OBJECTIVE To explore the mechanism by which Qingre antai decoction improves pregnancy outcomes of threatened abortion rats with blood heat syndrome. METHODS The pregnant rats were randomly divided into normal group， model group， dydrogesterone group （0.002 g/kg）， and Qingre antai decoction group （44.1 g/kg）， with 13 rats in each group. Except for normal group， other groups were given warming-yang Chinese medicine and corresponding drugs intragastrically， once a day， for 12 consecutive days. On the 13th day of pregnancy， a single intragastric administration of mifepristone （5 mg/kg） was performed to establish a model of threatened abortion with blood heat syndrome. On the 14th day of pregnancy， the abortion rate and uterine coefficient were calculated； the pathological morphology of pregnant uterine was observed； the serum levels of 3，5，3′-triiodothyronine （T3）， thyroid hormone （T4）， thyroid stimulating hormone （TSH）， as well as the levels of vascular endothelial growth factor （VEGF） and nitric oxide （NO） in the pregnant uterus were all determined； the expressions of mRNA and protein related to Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （AKT） pathways were detected. RESULTS Compared with normal group， the model group exhibited endometrial tissue damage， a reduced number of decidual cells， and a significant presence of blood stasis within the uterus； abortion rate， the serum levels of T3， T4 and TSH， the mRNA expressions of JAK2， STAT3 and suppressor of cytokine signaling 3 （SOCS3） as well as protein expressions of p-JAK2， p-STAT3 and SOCS3 in the pregnant uterus were increased significantly （ P ＜0.05）； uterine coefficient， the levels of VEGF and NO in pregnant uterus， mRNA expressions of VEGFR2， PI3K， AKT and endothelial nitric oxide synthase（eNOS）， protein expressions of VEGFR2， PI3K and eNOS as well as phosphorylation level of AKT in the pregnant uterus were significantly reduced （ P ＜0.05）. Compared with model group， the endometrial tissue damage and congestion in the Qingre antai decoction group were significantly improved， and the levels of the aforementioned quantitative indicators were significantly reversed （ P ＜0.05）. CONCLUSIONS Qingre antai decoction can improve the pregnancy outcomes in rats with threatened abortion of blood heat syndrome， the mechanism of which may be associated with inhibiting JAK2/STAT3 pathway and activating PI3K/AKT pathway.

BACKGROUND: Without timely and effective rehabilitation, hearing loss may profoundly affect human life quality. China has a large population of hearing-impaired individuals, which imposes a heavy health burden on society. Moreover, this population is projected to increase rapidly owing to China's aging society. METHODS: We used data from a population-representative epidemiological investigation of hearing loss and ear diseases in four Chinese provinces. We estimated the national prevalence using multiple linear regression of the age-group proportions and prevalence in 31 provinces with clustering analysis. We used years lived with disability (YLDs) to analyze the disease burden and forecasted the prevalence of hearing loss by 2060 in China. RESULTS: An estimated 115 million people had moderate-to-complete hearing loss in 2015 across the 31 provinces of China (8.4% of 1.37 billion people). Of these, 85.7% were older than age 50 years (99 million people) and 2.4% were younger than 20 years old (2.8 million people). Of all YLDs attributable to hearing loss, 68.9% were attributable to moderate-to-complete cases. By 2060, a projected 242 million people in China will have moderate-to-complete hearing loss, a 110.0% increase from 2015. CONCLUSIONS The hearing loss prevalence in China is high. Population aging and socioeconomic factors substantially affect the prevalence and severity of hearing loss and the disease burden. The prevalence and severity of hearing loss are unevenly distributed across different provinces. Future public health policies should take these trends and regional variations into account.
Humans ; China/epidemiology* ; Hearing Loss/epidemiology* ; Prevalence ; Middle Aged ; Male ; Female ; Adult ; Aged ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Aged, 80 and over ; Cost of Illness

Objective To construct a home care readiness program for caregivers of patients with chronic heart failure based on the McMaster Family Functioning Model and explore its application effects.Methods The pro-gram was developed through literature analysis,expert correspondence and pre-testing.86 pairs of patients with chronic heart failure and their caregivers who were admitted to the Department of Cardiology of a tertiary-level hos-pital in Bengbu City were conveniently selected from December 2023 to April 2024 as the study subjects.Using the coin-flip method,the patients were randomly divided into 43 pairs in an experimental group and 43 pairs in a control group on a ward-by-ward basis.The experimental group implemented the program on the basis of routine care,and the control group was given routine care.Differences in caregiver home care readiness,caregiver caregiv-ing ability and patients' quality of life were compared between the 2 groups at the time of admission,at the time of discharge,and 1 and 3 months after discharge.Results A total of 81 pairs of patients and their caregivers completed the intervention,with 41 in the experimental group and 40 in the control group.Repeated-measures ANOVA showed that there was an interaction effect between time and group for caregiver home care readiness,caregiver caregiving ability,and patient quality of life in both groups(F=320.995,P＜0.001;F=83.303,P＜0.001;F=113.283,P＜0.001).Simple effect analyses showed that caregiver home care readiness and caregiver caregiving com-petence scores were higher in the experimental group than those in the control group at the time of discharge and at 1 and 3 months post-discharge(P＜0.001);quality of life scores of patients in the experimental group were lower than it in the control group at 1 and 3 months post-discharge(P＜0.001).Conclusion The implemen-tation of the program can effectively improve the home care readiness and caregiving ability of caregivers of pa-tients with chronic heart failure,and improve the quality of life of patients.

Objective:To compare the curative effect of local anesthesia Lichtenstein, modified Kugel and general anesthetic transabdominal preperitoneal(TAPP) hemioplasty in the treatment of primary unilateral inguinal hernia in elderly patients.Methods:Six hundred and twenty-one patients with unilateral primary inguinal hernia admitted at Second Hospital of Tianjin Medical University from January 2021 to December 2023 were randomly divided into 3 groups before operation: Lichtenstein group, Modified-Kugel group, TAPP group,207 patients in each group. The clinical data were compared.Results:The average operation time of the Lichtenstein and modified Kugel hernia repair groups was significantly shorter than that of TAPP group ( P<0.01), and the hospitalization cost was also significantly lower than that of TAPP group. The postoperative pain score, time spent in the ground and hospital stay in TAPP group were significantly lower than those in Lichtenstein and modified Kugel groups ( P<0.05). There were no serious complications in the 3 groups. Conclusions:Three kinds of hernia repair are all safe and effective in the treatment of elderly patients with unilateral primary inguinal hernia. TAPP has lighter postoperative pain and quicker recovery. Lichtenstein and Modified-Kugel hernia repair under local anesthesia are suitable for those who cannot tolerate general anesthesia.

Objective To construct a home care readiness program for caregivers of patients with chronic heart failure based on the McMaster Family Functioning Model and explore its application effects.Methods The pro-gram was developed through literature analysis,expert correspondence and pre-testing.86 pairs of patients with chronic heart failure and their caregivers who were admitted to the Department of Cardiology of a tertiary-level hos-pital in Bengbu City were conveniently selected from December 2023 to April 2024 as the study subjects.Using the coin-flip method,the patients were randomly divided into 43 pairs in an experimental group and 43 pairs in a control group on a ward-by-ward basis.The experimental group implemented the program on the basis of routine care,and the control group was given routine care.Differences in caregiver home care readiness,caregiver caregiv-ing ability and patients' quality of life were compared between the 2 groups at the time of admission,at the time of discharge,and 1 and 3 months after discharge.Results A total of 81 pairs of patients and their caregivers completed the intervention,with 41 in the experimental group and 40 in the control group.Repeated-measures ANOVA showed that there was an interaction effect between time and group for caregiver home care readiness,caregiver caregiving ability,and patient quality of life in both groups(F=320.995,P＜0.001;F=83.303,P＜0.001;F=113.283,P＜0.001).Simple effect analyses showed that caregiver home care readiness and caregiver caregiving com-petence scores were higher in the experimental group than those in the control group at the time of discharge and at 1 and 3 months post-discharge(P＜0.001);quality of life scores of patients in the experimental group were lower than it in the control group at 1 and 3 months post-discharge(P＜0.001).Conclusion The implemen-tation of the program can effectively improve the home care readiness and caregiving ability of caregivers of pa-tients with chronic heart failure,and improve the quality of life of patients.

Objective:To compare the curative effect of local anesthesia Lichtenstein, modified Kugel and general anesthetic transabdominal preperitoneal(TAPP) hemioplasty in the treatment of primary unilateral inguinal hernia in elderly patients.Methods:Six hundred and twenty-one patients with unilateral primary inguinal hernia admitted at Second Hospital of Tianjin Medical University from January 2021 to December 2023 were randomly divided into 3 groups before operation: Lichtenstein group, Modified-Kugel group, TAPP group,207 patients in each group. The clinical data were compared.Results:The average operation time of the Lichtenstein and modified Kugel hernia repair groups was significantly shorter than that of TAPP group ( P<0.01), and the hospitalization cost was also significantly lower than that of TAPP group. The postoperative pain score, time spent in the ground and hospital stay in TAPP group were significantly lower than those in Lichtenstein and modified Kugel groups ( P<0.05). There were no serious complications in the 3 groups. Conclusions:Three kinds of hernia repair are all safe and effective in the treatment of elderly patients with unilateral primary inguinal hernia. TAPP has lighter postoperative pain and quicker recovery. Lichtenstein and Modified-Kugel hernia repair under local anesthesia are suitable for those who cannot tolerate general anesthesia.

With the development of social economy and changes of lifestyle, obesity has become a very prominent social problem. Obesity and its-related metabolic diseases such as hypertension and diabetes can promote the occurrence and development of kidney disease, and eventually lead to end-stage renal disease.. Kidney transplantation is the most effective treatment, but obesity increases the risk of surgical complications and poor outcomes. Hence obesity is considered a contraindication for kidney transplantation, as the benefits for obese patients are limited. Therefore, it becomes particularly important for obese patients to gain sufficient weight loss before kidney transplantation, which is not only related to whether transplant candidates are eligible for transplantation, but also the subsequent graft survival rate. Weight loss surgery can help obese patients achieve a significant amount of weight loss more quickly than traditional weight loss methods. In recent years, more and more scholars have applied bariatric surgery to the field of kidney transplantation. Research results have shown that bariatric surgery can improve the transplantation eligibility of kidney transplantation candidates with obesity, increase the survival rate of grafts and the lifetime of patients. Moreover, bariatric surgery can improve kidney function in patients with end-stage renal disease, thereby eliminating the need for kidney transplantation. At present, there is no any literature on the application of bariatric surgery in the field of kidney transplantation in China. This article reviews the current status and prospect of bariatric surgery in the field of kidney transplantation so as to provide reference for clinical practice.

Objective:To investigate the effects of extracts of Rhizoma Sparganii and Rhizoma Curcumae on cartilage damage in osteoarthritis rats and NADPH oxidase 2 (NOX2)/reactive oxygen species (ROS)/nuclear factor-κB (NF-κB) signaling pathways. Methods:Rats (50 cases) were divided into the sham group, and model group, as well as the low, medium, and high dose groups of extracts of Rhizoma Sparganii and Rhizoma Curcumae, with 10 rats in each group. Except for sham group, the rat model of cartilage damage in knee osteoarthritis was established. On the second day after modeling, the rats in the low, medium, and high dose groups received intragastric extracts perfusion of Rhizoma Sparganii and Rhizoma Curcumae at the doses of 5, 10, and 20 g/kg respectively. The rats in the sham and model groups received intragastric equivalent 0.9% sodium chloride solution perfusion, once daily, for 20 days by continuous administration. The knee joint behavior, bone metabolism indicators, serum superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH) levels, inflammatory factors, NOX2, and NF-κB levels of each group were observed. Results:Compared with the model group, the behavioral abnormality scores, cartilage oligomeric matrix protein (COMP), MDA, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), NOX2, and NF-κB levels in the low, medium, and high dose groups were all gradually decreased (all P < 0.05), while proteoglycan, SOD, GSH, and interleukin-10 (IL-10) levels in the low, medium, and high dose groups were all gradually increased (all P < 0.05), and it was dose-dependent. Conclusions:Rhizoma Sparganii and Rhizoma Curcumae extracts can effectively improve cartilage damage in osteoarthritis rats, and it may be related to the inhibition of the NOX2/ROS/NF-κB signaling pathway.

Objective:To evaluate the mid-term efficacy of single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) in the treatment of obesity and type 2 diabetes mellitus.Methods:The cohort of this retrospective observational study comprised 118 obese patients with body mass index (BMI) ≥40 kg/m 2 with or without other related metabolic diseases and BMI of (27.5-40.0) kg/m 2 with type 2 diabetes mellitus (T2DM) who had been treated with SADI-S. Patients who had undergone modified surgery or been followed up for less than 1 year were excluded. Clinical data of the included patients [56 men and 62 women aged (34.5±9.7) years], who had undergone SADI-S in China-Japan Union Hospital, Jilin University from October 2018 to August 2022, were collected. Their mean preoperative body mass was (125.9±25.0) kg and BMI (42.8±6.8) kg/m 2. The 60 patients with T2DM had a mean fasting blood glucose of (9.9±3.2) mmol/L and HBA1c of (8.4±1.7) % before surgery. The main outcome measures were mid-term weight loss after surgery (body mass, BMI, excess weight loss, and total weight loss) 1, 2, 3, and 4 years after surgery and efficacy regarding diabetes mellitus (fasting blood glucose, glycated hemoglobin and diabetes remission rate at 1, 2, and 3 years after surgery). Outcomes were defined as follows. Complete remission: HbA1c <6% or fasting blood glucose <6 mmol/L without hypoglycemic medication; partial remission: HBA1c <6.5% or fasting blood glucose <7 mmol/L without hypoglycemic medication; significant improvement: HBA1c <7.0%, stable decrease of at least 1% compared with preoperative HBA1c, and postoperative dose of hypoglycemic medication significantly less; ineffective: no change in HBA1c and no reduction in dosage of hypoglycemic medication. Other outcome measures included intraoperative and postoperative adverse effects and postoperative nutritional indexes. Results:SADI-S was successful in all patients. There was no significant bleeding, conversion to open surgery, or perioperative death. The operation time was (186.1±41.5) minutes, and the postoperative hospital stay 6 (5–7) days. Surgical complications occurred in four patients, comprising peritoneal effusion, internal jugular vein thrombosis, anastomotic leakage, and gastric fistula. Body weight and BMI 1, 2, 3 and 4 years were significantly lower post- than pre-operatively (all P<0.05). Excess weight loss was (81.9±16.2) %, (82.2±15.5) %, (88.3±20.1) %, and (83.2±18.1) % at 1, 2, 3, and 4 years postoperatively, respectively. Total weight loss was (39.7±8.7) %, (40.6±10.6) %, (42.2±11.5) % and (45.4±10.2) %, respectively. The mean fasting blood glucose concentrations of the 60 patients with T2DM were (5.1±1.0) mmol/L, (5.0±0.7) mmol/L, and (5.4±0.9) mmol/L 1, 2 and 3 years postoperatively, respectively. The values for glycosylated hemoglobin were (4.9±0.6) %, (4.8±0.5) %, and (5.1±0.8) %, respectively, all of which are significantly lower than preoperatively (all P<0.05). The complete remission rate of diabetes was 95.0% (38/40), 90.0% (36/40), and 9/13 1, 2, and 3 years postoperatively, respectively. Additionally, the partial remission rate and significant improvement rate were both 100%. Two years postoperatively, the incidence of anemia was 27.8% (10/36), of hypoproteinemia 11.8% (4/34), and of ferritin deficiency 25.8% (8/31), all of which were improved by conservative treatment such as blood transfusion, iron supplementation, and adjustment of diet. Conclusion:SADI-S has a significant mid-term beneficial effect on weight loss and diabetes remission status in patients with obesity and type 2 diabetes.