ObjectiveTo explore the longitudinal measurement invariance of standardized Constitution in Chinese Medicine Questionnaire （CCMQ） among Chinese adult populations， and to provide evidence for the longitudinal effect analysis of this questionnaire. MethodsA total of 509 adults who voluntarily received 26 weeks of comprehensive traditional Chinese medicine （TCM） constitution fitness intervention were included （3 time points： before intervention， 13 weeks intervention， and 26 weeks intervention）， evaluated by CCMQ with 9 subscales. A single-group confirmatory factor analysis was performed to establish a single-group baseline model with a well-fitting model， and then nested models， that is multiple groups of confirmatory factors analysis， are used to analyze the longitudinal measurement invariance， followed by configural invariance， metric invariance， scalar invariance， and strict invariance. Comparative Fit Index （CFI）， Root Mean Square Error of Approximation （RMSEA）， and Standardized Root Mean Square Residual （SRMR） were used as model fit indicators for the analysis. ResultsThe single-group confirmatory factors analysis proved that the 9 subscales of CCMQ fit well at the three time points （CFI： 0.933~0.992， RMSEA： 0.027~0.080， SRMR： 0.022~0.045）. The multiple-group confirmatory factors analysis showed that the configural， metric， scalar， and strict invariance across time of qi-stagnation and special diathesis constitution were established （ΔCFI＜0.01， ΔRMSEA＜0.01）； the configural， metric， scalar， and partial strict invariance across time of phlegm-dampness constitution subscale were established （ΔCFI＜0.01， ΔRMSEA＜0.01）； the configural， metric， partial scalar and partial strict invariance of 6 subscales， including gentleness， qi-deficiency， yang-deficiency， yin-deficiency， dampness-heat， and blood-stasis constitutions， were all established （ΔCFI＜0.01， ΔRMSEA＜0.01）. ConclusionThe CCMQ met at least metric invariance at 3 time points， which can be applied to the study of whether different time points have the same unit or meaning. The measurement invariance of the 3 subscales of phlegm-dampness， qi-stagnation and special diathesis， special diathesis have longitudinal measurement invariance， so the mean comparison over time could be made； while the 6 subscales of gentleness， qi-deficiency， yang-deficiency， yin-deficiency， dampness-heat， and blood-stasis constitutions meet partial scalar and partial strict invariance， which could be explained partially for the difference in the comparison of the mean over time.

Objective:To explore the research hotspots and trends of trauma informed care based on the Web of Science Core Collection, so as to provide reference for future research in China.Methods:Articles related to trauma informed care was searched on the Web of Science Core Collection from February 1, 2002 to February 1, 2022. Article duplication, screening, and data extraction were performed in EndNote X9. CiteSpace 5.0 R1 software was used for visual analysis.Results:A total of 510 articles were included. Since 2021, there had been a sharp increase in the number of articles, with the largest number of published articles in the United States. The overall collaboration between authors was not close, with 10 of the most productive authors, and a core author group was not formed. The top 10 research institutions were affiliated with universities. Published journals, disciplines, and keywords focused on the psychology, children, adolescents, psychiatry, women, violence, and public health services, and were developing towards a wide range of population.Conclusions:Research on trauma informed care currently focuses on the application of service objects in mental and psychological service environments, as well as the personnel training and development of measurement tools. With the deepening of research, trauma informed care for other sub healthy populations will be a research hotspot.

ObjectiveTo construct and evaluate the transformation model of the Constitution in Chinese Medicine Questionnaire （CCMQ） to SF-6Dv1 health utility and broaden the applications of CCMQ. MethodsThe data of CCMQ and SF-6Dv1 were collected from 595 participants at baseline， 3 months and 6 months after the comprehensive intervention suitable for the corresponding traditional Chinese medicine （TCM） constitution. The estimation and validation datasets were constructed， and four statistical algorithms including the ordinary least squares （OLS）， MM robust regression （MM）， censored least absolute deviations （CLAD） and the Tobit model were used to create alternative models. The mean absolute error （MAE）， root mean square error （RMSE） and intraclass correlation coefficient （ICC） were used to evaluate the prediction performance of the model. ResultsThe constitution scores of all TCM constitutions by CCMQ was significantly correlated with the SF-6Dv1 health utility value measured at three timepoints； the health utility value of the SF-6Dv1 was positively correlated with gentleness type （r=0.596， r=0.578， r=0.606， all P＜0.05） and negatively correlated with eight unbalanced constitutions （r=-0.586~-0.301， all P＜0.05）. The MM established based on the subscale scores of CCMQ was the optimal mapping model， and the MAE， RMSE， and ICC values were 0.0741， 0.0930 and 0.766， respectively. Gentleness type， qi-deficiency type， phlegm-wetness type， qi-constraint type， and age were the primary factors included in the model. The measured and predicted value of SF-6Dv1 had a moderate positive correlation （r=0.673， r=0.617， P＜0.05） and a good consistency as shown by the Bland-Altman plot. ConclusionBy using MM， the CCMQ can be transformed into SF-6Dv1 health utility value for health economics analysis.

Humans ; Blood Pressure/physiology* ; Cohort Studies ; Patient Discharge ; Ischemic Stroke ; Stroke ; Brain Ischemia ; Diabetes Mellitus ; Hypertension

Abstract OBJECTIVE To explore the effect of the polymorphisms of ATM(rs11212617), KCNJ11(rs5219), CYP2C9(rs1799853, rs1057910), TCF7L2(rs12255372, rs290487) and IRS1(rs1801278) on efficacy of metformin and gliclazide combined treatment for diabetes mellitus type 2. METHODS Eighty-one patients with newly diagnosed diabetes mellitus type 2 in Standardized Metabolic Disease Management Center of the Endocrinology Department of of Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital were enrolled in this study, and they were treated with metformin hydrochloride tablets and gliclazide modified release tablets. MassARRAY was used to type the above single nucleotide polymorphism(SNP), and followed up for 3 months. Fasting plasma glucose(FPG), glycosylated hemoglobin type Alc(HbA1c) and fasting insulin(FINS) were compared before and after treatment. RESULTS The gene frequencies of all SNPs were compliant to Hardy-Weinberg equilibrium, the samples were well represented. The rs1799853, rs1057910, rs12255372 and rs1801278 had low mutation frequencies with poor clinical significance. The benefits of FPG compliance rate, increase of FINS, decrease of HbAlc after treatment were stronger in patients with homozygous rs5219 C allele than those with T-allele carriers (P<0.05). However, there were no significant differences in treatment effects among the genotypes of rs11212617 and rs290487. CONCLUSION The rs5219 polymorphism of KCNJ11 gene is associated with the efficacy of metformin hydrochloride tablets and gliclazide modified release tablets in treating diabetes mellitus type 2, with a more significant effect observed in individuals homozygous for the C allele. This finding can serve as a reference for personalized medication in clinical treatment of diabetes mellitus type 2.

Objective:To use the interpretative phenomenological analysis method of qualitative research to deeply explore the parental care experience in the process of hematopoietic stem cell transplantation in children with hematological diseases.Methods:Through the semi-structured in-depth interview method, we interviewed 10 pairs (20 persons) parents of children receiving hematopoietic stem cell transplantation in Shanghai Children′s Medical Center from October 2019 to August 2020; And the contents of the interview were recorded and transcribed. The transcription data is analyzed according to the interpretive phenomenological analysis method.Results:The parents′ care experience in the process of hematopoietic stem cell transplantation in children with hematological diseases can be summarized into three themes: the emotional changes in the process of transplantation, the dilemma experienced in the process of care, and the personal growth experienced in the process of caring for the child.Conclusion:Understanding the parents′ care experience during the children′s transplantation process can help us to present the family caregivers′ living status, psychological pressure, and coping strategies and resources, and provide guidance for family-focused supportive interventions.

Objective:To investigate the characteristics of bacterial community in upper gastrointestinal tumors.Methods:The study population was patients with upper gastrointestinal tumors (esophageal cancer and gastric cancer). Gastroscopy was performed on the enrolled patients ( n=17), and the specimens were taken from the tumor sites. At the same time, non-tumor tissues more than 4 cm away from the tumor tissues were taken as the control. After total DNA was extracted and purified, high-throughput 16S DNA gene sequencing was used to detect the microbiota in tumor tissues and control tissues. Bioinformatics analysis was carried out and the differences between groups were compared. Results:16S DNA PCR showed that there was no significant difference in bacterial load between tumor tissues and control tissues. The α-diversity and β-diversity indexes showed that the community composition of the two groups was similar; the samples were discrete and the colony composition was different, but there was no significant difference between the two groups. The results of Venn diagram showed that there were more operational taxonomic units (OTUs) in non-tumor tissues than in tumor tissues (2 068 vs 1 358), indicating that the bacterial species in normal tissues were more abundant than those in tumor tissues. Compared with the control tissues, the percentages of Prevotellaceae ( Prevotella), Lactobacaceae ( Lactobacillus) and Fusobacteriaceae ( Fusobacterium) in tumor tissues were relatively higher (the average percentage was more than twice that of the control). Further paired comparison of the top ten bacteria in the family and genus abundance of the two groups of samples showed that Pseudomonas decreased significantly in tumor tissues at the family ( P=0.041) and genus ( P=0.041) levels, while Prevotella was significantly enriched in tumor tissues at the family ( P=0.031) and genus ( P=0.007) levels. Conclusions:The bacterial community in the tumor microenvironment of the upper gastrointestinal tumor changed, and the species enriched in the tumor site were mainly oral common anaerobic bacteria, such as Prevotellaceae ( Prevotella), Lactobacaceae ( Lactobacillus) and Fusobacteriaceae ( Fusobacterium), especially Prevotellaceae ( Prevotella).

At present, there is still a lack of comprehensive diagnosis and treatment criteria for pancreatic exocrine insufficiency around the world. Pancreatic surgeons often ignore or misjudge pancreatic exocrine insufficiency secondary to pancreatic cancer, and as a result, pancreatic exocrine insufficiency is not adequately treated, which greatly affects the quality of life of patients with pancreatic cancer. This article summarizes the latest research advances in the pathogenesis, typical symptoms, and diagnostic methods of pancreatic exocrine insufficiency, as well as pancreatic enzyme replacement therapy in different stages of pancreatic cancer. It is pointed out that pancreatic enzyme replacement therapy can significantly improve the quality of life of patients with different stages of pancreatic cancer.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

In recent years, more and more studies had found that ferroptosis regulated the death of nerve cells in the process of ischemic stroke. The ferroptosis of nerve cells was composed of three pathways: iron metabolism, lipid metabolism and amino acid metabolism. During ischemic stroke, the abnormal intake and excretion of iron in nerve cells with the pathway of iron pathway made the increase of intracellular free iron cause Fenton reaction; the up-regulation of acyl-coenzyme A synthetase long-chain family member 4 and lipoxygenase in lipid pathway promoted the transformation of polyunsaturated fatty acids into lipid peroxides on cell membrane; the abnormality of cystine/glutamate reverse transporter and glutathione peroxidase 4 in amino acid pathway led to the excessive accumulation of lipid peroxides. These pathways were related to each other and eventually led to ferroptosis of nerve cells. Here, the relationship between ischemic stroke and ferroptosis was summarized, in order to provide new ideas for the diagnosis and treatment of ischemic stroke.