ObjectiveTo observe the clinical effectiveness and safety of Qingfei Shenshi Decoction （清肺渗湿汤） combined with western medicine for patients with bronchial asthma of heat wheezing syndrome， and to explore its potential mechanism of action. MethodsEighty-six participants with bronchial asthma of heat wheezing syndrome were randomly divided into treatment group and control group， each group with 43 participants. The control group received conventional western medicine， and the treatment group was additionally administered Qingfei Shenshi Decoction orally on the basis of the control group， 1 dose per day. Both groups were treated for 14 days. The primary outcome measure was clinical effectiveness； secondary outcome measures included traditional Chinese medicine （TCM） syndrome score， asthma control test （ACT） score， pulmonary function indices such as forced expiratory volume in 1 second （FEV₁）， forced vital capacity （FVC）， peak expiratory flow （PEF）， serum inflammatory factor levels including interleukin-4 （IL-4）， tumour necrosis factor-α （TNF-α）， and high-sensitivity C-reactive protein （hs-CRP）， and immune function indices including CD3⁺， CD4⁺， CD8⁺， CD4⁺/CD8⁺. All outcome measures were evaluated before and after treatment. Vital signs were monitored， and electrocardiography， blood routine， urine routine， liver function， and renal function tests were performed before and after treatment. Adverse events and reactions during the study were recorded. ResultsA total of 80 patients completed the trial with 40 in each group. The total clinical effective rate of the treatment group was 97.5% （39/40）， which was significantly higher than that of the control group （85.0%， 34/40， P＜0.05）. After treatment， both groups showed decreased TCM syndrome scores， IL-4， TNF-α， hs-CRP， and CD8⁺ levels， as well as increased ACT scores， CD3⁺， CD4⁺， CD4⁺/CD8⁺， FEV₁， FVC， and PEF levels （P＜0.05 or P＜0.01）. Moreover， the improvements in these indices were more significant in the treatment group than in the control group （P＜0.05 or P＜0.01）. No significant abnormalities in safety indicators were observed in either group， and no adverse events or reactions occurred. ConclusionQingfei Shenshi Decoction combined with conventional western medicine for patients with bronchial asthma of heat wheezing syndrome can effectively improve the clinical symptoms， pulmonary function， and clinical effectiveness， with good safety. Its mechanism may be related to reducing inflammatory factor levels and regulating T lymphocyte subsets to improve immune function.

Background Against the background of global warming, frequent heatwaves pose a major threat to public health. Objective To investigate the effects of heatwaves on outpatient visits for skin diseases in Urumqi, characterize the exposure–response relationship, identify the critical temperature threshold, and provide scientific evidence for targeted prevention and control of heat-related skin diseases. Methods Data on meteorological conditions, air quality, and dermatological outpatient visits from 10 hospitals in Urumqi were collected from January 1, 2016 to December 31, 2024. A time-stratified case-crossover design combined with a distributed lag model was adopted to construct a conditional logistic regression model, with adjustment for potential confounders, including relative humidity, air pollutants, and COVID-19 lockdown measures. With a maximum lag of 14 d, single-lag and cumulative-lag effects of heatwaves were examined, and the exposure–response relationship between temperature and the risk of dermatological outpatient visit was fitted. Results A total of 385 heatwave days were identified in Urumqi from January 1, 2016 to December 31, 2024. These days were concentrated between June and September and showed an increasing annual trend. The median daily number of dermatological outpatient visits during heatwave periods (165 cases) was significantly higher than that during control periods (114 cases) (Z=−5.108, P<0.001). After adjusting for confounders, the odds of dermatological outpatient visits during heatwaves were 1.088 times higher than those of the control period (OR=1.088, 95%CI: 1.069, 1.107). Single-lag effects were statistically significant from lag0 to lag11 (P<0.05), peaking at lag0 (OR=1.088, 95%CI: 1.069, 1.107), showing an acute and immediate effect. Cumulative-lag effects were statistically significant from 1 to 14 d (P<0.05), peaking at lag04 (OR=1.117, 95%CI: 1.099, 1.136). The exposure–response relationship indicated that the OR values increased steeply with increasing temperature when the daily mean temperature exceeded 24.2 ℃, peaking at approximately 28.1 ℃ (OR=1.400, 95%CI: 1.189, 1.649). Conclusions Heatwave exposure is significantly associated with an increased risk of dermatological outpatient visits among residents in Urumqi. The impact of high temperature on skin diseases is predominantly acute, with peak risks observed on the day of exposure and within the subsequent 4 d. A daily mean temperature of 24.2 ℃ can serve as the critical threshold for heightened dermatological consultation risk. Strengthened health education and early warning systems are recommended to mitigate heatwave-related adverse dermatological outcomes.

ObjectiveTo investigate the current status of HIV-related health service uptake among cross-border couples (Chinese husbands and Myanmar wives) in Dehong Dai and Jingpo Autonomous Prefecture (hereinafter referred to as Dehong Prefecture), and to provide evidence for optimizing HIV prevention and control strategies in border areas. MethodsA cross-sectional survey was conducted from September 2022 to September 2023 among 14 662 cross-border couples (Chinese husbands and Myanmar wives) in Dehong Prefecture. Data on sociodemographic characteristics, HIV/AIDS knowledge awareness, and utilization of HIV-related health services within the past year were collected. Multivariable logistic regression was used to analyze factors associated with HIV testing uptake among husbands and wives. ResultsA total of 29 324 individuals (14 662 couples) were included. The overall awareness rate of HIV/AIDS was 82.09%, with the rate among husbands significantly higher than that among wives (85.17% vs. 79.01%, P<0.001). Overall, 94.98% of participants had received at least one HIV-related health service, and the HIV testing rate in the past year was 65.52%. Multivariable logistic regression analysis showed that, compared with participants married for 0‒3 years, those married for 4‒10 years and ≥11 years were more likely to have received HIV testing. The corresponding ORs were 1.344 (95%CI: 1.187‒1.521) and 1.381 (95%CI: 1.211‒1.574) among husbands, and 1.308 (95%CI: 1.155‒1.481) and 1.344 (95%CI: 1.178‒1.533) among wives, respectively. Compared with those holding a marriage certificate, those possessing a border marriage registration certificate were positively associated with HIV testing uptake, with ORs of 1.710 (95%CI: 1.575‒1.857) among husbands and 1.700 (95%CI: 1.565‒1.847) among wives. Compared with illiterate participants, those with primary school education showed lower testing rates, with ORs of 0.738 (95%CI: 0.650‒0.837) among husbands and 0.827 (95%CI: 0.766‒0.891) among wives. Additionally, a history of sexually transmitted diseases (OR=3.656, 95%CI: 1.243‒15.589) and participation in the New Rural Cooperative Medical Scheme (OR=1.51, 95%CI: 1.179‒1.935) were independently associated with higher testing rates among husbands. ConclusionThe overall utilization of HIV-related health services among cross-border couples in Dehong Prefecture is satisfactory, but significant gender disparities exist, with foreign wives showing lower rates of knowledge awareness and lower proportions obtaining such knowledge through certain channels compared with their Chinese husbands. Couples with shorter marriage duration, those with primary school education, and those not included in the border marriage registration system are vulnerable groups with lower HIV testing uptake. Future interventions should prioritize cross-border marriage families at the early stage of entry and in the newly married period. Based on the border marriage registration management system and primary healthcare networks, health education and HIV testing services targeting foreign spouses should be strengthened to improve service accessibility and equity.

BACKGROUND: The American Heart Association (AHA) introduced the concept of cardiovascular-kidney-metabolic (CKM) health and stage, reflecting the interaction among metabolism, chronic kidney disease (CKD), and the cardiovascular system. However, the association between CKM stage and the long-term risk of cardiovascular disease (CVD) has not been validated. This study aimed to evaluate the long-term CVD risk associated with CKM health metrics and CKM stage using data from a population-based cohort study. METHODS: In total, 5293 CVD-free participants were followed up to around 13 years in the Chinese Multi-provincial Cohort Study (CMCS). Considering the pathophysiologic progression of CKM health metrics abnormalities (comprising obesity, central adiposity, prediabetes, diabetes, hypertriglyceridemia, CKD, and metabolic syndrome), participants were divided into CKM stages 0, 1, and 2. The time-dependent Cox regression models were used to estimate the cardiovascular risk associated with CKM health metrics and stage. Additionally, broader CVD outcomes were examined, with a specific assessment of the impact of stage 3 in 2581 participants from the CMCS-Beijing subcohort. RESULTS: Among participants, 91.2% (4825/5293) had at least one abnormal CKM health metric, 8.8% (468/5293), 13.3% (704/5293), and 77.9% (4121/5293) were in CKM stages 0, 1, and 2, respectively; and 710 incident CVD cases occurred during a median follow-up time of 13.3 years (interquartile range: 12.1 to 13.6 years). Participants with each poor CKM health metric exhibited significantly higher CVD risk. Compared with stage 0, the hazard ratio (HR) (95% confidence interval [CI]) for CVD incidence was 1.31 (0.84-2.04) in stage 1 and 2.27 (1.57-3.28) in stage 2. Significant interactive impacts existed between CKM stage and age or sex, with higher CVD risk related to increased CKM stages in participants aged <60 years or females. CONCLUSION These findings highlight the contribution of CKM health metrics and CKM stage to the long-term risk of CVD, suggesting the importance of multi-component recognition and management of poor CKM health in CVD prevention.
Humans ; Female ; Male ; Cardiovascular Diseases/etiology* ; Middle Aged ; Adult ; Cohort Studies ; Renal Insufficiency, Chronic/metabolism* ; Aged ; Risk Factors ; Metabolic Syndrome/metabolism* ; China ; East Asian People

Mesenchymal stem cells (MSCs) are an effective therapeutic strategy to delay aging in dogs, they are prone to aging and have poor genetic stability when cultured for a long time in vitro. Therefore, it is of great significance to explore a method to improve the anti-aging ability of MSCs. Previous studies have shown that sirtuin 6 (SIRT6) plays an important role in anti-aging. This study constructed MSCs with overexpressed SIRT6 gene. Through Giemsa staining and senescence-associated β-galactosidase staining, it was found that SIRT6 significantly enhances the anti-aging capacity of MSCs. Transmission electron microscopy imaging and the detection of oxidative stress-related indicators revealed that SIRT6 improves the anti-aging capacity of MSCs by maintaining mitochondrial homeostasis and reducing oxidative stress levels. Transcriptome sequencing analysis revealed that SIRT6 mainly acted on phosphatidylinositol-3-kinase, mitogen-activated protein kinase and other aging and inflammation related pathways. In the establishment and verification of aging models in mice and dogs, it was found that the spatial memory ability of the model mice was significantly increased after intravenous transplantation of SIRT6 overexpression cells, the organ index was also significantly changed, and the anti-oxidative capacity of the dogs and mice blood was improved. The morphology of the spleens and livers in the SIRT6 overexpression cell treatment group could be effectively restored, and the expression levels of aging and inflammation-related proteins were significantly decreased. This study provides a new idea for the study of SIRT6-mediated anti-aging of MSCs.
Animals ; Dogs ; Mesenchymal Stem Cells/metabolism* ; Sirtuins/genetics* ; Aging/physiology* ; Mice ; Oxidative Stress ; Mesenchymal Stem Cell Transplantation

This paper summarized Professor ZHOU Zhaoshan's clinical experience in treating bronchial asthma （abbreviated as asthma） by stages with dampness-draining method. It is believed that pathogenic dampness is the key pathological factor in the onset of asthma. Dampness accumulates into water， which gathers into rheum； the condensed rheum forms phlegm， which lingers in the lungs. When external pathogens trigger the latent phlegm， phlegm and qi become mutually obstructed， leading to airway obstruction， disrupted qi movement， and upward reversal of lung qi， thereby resulting in asthma attacks. The treatment emphasizes a stage-based approach. During acute attacks， the main syndromes include cold-damp obstructing the lungs， damp-heat accumulating in the lungs， and shaoyang （少阳） constraint with heat. For the syndrome of cold-damp obstructing the lungs， a self-formulated Wenfei Shenshi Decoction （温肺渗湿汤） is used to warm the lungs and disperse cold， drain dampness and relieve panting； for the syndrome of damp-heat accumulating in the lungs， a self-formulated Qingfei Shenshi Decoction （清肺渗湿汤） is employed to clear the lungs and expel heat， drain dampness and relieve asthma； and for the syndrome of shaoyang constraint with heat， a self-formulated Chaihu Shenshi Decoction （柴胡渗湿汤） is administered to harmonize the shaoyang， clear heat and drain dampness. During the remission stage， treatment is based on the underlying kidney-deficiency constitution， and a self-formulated Bushen Shenshi Decoction （补肾渗湿汤） is formulated to tonify the kidneys and drain dampness， improve qi reception and relieve panting.

OBJECTIVE To investigate the correlation of serum P-Tau protein and β-amyloid protein expression levels with obstructive sleep apnea syndrome(OSAS)and mild cognitive impairment(MCI)patients,and their diagnostic value.METHODS From December 2020 to December 2023,120 patients with OSAS admitted to Third Hospital of Shijiazhuang were collected as the case group.According to the diagnostic criteria for MCI,patients were grouped into OSAS without MCI group(40 cases)and OSAS with MCI group(80 cases).ELISA method was applied to detect the levels of serum P-Tau protein and β-amyloid protein.Spearman method was applied to analyze the correlation between serum P-Tau protein,β-amyloid protein,and MCI.Multivariate logistic regression was applied to analyze the influencing factors of OSAS patients with MCI.ROC curve was applied to evaluate the diagnostic efficacy of serum P-Tau protein and β-amyloid protein in OSAS patients with MCI.RESULTS The Montreal Cognitive Assessment(MoCA)score in the OSAS with MCI group was obviously lower than that in the OSAS without MCI group(P<0.05).The expression levels of P-Tau protein and β-amyloid protein in the OSAS with MCI group were obviously higher than those in the OSAS without MCI group(P<0.05).The expression levels of serum P-Tau protein and β-amyloid protein in OSAS patients were negatively correlated with MoCA score(r=-0.346,-0.565,P<0.001).Serum P-Tau protein and β-amyloid protein were risk factors for OSAS with MCI(P<0.05).The AUC of the expression levels of serum P-Tau protein,β-amyloid protein,and their combination for OSAS with MCI was 0.751,0.848,and 0.928,respectively.The combined evaluation of the two showed better results(Zcombination-P-Tau protein=4.102,P<0.001;Zcombination-β amyloid protein=2.147,P=0.032).CONCLUSION The expression of serum P-Tau protein and β-amyloid protein is upregulated in OSAS patients with MCI,they are risk factors for the development of MCI in OSAS patients.The combined detection of the two has higher diagnostic efficacy.

Objective To explore the value of serum matrix metalloproteinase 7 combined with glutamyl transferase and total bile acids in the diagnosis of biliary atresia.Methods 112 children hospitalized in Kunming Children's Hospital with the cholestatic jaundice from July 2023 to September 2024 were selected as the research subjects.According to the surgical exploration,intraoperative cholangiography,liver biopsy and follow-up,the children were divided into the biliary atresia group(BA)(n=52)and non-biliary atresia group(Non-BA)(n=60)respecvely.The age,gender,serum matrix metalloproteinase 7(MMP-7),glutamyl transferase(GGT),alanine aminative aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TB),direct bilirubin(DB),total bile acid(TBA)and aspartate aminotransferase/platelet index(APRI)were compared between the two groups.Statistically significant indicators were included in receiver operating characteristic curve(ROC)analysis,and the area under the ROC curve(AUC)and optimal diagnostic margin(Youden index)were calculated.Results There was no significant difference in age,ALT,AST,DB,TB and APRI levels between the two groups of patients(P>0.05);There was a difference in gender composition ratio between the two groups(P=0.006);MMP-7,GGT,TBA levels in the BA group were significantly higher than those in the Non-BA group,and the difference was statistically significant(P<0.05);the AUC of MMP-7,GGT,and TBA in diagnosing BA were 0.946(95%CI 0.897～0.996),0.857(95%CI 0.789～0.926),0.654(95%CI 0.552～0.755)respectively;When the cut-off value of MMP-7 was 22.37 ng/ml,the sensitivity and specificity for diagnosing BA were 0.923 and 0.933 respectively;When the cut-off value of GGT was 151.5 U/L,the sensitivity and specificity of diagnosing BA were 0.885 and 0.733 respectively;When the cut-off value of TBA was 119.5 μmol/L,the sensitivity and specificity of diagnosing BA were 0.788 and 0.500,respectively.The AUC of MMP-7+GGT and MMP-7+TBA combined to diagnose BA were 0.971(95%CI 0.946～0.997)and 0.943(95%CI 0.889～0.996)respectively.Conclusion Serum MMP-7 has the good diagnostic value as a single indicator for diagnosing BA;MMP-7 combined with GGT is better than a single indicator for diagnosing BA;MMP-7 combined with TBA cannot improve the diagnostic efficiency.

Objective To understand the current status of illness benefit perception among caregivers of type 2 diabetes patients,analyze its relationship with coping strategies and social support,and explore its influencing factors.Methods Using a convenience sampling method,240 caregivers of type 2 diabetes patients hospitalized in the endocrinology department of a tertiary hospital in Kunming from October 2023 to October 2024 were selected.Questionnaires including general information survey,Benefit Finding Scale,Simplified Coping Strategy Scale,and Social Support Rating Scale were used to investigate the caregivers.Results The caregivers'benefit finding score was(66.82±16.73),coping strategy score was(36.01±9.64),and social support score was(42.00±8.11).Pearson correlation analysis showed positive correlations between coping styles,social support,and illness benefit perception(r=0.445,r=0.493,P<0.01);multiple linear regression analysis indicated that family residence,education level,duration of caregiving,and understanding of the patient's disease were key factors influencing illness benefit perception(P<0.01).Conclusion Caregivers of type 2 diabetes patients have a moderate level of illness benefit perception,with positive correlations between coping strategies,social support,and illness benefit perception.The disease benefit perception of caregivers is also influenced by family residence,education level,caregiving duration,and disease knowledge.