1.Uyghur Medicine Yangxin Dawayimixike Honey Paste (养心达瓦依米西克蜜膏) in Treatment of 279 Cases Stable Angina Pectoris Patients with Qi Stagnation and Blood Stasis Syndrome:A Multi-center,Double-blind,Positive-controlled Randomized Clinical Trial
Binghua JIANG ; Lihua FAN ; Xiaofeng WANG ; Yingmin SONG ; Yanlai ZHANG ; Songyan QIAO ; Jing DONG ; Lihua JIN ; Yanping DING ; MAINISHA·MAIMAITI ; Jixian ZHAO ; Dongsheng GAO ; Qiuping ZHAO ; Lingxia GUAN ; Hongbin SUN ; Meise LIN ; Hengliang WANG ; Jun LI
Journal of Traditional Chinese Medicine 2024;65(21):2225-2233
ObjectiveTo observe the efficacy and safety of Uyghur medicine Yangxin Dawayimixike Honey Paste (养心达瓦依米西克蜜膏, YDMHP) in the treatment of stable angina pectoris (SAP) of qi stagnation and blood stasis syndrome. MethodsA randomized , double-blind, positive-controlled,multi-center clinical trial was conducted, in which 370 patients with SAP of qi stagnation and blood stasis syndrome were randomly divided into treatment group(279 cases)and control group(91cases)at a ratio of 3∶1. The treatment group was orally administered with YDMHP, 3 g each time, and placebo of Xuefu Zhuyu Capsule (血府逐瘀胶囊), 2.4 g each time, while the control group was treated with Xuefu Zhuyu Capsule, 2.4 g each time, and placebo of YDMHP, 3 g each time, both twice a day for a course of 12 weeks. The primary outcome was the effect of angina pectoris symptom. The secondary outcomes include single angina symptom scores such as number of attacks, duration of attacks, pain intensity and usae of nitroglycerin scores, the total angina symptom score before and after the treatment, the usage of nitroglycerin, the exercise duration in treadmill exercise test (TET) and the Duck treadmill score among patients,the scores of Seattle Angina Questionnaire (SAQ) on five dimensions including physical limitations, anginal stability, anginal frequency, treatment satisfaction, and disease perception, and efficacy of TCM syndrome and of each single TCM symptom after treatment. The safety were evaluated by examine blood routine, urine routine, liver and kidney function, fasting blood sugar, electrocardiogram, adverse events. ResultsThe total effective rate of angina symptom in the treatment group was 71.69% (200/279), significantly higher than 51.64% (47/91) in the control group (P<0.01). The curative and markedly effective rate of TCM syndrome in the treatment group was 53.05% (148/279), which was significantly higher than 25.27% (23/91) in the control group (P<0.01). After treatment, scores of the number as well as duration of angina attacks and pain severity, the total score of angina symptoms, and the usage of nitroglycerin significantly decreased in both groups, and more changes were seen in the treatment group than in the control group; the scores of physical limitations, anginal stability, anginal frequency, treatment satisfaction, and disease perception in both groups significantly increased, and more improvement were shown in the experimental group regarding the anginal stability, anginal frequency and treatment satisfaction (P<0.05 or P<0.01). The effects of chest pain, chest tightness, palpitation, shortness of breath and fatigue in experimental group were significantly higher than those in control group (P<0.05 or P<0.01). There was no significant difference in the exercise duration of treadmill test and Duke score among patients between the two groups either before or after treatment (P>0.05). Adverse events occurred in 66 cases (23.66%) of the experimental group and 16 cases (17.58%) of the control group, with no statistical significance between the two groups (P>0.05). ConclusionThe Uyghur medicine YDMHP can effectively improve symptoms of angina pectoris, reduce the number, duration, and intensity of attacks, decrease the dosage of nitrogly-cerin and improve the individual TCM symptoms and has good safety in the treatment of SAP patients of qi stagnation and blood stasis.
2.Comparison and related factors of suicide risk among patients with schizophrenia,major depressive disorder,and bipolar disorder
Chuanlin LUO ; Yuanyuan LI ; Zhaorui LIU ; Yanling HE ; Liang ZHOU ; Bo LIU ; Jie ZHANG ; Yuandong GONG ; Yan LIU ; Jin LU ; Yanping ZHOU ; Changqing GAO ; Qing DONG ; Defang CAI ; Runxu YANG ; Tingting ZHANG ; Yueqin HUANG
Chinese Mental Health Journal 2024;38(1):1-8
Objective:To describe and analyze suicide risk of patients with schizophrenia,major depressive disorder,and bipolar disorder.Methods:A total of 2 016 patients with schizophrenia,903 patients with major de-pressive disorder,and 381 patients with bipolar disorder from inpatients,clinics,or communities who met the diag-nostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition were recruited.All patients were interviewed by psychiatrists using the Mini International Neuropsychiatric Interview to diagnose mental disor-ders and assess suicide risk,as well as Clinical-Rated Dimensions of Psychosis Symptom Severity(CRDPSS)to as-sess symptoms.Differences and risk factors of suicide risk among three types of mental disorders were explored u-sing multivariate logistic regression analysis.Results:In the past one month,37 patients with schizophrenia(1.8%),516 patients with major depressive disorder(57.1%),and 102 patients with bipolar disorder(26.8%)had suicide risk.Compared with patients with schizophrenia,suicide risk in patients with major depressive disorder(OR=36.50)and bipolar disorder(OR=20.10)increased.Female(OR=1.87),smoking(OR=1.76),family history of suicide(OR=5.09),higher score of CRDPSS hallucination(OR=1.80),and higher score of CRDPSS depression(OR=1.54)were risk factors of suicide risk of patients.Conclusions:Suicide risk of patients with ma-jor depressive disorder and bipolar disorder is higher than that of patients with schizophrenia.In clinical practice,it is important to regularly assess suicide risk of patients.Patients who experience symptoms of hallucination and de-pression should be paid more attention to.
3.Ginger oil-loaded transdermal adhesive patch treats post-traumatic stress disorder
Xingshuang Song ; Yizhi Zhang ; Ziyan Tang ; Jing Dai ; Yanping Wu ; Guiyu Huang ; Hong Niu ; Yaxin Wang ; Xu Jin ; Lina Du
Journal of Traditional Chinese Medical Sciences 2024;11(3):316-329
Objective:
To find a viable alternative to reduce the number of doses required for the patients with post-traumatic stress disorder (PTSD), and to improve efficacy and patient compliance.
Methods:
In this study, we used ginger oil, a phytochemical with potential therapeutic properties, to prepare ginger oil patches. High-performance liquid chromatography (HPLC) was used to quantify the main active component of ginger oil, 6-gingerol. Transdermal absorption experiments were conducted to optimize the various pressure-sensitive adhesives and permeation enhancers, including their type and concentration. Subsequently, the ginger oil patches were optimized and subjected to content determination and property evaluations. A PTSD mouse model was established using the foot-shock method. The therapeutic effect of ginger oil patches on PTSD was assessed through pathological sections, behavioral tests, and the evaluation of biomarkers such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), brain-derived neurotrophic factor (BDNF), and melatonin (MT).
Results:
The results demonstrated that ginger oil patches exerted therapeutic effects against PTSD by inhibiting inflammatory responses and modulating MT and BDNF levels. Pharmacokinetic experiments revealed that ginger oil patches maintained a stable blood drug concentration for at least one day, addressing the rapid metabolism drawback of 6-gingerol and enhancing its therapeutic efficacy.
Conclusions
Ginger oil can be prepared as a transdermal drug patch that meets these requirements, and the bioavailability of the prepared patch is better than that of oral administration. It can improve PTSD with good patient compliance and ease of administration. Therefore, it is a promising therapeutic formulation for the treatment of PTSD.
4.Development and reliability and validity test of the Intrinsic Capacity Assessment Scale for the Older People
Zhili YAN ; Zhilan YANG ; Huimin ZHAO ; Yanping ZHAI ; Yueyue JIA ; Yuanyuan JIN ; Ziwei TIAN ; Xingyu LIU
Chinese Journal of Nursing 2024;59(15):1852-1859
Objective To develop and test the reliability and validity of the Intrinsic Capacity Assessment Scale for the Older People,so as to provide an effective tool for the assessment of the intrinsic capacity of the aged.Methods Based on the International Classification of Functioning,Disability and Health(ICF)as the theoretical framework,the initial version of The Intrinsic Capacity Assessment Scale for the Older People was developed through literature analysis,Delphi expert consultation and pre-survey.From July to September 2023,650 old people were selected by convenience sampling method to conduct a survey,and 20 old people were surveyed after 2 weeks again to test the reliability and validity of the scale.Results The effective questionnaire recovery rates of the 2 rounds of expert correspondence were 92.3%and 91.7%;the expert authority coefficients were 0.83 and 0.86;the mean importance scores of items were 2.04-3.79 and 3.50-3.82,and the full score ratios were 4.2%-83.3%and 54.6%-86.4%,respectively.The coefficients of variation were 0.11-0.42 and 0.11-0.23,respectively.A total of 5 common factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 68.327%.The results of confirmatory factor analysis showed that the fit indexes were x2/df=1.908,RMSEA=0.054,CFI=0.931,IFI=0.932,TLI=0.922,indicating a good fit.The Cronbach's α coefficient of the scale was 0.944;the split half reliability was 0.806;the retest reliability was 0.933.The content validity index of item level was 0.82-1.00,and the content validity index of scale level was 0.91.The Intrinsic Capacity Assessment Scale for the Older People included 35 items in 5 dimensions:movement,vitality,sensation,cognition and psychology.Conclusion The Intrinsic Capacity Assessment Scale for the Older People has good reliability and validity,and it can be used as a reliable tool to evaluate the intrinsic capacity level of the aged.
5.Seroepidemiological analysis of hepatitis B virus infection among adolescents aged 0-14 years in Henan Province and preliminary evaluation of the effectiveness of childhood hepatitis B vaccine immunization program
Yonghao GUO ; Yanping CHEN ; Qiaohua DOU ; Qian LIU ; Jianhui YANG ; Minghua SENG ; Wanyu LYU ; Changshuang WANG ; Mingxia LU ; Jin XU ; Yanyang ZHANG ; Dongyang ZHAO
Chinese Journal of Preventive Medicine 2024;58(2):202-207
Objective:To analyze the seroepidemiological characteristics of hepatitis B virus (HBV) infection among adolescents aged 0-14 years in Henan Province and to evaluate the effectiveness of the childhood hepatitis B vaccine (HepB) immunization program.Methods:From September 2021 to March 2022, a total of 4 883 adolescents aged 0-14 years were selected from 25 villages or communities of 18 provincial-level cities in Henan Province by using the multi-stage random cluster sampling method. Demographic data were collected through questionnaires. The 3 ml of blood samples were collected from individuals aged 0-4 years and 5 ml of blood samples were collected from individuals aged 5-14 years to test HBsAg, HBcAb and HBsAb. Data on vaccination were collected through Henan Provincial Immunization Information System and hepatitis B cases in Henan Province were collected through China Infectious Disease Reporting System. The effectiveness of the childhood HepB immunization program was analyzed.Results:The average age of 4 883 subjects was (7.32±2.81) years old. The positive rates of HBsAg and HBcAb were 0.1% (7/4 883) and 1.0% (50/4 883), and the population standardized rates were 0.3% and 1.7%. In 2002, the positive rate of HBsAg among adolescents aged 0-14 years in Henan Province was 3.39%. Compared with that in 2002, the number of chronic HBV infections among adolescents in Henan Province in 2022 decreased by about 0.7 million. In 2002, the vaccination rate of newborns who completed all three doses of vaccine was 6.26%. In 2003, the vaccination rate of the hepatitis B vaccine rose rapidly, reaching 90% in 2013 for the first time. After 2014, the vaccination rate in Henan Province continued to remain above 95%. The proportion of cases among children aged 1-4 years in clinical reports decreased from 0.43% (1 108/256 566) in 2006 to 0.01% (78/80 655) in 2021. The proportion of cases among adolescents aged 5-19 years decreased from 18.21% (46 710/256 566) in 2006 to 1.1% (827/80 655) in 2021.Conclusions:From 2002 to 2022, the positive rate of HBsAg among adolescents aged 0-14 years has decreased significantly in Henan Province. The effectiveness of the HepB immunization program for children is good.
6.Malnutrition is associated with dysphagia in patients with Parkinsonism
Rui WANG ; Jin FU ; Rui LI ; Yuping ZHANG ; Han WANG ; Yanping LIU
Basic & Clinical Medicine 2024;44(9):1274-1278
Objective To identify the characteristics of nutritional problems in patients with Parkinsonism who par-ticipated in multi-disciplinary team(MDT)and to investigate the correlation between nutritional status and dyspha-gia in these patients.The predictive value of video fluoroscopic swallowing study(VFSS)and EAT-10 scale for malnutrition was compared.Methods Subjects were patients with Parkinsonism participated in joint MDT consulta-tion project in Peking Union Medical College Hospital from November 2020 to January 2023.Subjective and objec-tive dysphagia were evaluated by EAT-10 scale score and VFSS dysphagia score.Nutritional status of the patients was evaluated by geriatric nutrition risk index(GNRI),albumin,prealbumin,serum folic acid,vitamin B12 and temporal muscle thickness.Results A total of 30 participants met the criteria and were included in the study.The age was 45-82(66.1±9.0)years old.Six(20%)were at risk of malnutrition shown b a comprehensive nutri-tional status assessment using GNRI.The areas under receiver operating characteristic(ROC)curves(AUC)of VFSS dysphagia score and EAT-10 score to predict malnutrition were 0.781(0.568-0.995)and 0.927(0.827-1.000),respectively.EAT-10 score was correlated with GNRI(r=-0.524,P<0.01),BMI(r=-0.618,P<0.001),prealbumin(r=-0.616,P<0.001).The VFSS dysphagia score was only correlated with BMI(r=-0.446,P<0.05)and prealbumin(r=-0.387,P<0.05).Conclusions Patients with Parkin-sonism requiring MDT often have multiple micronutrient imbalance.Patients' subjective perception of dysphagia has a greater impact on their nutritional status than objective assessment of dysphagia.
7.Prevalence and risk factors of sarcopenia in patients with multiple system atrophy
Jin FU ; Yanping LIU ; Han WANG ; Rui WANG ; Kang YU
Basic & Clinical Medicine 2024;44(11):1516-1521
Objective To find the prevalence of sarcopenia in patients with multiple system atrophy(MSA)and to explore the muscle related risk factors that affect the ability if living and exercise of patients.Methods Through a cross-sectional study,patients with Parkinson's disease(PD)and movement disorders who visited the multidiscipli-nary outpatient clinic of Peking Union Medical College Hospital from October 2022 to December 2023 were includ-ed.Their demographic data and disease duration were collected.The modified Barthel Index(simplified Chinese version)was applied to evaluate the participants'living ability.The severity of movement disorders and non-motor symptoms were evaluated by the Unified PD rating scale.The body composition,grip strength,SARC-F score were used to evaluate the muscle condition of patients and the diagnosis of sarcopenia and pre sarcopenia were made ac-cording to EWGSOP2.Results Among 44 patients included in this study,8(18.8%)were diagnosed with sarcope-nia,17(38.6%)were pre-sarcopenia and 19(43.2)had normal muscle condition.There were significant differences in disease-related clinical characteristics among the three groups.MSA patients were characterized by older age(P<0.01).They had lower BMI(P<0.01),and worse disease symptom score(P<0.01),SARC-F score(P<0.05),and activity score(P<0.01),significantly reduced fat removal weight(P<0.01)and phase angle(P<0.05).Regression analysis showed that SARC-F score,grip strength,limb skeletal muscle index and fat free weight were all independent risk factors affecting the ability of living and exercise of MSA patients.Conclusions The preval-ence of MSA sarcopenia is higher and sarcopenia is closely associated with more severe clinical illness and lower living ability.It is an independent risk factor for increased living ability score and motor function score.
8.Risk factors for unplanned readmission after transjugular intrahepatic portosystemic shunt in cirrhotic patients with esophagogastric variceal bleeding and construction of a nomogram model
Qin YIN ; Zhaorong WU ; Feng ZHANG ; Chunyan JIN ; Yanping CAO ; Jiangqiang XIAO ; Yuzheng ZHUGE ; Qian WANG
Journal of Clinical Hepatology 2024;40(9):1796-1801
Objective To investigate the risk factors for unplanned readmission within 30 days after discharge in cirrhotic patients with esophagogastric variceal bleeding undergoing transjugular intrahepatic portosystemic shunt(TIPS),and to construct a nomogram predictive model.Methods A total of 241 cirrhotic patients who underwent TIPS due to esophagogastric variceal bleeding in Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2020 to June 2023 were enrolled as subjects,and unplanned readmission within 30 days was analyzed.According to the presence or absence of unplanned readmission,they were divided into readmission group with 36 patients and non-readmission group with 198 patients,and related clinical data were collected from all patients.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups.A logistic regression analysis was used to identify independent risk factors for unplanned readmission.A nomogram prediction model was constructed,and the receiver operating characteristic(ROC)curve was plotted to assess its discriminatory ability for unplanned readmission;the calibration curve was plotted to evaluate the consistency of the nomogram model in predicting unplanned readmission;the ResourceSelection package of R language was used for the Hosmer-Lemeshow goodness-of-fit test to evaluate the degree of fitting of the mode;the decision curve analysis was used to investigate the practicality of the model.Results Age(odds ratio[OR]=2.664,95%confidence interval[CI]:1.139-6.233,P<0.05),CTP score(OR=1.655,95%CI:1.098-2.495,P<0.05),and blood ammonia(OR=1.032,95%CI:1.016-1.048,P<0.05)were independent risk factors for unplanned readmission within 30 days after discharge in the patients undergoing TIPS.The multivariate analysis showed that for the nomogram predictive model constructed in this study,repeated sampling for 1 000 times using the Bootstrap method was performed for internal validation,and the area under the ROC curve was 0.773,which was significantly higher than that of age(0.582),CTP score(0.675),and blood ammonia(0.641).The calibration curve showed good consistency between the probability of unplanned readmission predicted by the nomogram model and the actual probability,and the Hosmer-Lemeshow goodness-of-fit test showed good degree of fitting(c2=5.647 3,P=0.686 7).Conclusion Age,CTP score,and blood ammonia are independent risk factors for unplanned readmission within 30 days after TIPS,and the nomogram prediction model constructed based on these factors can help to predict the risk of unplanned readmission in TIPS patients and provide an accurate decision-making basis for early prevention.
9.Inhibitory effect and mechanism of alkaloids derived from Gelsemium elegans Benth on lung cancer
Mingjing JIN ; Yanping LI ; Huansi ZHOU ; Binrui WANG ; Zhuoling WU ; Chunhua LU
Journal of Army Medical University 2024;46(23):2629-2641
Objective To determine the anti-lung cancer effect of koumine(KOU)and total alkaloids of Gelsemium elegans Benth(TAG)and investigate the underlying mechanism.Methods After low,medium and high concentrations(100,150,200 μg/mL)of KOU were used to treat human lung adenocarcinoma cell lines A549 and SPCA1,Live Cell Imaging and Analysis by Sartorius colony formation assay was employed to detect the cell proliferation.The transplanted tumor model of lung cancer cells in mice was constructed and divided into model group(model group),cyclophosphamide group(CTX group,20 mg/kg),KOU group(2 mg/kg)and TAG group(0.5 mg/kg).After the mice of the CTX,KOU and TAG groups were intraperitoneally injected with 0.1 mL/10 g corresponding agents every other day for 10 d,the growth of lung cancer solid tumors was observed grossly and with HE staining,immunohistochemical(IHC)assay and TUNEL staining to and calculate the tumor size and growth inhibitory rate.RNA sequencing analysis was performed on A549 cells treated with TAG for 48 h to screen the differentially expressed genes(DEGs)between the treatment group and the control group,and the obtained DEGs were further analyzed with Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)functional enrichment analyses.RT-qPCR was applied to further analyze and verify the expression of related genes.Results Live Cell Imaging and Analysis fitted that the confluence of A549 and SPCA1 cells was decreased and the number of cells in the treated groups was observed to decrease,with poor growth.The results of colony formation assay confirmed that KOU reduced the number of cell clones,especially at a dose of 200 μg/mL(P<0.01).Animal experiments showed that KOU and TAG treatment inhibited the tumor growth by 24.55%and 36.08%,respectively.TAG treatment resulted in significantly decreased tumor size when compared with the model group(P<0.05).RNA sequencing analysis revealed that there were totally 2 793 DEGs,including 1 433 up-regulated genes and 1 360 down-regulated ones.Enrichment analysis displayed that the DEGs were mainly enriched in IL-17 signaling pathway,tumor necrosis factor signaling pathway and P53 signaling pathway.The results of RT-qPCR were consistent with the results of RNA sequencing analysis.The expression levels of GADD34,ZFP36,GADD45 A,GADD45 B and TP53INP2 genes were significantly increased in the TAG group(P<0.01).Conclusion Alkaloids of Gelsemium elegans Benth inhibits the proliferation of lung cancer in vivo and in vitro.Transcriptomics find that KOU and TAG inhibit multiple DEGs and pathways of lung cancer.
10.Seroepidemiological analysis of hepatitis B virus infection among adolescents aged 0-14 years in Henan Province and preliminary evaluation of the effectiveness of childhood hepatitis B vaccine immunization program
Yonghao GUO ; Yanping CHEN ; Qiaohua DOU ; Qian LIU ; Jianhui YANG ; Minghua SENG ; Wanyu LYU ; Changshuang WANG ; Mingxia LU ; Jin XU ; Yanyang ZHANG ; Dongyang ZHAO
Chinese Journal of Preventive Medicine 2024;58(2):202-207
Objective:To analyze the seroepidemiological characteristics of hepatitis B virus (HBV) infection among adolescents aged 0-14 years in Henan Province and to evaluate the effectiveness of the childhood hepatitis B vaccine (HepB) immunization program.Methods:From September 2021 to March 2022, a total of 4 883 adolescents aged 0-14 years were selected from 25 villages or communities of 18 provincial-level cities in Henan Province by using the multi-stage random cluster sampling method. Demographic data were collected through questionnaires. The 3 ml of blood samples were collected from individuals aged 0-4 years and 5 ml of blood samples were collected from individuals aged 5-14 years to test HBsAg, HBcAb and HBsAb. Data on vaccination were collected through Henan Provincial Immunization Information System and hepatitis B cases in Henan Province were collected through China Infectious Disease Reporting System. The effectiveness of the childhood HepB immunization program was analyzed.Results:The average age of 4 883 subjects was (7.32±2.81) years old. The positive rates of HBsAg and HBcAb were 0.1% (7/4 883) and 1.0% (50/4 883), and the population standardized rates were 0.3% and 1.7%. In 2002, the positive rate of HBsAg among adolescents aged 0-14 years in Henan Province was 3.39%. Compared with that in 2002, the number of chronic HBV infections among adolescents in Henan Province in 2022 decreased by about 0.7 million. In 2002, the vaccination rate of newborns who completed all three doses of vaccine was 6.26%. In 2003, the vaccination rate of the hepatitis B vaccine rose rapidly, reaching 90% in 2013 for the first time. After 2014, the vaccination rate in Henan Province continued to remain above 95%. The proportion of cases among children aged 1-4 years in clinical reports decreased from 0.43% (1 108/256 566) in 2006 to 0.01% (78/80 655) in 2021. The proportion of cases among adolescents aged 5-19 years decreased from 18.21% (46 710/256 566) in 2006 to 1.1% (827/80 655) in 2021.Conclusions:From 2002 to 2022, the positive rate of HBsAg among adolescents aged 0-14 years has decreased significantly in Henan Province. The effectiveness of the HepB immunization program for children is good.


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