic acid,Truxillic acid)and 7 metabolites were identified from the plasma samples of Zhigancao Decoction,mainly including flavonoids(flavonoids glycosides),organic acids,and iridoid glyco-sides,etc.Additionally,6 prototype components(Ajugol,Isoschaftoside,Rehmapicrogenin,4′,7-Dihydroxyflavone,Liquiritigenin,3′,4′,7-Trihydroxyflavone)and 3 metabolites were identified from the cardiac samples(the atrium and the ventricle showed the same results).The metabolic pathways mainly involved Phase Ⅰ metabolism and glucuronidation.CONCLUSION The prototype compo-nents and metabolites in plasma and heart tissue of Zhigancao Decoction is preliminarily determined,providing a reference for analyzing the active components of Zhigancao Decoction in heart tissue.

BACKGROUND:Monounsaturated fatty acids are mostly recognized as a fatty acid with beneficial effects on human health,and some studies have suggested that they may contribute to non-inflammatory pain at multiple sites in the body.OBJECTIVE:To investigate the effect of monounsaturated fatty acids on the incidence of low back pain and all-cause mortality,thereby providing potential biomarkers and intervention strategies for low back pain management and prevention.METHODS:A Mendelian randomization method was used to analyze the potential association of monounsaturated fatty acids on the incidence of low back pain and all-cause mortality in conjunction with large sample data from the National Health and Nutrition Examination Survey(NHANES)database.Results were validated and sensitivity analyzed using multiple statistical models(e.g.,inverse variance weighting,MR-Egger regression,simple median,weighted median,and weighted median)to enhance the reliability of causal inferences.In the NHANES study,multivariate Cox proportional risk regression models were used to assess the independent predictive values of different fatty acid ratios and to control for confounders.Potential nonlinear relationships between monounsaturated fatty acids and all-cause mortality were assessed using Kaplan-Meier curves,log-rank tests,and restricted cubic spline curves.RESULTS AND CONCLUSION:Elevated monounsaturated fatty acids have been found to be associated with a significantly higher risk of low back pain,suggesting an unfavorable effect of this fatty acid.Also,monounsaturated fatty acids may increase all-cause mortality in patients with low back pain.This provides new insights into the potential effects of monounsaturated fatty acids on low back pain and all-cause mortality,and provides a scientific basis for nutritional interventions for low back pain.The results support the use of dietary modification as one of the strategies for the prevention and management of low back pain in the European population,but further studies are needed to explore the specific biological mechanisms and potential for clinical application,thereby improving guidance for the prevention and treatment of diseases in China.

Objective:To summarize the clinical characteristics, prognostic factors and treatment outcomes of childhood aggressive mature B-cell lymphoma after liver transplantation.Methods:This retrospective study included 18 children with newly diagnosed aggressive mature B-cell lymphoma after liver transplantation and treated from June 2018 to June 2022 in the Department of Hematology and Oncology of Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine. Clinical characteristics, treatment and outcomes of patients at last evaluation were analyzed. Overall survival (OS) and event free survival (EFS) rates were calculated by Kaplan-Meier method and Log-Rank analysis was performed to find factors of poor prognosis.Results:Among all 18 patients, there were 6 males and 12 females, and the age of onset was 40 (35, 54) months. The interval from transplant to tumor diagnosis was 21 (17, 35) months and 5 patients had early onset disease (<1 year since transplant). Seventeen patients had abdominal lesions. Diarrhea, vomiting and abdominal masses were the main clinical manifestations. All patients were Epstein-Barr virus (EBV) related posttransplant lymphoproliferative disorders (PTLD). One patient received individualized therapy due to critical sick at diagnosis, and the remaining 17 patients received CP (cyclophosphamide, methylprednisolone plus rituximab) and (or) modified EPOCH (prednisone, etoposide, doxorubicin, vincristine, cyclophosphamide plus rituximab) regimens. Of all 18 patients, 15 cases got complete response, 2 cases got partial response, 1 patient died of severe infection. The 2-year OS and EFS rates of 18 patients were (94±5)% and (83±8)%, respectively. None of age, gender or early onset disease had effect on OS and EFS rates in univariate analysis (all P>0.05). Conclusions:The symptoms of PTLD were atypical. Close surveillance of EBV-DNA for patients after liver transplantation was crucial to early stage PTLD diagnosis. CP or modified EPOCH regimen was efficient for pediatric patients with aggressive mature B cell lymphoma after liver transplantation.