Objective To investigate the causal relationship between metabolic syndrome and breast cancer by using a bidirectional two-sample Mendelian randomization (MR) approach. Methods Genome-wide association study (GWAS) summary statistics for metabolic syndrome and breast cancer were acquired from the Integrative Epidemiology Unit GWAS database and the GWAS Catalog, with populations encompassing the United States and East Asia. A bidirectional causal design was employed: a forward analysis with metabolic syndrome as the exposure and breast cancer as the outcome, followed by a reverse analysis wherein their roles were interchanged. The inverse-variance weighting (IVW) method was primarily used for effect estimation, supplemented by MR-Egger regression, the weighted median method, the simple mode method, and the weighted mode method. Instrument variable strength was screened using the F-statistic (F>10). Robustness of the results was assessed through heterogeneity tests, horizontal pleiotropy tests, forest plots, and leave-one-out sensitivity analyses. Results The IVW analysis indicated no significant causal relationship between metabolic syndrome and breast cancer (OR=1.00, 95%CI: 0.97-1.03), P>0.05). Sensitivity analyses yielded consistent results, suggesting the good robustness of the study findings. Conclusion This study found no evidence to support a causal relationship, either positive or negative, between metabolic syndrome and breast cancer.

Through collecting the existing clinical evidences on acupuncture and moxibustion for urticaria, the distribution of evidence in this field was mapped. A systematic search of Chinese and English literature was conducted in CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library for treatment of urticaria with acupuncture and moxibustion, published up to December 31, 2023 since inception of each database. The research status in this field was summarized using an evidence mapping approach, and methodological quality was assessed. A total of 323 randomized controlled trials (RCTs) and 22 systematic reviews were included. The number of studies on acupuncture and moxibustion for urticaria has been increasing, with a significant rise in recent years. In most RCTs, the study scale was small, and the subjects focused on chronic spontaneous urticaria in adolescents and middle-aged adults, aged 14 to 60 years. Regarding the intervention measures, the single therapy of acupuncture and moxibustion was predominant such as acupoint injection, acupoint embedding thread, and filiform needling. In acupuncture with filiform needles, the commonly used acupoints were Quchi (LI11), Xuehai (SP10), Sanyinjiao (SP6), Zusanli (ST36) and Hegu (LI4). The main outcome measures referred to effectiveness rate, score of disease severity, recurrence rate, laboratory indexes, and score of quality of life; and the short-term effect was evaluated specifically. The overall methodological quality of the included studies was relatively low. It is suggested that the future research should focus on large-scale, multi-center, high-quality clinical trials, optimize the protocols for acupuncture and moxibustion intervention, standardize the outcomes, and draw the attention to the evaluation of long-term efficacy, so as to provide clinical evidences of high certainty for urticaria treated with acupuncture and moxibustion.
Humans ; Moxibustion ; Acupuncture Therapy ; Urticaria/therapy* ; Acupuncture Points ; Randomized Controlled Trials as Topic ; Adolescent ; Adult ; Young Adult

OBJECTIVE: To reveal the gap between the evidence of systematic reviews (SRs) and clinical concerns by systematically summarizing the evidence on acupuncture and moxibustion for frozen shoulder and investigating the concerns and needs of clinicians in treatment with acupuncture and moxibustion for this disease. METHODS: The articles of SR and Meta-analysis on acupuncture and moxibustion for frozen shoulder were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library, starting from the inception of each database up to December 31st, 2022. Two researchers screened the articles and extracted data independently. Using AMSTAR-2, the methodological quality of the included studies was evaluated. Based on systematic reviews and expert discussion, a questionnaire on clinical concerns of acupuncture and moxibustion for frozen shoulder was developed and distributed to clinicians. The discrepancies between the evidence and clinical concerns were compared from 5 dimensions, including population, interventions, control measures, outcome indicators and review time points. RESULTS: The evidence gaps existed between SRs and clinical concerns. In the existing studies, the needs of personalized treatment were not fully considered in terms of different syndromes/patterns of frozen shoulder and stages of illness, the outcome indicators were not employed properly, the time for outcome measurement was vague, the control groups were set up outside of standardization, and the methodological quality was lower. CONCLUSION It is suggested that future studies should improve the quality of methodology, lay more consideration to different patient groups, optimize outcome indicators and standardize the setting of control groups, so as to better meet the needs of patients and achieve the best match between evidence and clinicians' needs.
Humans ; Acupuncture Therapy ; Bursitis/therapy* ; Evidence Gaps ; Moxibustion ; Systematic Reviews as Topic ; Meta-Analysis as Topic

Objective:To investigate the characteristics of the endometrial microbiota in patients with varying degrees of intrauterine adhesion (IUA).Methods:This single-center cross-sectional observational study enrolled 115 patients with IUA who were treated at the Hysteroscopic Center of Fuxing Hospital, Capital Medical University, from May 2022 to October 2023. After quality control and data preprocessing, 81 samples met the inclusion criteria for analysis. Patients were grouped according to an established IUA scoring and grading system into mild IUA ( n=38) and moderate-to-severe IUA ( n=43). Endometrial tissue was collected under sterile conditions. Bacterial genomic DNA was extracted, the 16S rRNA V3-V4 region was amplified, and sequencing was performed on an Illumina platform. Differences in endometrial microbiota diversity and composition were compared between the two groups. Results:Patients with varying degrees of IUA exhibited comparable species richness, evenness and diversity of endometrial microbiota. At the phylum level, the endometrial microbiota across all subjects was predominantly composed of Proteobacteria, Firmicutes, Cyanobacteriota, Bacteroidota, and Actinobacteriota, with Proteobacteria (32.29%) and Firmicutes (23.82%) showing the highest mean relative abundances. At the genus level, Ralstonia (16.67%), Lactobacillus (13.45%), and Streptococcus (7.07%) were the most abundant genera. Group comparisons showed that the abundance of Ralstonia was higher in the mild IUA group, whereas Lactobacillus, Vibrio and Pseudoalteromonas were more abundant in the moderate-to-severe IUA group; however, these differences did not reach statistical significance (all P>0.05). LEfSe analysis further indicated that Lactobacillus, Vibrio, Pseudoalteromonas, Aeromonas, Ureaplasma and Acetobacterium were relatively enriched in the moderate-to-severe IUA group, while Geobacillus, Stomatobaculum and Fusicatenibacter were more abundant in the mild IUA group. Conclusion:The composition of the endometrial microbiota differs among patients with varying IUA severity. IUA progression may be associated with alterations in the endometrial microbiota; however, causal relationships and underlying mechanisms require further investigation.

Objective To evaluate the impact of different exercise frequencies on the symptoms,quality of life,and duration of rehabilitative effects in patients with Parkinson's disease(PD).Methods A total of 90 PD patients(Hoehn and Yahr stage ≤3,receiving continuous dopaminer-gic stimulation)admitted in Department of Neurology of Chinese PLA General Hospital were en-rolled and randomly divided into groups G1,G2 and G3,with 30 participants in each group.They received rehabilitation exercises of Parkinson's Wellness Recovery(PWR)1 h per time,at differ-ent frequencies,that is,once(G1),twice(G2)and three times(G3)a week,for totally 6 months.Unified Parkinson's disease rating scale(UPDRS),levodopa equivalent dose,10-meter walk test(10-MWT),Fullerton advanced balance(FAB)Scale,trail making test-A(TMT-A),nine-hole peg test(9-HPT)and Parkinson's disease questionare-39(PDQ-39)were applied to evaluate the efficacy of the rehabilitation.Results The PDQ-39 score was significantly decreased in all the three groups after PWR exercise(P＜0.05,P＜0.01).Compared with the corresponding levels before intervention,the group G2 had obviously lower 10-MWT score and higher FAB score(P＜0.05),and the group G3 obtained notably decreased scores in UPDRS,UPDRS-Ⅲ,10-MWT,TMT-A,9-HPT,and PDQ-39[30.72±11.31 vs 31.41±10.42,P=0.001;19.21±9.72 vs 20.17±8.80,P=0.001;7.38(6.26,8.49)s vs 7.48(6.53,8.56)s,P=0.004;53.97±8.74 s vs 54.07±8.62 s,P=0.026;38.71(33.71,49.71)s vs 38.90(33.78,49.82)s,P=0.001;28.00(14.50,36.00)vs 30.00(15.50,38.50),P=0.001],and increased FAB score[23.00(16.00,33.00)vs 21.00(16.00,32.00),P=0.005].In addition,the patients in the G3 group experienced the most pronounced re-habilitation effect immediately after exercise,but,all aforementioned indicators remained augmen-ted even 4 weeks after exercise.Conclusion Exercise rehabilitation three times weekly can greatly enhance the motor function of PD patients,ameliorate non-motor symptoms,and the overall quali-ty of life,with the beneficial effects persisting for a minimum of 4 weeks.

Objective:To investigate the characteristics of the endometrial microbiota in patients with varying degrees of intrauterine adhesion (IUA).Methods:This single-center cross-sectional observational study enrolled 115 patients with IUA who were treated at the Hysteroscopic Center of Fuxing Hospital, Capital Medical University, from May 2022 to October 2023. After quality control and data preprocessing, 81 samples met the inclusion criteria for analysis. Patients were grouped according to an established IUA scoring and grading system into mild IUA ( n=38) and moderate-to-severe IUA ( n=43). Endometrial tissue was collected under sterile conditions. Bacterial genomic DNA was extracted, the 16S rRNA V3-V4 region was amplified, and sequencing was performed on an Illumina platform. Differences in endometrial microbiota diversity and composition were compared between the two groups. Results:Patients with varying degrees of IUA exhibited comparable species richness, evenness and diversity of endometrial microbiota. At the phylum level, the endometrial microbiota across all subjects was predominantly composed of Proteobacteria, Firmicutes, Cyanobacteriota, Bacteroidota, and Actinobacteriota, with Proteobacteria (32.29%) and Firmicutes (23.82%) showing the highest mean relative abundances. At the genus level, Ralstonia (16.67%), Lactobacillus (13.45%), and Streptococcus (7.07%) were the most abundant genera. Group comparisons showed that the abundance of Ralstonia was higher in the mild IUA group, whereas Lactobacillus, Vibrio and Pseudoalteromonas were more abundant in the moderate-to-severe IUA group; however, these differences did not reach statistical significance (all P>0.05). LEfSe analysis further indicated that Lactobacillus, Vibrio, Pseudoalteromonas, Aeromonas, Ureaplasma and Acetobacterium were relatively enriched in the moderate-to-severe IUA group, while Geobacillus, Stomatobaculum and Fusicatenibacter were more abundant in the mild IUA group. Conclusion:The composition of the endometrial microbiota differs among patients with varying IUA severity. IUA progression may be associated with alterations in the endometrial microbiota; however, causal relationships and underlying mechanisms require further investigation.

Objective To evaluate the impact of different exercise frequencies on the symptoms,quality of life,and duration of rehabilitative effects in patients with Parkinson's disease(PD).Methods A total of 90 PD patients(Hoehn and Yahr stage ≤3,receiving continuous dopaminer-gic stimulation)admitted in Department of Neurology of Chinese PLA General Hospital were en-rolled and randomly divided into groups G1,G2 and G3,with 30 participants in each group.They received rehabilitation exercises of Parkinson's Wellness Recovery(PWR)1 h per time,at differ-ent frequencies,that is,once(G1),twice(G2)and three times(G3)a week,for totally 6 months.Unified Parkinson's disease rating scale(UPDRS),levodopa equivalent dose,10-meter walk test(10-MWT),Fullerton advanced balance(FAB)Scale,trail making test-A(TMT-A),nine-hole peg test(9-HPT)and Parkinson's disease questionare-39(PDQ-39)were applied to evaluate the efficacy of the rehabilitation.Results The PDQ-39 score was significantly decreased in all the three groups after PWR exercise(P＜0.05,P＜0.01).Compared with the corresponding levels before intervention,the group G2 had obviously lower 10-MWT score and higher FAB score(P＜0.05),and the group G3 obtained notably decreased scores in UPDRS,UPDRS-Ⅲ,10-MWT,TMT-A,9-HPT,and PDQ-39[30.72±11.31 vs 31.41±10.42,P=0.001;19.21±9.72 vs 20.17±8.80,P=0.001;7.38(6.26,8.49)s vs 7.48(6.53,8.56)s,P=0.004;53.97±8.74 s vs 54.07±8.62 s,P=0.026;38.71(33.71,49.71)s vs 38.90(33.78,49.82)s,P=0.001;28.00(14.50,36.00)vs 30.00(15.50,38.50),P=0.001],and increased FAB score[23.00(16.00,33.00)vs 21.00(16.00,32.00),P=0.005].In addition,the patients in the G3 group experienced the most pronounced re-habilitation effect immediately after exercise,but,all aforementioned indicators remained augmen-ted even 4 weeks after exercise.Conclusion Exercise rehabilitation three times weekly can greatly enhance the motor function of PD patients,ameliorate non-motor symptoms,and the overall quali-ty of life,with the beneficial effects persisting for a minimum of 4 weeks.

Currently,common primary malignant bone tumors in clinical practice include osteosarcoma,chondrosarcoma,Ewing's sarcoma,chordoma,and multiple myeloma.Malignant bone tumors often metastasize to the lungs through the bloodstream,but lymph node metastasis can also occur.Once lymph node metastasis occurs,the prognosis for patients is worse than with lung metastasis,making the study of lymph node metastasis in malignant bone tumors a growing research focus in recent years.According to current research,primary malignant bone tumors mainly metastasize to lymph nodes through two pathways:firstly,bone tumor cells break through the periosteum into the surrounding lymphatic tissue;secondly,they regulate the expression of VEGF-C by secreting factors like WISP-3,CCL5,BDNF,thus inducing the neogenesis of lymphatic vessels in malignant bone tumors.Past research on lymph node metastasis of primary malignant bone tumors has mostly focused on clinical studies of a single type of malignant bone tumor,lacking systematic basic research and reviews,and the mechanisms of metastasis are not yet fully elucidated.Moreover,different types of malignant bone tumors vary in their rates and sites of lymph node metastasis.Therefore,this article mainly reviews the rates,sites,diagnostic methods,potential mechanisms,and treatment methods of lymph node metastasis in these five common types of malignant bone tumors,aiming to deepen understanding of lymph node metastasis in primary malignant bone tumors and to provide new ideas for clinical treatment and drug development.