BACKGROUND:Preliminary research by our group suggests that targeting fibroblast growth factor receptor 1(FGFR1)may be an effective strategy for treating RA. OBJECTIVE:To investigate the effects of an FGFR1 inhibitor(PD173074)on bone destruction in rats with collagen-induced arthritis. METHODS:Twenty-five female Sprague-Dawley rats were randomly divided into five groups:normal control group,model group,methotrexate group,low-dose PD173074 group,and high-dose PD173074 group.Except for the normal control group,rat models of type Ⅱ collagen-induced arthritis were made in each group.After successful modeling,rats were injected intraperitoneally with sterile PBS in the normal and model groups,1.04 mg/kg methotrexate in the methotrexate group,and 5 and 20 mg/kg in the low-dose group and high-dose PD173074 groups,once a week.After 4 weeks of drug administration,clinical symptoms and joint swelling in rats were observed.Micro-CT was used for three-dimensional reconstruction and analysis of the ankle joints.Pathological changes in the ankle joints were observed.Periarticular angiogenesis and the expression of receptor activator of nuclear factor-Κb ligand were detected.The expression levels of p-FGFR1,vascular endothelial growth factor A,and tartrate-resistant acid phosphatase in the synovial membrane were measured.Pathological changes in the liver,spleen,and kidney were observed and liver,spleen,and kidney indices were calculated. RESULTS AND CONCLUSION:PD173074 could alleviate clinical symptoms and joint swelling,delay bone loss,improve bone structure,reduce synovial invasion and cartilage bone erosion,reduce the number of periarticular osteoclasts,inhibit angiogenesis in synovial tissues,reduce the expression of receptor activator of nuclear factor-Κb ligand,and inhibit the expression of FGFR1 phosphorylated protein,tartrate-resistant acid phosphatase and vascular endothelial growth factor A.Pathologic observation of the liver,spleen and kidney in rats showed no obvious toxic side effects after PD173074 treatment.To conclude,the FGFR1 inhibitor can delay the progression of joint inflammation and bone destruction and inhibit angiogenesis in the rat model of type Ⅱ collagen-induced arthritis.The therapeutic effect of PD173074 has been preliminarily validated in the type Ⅱ collagen-induced arthritis model and may act by inhibiting FGFR1 phosphorylation,which provides a direction for the search of new therapeutic targets for rheumatoid arthritis.

BACKGROUND:Although researchers have noted that fibroblast growth factor receptor 1 shows great potential in rheumatoid arthritis bone destruction,there is a lack of reviews related to the potential mechanisms of fibroblast growth factor receptor 1 in rheumatoid arthritis bone destruction. OBJECTIVE:To comprehensively analyze the mechanism of fibroblast growth factor receptor 1 in bone destruction in rheumatoid arthritis by reviewing the relevant literature at both home and abroad. METHODS:We searched the CNKI database using the Chinese search terms"fibroblast growth factor receptor 1,rheumatoid arthritis,bone destruction,bone cells,osteoblasts,osteoclasts,chondrocytes,macrophages,synovial fibroblasts,T cells,vascular endothelial cells."PubMed database was searched using the English search terms"fibroblast growth factor receptor 1,rheumatoid arthritis,bone destruction,osteocytes,osteoblasts,osteoclasts,chondrocytes,macrophages,synovial fibroblasts,T cells,endothelial cells."The search period focused on April 1992 to January 2024.After screening the literature by reading titles,abstracts,and full texts,a total of 82 articles were finally included for review according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:Fibroblast growth factor receptor 1 was found to be widely expressed in bone tissue-associated cells,including osteoblasts,osteoclasts,and osteoclasts.Fibroblast growth factor receptor 1 affects bone remodeling and homeostasis by regulating the function of these cells,as well as promoting the onset and progression of bone destruction in rheumatoid arthritis.Fibroblast growth factor receptor 1 is involved in the inflammatory response of synovial fibroblasts and macrophages and regulates angiogenesis of endothelial cells in synovial tissues.Fibroblast growth factor receptor 1 promotes bone destruction in several ways.Fibroblast growth factor receptor 1 may be a potential causative agent of bone destruction in rheumatoid arthritis and provides a reference for further research on its therapeutic targets.

Objectives: This study aimed to achieve expert consensus on menopause management in the Asia-Pacific region, taking into account patient diversity, the latest evidence, and current treatment options. Methods: A focused literature search was performed to identify clinical practice statements on menopause management. Menopause experts were nominated by members of the Asia-Pacific Menopause Federation (APMF) society. A modified Delphi methodology, involving iterative rounds of anonymous surveys, was employed until consensus was reached for each statement. Consensus was defined as ≥ 70% of experts voting ‘agree’ or ‘strongly agree’ for a given clinical practice statement. Results: A total of 39 participants from 14 different APMF member societies were involved. Eighty-five clinical practice statements reached a consensus. Based on the clinical practice statements, an algorithm was created as a tool to guide clinicians on menopause management. APMF experts agreed that, in addition to vasomotor symptoms, Asian women experiencing somatic or psychological symptoms may also benefit from treatment with menopausal hormone therapy (MHT). MHT should also be considered for the prevention of osteoporosis in asymptomatic peri- and postmenopausal women. Conclusions This APMF consensus statement supersedes the previous one published in 2008. It provides guidance to gynecologists, endocrinologists, family physicians, and other healthcare professionals in delivering optimal care to menopausal women in the ethnically and culturally diverse Asia-Pacific region.

OBJECTIVE: Traditional Chinese medicine (TCM) incorporates traditional diagnostic methods and several major treatment modalities including Chinese herbal medicine, Chinese patent medicine, and non-pharmacological methods such as acupuncture and tuina. Even though TCM is used daily by more than 70,000 healthcare facilities and over 700,000 clinical practitioners in China, there is a poor understanding of the extent to which TCM diagnostic methods are used, how different treatment modalities are deployed in general, and what major factors may affect the integration of TCM and Western medicine. This study aimed to fill this void in the literature. METHODS: In the 2021 National Healthcare Improvement Evaluation Survey, we included three questions gauging the perception and practices of TCM amongst physicians working in TCM-related facilities, investigating the frequency of their deployment of TCM diagnostic methods, and predominant TCM treatment methods. Our empirical analysis included descriptive statistics, intergroup chi-square analysis, and binary logistic regression to examine the association between different types of facilities and individual characteristics and TCM utilization patterns. RESULTS: A total of 7618 clinical physicians comprised our study sample. Among them, 84.27% have integrated TCM and Western medicine in their clinical practice, and 80.77% of TCM practitioners used the 4 diagnostic methods as a tool in their clinical practice. Chinese herbal medicine was the most widely utilized modality by Chinese TCM physicians (used by 88.49% of respondents), compared with the Chinese patent medicine and non-pharmacological TCM methods, which were used by 73.14%, and 69.39%, respectively. Herbal tea as an out-of-pocket health-maintenance intervention is also a notable practice, recommended by 29.43% of physicians. Significant variations exist across certain institutions, departments, and individual practitioners. CONCLUSION Given that most of the surveyed physicians integrated TCM with Western medicine in their clinical practices, the practice of "pure TCM" appears to be obsolete in China's tertiary healthcare institutions. Notably, remarkable variation exists in the use of different TCM modalities across institutions and among individuals, which might be related to and thus limited by the practitioners' experience. Future research focusing on the efficacy and safety of TCM interventions for specific diseases, the development of standardized clinical guidelines, and the enhancement of TCM education and training are called for to optimize TCM-Western medicine integration. Please cite this article as: Guo R, Zeng D, Zhao Q, Zhang XY, Zhang XK, Liu YL. How are different traditional Chinese medicine modalities deployed by clinical practitioners in China? Findings from a national survey. J Integr Med. 2025; 23(1): 36-45.
Medicine, Chinese Traditional/statistics & numerical data* ; Humans ; China ; Surveys and Questionnaires ; Female ; Male ; Physicians/statistics & numerical data* ; Practice Patterns, Physicians'/statistics & numerical data* ; Adult ; Middle Aged

OBJECTIVE: The results of limited studies on the relationship between environmental pollution and dementia have been contradictory. We analyzed the combined effects of PM _2.5 and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population. METHODS: We assessed 24,117 individuals along with the annual average PM _2.5 concentrations from 2012 to 2016. Dementia was confirmed in the baseline survey at a qualified clinical facility, and newly suspected dementia was assessed in 2017, after excluding cases of suspected dementia in 2015. National census data were used to weight the sample data to reflect the entire population in China, with multiple logistic regression performed to analyze the combined effects of PM _2.5 and smoking frequency on dementia and cognitive impairment. RESULTS: Individuals exposed to the highest PM _2.5 concentration and smoked daily were at higher risk of dementia than those in the lowest PM _2.5 concentration group ( OR, 1.603; 95% CI [1.626-1.635], P < 0.0001) and in the nonsmoking group ( OR, 1.248; 95% CI [1.244-1.252]; P < 0.0001). Moderate PM _2.5 exposure and occasional smoking together increased the short-term risk of cognitive impairment. High-level PM _2.5 exposure and smoking were associated with an increased risk of dementia, so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns. CONCLUSION High-level PM _2.5 exposure and smoking were associated with an increased risk of dementia. Lowering the ambient PM _2.5, and smoking cessation are recommended to promote health.
Humans ; Dementia/etiology* ; Male ; Aged ; Female ; Cognitive Dysfunction/etiology* ; China/epidemiology* ; Particulate Matter/analysis* ; Smoking/epidemiology* ; Air Pollutants/analysis* ; Aged, 80 and over ; Environmental Exposure/adverse effects* ; Prevalence ; Middle Aged

BACKGROUND:The treatment of Pauwels type Ⅲ femoral neck fractures in young adults is extremely difficult.When treating Pauwels type Ⅲ femoral neck fractures with internal fixation,it is not only necessary to ensure the mechanical stability of the internal fixation,but also to ensure that it can resist the impact of shear,compression and tension,so as to prevent the internal fixation from breaking or loosening due to fatigue during the fracture healing process.However,existing internal fixation methods do not fully meet our requirements for the treatment of this fracture.OBJECTIVE:To provide a more reasonable and effective choice of internal fixation mode for clinicians in the treatment of young adults with Pauwels type Ⅲfemoral neck fracture,so as to optimize the treatment effect,reduce the occurrence of complications,and improve the recovery speed and quality of life of patients.METHODS:A femoral neck fracture model with Pauwels angle of 70° was constructed using CT data extracted from volunteers,and three placement modes were set up:(1)femoral neck system group:the main nail of femoral neck system was located in the center of the femoral neck axis.(2)Combination group:The main nail of femoral neck system was located in the lower third of the femoral neck axis,and a cannulated compression screw was located in the upper third of the femoral neck axis.(3)Cannulated compression screw group:The arrangement of three cannulated compression screws was arranged in the classic inverted triangle shape to ensure the maximum fixed effect.Stress distribution and displacement of proximal femoral fracture fragments and internal fixation devices were analyzed under three different internal fixation methods.RESULTS AND CONCLUSION:(1)The stress of the proximal femur models in the three groups was concentrated near the fracture line:combination group(201.10 MPa)＜femoral neck system group(222.25 MPa)＜cannulated compression screw group(271.25 MPa).(2)The peak value of proximal femur displacement was located at the top:combination group(6.33 mm)＜femoral neck system group(9.37 mm)＜cannulated compression screw group(9.92 mm).(3)The internal fixation stress was concentrated on the screw surface at the broken end of the fracture and gradually extended from there to both sides;cannulated compression screw group(136.67 MPa)＜combination group(201.10 MPa)＜femoral neck system group(222.25 MPa).(4)The maximum displacement of the internal fixation device model was located at the very top of the internal fixation.The three groups gradually decreased from the top to the far end.The peak displacement values of combination group(6.21 mm)＜femoral neck system group(9.19 mm)＜cannulated compression screw group(9.51 mm).(5)The stress of proximal bone mass in the three models was mainly concentrated in the fracture end,especially in the lower part of the fracture end.This indicates that these regions were subjected to greater stress and strain during mechanical transfer;combination group(24.96 MPa)＜femoral neck system group(39.69 MPa)＜cannulated compression screw group(44.47 MPa).(6)The results indicate that the internal fixation strategy of femoral neck system combined with cannulated compression screw arranged in parallel coronal surface shows higher biomechanical stability than single femoral neck system fixation or cannulated compression screw in inverted triangle arrangement fixation,and provides a more reliable and effective solution for the treatment of Pauwels type Ⅲ femoral neck fracture in young adults.

Objective:To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PTLIF) on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods:A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method: 42 cases in the control group were treated with traditional open posterior lumbar interbody fusion (PLIF), and 42 cases in the observation group were treated with midline approach MIS-PTLIF. Perioperative related indicators, Visual Analogue Scale (VAS) scores, creatine phosphokinase (CPK) levels, Oswestry Disability Index (ODI) scores at different time points, and the incidence of postoperative complications were compared between the two groups.Results:The observation group was superior to the control group in operation time, incision length, intraoperative blood loss, time to get out of bed, and hospital stay (all P<0.05). There were no significant differences in preoperative VAS and ODI scores between the two groups (all P>0.05). At 1 week and 3 months after surgery, the VAS and ODI scores of both groups were significantly lower than those before surgery (all P<0.05). The VAS and ODI scores of the observation group at 1 week after surgery were significantly lower than those of the control group (all P<0.05). There was no significant difference in serum CPK level between the two groups 1 day before surgery ( P>0.05). The serum CPK levels of the observation group on the 1st, 3rd, and 5th days after surgery were significantly lower than those of the control group (all P<0.05). The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery ( P>0.05), while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery ( P<0.05). There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups (all P>0.05). Conclusions:MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases, which can effectively relieve postoperative pain, help the recovery of lumbar function, and its safety and fusion rate are comparable to traditional PLIF, which is worthy of clinical promotion.