Objective:To explore the application value of Jiedu Jiangtang Futan Decoction combined with acupuncture and moxibustion in the treatment of acute cerebral infarction patients with diabetes(qi deficiency and blood stasis type).Methods:All pa-tients with acute cerebral infarction complicated with diabetes(type of qi deficiency and blood stasis)were treated in Hongdu Tradi-tional Chinese Medicine Hospital from October 2020 to September 2022 and randomly divided into two groups,with 69 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Jiedu Jiangtang Futan Decoction and acupuncture and moxibustion,and the efficacy was compared after two weeks of treatment.Results:Compared with before treatment,the serum levels of superoxide dismutase(SOD),vascular endothelial growth factor(VEGF)and brain-derived neurotrophic factor(BDNF)were increased in the two groups after treatment.The levels of serum matrix metalloproteinase-9(MMP-9),IL-6,fasting blood glucose(FBG),2-hour postprandial glucose(2 h PG)and glycated hemoglobin(HbA1c)were decreased.The Barthel index(BI)was increased,and the modified Rankin score(mRS)and National Institutes of Health Stroke Scale(NIHSS)were decreased(P<0.05).Compared with the control group,the levels of SOD,VEGF,BDNF and other indicators in the observation group were higher after treatment.The levels of MMP-9,IL-6,FBG,2 h PG and HbA1c were lower.BI was higher,mRS and NIHSS were lower,the difference were statistically significant(P<0.05).The total effective rate in the observation group was 94.20%(65/69),higher than 84.06%(58/69)in the control group(P<0.05).Conclusion:For patients with acute cerebral infarction complicated with diabetes(type of qi deficiency and blood stasis),the combination of Jiedu Jiangtang Futan Decoction and acupuncture and moxi-bustion treatment is helpful to promote blood supply to the brain,correct the imbalance of oxidative stress,regulate blood sugar level and improve clinical efficacy.

Objective:To explore the application value of Jiedu Jiangtang Futan Decoction combined with acupuncture and moxibustion in the treatment of acute cerebral infarction patients with diabetes(qi deficiency and blood stasis type).Methods:All pa-tients with acute cerebral infarction complicated with diabetes(type of qi deficiency and blood stasis)were treated in Hongdu Tradi-tional Chinese Medicine Hospital from October 2020 to September 2022 and randomly divided into two groups,with 69 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Jiedu Jiangtang Futan Decoction and acupuncture and moxibustion,and the efficacy was compared after two weeks of treatment.Results:Compared with before treatment,the serum levels of superoxide dismutase(SOD),vascular endothelial growth factor(VEGF)and brain-derived neurotrophic factor(BDNF)were increased in the two groups after treatment.The levels of serum matrix metalloproteinase-9(MMP-9),IL-6,fasting blood glucose(FBG),2-hour postprandial glucose(2 h PG)and glycated hemoglobin(HbA1c)were decreased.The Barthel index(BI)was increased,and the modified Rankin score(mRS)and National Institutes of Health Stroke Scale(NIHSS)were decreased(P<0.05).Compared with the control group,the levels of SOD,VEGF,BDNF and other indicators in the observation group were higher after treatment.The levels of MMP-9,IL-6,FBG,2 h PG and HbA1c were lower.BI was higher,mRS and NIHSS were lower,the difference were statistically significant(P<0.05).The total effective rate in the observation group was 94.20%(65/69),higher than 84.06%(58/69)in the control group(P<0.05).Conclusion:For patients with acute cerebral infarction complicated with diabetes(type of qi deficiency and blood stasis),the combination of Jiedu Jiangtang Futan Decoction and acupuncture and moxi-bustion treatment is helpful to promote blood supply to the brain,correct the imbalance of oxidative stress,regulate blood sugar level and improve clinical efficacy.

Objective To systematically assess the interventional effects of aerobic combined resistance exercise on walking ability,cardiorespiratory endurance,dialysis adequacy and quality of life in the patients with hemodialysis(HD).Methods The published randomized controlled trials on the interventional effects of aerobic combined resistance exercise in HD patients were retrieved from the databases of PubMed,Cochrane Library,Embase,Ovid,Web of Science,CNKI,VIP,Wanfang and China Biomedical Literature Service System(SinoMed).The retrieval time was from the database establishment to May 28,2021;the included literatures were analyzed by using RevMan 5.4 software.Results A total of 24 studies with 1 086 research subjects were included.The results showed that compared with the control group(adopting the usual care or conducting no-resistance limb movement),the walking ability,cardiopulmonary endurance and the dimensions of partial quality of life in the HD patients of the intervention group(aerobic combined resistance exercise)were signifi-cantly improved.The dialysis adequacy during dialysis in the intervention group was significantly improved compared with that in the control group.Conclusion Aerobic combined resistance exercise could improve the physical function,quality of life and dialysis adequacy in HD patients,and it is recommended that the patients are encouraged to conduct the aerobic combined resistance exercise by combining with the specific situation.

As a chronic metabolic disease,type 2 diabetes poses a significant threat to human health with increasing incidence.An increasing number of studies confirm that the pathogenesis of diabetes is closely related with alterations in multiple cellular signaling pathways.Although numerous studies have reported that traditional Chinese medicine compounds prevent diabetes by modulating cell signaling pathways,asystematic review of the mechanism of action of traditional Chinese medicine compounds in modulating cell signaling pathways is still lacking.Therefore,this paper summarizes the research of type 2 diabetes prevention and treatment,which was found mainly related to the signaling pathways such as PI3K/AKT,AMPK,MAPK,NF-κB,PPAR,TGF-β.This family of signaling pathways can treat type 2 diabetes by inhibiting pancreatic islet cell apoptosis,protecting pancreatic β-cell function,ameliorating insulin resistance,inhibiting hepatic gluconeogenesis,promoting glycogen synthesis,attenuating inflammation,and resisting oxidative stress.At the same time,we analyze the problems in current research and the future development trend,in order to provide a scientific theoretical basis for the drug development and clinical application of traditional Chinese medicine compound in the prevention and treatment of diabetes.

Objective:To evaluate and analyze the methodology and quality of recommendations in clinical practice guidelines for frail elderly people.Methods:We systematically searched 4 databases including the PubMed, China National Knowledge Infrastructure (CNKI) , China Biology Medicine Database, Wanfang Data, as well as 5 guideline websites involving Guidelines International Network, Canadian Medical Association Clinical Practice Guideline, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, New Zealand Guidelines Group, and supplemented to search Medlive. The Appraisal of Guidelines for Research and EvaluationⅡ (AGREEⅡ) and the Appraisal of Guidelines for Research and Evaluation-Recommendation Excellence (AGREE-REX) were used to evaluate the overall quality of the included guidelines and the quality of the recommendations respectively.Results:A total of 862 documents were retrieved, and 5 guidelines were finally included after screening. Among the overall scoring results of the guideline, there were 4 articles in Grade B and 1 article in Grade C. The average scores of 6 fields in AGREEⅡ were scope and purpose 82.2%, stakeholder involvement 54.5%, rigor of development 38.7%, clarity of presentations 83.3%, applicability 30.8% and independence 21.1%. The average scores of 3 fields in AGREE-REX were clinical applicability 73.3%, values and preferences 20.8%, and implementability 65.0%. The guideline issued by the International Conference on Frailty and Sarcopenia Research in 2019 was of the highest quality.Conclusions:Most of the guidelines come from developed countries in Europe and America, and there are no clinical practice guidelines for frail elderly people in China. The newly released guidelines have improved the quality of the methodology and guideline recommendations, but the four fields of rigor, applicability, editorial independence, values and preferences need to be improved.

Randomized controlled trial (RCT) can be designed as explanatory trial and pragmatic/practical trial (PCT) for clinical effect evaluation.The pragmatic/practical trial reflects the intervention effect under actual clinical condition,which has relatively good extrapolation,but its internal validity is relatively poor.In contrast,explanatory trials conducted under ideal conditions have better inner validity but inferior external validity.However,in the design of RCT,PCT and explanatory trials are not always opposite.Many RCTs have the properties of the two designs at the same time,Pragmatic-explanatory continuum indicator summary (PRECIS) can be used in the design of RCT for the balance between internal validity and external validity.There are few available reports about the application of PRECIS in China at present,so this paper summarizes the basic principles,characteristics of PRECIS and the application of PRECIS in order to provide reference for the clinical trial design in China.

OBJECTIVETo investigate both genetic and environmental influences on the exercise participation and sedentary behavior in Qingdao, Shandong province and 326 in Lishui, Zhejiang province.

METHODS568 twin pairs, including 242 in Qingdao and 326 in Lishui, were studied. Exercise participation was measured by two questions on the frequency and intensity and then divided into two groups. Sedentary behavior was measured by one question as 'how long do you spend on sitting every day'. Variance component models based on twins was used to estimate the genetic and environmental factors on these traits.

RESULTSThe average age in monozygotic twins was (41.14 ± 10.11)while in dizygotic twins it was (41.23 ± 9.89). Genetic factors accounted 78% (35%-96%) and 59% (0-94%) for exercise participation variance in Qingdao and Lishui in people aged between 20 and 40. However, there were no heritability noticed on physical activity in people older than 40 years of age. Rates of heritability on sedentary behavior in Qingdao and Lishui were 68% (59%-75%) and 32% (7%-62%), respectively.

CONCLUSIONResults from the study suggested that sedentary behavior in Chinese people was influenced by genetic factors, which could also explain much of the exercise participation variance in people aged between 20 and 40.

Adult ; China ; Cross-Sectional Studies ; Exercise ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Sedentary Lifestyle ; Surveys and Questionnaires ; Twins ; genetics ; Young Adult

OBJECTIVETo explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai.

METHODSObservational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level, marital status, annual household income and risk of hypertension, coronary heart disease, stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases, based on logistic regression model.

RESULTSAfter adjusted for age, the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education, the risk of hypertension increased in females when the education level declined, with OR as 1.08 (95% CI:0.89-1.30). For those having had senior high school junior high school or elementary education, the risks of hypertension were 1.26 (95%CI:1.05-1.51), 1.34 (95%CI:1.08-1.65), 0.72 (95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94), and 0.70 (95%CI:0.52-0.92) for males, respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%, with OR for medium being 0.72 (95%CI:0.61-0.84) and for lower ones it was 0.70 (95% CI:0.57-0.87). However, similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study.

CONCLUSIONThe risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.

Adult ; Aged ; Cardiovascular Diseases ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Social Class ; Socioeconomic Factors

Objective To explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai. Methods Observational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level,marital status,annual household income and risk of hypertension,coronary heart disease,stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases,based on logistic regression model. Results After adjusted for age,the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education,the risk of hypertension increased in females when the education level declined,with OR as 1.08(95%CI:0.89-1.30). For those having had senior high school junior high school or elementary education,the risks of hypertension were 1.26(95%CI:1.05-1.51),1.34(95%CI:1.08-1.65),0.72(95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94),and 0.70(95%CI:0.52-0.92)for males,respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%,with OR for medium being 0.72(95%CI:0.61-0.84)and for lower ones it was 0.70(95%CI:0.57-0.87). However,similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study. Conclusion The risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.

Objective To investigate both genetic and environmental influences on the exercise participation and sedentary behavior in Qingdao,Shandong province and 326 in Lishui, Zhejiang province. Methods 568 twin pairs,including 242 in Qingdao and 326 in Lishui,were studied. Exercise participation was measured by two questions on the frequency and intensity and then divided into two groups. Sedentary behavior was measured by one question as‘how long do you spend on sitting every day’. Variance component models based on twins was used to estimate the genetic and environmental factors on these traits. Results The average age in monozygotic twins was(41.14 ± 10.11)while in dizygotic twins it was(41.23 ± 9.89). Genetic factors accounted 78%(35%-96%)and 59%(0-94%)for exercise participation variance in Qingdao and Lishui in people aged between 20 and 40. However,there were no heritability noticed on physical activity in people older than 40 years of age. Rates of heritability on sedentary behavior in Qingdao and Lishui were 68%(59%-75%)and 32%(7%-62%),respectively. Conclusion Results from the study suggested that sedentary behavior in Chinese people was influenced by genetic factors,which could also explain much of the exercise participation variance in people aged between 20 and 40.