OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

OBJECTIVE: We aimed to investigate the patterns of fasting blood glucose (FBG) trajectories and analyze the relationship between various occupational hazard factors and FBG trajectories in male steelworkers. METHODS: The study cohort included 3,728 workers who met the selection criteria for the Tanggang Occupational Cohort (TGOC) between 2017 and 2022. A group-based trajectory model was used to identify the FBG trajectories. Environmental risk scores (ERS) were constructed using regression coefficients from the occupational hazard model as weights. Univariate and multivariate logistic regression analyses were performed to explore the effects of occupational hazard factors using the ERS on FBG trajectories. RESULTS: FBG trajectories were categorized into three groups. An association was observed between high temperature, noise exposure, and FBG trajectory ( P < 0.05). Using the first quartile group of ERS1 as a reference, the fourth quartile group of ERS1 had an increased risk of medium and high FBG by 1.90 and 2.21 times, respectively (odds ratio [ OR] = 1.90, 95% confidence interval [ CI]: 1.17-3.10; OR = 2.21, 95% CI: 1.09-4.45). CONCLUSION An association was observed between occupational hazards based on ERS and FBG trajectories. The risk of FBG trajectory levels increase with an increase in ERS.
Humans ; Male ; Adult ; Blood Glucose/analysis* ; China ; Prospective Studies ; Occupational Exposure/adverse effects* ; Risk Factors ; Middle Aged ; Steel ; Fasting/blood* ; Metal Workers ; East Asian People

Objective·To evaluate the applicability of dual-unit cantilever restorations supported by a single narrow-diameter implant for consecutive missing teeth in the anterior mandibular region.Methods·A simplified mandibular anterior jaw model and a dual-unit cantilever model supported by a single narrow-diameter implant were constructed.The dimensions of the mandibular anterior bone block were set to 20 mm(length),5 mm(width),and 15 mm(height).The narrow-diameter implant used was the Axiom 2.8 two-stage implant,2.8 mm× 10 mm,paired with a 2.5 mm straight abutment.Based on calculations,the edentulous gap ranged from 5.8 mm to 11.6 mm,leading to the creation of seven crown models with mesiodistal widths of 5.8,6.8,7.8,8.8,9.8,10.8,and 11.8 mm.The implant,crowns,and jaw model were assembled using Siemens Nx 12.0 software,and the data were imported into Ansys Workbench 18.0 for finite element analysis.A vertical load of 100 N and a 30° oblique load were applied to simulate occlusal forces.The Von-Mises stress on the implants,as well as the maximum compressive and tensile stresses in the cortical bone and the maximum tensile stress in the cancellous bone,was analyzed to investigate stress distribution under varying cantilever lengths.Results·The implant neck region exhibited the highest stress concentration.As the cantilever length increased,the peak Von-Mises stress on the implants,the maximum tensile stress in the cortical and cancellous bones,and the maximum compressive stress in the cortical bones all increased progressively.However,all stress values remained within physiological limits.The peak Von-Mises stress ranged from 141.52 MPa to 707.17 MPa,below the implant's ultimate tensile strength of 930 MPa.The maximum tensile stress in the cortical bones(with a peak of 60.82 MPa in the 11.8 mm group)was below the cortical bone's tensile strength limit of 100-130 MPa.The maximum compressive stress in the cortical bone(with an absolute maximum value of 129.39 MPa in the 11.8 mm group)was below the cortical bone's compressive strength limit of 170 to 190 MPa(absolute values).The maximum tensile stress in the cancellous bone ranged from 0.84 MPa to 4.70 MPa,which was below or close to its ultimate tensile strength of 2-5 MPa.Conclusion·Dual-unit cantilever restorations supported by a single narrow-diameter implant may represent a viable treatment option for consecutive missing teeth in the anterior mandibular region.

Objective·To evaluate the applicability of dual-unit cantilever restorations supported by a single narrow-diameter implant for consecutive missing teeth in the anterior mandibular region.Methods·A simplified mandibular anterior jaw model and a dual-unit cantilever model supported by a single narrow-diameter implant were constructed.The dimensions of the mandibular anterior bone block were set to 20 mm(length),5 mm(width),and 15 mm(height).The narrow-diameter implant used was the Axiom 2.8 two-stage implant,2.8 mm× 10 mm,paired with a 2.5 mm straight abutment.Based on calculations,the edentulous gap ranged from 5.8 mm to 11.6 mm,leading to the creation of seven crown models with mesiodistal widths of 5.8,6.8,7.8,8.8,9.8,10.8,and 11.8 mm.The implant,crowns,and jaw model were assembled using Siemens Nx 12.0 software,and the data were imported into Ansys Workbench 18.0 for finite element analysis.A vertical load of 100 N and a 30° oblique load were applied to simulate occlusal forces.The Von-Mises stress on the implants,as well as the maximum compressive and tensile stresses in the cortical bone and the maximum tensile stress in the cancellous bone,was analyzed to investigate stress distribution under varying cantilever lengths.Results·The implant neck region exhibited the highest stress concentration.As the cantilever length increased,the peak Von-Mises stress on the implants,the maximum tensile stress in the cortical and cancellous bones,and the maximum compressive stress in the cortical bones all increased progressively.However,all stress values remained within physiological limits.The peak Von-Mises stress ranged from 141.52 MPa to 707.17 MPa,below the implant's ultimate tensile strength of 930 MPa.The maximum tensile stress in the cortical bones(with a peak of 60.82 MPa in the 11.8 mm group)was below the cortical bone's tensile strength limit of 100-130 MPa.The maximum compressive stress in the cortical bone(with an absolute maximum value of 129.39 MPa in the 11.8 mm group)was below the cortical bone's compressive strength limit of 170 to 190 MPa(absolute values).The maximum tensile stress in the cancellous bone ranged from 0.84 MPa to 4.70 MPa,which was below or close to its ultimate tensile strength of 2-5 MPa.Conclusion·Dual-unit cantilever restorations supported by a single narrow-diameter implant may represent a viable treatment option for consecutive missing teeth in the anterior mandibular region.

AIM:To explore the expression level of vitamin D receptor(VDR)in lung adenocarcinoma and its impact on the biological function of lung adenocarcinoma cells.METHODS:The mRNA expression level of VDR in lung adenocarcinoma and its relationship with prognosis were analyzed through 6 lung adenocarcinoma datasets(compris-ing a total of 792 lung adenocarcinoma tissues and 230 adjacent non-tumor tissues).Immunohistochemistry was used to de-tect VDR protein expression in 30 lung cancer patients.Lung adenocarcinoma cell lines A549 and H1650 were studied,with transfection of negative control(NC)or two VDR short hairpin RNAs(VDR-shRNAs).CCK-8 assay compared the cell viability of cells in each experimental group.Transwell and wound-healing assays compared the invasion and migra-tion capabilities.Gene set enrichment analysis identified pathways enriched in lung adenocarcinoma tissues with high VDR expression.RESULTS:The mRNA expression level of VDR was significantly increased in lung adenocarcinoma tissues(P<0.01).Immunohistochemistry further confirmed the high expression of VDR in lung adenocarcinoma(P<0.01).The survival analysis showed that the expression of VDR had no significant effect on the overall survival of lung ad-enocarcinoma patients(P>0.05).Knockdown of VDR significantly inhibited the cell viability,invasion,and migration ca-pacity of lung adenocarcinoma cells(P<0.05).Gene set enrichment analysis showed that lung adenocarcinoma tissues with high VDR expression were enriched in signaling pathways such as epithelial-mesenchymal transition(P<0.05).CONCLUSION:VDR is highly expressed in lung adenocarcinoma,and VDR knockdown can inhibit the cell viability,in-vasion,and migration capacity of lung adenocarcinoma cells.

At present,multiple renal denervation(RDN)devices with their own specific characteristics are being developed.The Iberis circular 4-electrode radiofrequency ablation catheter was used in this study,which was a new RDN device with independent intellectual property rights(produced by AngioCare Medical Technology Company,Shanghai).Recently,the efficacy has been validated in Iberis-HTN randomized,sham-operated controlled clinical trial,and the following case that was enrolled into Iberis-HTN study could elaborate its features.

Objective: This study aimed to evaluate the effects of 2 endoscopic spine surgeries on the biomechanical properties of normal and osteoporotic spines. Methods: Based on computed tomography images of a healthy adult volunteer, 6 finite element models were created. After validating the normal intact model, a concentrated force of 400 N and a moment of 7.5 Nm were exerted on the upper surface of L3 to simulate 6 physiological activities of the spine. Five types of indices were used to assess the biomechanical properties of the 6 models, range of motion (ROM), maximum displacement value, intervertebral disc stress, maximum stress value, and articular protrusion stress, and by combining them with finite element stress cloud. Results: In normal and osteoporotic spines, there was no meaningful change in ROM or disc stress in the 2 surgical models for the 6 motion states. Model N1 (osteoporotic percutaneous transforaminal endoscopic discectomy model) showed a decrease in maximum displacement value of 20.28% in right lateral bending. Model M2 (unilateral biportal endoscopic model) increased maximum displacement values of 16.88% and 17.82% during left and right lateral bending, respectively. The maximum stress value of L4–5 increased by 11.72% for model M2 during left rotation. In addition, using the same surgical approach, ROM, maximum displacement values, disc stress, and maximum stress values were more significant in the osteoporotic model than in the normal model. Conclusion In both normal and osteoporotic spines, both surgical approaches were less disruptive to the physiologic structure of the spine. Furthermore, using the same endoscopic spine surgery, normal spine biomechanical properties are superior to osteoporotic spines.

Objective: This study aimed to evaluate the effects of 2 endoscopic spine surgeries on the biomechanical properties of normal and osteoporotic spines. Methods: Based on computed tomography images of a healthy adult volunteer, 6 finite element models were created. After validating the normal intact model, a concentrated force of 400 N and a moment of 7.5 Nm were exerted on the upper surface of L3 to simulate 6 physiological activities of the spine. Five types of indices were used to assess the biomechanical properties of the 6 models, range of motion (ROM), maximum displacement value, intervertebral disc stress, maximum stress value, and articular protrusion stress, and by combining them with finite element stress cloud. Results: In normal and osteoporotic spines, there was no meaningful change in ROM or disc stress in the 2 surgical models for the 6 motion states. Model N1 (osteoporotic percutaneous transforaminal endoscopic discectomy model) showed a decrease in maximum displacement value of 20.28% in right lateral bending. Model M2 (unilateral biportal endoscopic model) increased maximum displacement values of 16.88% and 17.82% during left and right lateral bending, respectively. The maximum stress value of L4–5 increased by 11.72% for model M2 during left rotation. In addition, using the same surgical approach, ROM, maximum displacement values, disc stress, and maximum stress values were more significant in the osteoporotic model than in the normal model. Conclusion In both normal and osteoporotic spines, both surgical approaches were less disruptive to the physiologic structure of the spine. Furthermore, using the same endoscopic spine surgery, normal spine biomechanical properties are superior to osteoporotic spines.

Objective: This study aimed to evaluate the effects of 2 endoscopic spine surgeries on the biomechanical properties of normal and osteoporotic spines. Methods: Based on computed tomography images of a healthy adult volunteer, 6 finite element models were created. After validating the normal intact model, a concentrated force of 400 N and a moment of 7.5 Nm were exerted on the upper surface of L3 to simulate 6 physiological activities of the spine. Five types of indices were used to assess the biomechanical properties of the 6 models, range of motion (ROM), maximum displacement value, intervertebral disc stress, maximum stress value, and articular protrusion stress, and by combining them with finite element stress cloud. Results: In normal and osteoporotic spines, there was no meaningful change in ROM or disc stress in the 2 surgical models for the 6 motion states. Model N1 (osteoporotic percutaneous transforaminal endoscopic discectomy model) showed a decrease in maximum displacement value of 20.28% in right lateral bending. Model M2 (unilateral biportal endoscopic model) increased maximum displacement values of 16.88% and 17.82% during left and right lateral bending, respectively. The maximum stress value of L4–5 increased by 11.72% for model M2 during left rotation. In addition, using the same surgical approach, ROM, maximum displacement values, disc stress, and maximum stress values were more significant in the osteoporotic model than in the normal model. Conclusion In both normal and osteoporotic spines, both surgical approaches were less disruptive to the physiologic structure of the spine. Furthermore, using the same endoscopic spine surgery, normal spine biomechanical properties are superior to osteoporotic spines.

Objective: This study aimed to evaluate the effects of 2 endoscopic spine surgeries on the biomechanical properties of normal and osteoporotic spines. Methods: Based on computed tomography images of a healthy adult volunteer, 6 finite element models were created. After validating the normal intact model, a concentrated force of 400 N and a moment of 7.5 Nm were exerted on the upper surface of L3 to simulate 6 physiological activities of the spine. Five types of indices were used to assess the biomechanical properties of the 6 models, range of motion (ROM), maximum displacement value, intervertebral disc stress, maximum stress value, and articular protrusion stress, and by combining them with finite element stress cloud. Results: In normal and osteoporotic spines, there was no meaningful change in ROM or disc stress in the 2 surgical models for the 6 motion states. Model N1 (osteoporotic percutaneous transforaminal endoscopic discectomy model) showed a decrease in maximum displacement value of 20.28% in right lateral bending. Model M2 (unilateral biportal endoscopic model) increased maximum displacement values of 16.88% and 17.82% during left and right lateral bending, respectively. The maximum stress value of L4–5 increased by 11.72% for model M2 during left rotation. In addition, using the same surgical approach, ROM, maximum displacement values, disc stress, and maximum stress values were more significant in the osteoporotic model than in the normal model. Conclusion In both normal and osteoporotic spines, both surgical approaches were less disruptive to the physiologic structure of the spine. Furthermore, using the same endoscopic spine surgery, normal spine biomechanical properties are superior to osteoporotic spines.