Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Aim To investigate the effect of hypobaric hypoxia on macrophage necroptosis and atherosclerotic plaque instability and explore the underlying mechanisms.Methods Mouse bone marrow-derived macrophages were i-solated and cultured,and divided into control group(21％oxygen concentration)and hypoxia group(3％oxygen concen-tration).After 48 hours,cell necroptosis was detected,and the expression of cell necroptosis related proteins was deter-mined by Western blot.Healthy male ApoE-/-mice were randomly divided into control group and hypobaric hypoxia group.After the intervention for 16 weeks,the plasma lipids and inflammatory cytokines were measured,the areas of ath-erosclerotic plaque and necrotic core were evaluated by HE staining.The content of plaque collagen was detected by Mas-son staining.The number of macrophages in the plaque and the expression of necrotic apoptosis related proteins were de-tected by immunohistochemical staining and Western blot.Results Hypoxia induced increased necrotic apoptosis of macrophages(P＜0.01),while necroptotic inhibitor necrostatin-1(Nec-1)reduced hypoxia induced cell death(P＜0.05);hypoxia leads to a decrease in the expression of adenosine deaminase acting on RNA 1(ADAR1)in macrophages(P＜0.01),and an increase in the expression of Z-DNA binding protein 1(ZBP1),phosphorylated receptor-interacting serine/threonine-protein kinase(p-RIPK3),and phosphorylated mixed lineage kinase domain-like protein(p-MLKL)(all P＜0.01).Compared with the control group,the plasma lipid levels of ApoE-/-mice in the hypobaric hypoxia group did not change significantly(P＞0.05),the plasma inflammatory cytokines(TNF-α,IL-1β,IL-6 and MCP-1)increased(all P＜0.05),the area of atherosclerotic plaque increased(P＜0.05),the area of plaque necrotic core increased,the content of plaque collagen decreased,the number of macrophages increased,the expression of ADAR1 decreased,and the expres-sion of ZBP1 and p-MLKL increased(all P＜0.01).Conclusion Hypobaric hypoxia causes the imbalance of A-DAR1/ZBP1 expression in macrophages,activates RIPK3/MLKL signaling pathway,promotes macrophage necroptosis,in-creases the area of plaque necrosis core,and leads to increase instability of atherosclerotic plaque.

Objective To explore the correlation between traditional Chinese medicine(TCM)syndromes of chronic gastritis and the indicators of five circuits and six qi,revealing the influence of different congenital qi endowments on TCM syndrome differentiation and providing evidence for individualized treatment.Methods Medical records meeting inclusion/exclusion criteria were collected from the Hospital Information System(HIS)of Rui Bao Street Community Health Service Center in Haizhu District,Guangzhou between January 20,2017 and January 20,2023.Data included age,birth date,and syndrome differentiation.Yearly circuit(Suiyun),celestial control-terrestrial effect(Sitian-Zaiqian)qi,three patterns of five circuits(Wuyun-Sanji),and syndrome patterns were statistically analyzed using Excel for database construction,with SPSS 23.0 for x2 tests and Logistic regression.Results(1)Among 1 882 chronic gastritis patients,spleen-stomach weakness(25.3％,477/1 882)was the most prevalent syndrome,followed by liver-stomach disharmony type,damp-heat in the spleen-stomach type,stomach-yin deficiency type,and stasis obstruction of stomach collateral type(x2=69.950,P=0.000).(2)Significant differences existed in Suiyun(Taijiao,Taigong,Taiyu,Taizhi,Shaogong,Taishang),Sitian-Zaiqian(Shaoyin-Yangming,Taiyin-Taiyang,Yangming-Shaoyin,Taiyang-Taiyin),and Wuyun-Sanji(excessive/insufficient earth/metal/water circuit)distributions among syndromes(P＜0.05 or P＜0.01).(3)For Suiyun-syndrome relationships:Birth in Taijiao/Shaogong years was the high-risk factor for developing chronic gastritis of liver-stomach disharmony type(P＜0.01);Taishang years were associated with stomach yin deficiency type(P＜0.05);Taijiao/Shaogong/Taiyu years were protective against damp-heat in the spleen-stomach type(P＜0.05 or P＜0.01).(4)For Sitian-Zaiqian-syndrome relationships:Jueyin-Shaoyang/Yangming-Shaoyin years linked to spleen-stomach weakness type(P＜0.05);Shaoyang-Jueyin years were correlated with damp-heat in the spleen-stomach type(P＜0.05).(5)For Wuyun-Sanji-syndrome relationships:Insufficient earth/water circuit years were associated with liver-stomach disharmony type(P＜0.05 or P＜0.01);excessive/balanced metal circuit years linked to stomach yin deficiency type(P＜0.05 or P＜0.01);insufficient metal circuit years were correlated with damp-heat in the spleen-stomach type(P＜0.05).Conclusion TCM syndromes of chronic gastritis are influenced by environment-body interactions,disordered visceral function and yin-yang imbalance.Clinical treatment should integrate the varied indicators of five circuits and six qi variations for personalized regimens to improve symptoms and quality of life.

OBJECTIVE: To observe the efficacy of "Biaoben acupoint compatibility" moxibustion for abdominal obesity and its effect on blood lipid, lipid accumulation product (LAP) and cardiometabolic index (CMI). METHODS: A total of 150 patients with abdominal obesity were randomly divided into an observation group (75 cases, 5 cases dropped out) and a control group (75 cases, 6 cases dropped out). The control group received lifestyle guidance. The observation group received "Biaoben acupoint compatibility" moxibustion at Zhongwan (CV12), Guanyuan (CV4) and bilateral Tianshu (ST25), Zusanli (ST36) on the basis of the control group, 20 min each time, once every other day, 3 times a week for 8 weeks. Before and after treatment, the waist circumference, hip circumference, weight, body mass index (BMI) were observed, the levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured, and the LAP and CMI were calculated in the two groups. RESULTS: After treatment, the waist circumference, weight and BMI were decreased compared with those before treatment in both groups (P<0.05), the changes of the above indexes in the observation group were larger than those in the control group (P<0.05). After treatment, the hip circumference, TC level, TG level, LAP and CMI in the observation group were decreased compared with those before treatment (P<0.05), the HDL-C level was increased compared with that before treatment (P<0.05)；the changes of the TC level, TG level, LAP, CMI and HDL-C level in the observation group were larger than those in the control group (P<0.05). CONCLUSION "Biaoben acupoint compatibility" moxibustion can reduce the degree of obesity in patients with abdominal obesity, and improve blood lipid and reduce lipid accumulation.
Humans ; Acupuncture Points ; Moxibustion ; Male ; Female ; Middle Aged ; Obesity, Abdominal/blood* ; Adult ; Lipids/blood* ; Lipid Metabolism ; Triglycerides/blood* ; Young Adult ; Treatment Outcome ; Aged

OBJECTIVE: To observe the efficacy and safety of moxibustion in treating patients with central obesity of phlegm-dampness constitution. METHODS: A total of 66 patients with central obesity of phlegm-dampness constitution were randomly assigned to a moxibustion group (n=33, 3 cases dropped out) and a sham moxibustion group (n=33, 4 cases dropped out). The moxibustion group received mild moxibustion combined with lifestyle intervention; the moxibustion was applied at Shenque (CV8) and bilateral Zusanli (ST36), 30 min per session, maintaining a local skin temperature of (43±1) ℃. The sham moxibustion group received simulated moxibustion combined with lifestyle intervention; the simulated moxibustion was applied at the same acupoints, with the same session length, but with a maintained skin temperature of (37±1) ℃. Both groups were treated once every other day, three times per week for 8 consecutive weeks. Obesity-related physical indicators (waist circumference, hip circumference, body weight, body fat percentage, body mass index [BMI]), constitution evaluation indicators (phlegm-dampness constitution conversion score, symptom score), the impact of weight on quality of life-lite (IWQOL-Lite), the hospital anxiety and depression scale (HADS), and the incidence of adverse events were measured before and after treatment, and after 4 weeks of follow-up. RESULTS: Compared with before treatment, both groups showed significant reductions in waist circumference, hip circumference, body weight, body fat percentage, BMI, phlegm-dampness constitution conversion score and symptom score, IWQOL-Lite, and both anxiety and depression subscale scores of HADS after treatment and at follow-up (P<0.001). These improvements were significantly greater in the moxibustion group than those in the sham moxibustion group (P<0.001, P<0.01, P<0.05). One patient in the moxibustion group experienced a mild burn that resolved with routine care; the incidence of adverse reactions was 3.0% (1/33) in the moxibustion group and 0% (0/33) in the sham moxibustion group, with no statistically significant difference (P>0.05). CONCLUSION On the basis of lifestyle intervention, moxibustion effectively improves obesity-related physical indicators, enhances quality of life, alleviates anxiety and depression, and improves the phlegm-dampness constitution in patients with central obesity. These benefits persist for at least 4 weeks after treatment.
Humans ; Moxibustion ; Male ; Female ; Middle Aged ; Adult ; Obesity, Abdominal/psychology* ; Acupuncture Points ; Treatment Outcome ; Aged ; Quality of Life ; Young Adult ; Body Mass Index

Aim To investigate the effect of hypobaric hypoxia on macrophage necroptosis and atherosclerotic plaque instability and explore the underlying mechanisms.Methods Mouse bone marrow-derived macrophages were i-solated and cultured,and divided into control group(21％oxygen concentration)and hypoxia group(3％oxygen concen-tration).After 48 hours,cell necroptosis was detected,and the expression of cell necroptosis related proteins was deter-mined by Western blot.Healthy male ApoE-/-mice were randomly divided into control group and hypobaric hypoxia group.After the intervention for 16 weeks,the plasma lipids and inflammatory cytokines were measured,the areas of ath-erosclerotic plaque and necrotic core were evaluated by HE staining.The content of plaque collagen was detected by Mas-son staining.The number of macrophages in the plaque and the expression of necrotic apoptosis related proteins were de-tected by immunohistochemical staining and Western blot.Results Hypoxia induced increased necrotic apoptosis of macrophages(P＜0.01),while necroptotic inhibitor necrostatin-1(Nec-1)reduced hypoxia induced cell death(P＜0.05);hypoxia leads to a decrease in the expression of adenosine deaminase acting on RNA 1(ADAR1)in macrophages(P＜0.01),and an increase in the expression of Z-DNA binding protein 1(ZBP1),phosphorylated receptor-interacting serine/threonine-protein kinase(p-RIPK3),and phosphorylated mixed lineage kinase domain-like protein(p-MLKL)(all P＜0.01).Compared with the control group,the plasma lipid levels of ApoE-/-mice in the hypobaric hypoxia group did not change significantly(P＞0.05),the plasma inflammatory cytokines(TNF-α,IL-1β,IL-6 and MCP-1)increased(all P＜0.05),the area of atherosclerotic plaque increased(P＜0.05),the area of plaque necrotic core increased,the content of plaque collagen decreased,the number of macrophages increased,the expression of ADAR1 decreased,and the expres-sion of ZBP1 and p-MLKL increased(all P＜0.01).Conclusion Hypobaric hypoxia causes the imbalance of A-DAR1/ZBP1 expression in macrophages,activates RIPK3/MLKL signaling pathway,promotes macrophage necroptosis,in-creases the area of plaque necrosis core,and leads to increase instability of atherosclerotic plaque.

Objective Based on the real-world data,we aimed to study the clinical efficacy and safety of Yangyin Shugan(method of nourishing yin and soothing liver)Decoction,an empirical prescription of famous traditional Chinese medicine(TCM)practitioners,in the treatment of premature ovarian insufficiency(POI)with pattern of kidney deficiency and liver depression.Methods A total of 618 POI patients with pattern of kidney deficiency and liver depression who registered in the outpatient electronic medical record system of Guangdong Provincial Hospital of Chinese Medicine were collected from January 2020 to December 2023.After 1:1 propensity matching,a total of 222 patients with POI who met the criteria were included and assigned to a Yangyin Shugan Decoction group(treated with Yangyin Shugan Decoction only)and a hormone control group(hormone treatment only),with 111 cases in each group.Age,age at menarche,marriage status,duration,times of pregnancy,times of miscarriage,menstrual total score,total score of TCM syndrome,basal serum follicle-stimulating hormone(bFSH),and anti-Müllerian hormone(AMH)were recorded and compared.After 3 to 4 months of treatment,the clinical efficacy between the two groups include TCM syndromes,menstrual,bFSH,and menstrual normalization rates during the follow-up period(3 months after discontinuation of medication)were compared.Additionally,comparisons were also made before and after treatment for the total score of TCM syndrome and scores of individual symptom,menstrual total score and scores of indicator,bFSH level,and AMH levels in both groups.Results(ⅰ)The total effective rate of the TCM syndrome in the Yangyin Shugan Decoction group and hormone control group were 85.59%and 52.25%,respectively;the total effective rate of menstrual were 54.95%and 90.99%,respectively;the menstrual normalization rate during the follow-up period were 31.53%and 9.01%,respectively;and regarding bFSH efficacy,the total effective rate were 70.27%and 27.03%,respectively,and the normalization rate of bFSH were 35.14%and 9.01%,respectively.The differences between the two groups were statistically significant(P<0.01).(ⅱ)The bFSH value in the Yangyin Shugan Decoction group decreased after treatment compared to before treatment(P<0.01),while the bFSH value in the hormone control group showed no change before and after treatment.The AMH value increased after treatment compared to before treatment in Yangyin Shugan Decoction group(P<0.01),while the AMH value in the hormone control group showed no change before and after treatment.The difference of bFSH and AMH between the two groups after treatment was statistically significant(P<0.01).(ⅲ)After treatment,the total score of TCM syndrome and the scores of individual symptom in the Yangyin Shugan Decoction group were lower than those before treatment(P<0.01);the total score of TCM syndrome,scores of hot flushes and sweating,hyposexuality,and insomnia in the hormone control group were lower than those before treatment(P<0.01).After treatment,the total score of TCM syndrome and the scores of individual symptom in the Yangyin Shugan Decoction group were lower than those in the hormone control group(P<0.01).(ⅳ)After treatment,the menstrual total score,scores of menstrual cycle,period,menstrual flow,and menstrual blood color in the Yangyin Shugan Decoction group were lower than those before treatment(P<0.01);the menstrual total score,score of menstrual cycle,period,and menstrual flow in the hormone control group were lower than those before treatment(P<0.01);after treatment,the menstrual total score and menstrual cycle score in the hormone control group were better than those in the Yangyin Shugan Decoction group(P<0.01).(ⅴ)No adverse reactions were observed in the Yangyin Shugan Decoction group and 29 cases of adverse reactions were observed in the hormone control group.Conclusion Yangyin Shugan Decoction can effectively improve TCM syndrome in POI patients with pattern of kidney deficiency and liver depression;downregulate the elevated bFSH level,increase the low AMH level,and effectively improve ovarian function,even continue to maintain menstruation after drug withdrawal.In the real world,Yangyin Shugan Decoction got satisfactory efficacy and good safety in the treatment of POI,which deserves clinical promotion and application.

AIM:To examine the effects of borneol on inflammation and myocardial remodeling after myocar-dial infarction(MI)in mice,and to investigate the underlying mechanisms.METHODS:Eight-week-old wild-type(WT)C57BL/6 mice and transient receptor potential cation channel subfamily M member 8(TRPM8)gene knockout(TRPM8-/-)mice were randomly divided into sham and MI groups,and were subsequently treated with normal saline(control group)or borneol(borneol group)via gavage.Survival curves were plotted for WT and TRPM8-/-mice with MI treated with or with-out borneol.After 28 d,cardiac function of the mice was assessed through echocardiography,and haemodynamic indexes were evaluated using a multi-channel physiological instrument.Infarct size,myocardial hypertrophy and interstitial fibro-sis were assessed via pathological staining.In addition,inflammatory response in the peri-infarct region was detected.RE-SULTS:The TRPM8 expression was up-regulated in the peri-infarct region of the mice with MI(P＜0.05),and borneol had no effect on TRPM8 expression(P＞0.05).Borneol increased the survival rate,reduced the infarct size,inhibited car-diac remodeling and improved cardiac function in WT mice with MI(P＜0.05 or P＜0.01).However,it did not affect the survival rate,infarct size,myocardial hypertrophy,myocardial fibrosis or cardiac function in TRPM8-/-mice(P＞0.05).Furthermore,borneol reduced inflammatory cell infiltration and the expression of inflammatory cytokines,tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-6 and monocyte chemotactic protein-1(MCP-1),in WT mice(P＜0.05 or P＜0.01)but not in TRPM8-/-mice(P＞0.05).CONCLUSION:Borneol attenuates inflammation,inhibits cardiac re-modeling and improves cardiac function in mice with MI via TRPM8.

Objective Based on the real-world data,we aimed to study the clinical efficacy and safety of Yangyin Shugan(method of nourishing yin and soothing liver)Decoction,an empirical prescription of famous traditional Chinese medicine(TCM)practitioners,in the treatment of premature ovarian insufficiency(POI)with pattern of kidney deficiency and liver depression.Methods A total of 618 POI patients with pattern of kidney deficiency and liver depression who registered in the outpatient electronic medical record system of Guangdong Provincial Hospital of Chinese Medicine were collected from January 2020 to December 2023.After 1:1 propensity matching,a total of 222 patients with POI who met the criteria were included and assigned to a Yangyin Shugan Decoction group(treated with Yangyin Shugan Decoction only)and a hormone control group(hormone treatment only),with 111 cases in each group.Age,age at menarche,marriage status,duration,times of pregnancy,times of miscarriage,menstrual total score,total score of TCM syndrome,basal serum follicle-stimulating hormone(bFSH),and anti-Müllerian hormone(AMH)were recorded and compared.After 3 to 4 months of treatment,the clinical efficacy between the two groups include TCM syndromes,menstrual,bFSH,and menstrual normalization rates during the follow-up period(3 months after discontinuation of medication)were compared.Additionally,comparisons were also made before and after treatment for the total score of TCM syndrome and scores of individual symptom,menstrual total score and scores of indicator,bFSH level,and AMH levels in both groups.Results(ⅰ)The total effective rate of the TCM syndrome in the Yangyin Shugan Decoction group and hormone control group were 85.59%and 52.25%,respectively;the total effective rate of menstrual were 54.95%and 90.99%,respectively;the menstrual normalization rate during the follow-up period were 31.53%and 9.01%,respectively;and regarding bFSH efficacy,the total effective rate were 70.27%and 27.03%,respectively,and the normalization rate of bFSH were 35.14%and 9.01%,respectively.The differences between the two groups were statistically significant(P<0.01).(ⅱ)The bFSH value in the Yangyin Shugan Decoction group decreased after treatment compared to before treatment(P<0.01),while the bFSH value in the hormone control group showed no change before and after treatment.The AMH value increased after treatment compared to before treatment in Yangyin Shugan Decoction group(P<0.01),while the AMH value in the hormone control group showed no change before and after treatment.The difference of bFSH and AMH between the two groups after treatment was statistically significant(P<0.01).(ⅲ)After treatment,the total score of TCM syndrome and the scores of individual symptom in the Yangyin Shugan Decoction group were lower than those before treatment(P<0.01);the total score of TCM syndrome,scores of hot flushes and sweating,hyposexuality,and insomnia in the hormone control group were lower than those before treatment(P<0.01).After treatment,the total score of TCM syndrome and the scores of individual symptom in the Yangyin Shugan Decoction group were lower than those in the hormone control group(P<0.01).(ⅳ)After treatment,the menstrual total score,scores of menstrual cycle,period,menstrual flow,and menstrual blood color in the Yangyin Shugan Decoction group were lower than those before treatment(P<0.01);the menstrual total score,score of menstrual cycle,period,and menstrual flow in the hormone control group were lower than those before treatment(P<0.01);after treatment,the menstrual total score and menstrual cycle score in the hormone control group were better than those in the Yangyin Shugan Decoction group(P<0.01).(ⅴ)No adverse reactions were observed in the Yangyin Shugan Decoction group and 29 cases of adverse reactions were observed in the hormone control group.Conclusion Yangyin Shugan Decoction can effectively improve TCM syndrome in POI patients with pattern of kidney deficiency and liver depression;downregulate the elevated bFSH level,increase the low AMH level,and effectively improve ovarian function,even continue to maintain menstruation after drug withdrawal.In the real world,Yangyin Shugan Decoction got satisfactory efficacy and good safety in the treatment of POI,which deserves clinical promotion and application.

Objective To determine the serum IgM and IgG antibody levels post-COVID-19 vaccination， and provide scientific evidence for COVID-19 antibody response after vaccination. Methods A total of 980 healthy persons were included in Kunming Third People’s Hospital from July through August， 2021， which had been vaccinated with COVID-19 vaccines and then tested for anti-SARS-CoV-2 IgM and IgG antibodies. Results After the COVID-19 vaccination， 469 persons （positive rate， 47.86%） were positive for anti-IgG antibody. Of them， 75 were males with （positive rate， 39.06%）， and the average IgG level was 0.618 （0.180， 2.526） AU·mL^-1［M（Q₁，Q₃）］； 394 were females （50.00%）， and the IgG level was 0.999 （0.305， 3.334） AU·mL^-1. In addition， 53 persons （5.41%） were anti-IgM antibody positive. Of them， 14 were males （positive rate， 7.29%）， and the average IgM level was 0.057 （0.026， 0.195） AU·mL^-1； 39 were females （4.95%）， and the IgM level was 0.047 （0.027， 0.110） AU·mL^-1. The positive rate of anti-IgG antibody was highest in those aged ≤30 years， which was 51.02% in male （n=25） and 55.88% in female （n=133）. The anti-IgG response differed significantly by gender （χ²=7.401， D=0.135 1， P<0.05）， whereas the anti-IgM response was not significantly different （χ²=1.656， P>0.05）. Among the age groups， anti-IgG antibody level was higher in those aged ≤30 and 51-70 years， with 158 （55.05%） and 122 （52.36%） persons， respectively； the average antibody level was 1.209 （0.426， 4.386） AU·mL^-1 and 1.074 （0.191， 7.670） AU·mL^-1， respectively. The differences in the positive rates of IgG and IgM antibodies and the levels of IgG antibodies among different age groups were statistically significant （P<0.05）. Using Kruskal-Wallis test and Spearman correlation analysis， it showed a high correlation between the IgG and IgM antibodies （r=0.836 4， H=64.82， 20.09， P<0.05）. Conclusion The Anti-SARS-CoV-2 IgG antibody remains high six months post-COVID-19 vaccination， while anti-IgM antibody is low. The IgM and IgG response are higher in the young and elderly. The response differs by gender and age， demonstrating a correlation.