1.Discussion the syndrome and treatment of consumptive thirst based on the core concept of Huangdi Neijing
Dong TIAN ; Shuqin LIAO ; Changqing TONG ; Xiaoyi ZHANG ; Na CAO ; Weiguang WANG ; Zijie CHEN ; Shuangqing ZHAI
Journal of Beijing University of Traditional Chinese Medicine 2024;47(6):797-801
Consumptive thirst is widely discussed in Huangdi Neijing and it is classified as a"strange disease"in Suwen·Strange Diseases Treatise,which reflects the intractable nature of consumptive thirst.This paper explores and analyzes consumptive thirst based on the core concept in Huangdi Neijing.First,this paper approaches the subject through the use of image thinking method from Huangdi Neijing,recognizing that consumptive thirst can lead to changes in the internal climate of the human body.Then,guided by the theories of essence and qi,yin and yang,and the five elements in Huangdi Neijing,it deconstructs and analyzes the causes of these changes and the laws of qi transformation.It points out that the changing climate of consumptive thirst is characterized by"heat symptoms".The main cause of"heat symptoms"is spleen deficiency and excessive dampness,and its qi transformation law is the heat transformation of Shaoyin.The intractable nature of consumptive thirst is mainly reflected in the uncontrolled"heat symptoms"caused by the imbalance of the five elements.Based on the understanding of the heat symptoms of consumptive thirst,this paper proposes a treatment strategy for preventing the disease by resolving dampness and regulating the spleen,harmonizing kidney qi to prevent progression,and balancing yin and yang to treat chronic and recalcitrant conditions.The aim is to provide a reference for optimizing the treatment of consumptive thirst.
2.Liraglutide protects nucleus pulposus cells by inhibiting the activation of NLRP3 inflammasome in high glucose environment
Mingyan YAO ; Jing ZHANG ; Shuqin GUO
Chinese Journal of Diabetes 2024;32(1):46-50
Objective To evaluate the protective effect of human nucleus pulposus cell by Liraglutide(Lir)under high-glucose environment via inhibition of NOD-like receptor family,pyrin domain containing 3(NLRP3)inflammasome activation and its mechanism.Methods Human nucleus pulposus cell lines were cultured and the third-generation nucleus pulposus cells were randomly divided into control group(Con group),high glucose group(HG group),and Liraglutide interference group(Lir group),and cultured for 48 h.ELISA was used to detect interleukin IL-1β;flow cytometry was used to testreactive oxygen species(ROS),and Western blot was used to evaluate the protein expressions of NLRP3,Pro-caspase-1,and Caspase-1.Results Compared with Con group,IL-1β,ROS,NLRP3,Pro-caspase-1,Caspase-1 protein expression and cell apoptosis were increased in HG and Lir groups(P<0.05).Compared with HG group,IL-1β,ROS,NLRP3,Pro-caspase-1,Caspase-1 protein expression and cell apoptosis were significantly decreased in Lir group(P<0.05).Conclusion Liraglutide protects human NPCs by inhibiting the activation of NLRP3 inflammasome,reducing IL-1β secretion,and inhibiting cell apoptosis.
3.Status risk factors and prevention and control strategies of familial aggregation of Helicobacter pylori infection
Lihua SONG ; Sijing HAN ; Shuqin REN ; Wen YANG ; Sihong DING ; Yixin ZHONG ; Yao QIN ; Huiyue ZHANG ; Yang ZHANG
Journal of Public Health and Preventive Medicine 2024;35(2):148-151
Objective To investigate the status of familial aggregation of Helicobacter pylori (Hp) infection in Jinniu District, Chengdu, and analyze its risk factors so as to provide a basis for developing prevention and control strategies of family aggregation of Hp infection. Methods A total of 172 subjects in the Second Affiliated Hospital of Chengdu Medical College · 416 Hospital of Nuclear Industry from January 2022 to January 2023 were selected as the research subjects. All subjects underwent 13C-urea breath test (13C-UBT) to diagnose whether there was Hp infection. Analyze the current situation of family aggregation of Hp infection in the region, collect general data of survey subjects, analyze the relevant factors affecting Hp family aggregation infection, and develop prevention and control strategies based on this. Results A total of 242 people from 97 households were surveyed, and the Hp family aggregation rate was 29.33%. Univariate analysis showed that there were statistically significant differences in family aggregation of Hp infection in terms of different age groups (χ2=9.719, P=0.008), marital status (χ2=8.496, P=0.014), occupations (χ2=19.462, P<0.001), frequencies of dining out (χ2=5.457, P=0.019), previous Hp test results (χ2 =4.131, P=0.042) and test results after treatment (χ2=12.000, P=0.001), with statistical significance (P<0.05). Multivariate logistic regression analysis showed that the frequency of dining out 2 days or more per week and a positive Hp test results in the past were risk factors for family aggregation of Hp infection, while the occupation of teachers/medical staff/management/technology personnel and a negative Hp results after treatment were protective factors (P<0.05). Conclusion Family aggregation of Hp infection is related to family members' occupation, frequency of dining out, previous Hp test results and Hp test results after eradication, which deserves attention in clinical practice.
4.Association of maternal emotional symptoms and parent-child relationship with emotional and behavioral problems in primary school students
ZHANG Ying, XU Huiqiong, LI Shuqin, LI Ruoyu, GAO Yue, WAN Yuhui
Chinese Journal of School Health 2024;45(9):1319-1323
Objective:
To understand the association of maternal emotional symptoms and parent-child relationship with emotional and behavioral problems (EBPs) in primary school students, so as to provide a reference for the prevention of EBPs in primary school students.
Methods:
In May 2023, a convenient cluster sampling method was used to select 1 324 students from two primary schools in Hefei City, Anhui Province as the study subjects. The Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Family Adaptation and Cohesion Evaluation ScalesⅡ (FACES Ⅱ), and Strengths and Difficulties Questionnaire (SDQ) of parental version were used to investigate maternal emotional symptoms, parent-child relationship, and EBPs of primary school students, respectively. Multivariate Logistic regression analysis model was used to analyze the association of different maternal emotional symptoms and parent-child relationship with EBPs of primary school students.
Results:
The abnormal detection rates of emotional symptoms, conduct problems, hyperactivity disorder, peer problems, prosocial behavior and total difficulties in primary school students were 13.6%, 19.4%, 20.2%, 36.5%, 20.9% and 51.9%, respectively. Multivariate Logistic regression analysis showed that the detection rates of EBPs in primary school students whose mothers had anxiety and depression symptoms with low level of parent-child relationship increased ( OR=1.52-6.97, P <0.01). The combined effect of mothers who had anxiety and depression symptoms with low level of parent-child relationship increased the risk of EBPs in all dimensions of primary school students ( OR=4.07-10.14, P <0.01). After gender stratification, the combined effect of mothers who had anxiety and depression symptoms with low level of parent-child relationship increased the risk of EBPs in all dimensions of boys and girls ( OR=3.71- 10.95 , P <0.01).
Conclusions
Maternal emotional symptoms and parent-child relationship are associated with EBPs in primary school students. Reducing maternal anxiety and depression symptoms, and improving parent-child relationship are beneficial to reduce the incidence of EBPs problems in primary school students.
5.Incidence and influencing factors of aggressive behavior in adolescent inpatients with mental disorders
Shuqin ZHAO ; Junlei ZHANG ; Susu WANG ; Feifei GUO ; Shuanrong LI
Journal of Xinxiang Medical College 2024;41(3):227-231
Objective To investigate the incidence and influencing factors of aggressive behavior in adolescent inpatients with mental disorders.Methods A total of 372 patients with mental disorders admitted to the Department of Child and Adolescent Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University from January to December 2022 were selected as research subjects.The occurrence of aggressive behavior and its influencing factors were analyzed.Results Among the 372 patients,38(10.2%)cases had aggressive behavior during hospitalization.Univariate and multivariate logistic regression results showed that the history of aggressive behavior,only child,and high irritation factor scores were the risk factors of aggressive behavior in hospitalized adolescents with mental disorders(P<0.05).Mild,outgoing,insecure and isolated personalities before the onset were protective factors of aggressive behavior in hospitalized adolescents with mental disorders(P<0.05).Conclusion Adolescent inpatients with mental disorders are likely to have aggressive behavior.Those who have aggressive behavior before,are the only child in their family and get a high score of irritant factors need more attention.Corresponding nursing interventions should be taken in time through nursing assessment to reduce the occurrence of aggressive behavior.
6.Clinical study of atorvastatin combined with indobufen in the treatment of elderly patients with diabetic kidney disease complicated with large atheromatous ischemic stroke during convalescence
Meijie LI ; Yan MA ; Wei SHI ; Lina ZHANG ; Kang BAI ; Shuqin GUO
Chinese Journal of Postgraduates of Medicine 2024;47(3):247-253
Objective:To investigate the efficacy and safety of atorvastatin combined with indobufen in the treatment of elderly patients with diabetic kidney disease (DKD) complicated with large atheromatous ischemic stroke (LAA-IS) during convalescence.Methods:The clinical data of 102 elderly patients with DKD complicated with LAA-IS during convalescence from September 2018 to April 2022 in Baoding Second Central Hospital were retrospectively analyzed. Among them, 51 patients were treated with atorvastatin combined with indobufen (observation group), 51 patients were treated with atorvastatin combined with aspirin (control group), and both groups were treated continuously for 6 months. The prethrombotic state indexes, neurological function and quality of daily life, carotid artery ultrasound indexes, renal fibrosis indexes before treatment and after treatment were compared between two group. The prethrombotic state indexes included arachidonic acid (AA) and adenosine diphosphate (ADP) induction platelet aggregation rate, fibrinogen (FIB), protein C; the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological function, and the modified Barthel index (MBI) was used to evaluate the quality of daily life; carotid artery ultrasound indexes included carotid artery intima-media thickness (IMT) and maximum plaque area; the renal fibrosis indexes included transforming growth factor-β 1 (TGF-β 1), matrix metalloproteinase-9 (MMP-9), hyaluronic acid and platelet derived growth factor-BB (PDGF-BB). The adverse reactions were recorded. Results:There were no statistical differences in the all indexes before treatment between two groups ( P>0.05). In two groups, compared before treatment, the AA induction platelet aggregation rate, ADP induction platelet aggregation rate, FIB, NIHSS score, IMT and maximum plaque area after treatment were significantly lower, the protein C and MBI score were significantly higher, and there were statistical differences ( P<0.01); but there were no statistical differences after treatment between two groups ( P>0.05). The TGF-β 1, MMP-9, hyaluronic acid and PDGF-BB after treatment in two groups were significantly lower than before treatment, and the indexes in observation group were significantly lower than those in control group: (39.46 ± 6.89) μg/L vs. (45.04 ± 8.20) μg/L, (278.46 ± 49.39) μg/L vs. (327.30 ± 57.28) μg/L, (102.37 ± 20.62) μg/L vs. (116.84 ± 24.97) μg/L vs. (25.26 ± 4.45) μg/L vs. (28.13 ± 5.08) μg/L, with statistically significant differences( P<0.01). The incidence of adverse reactions in observation group was significantly lower than that in control group: 7.84% (4/51) vs. 23.53% (12/51), and there was statistical difference ( P<0.05). Conclusions:Compared with atorvastatin combined with aspirin, atorvastatin combined with indobufen in elderly patients with DKD complicated with LAA-IS during convalescence has the same effect in improving the related indicators of prethrombotic state, reducing neurological function deficit, improving the ability of daily living, and reversing carotid atherosclerosis. However, atorvastatin combined with indobufen can further protect renal function with higher safety.
7.Traditional Chinese Medicine Syndrome Element, Evolutionary Patterns of Patients with Hepatitis B Virus-Related Acute on Chronic Liver Failure at Different Stages: A Multi-Center Clinical Study
Simiao YU ; Kewei SUN ; Zhengang ZHANG ; Hanmin LI ; Xiuhui LI ; Hongzhi YANG ; Qin LI ; Lin WANG ; Xiaozhou ZHOU ; Dewen MAO ; Jianchun GUO ; Yunhui ZHUO ; Xianbo WANG ; Xin DENG ; Jiefei WANG ; Wukui CAO ; Shuqin ZHANG ; Mingxiang ZHANG ; Jun LI ; Man GONG ; Chao ZHOU
Journal of Traditional Chinese Medicine 2024;65(12):1262-1268
ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure (HBV-ACLF) at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients, including 618 in the early stage, 355 in the middle stage, and 85 in the late stage, were collected from 18 clinical centers across 12 regions nationwide from January 1, 2012 to February 28, 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients, like the four diagnostic information (including symptoms, tongue, pulse) of traditional Chinese medicine (TCM), and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients, and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries, including 36 symptom information, 12 tongue information, and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF, which were liver-gallbladder damp-heat pattern, qi deficiency and blood stasis pattern, liver-kidney yin deficiency pattern, and spleen-kidney yang-deficiency pattern. In the early stage, heat (39.4%, 359/912) and dampness (27.5%, 251/912) were most common, and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern (74.6%, 461/618); in the middle stage, dampness (30.2%, 187/619) and blood stasis (20.7%, 128/619) were most common, and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern (53.2%, 189/355), and qi deficiency and blood stasis pattern (27.6%, 98/355); and in the late stage, the pattern of the disease was dominated by qi deficiency (26.3%, 40/152) and yin deficiency (20.4%, 31/152), and the patterns were dominated by qi deficiency and blood stasis pattern (36.5%, 31/85), and liver-gallbladder damp-heat pattern (25.9%, 22/85). ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF, presenting an overall trend of evolving patterns as "from excess to deficiency, transforming from excess to deficiency", which is damp-heat → blood stasis → qi-blood yin-yang deficiency.
8.A polylactic acid/hydroxyapatite/scholzite composite scaffold for promoting healing of osteoporotic bone defects in rats
Caizhu LUO ; Jinxiang CHEN ; Qun ZHANG ; Xuezhao YU ; Shuqin ZHANG
Journal of Southern Medical University 2024;44(2):370-380
Objective To investigate the release kinetics of Zn2+ from nZCP-loaded polylactic acid/hydroxyapatite(PLA/HA)composite scaffold(PHZ)and determine the optimal nZCP content in the scaffold.Methods The particle size of nZCP was measured by DLS measurement,and PXRD,FTIR,and SEM were used to characterize the scaffolds and nZCP distribution;EDS was used to analyze element composition of the scaffold.Compression strength of the scaffold was determined,and ion release profile was investigated using ICP-MS.The biocompatibility of the materials was evaluated by CCK-8 assay and dead/alive staining of rat bone marrow stem cells(BMSCs)incubated with their aqueous extracts.ALP staining,alizarin red staining,RT-qPCR,and Western blotting were used to assess the osteogenic potential of the treated cells.In a rat model of bilateral ovariectomy(OVX)with femoral condylar bone defect,PHZ-1,PHZ-2,PHZ-3 or PLA/HA scaffold was implanted into the bone defect,and bone repair was observed using a microCT scanner and histological staining at 6 and 12 weeks.Results DLS,PXRD,SEM,FTIR,and EDS confirmed successful synthesis of 10-nm ZCP and efficient nZCP loading in the scaffold.PHZ-2 and PHZ-3 had significantly greater compression strength than PLA/HA.ICP-MS showed that Zn2+ release from PHZ-1,PHZ-2 and PHZ-3 were all optimal for promoting osteogenesis.In rat BMSCs,all the 4 scaffolds showed good biocompatibility,and their extracts enhanced ALP activity and extracellular matrix mineralization and promoted expressions of ALP,RUNX2,and OCN in the cells.In the rat models,nZCP in the implants improved bone graft integration at 6 weeks,and PHZ-2 and PHZ-3 more effectively induced new bone formation at 12 weeks(P<0.05).Conclusion PHZ scaffold is capable of stable Zn2+ release to promote osteoporotic bone defect healing,and PHZ-2 and PHZ-3 scaffolds with nZCP mass fraction of 4.5%-7.5%have better osteogenic activity.
9.A polylactic acid/hydroxyapatite/scholzite composite scaffold for promoting healing of osteoporotic bone defects in rats
Caizhu LUO ; Jinxiang CHEN ; Qun ZHANG ; Xuezhao YU ; Shuqin ZHANG
Journal of Southern Medical University 2024;44(2):370-380
Objective To investigate the release kinetics of Zn2+ from nZCP-loaded polylactic acid/hydroxyapatite(PLA/HA)composite scaffold(PHZ)and determine the optimal nZCP content in the scaffold.Methods The particle size of nZCP was measured by DLS measurement,and PXRD,FTIR,and SEM were used to characterize the scaffolds and nZCP distribution;EDS was used to analyze element composition of the scaffold.Compression strength of the scaffold was determined,and ion release profile was investigated using ICP-MS.The biocompatibility of the materials was evaluated by CCK-8 assay and dead/alive staining of rat bone marrow stem cells(BMSCs)incubated with their aqueous extracts.ALP staining,alizarin red staining,RT-qPCR,and Western blotting were used to assess the osteogenic potential of the treated cells.In a rat model of bilateral ovariectomy(OVX)with femoral condylar bone defect,PHZ-1,PHZ-2,PHZ-3 or PLA/HA scaffold was implanted into the bone defect,and bone repair was observed using a microCT scanner and histological staining at 6 and 12 weeks.Results DLS,PXRD,SEM,FTIR,and EDS confirmed successful synthesis of 10-nm ZCP and efficient nZCP loading in the scaffold.PHZ-2 and PHZ-3 had significantly greater compression strength than PLA/HA.ICP-MS showed that Zn2+ release from PHZ-1,PHZ-2 and PHZ-3 were all optimal for promoting osteogenesis.In rat BMSCs,all the 4 scaffolds showed good biocompatibility,and their extracts enhanced ALP activity and extracellular matrix mineralization and promoted expressions of ALP,RUNX2,and OCN in the cells.In the rat models,nZCP in the implants improved bone graft integration at 6 weeks,and PHZ-2 and PHZ-3 more effectively induced new bone formation at 12 weeks(P<0.05).Conclusion PHZ scaffold is capable of stable Zn2+ release to promote osteoporotic bone defect healing,and PHZ-2 and PHZ-3 scaffolds with nZCP mass fraction of 4.5%-7.5%have better osteogenic activity.
10.Incidence of postoperative complications in Chinese patients with gastric or colorectal cancer based on a national, multicenter, prospective, cohort study
Shuqin ZHANG ; Zhouqiao WU ; Bowen HUO ; Huining XU ; Kang ZHAO ; Changqing JING ; Fenglin LIU ; Jiang YU ; Zhengrong LI ; Jian ZHANG ; Lu ZANG ; Hankun HAO ; Chaohui ZHENG ; Yong LI ; Lin FAN ; Hua HUANG ; Pin LIANG ; Bin WU ; Jiaming ZHU ; Zhaojian NIU ; Linghua ZHU ; Wu SONG ; Jun YOU ; Su YAN ; Ziyu LI
Chinese Journal of Gastrointestinal Surgery 2024;27(3):247-260
Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.


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