In recent years,natural antimicrobial peptides have become an important direction in the development of novel antibiotics.Cecropin has the characteristics of wide antibacterial spectrum,good tolerance and low adverse drug reactions.As the first antimicrobial peptide discovered in the family of Cecropin,Cecropin A has many important biological activities.In this paper,the research on the antibacterial,antifungal,antiparasitic and antitumor activities of Cecropin A and its derivatives in recent years was reviewed,and its application prospect was prospected,in order to provide reference for further research and development of cecropin.

Objective:To analyze the equity of Traditional Chinese medicine(TCM)human resource allocation across 31 provinces in China and explore its influencing pathways,aiming to provide scientific reference for optimizing the allocation of TCM human resources.Methods:The Health Resource Density Index(HRDI)was employed to measure the equity of TCM human resource allocation in China,and the fuzzy-set qualitative comparative analysis(fsQCA)was utilized to explore the configurational pathways influencing this equity.Results:Based on the data from 2021,the HRDI of TCM human resources in China exhibited significant regional disparities,manifesting as a distribution pattern of"high in the east and low in the west."Three pathways promoting high equity were identified:the internal-external balance-driven pathway(H1),the economy-demand co-driven pathway(H2),and the government-led driving pathway(H3).Meanwhile,three pathways leading to low equity were also recognized:the economy-demand constraint pathway(L1)and the internal-external constraint pathways(L2、L3).Conclusion:There are notable regional disparities in the equity of TCM human resource allocation in China,with multiple factors jointly influencing this equity,among which population density serves as a core factor.In subsequent efforts to enhance equity,it is advisable to consider optimizing the synergies among multiple factors and implementing precise policies for different regions to promote efficient allocation and balanced development of TCM human resources.

Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
Female ; Humans ; Male ; Aged ; Middle Aged ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy* ; Prognosis ; Lymphoma, B-Cell ; Immunohistochemistry ; Immunoglobulin Heavy Chains/therapeutic use*

Objective: To evaluate different methods' efficacy of controlling acute bleeding and managing long-term menstruation in patients with heavy menstrual bleeding (HMB) associated with antithrombotic therapy. Methods: The clinical data of 22 cases with HMB associated with antithrombotic therapy admitted to Peking University People's Hospital from January 2010 to August 2022 were analyzed, aged 39 years old (26-46 years). Changes in menstrual volume, hemoglobin (Hb), and quality of life were collected after control of acute bleeding and long-term menstrual management. Menstrual volume was assessed by pictorial blood assessment chart (PBAC), and quality of life was assessed by menorrhagia multi-attribute scale (MMAS). Results: (1) Treatment of acute bleeding: of the 22 cases with HMB associated with antithrombotic therapy, 16 cases were treated in our hospital and 6 in other hospital for emergency bleeding; of the 16 cases treated in our hospital, 3 underwent emergency intrauterine Foley catheter balloon compression due to severe bleeding (Hb decreased by 20 to 40 g/L within 12 hours). Of the 22 cases with antithrombotic therapy-related HMB, 15 (including 2 cases with severe bleeding) underwent emergency aspiration or endometrial resection, and intraoperative placement of levonorgestrel-releasing intrauterine system (LNG-IUS) followed by a significant reduction in bleeding volume; 3 cases had controlled acute bleeding after rivaroxaban dose reduction and continued observation; 2 cases were given gonadotropin-releasing hormone agonists to control acute bleeding in other hospital, of which 1 case was temporarily treated with periodic blood transfusion, and the other one patient underwent total hysterectomy; and 2 cases had temporary amenorrhea with oral mifepristone after intrauterine balloon compression or oral norethindrone. (2) Long-term menstrual management: of the 22 cases with antithrombotic therapy-related HMB, 15 had LNG-IUS placement and 12 had LNG-IUS placement for 6 months, and menstrual volume was significantly reduced [PBAC scores were 365.0 (272.5-460.0) vs 25.0 (12.5-37.5), respectively; Z=4.593, P<0.001], Hb was significantly increased [91.5 g/L (71.8-108.2 g/L) vs 128.5 g/L (121.2-142.5 g/L); Z=4.695, P<0.001], and quality of life was significantly improved [MMAS scores were 415.0 (327.5-472.5) vs 580.0 (570.0-580.0), respectively; Z=-3.062, P=0.002] before placement compared with 6 months after placement. Three rivaroxaban dose reduction patients' PBAC scores decreased by 20 to 35 but remained >100, and perceived quality of life did not change significantly. Two cases with temporary amenorrhea treated with oral mifepristone felt significantly improved quality of life, and the MMAS scores increased by 220 and 180, respectively. Conclusion: Intrauterine Foley catheter balloon compression, aspiration or endometrial ablation could be used to control acute bleeding in patients with antithrombotic therapy-related HMB, and LNG-IUS for long-term management could reduce menstrual volume, increase hemoglobin, and improve the quality of life of patients.
Female ; Humans ; Adult ; Menorrhagia/etiology* ; Fibrinolytic Agents/adverse effects* ; Levonorgestrel/adverse effects* ; Amenorrhea/drug therapy* ; Mifepristone/therapeutic use* ; Quality of Life ; Rivaroxaban/therapeutic use* ; Hemoglobins ; Intrauterine Devices, Medicated/adverse effects* ; Contraceptive Agents, Female

OBJECTIVE: To observe the clinical effect of electroacupuncture at acupoints of yangming meridians for sarcopenia. METHODS: A total of 60 patients with sarcopenia were randomized into an observation group and a control group, 30 cases in each group. In the control group, conventional nutrition intervention for sarcopenia was adopted. In the observation group, on the basis of the treatment in the control group, acupuncture was applied at bilateral Binao (LI 14), Quchi (LI 11), Zusanli (ST 36), Yanglingquan (GB 34), etc.,ipsilateral Quchi (LI 11) and Zusanli (ST 36) were connected to electroacupuncture, with discontinuous wave, 2 Hz in frequency, 1-10 mA in intensity, 2 times a week, with a interval of 3 days. A total of 12-week treatment was required in the two groups. Before and after treatment, the appendicular skeletal muscle mass index (ASMI), grip strength, 6 m-walking time, body fat percentage and body moisture percentage were observed in the two groups. RESULTS: Compared with those before treatment, after treatment, ASMI and grip strength were increased while 6 m-walking time was shortened in the two groups (P<0.05); body fat percentage was decreased while body moisture percentage was increased in the observation group (P<0.05). After treatment, in the observation group, ASMI, grip strength and body moisture percentage were increased (P<0.05), 6 m-walking time was shortened and body fat percentage was decreased (P<0.05) compared with those in the control group. CONCLUSION Electroacupuncture at acupoints of yangming meridians can effectively improve the skeletal muscle mass, muscle function, body fat percentage and body moisture percentage in patients with sarcopenia, and make the distribution of muscle and fat more reasonable.
Humans ; Meridians ; Acupuncture Points ; Electroacupuncture ; Sarcopenia/therapy* ; Acupuncture Therapy

Child ; Child, Preschool ; Humans ; China ; Practice Guidelines as Topic ; Dyssomnias ; Child Behavior

Objective To investigate the bacteriostatic activity of five hemostatic dressings for war injury to provide references for the development of novel hemostatic dressings.Methods The bacteriostatic ratios of Combat Gauze made of kaolin and four kinds of dressings made of chitosan including Celox Rapid Gauze,Celox Gauze,ChitoGauze and a self-developed dressing against S.aureus and E.coli were explored according to GB/T 20944.2-2007.The bacteriostatic time and activity were inferred by investigating the growth of S.aureus under simulated conditions.Results Combat Gauze had the hemostatic ratios lower than 20％against both S.aureus and E.coli within 24 h.The hemostatic ratios of Celox Rapid Gauze,Celox Gauze,ChitoGauze and the self-developed dressing against S.aureus were all higher than 90％after 30 min action,while the ratios of the four dressings against E.coli were slightly different and changed with the prolongation of the time of action:after 30 min action only Celox Rapid Gauze had the hemostatic ratio higher than 90％;after 3 h action,ChitoGauze had a low ratio of 35％while the other dressings were all higher than 95％;after 24 h action the four dressings all had the ratios higher than 99％.Celox Rapid Gauze,Celox Gauze,ChitoGauze and the self-developed dressing all significantly inhibited the growth of S.aureus within 15 h and the time for S.aureus to reach the threshold of clinical infection under simulated conditions was 18,15,24 and 15 h,respectively.Conclusion Combat Gauze is not effective in inhibiting S.aureus and E.coli,while Celox Rapid Gauze,Celox Gauze,ChitoGauze and the self-developed dressing behave well with Celox Rapid Gauze gaining high compre-hensive bacteriostatic activity and ChitoGauze having the longest bacteriostatic time against S.aureus.

Objective: To systematically summarize and evaluate the development of update and detailed recommendations of the existing global screening guidelines in high-risk population with a family history of colorectal cancer. Methods: The words "colorectal cancer", "screening", "guideline", "consensus", "recommendations" and "family history" in Chinese and English were used as MESH terms for literature retrieval, as well as entry terms. The retrieval was performed based on China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, PubMed, Embase, Cochrane Library and Web of Science, as well as official websites. The languages of literatures were limited in Chinese and English. As of May 24, 2022, a total of 20 valid literatures had been retrieved. The basic information of the literatures and the recommendations of colorectal cancer screening for people with family history were collected and analyzed. Results: The analysis on the 20 literatures indicated that most countries/regions/institutions recommended age range of screening, screening modalities and intervals for people with family history of colorectal cancer. For the individuals who have one first-degree relative diagnosed with colorectal cancer before 60 years of age,most guidelines recommended the screening to be started at 40 years or 10 years earlier than the age when the youngest first-degree relative was diagnosed. The most commonly recommended screening modality was colonoscopy. Conclusions: Most current screening guidelines for high-risk people with family history of colorectal cancer recommend colonoscopy as the main modality. This review will provide reference for the update of screening strategies in high-risk people with family history of colorectal cancer in China, and further improve the practices of screening, early diagnosis and treatment of colorectal cancer.
Adult ; Colonoscopy ; Colorectal Neoplasms/epidemiology* ; Early Detection of Cancer ; Humans ; Mass Screening ; Risk Factors

Objective: To compare the therapeutic efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This is a multicenter randomized controlled trial. From March 2017 to July 2019, moderate to severe OSAHS patients from three clinical center in Shanghai who were intolerant to continuous positive airway pressure (CPAP) and with velopharyngeal and glossopharyngeal plane obstruction were enrolled in this study. According to the surgical type, they were 1∶1 randomized to HUPPP plus radiofrequency ablation of tongue base group (Ablation group) or HUPPP plus traction of tongue base group (Traction group). All patients completed over-night standard Polysomnography (PSG), upper-airway assessment (Friedman classification, Müller test, CT and cephalometric examination), preoperative routine examination, Epworth Sleepiness Scale (ESS) and Quebec sleep questionnaire (QSQ). Six to 12 months after operation, all the above-mentioned examinations were repeatedly performed. Changes of aforementioned variables before and after operation were assessed. Results: A total of 43 patients with moderate to severe OSAHS were enrolled in this study. One patient lost to follow-up, the remaining 21 were allocated to Ablation group and 21 were allocated to Traction group. The total therapeutic efficacy of all patients was 69.05% (61.90% in Ablation group and 76.19% in Traction group), but there was no statistical significance between the two groups (P= 0.317). The value of sleep scale score (ESS and QSQ), objective sleep variables (apnea-hypopnea index, oxygen saturation, percentage of time with blood oxygen less than 90% in total sleep time, oxygen desaturation index and micro-arousals) and upper airway cross-sectional area (palatopharyngeal and retrolingual area) of the two groups were improved (P<0.05), but the differences between the two groups were not statistically significant (P>0.05). Conclusion: For moderate to severe OSAHS who had glossopharyngeal plane obstruction, both HUPPP plus radiofrequency ablation of tongue base or HUPPP plus traction of tongue base are effective treatment for OSAHS, and the curative effect is similar. The choice of surgical type could be selected according to patient's or surgical conditions.
China ; Humans ; Oxygen Saturation ; Radiofrequency Ablation ; Sleep Apnea, Obstructive/surgery* ; Tongue/surgery* ; Traction

Fibrosis is a pathological process of abnormal hyperplasia and excessive deposition of extracellular matrix during the process of repair after tissue and organ damage. Injury/inflammation caused by variously chronic diseases is a major trigger for fibrogenesis. Fibrosis of the liver and kidney is a common organ fibrosis. Recently, the intestinal microbiota has been shown to be extensively involved in the development of liver and kidney diseases, which may follow from changes in the intestinal microbial composition and intestinal integrity. This promotes the development of liver and/or kidney fibrosis through endocrine, cell signaling and other pathways. This paper reviews the research progress in understanding liver fibrosis and kidney fibrosis based on the gut-liver-kidney axis, which may be helpful for providing new strategies and theoretical basis for the diagnosis and treatment of hepatic and renal fibrosis.