Wumei Pills, a classic traditional Chinese medicine(TCM) formula, are widely used in the treatment of biliary ascariasis and diarrhea. In recent years, studies have shown that Wumei Pills have advantages in the treatment of type 2 diabetes mellitus(T2DM), while there are no relevant reports that systematically evaluate the efficacy of Wumei Pills in the treatment of T2DM. This study addresses this issue by systematically evaluating the efficacy and safety of Wumei Pills, aiming to provide an evidence-based basis for clinical practice. PubMed, Cochrane Library, EMbase, Web of Science, CNKI, Wanfang, and VIP were researched for the randomized controlled trial(RCT) involving Wumei Pills for the treatment of T2DM that were published from inception to September 2024. RevMan 5.3 was used for the Meta-analysis of the data. A total of 18 RCTs were included, with a total of 1 437 patients. Meta-analysis produced the following results.(1)Treatment group outperformed control group in terms of overall response rate(RR=1.28, 95%CI[1.14, 1.43], P<0.000 1), fasting blood glucose(FPG)(WMD=-0.69, 95%CI[-0.93,-0.46], P<0.000 01), two-hour postprandial plasma glucose(2hPG)(WMD=-0.74, 95%CI[-1.17,-0.31], P<0.000 7), glycated hemoglobin(HbA1c)(WMD=-0.39, 95%CI[-0.60,-0.18], P=0.000 3), high-density lipoprotein(HDL)(WMD=0.38, 95%CI[0.28, 0.48], P<0.000 01), and body mass index(BMI)(WMD=-1.41, 95%CI[-2.40,-0.42], P=0.005).(2)The two groups had comparable effects regarding total cholesterol(TC)(WMD=-0.53, 95%CI[-1.13, 0.08], P=0.09) and low-density lipoprotein(LDL)(WMD=-0.25, 95%CI[-0.56, 0.06], P=0.12).(3)Triglycerides(TG)(WMD=-0.28,95%CI [-0.59,0.03],P=0.08), sensitivity analysis showed potential reduction effect(WMD=-0.20,95%CI[-0.36,-0.04],P=0.01). Occurrence of adverse drug reaction(RR=0.43,95%CI [0.23,0.80],P=0.007), sensitivity analysis showed significant disappearance(RR=0.56,95%CI[0.26,1.22],P=0.14), suggesting that the efficacy of treatment group was not better than that of control group. The results indicate that the treatment of T2DM with Wumei Pills is greatly related to the improvement of glucose metabolism, lipid metabolism, and clinical efficacy. The findings provide a basis for clinical application of Wumei Pills in treating T2DM, while the conclusion remains to be verified by clinical studies with higher quality.
Humans ; Diabetes Mellitus, Type 2/blood* ; Drugs, Chinese Herbal/administration & dosage* ; Randomized Controlled Trials as Topic ; Blood Glucose/metabolism* ; Hypoglycemic Agents/therapeutic use* ; Treatment Outcome ; Glycated Hemoglobin/metabolism* ; Female

OBJECTIVE: To assess the efficacy of Qingda Granule (QDG) in ameliorating hypertension-induced cardiac damage and investigate the underlying mechanisms involved. METHODS: Twenty spontaneously hypertensive rats (SHRs) were used to develope a hypertension-induced cardiac damage model. Another 10 Wistar Kyoto (WKY) rats were used as normotension group. Rats were administrated intragastrically QDG [0.9 g/(kg•d)] or an equivalent volume of pure water for 8 weeks. Blood pressure, histopathological changes, cardiac function, levels of oxidative stress and inflammatory response markers were measured. Furthermore, to gain insights into the potential mechanisms underlying the protective effects of QDG against hypertension-induced cardiac injury, a network pharmacology study was conducted. Predicted results were validated by Western blot, radioimmunoassay immunohistochemistry and quantitative polymerase chain reaction, respectively. RESULTS: The administration of QDG resulted in a significant decrease in blood pressure levels in SHRs (P<0.01). Histological examinations, including hematoxylin-eosin staining and Masson trichrome staining revealed that QDG effectively attenuated hypertension-induced cardiac damage. Furthermore, echocardiography demonstrated that QDG improved hypertension-associated cardiac dysfunction. Enzyme-linked immunosorbent assay and colorimetric method indicated that QDG significantly reduced oxidative stress and inflammatory response levels in both myocardial tissue and serum (P<0.01). CONCLUSIONS Both network pharmacology and experimental investigations confirmed that QDG exerted its beneficial effects in decreasing hypertension-induced cardiac damage by regulating the angiotensin converting enzyme (ACE)/angiotensin II (Ang II)/Ang II receptor type 1 axis and ACE/Ang II/Ang II receptor type 2 axis.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Hypertension/pathology* ; Renin-Angiotensin System/drug effects* ; Rats, Inbred SHR ; Oxidative Stress/drug effects* ; Male ; Rats, Inbred WKY ; Blood Pressure/drug effects* ; Myocardium/pathology* ; Rats ; Inflammation/pathology*

OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

OBJECTIVE: Recombination events are common and serve as the primary driving force of diverse human adenovirus (HAdV), particularly in children with acute respiratory tract infections (ARIs). Therefore, continual monitoring of these events is essential for effective viral surveillance and control. METHODS: Respiratory specimens were collected from children with ARIs between January 2022 and December 2023. The penton base, hexon, and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type. In cases with inconsistent typing results, genes were cloned into the pGEM-T vector to detect recombination events. Metagenomic next-generation sequencing (mNGS) was performed to characterize the recombinant HAdV genomes. RESULTS: Among 6,771 specimens, 277 (4.09%, 277/6,771) were positvie for HAdV, of which 157 (56.68%, 157/277) were successfully typed, with HAdV-B3 being the dominant type (91.08%, 143/157), and 14 (5.05%, 14/277) exhibited inconsistent typing results, six of which belonged to species B. The penton base genes of these six specimens were classified as HAdV-B7, whereas their hexon and fiber genes were classified as HAdV-B3, resulting in a recombinant genotype designated P7H3F3, which closely resembled HAdV-B114. Additionally, a partial gene encoding L1 52/55 kD was identified, which originated from HAdV-B16. CONCLUSION A novel recombinant, P7H3F3, was identified, containing sequences derived from HAdV-B3 and HAdV-B7, which is similar to HAdV-B114, along with additional sequences from HAdV-B16.
Humans ; Adenoviruses, Human/isolation & purification* ; Respiratory Tract Infections/epidemiology* ; Child, Preschool ; Child ; Recombination, Genetic ; Male ; Beijing/epidemiology* ; Infant ; Female ; Phylogeny ; Adenovirus Infections, Human/epidemiology* ; Acute Disease ; Genome, Viral

Objective To investigate the value of CT perfusion imaging (CTP) combined with serum eicosapentaenoic acid (EPA)/arachidonic acid (AA) in predicting hemorrhage transformation and short-term prognosis after thrombolysis in acute ischemic stroke (AIS) patients with leukoaraiosis. Methods Ninety-eight AIS patients with leukoaraiosis admitted to the department of neurology of our hospital from January 2021 to December 2022 were selected and divided into the hemorrhage transformation group and non-hemorrhage transformation group according to whether hemorrhage transformation occurred after thrombolysis. The Fazekas scale was used to evaluate the leukoaraiosis of the patients. CTP parameters and EPA/AA were compared between patients in the two groups and patients with different degrees of leukoaraiosis in the hemorrhage transformation group. The predictive value of CTP parameters and EPA/AA on the occurrence of hemorrhage transformation was evaluated by receiver operating characteristic (ROC) curve. The prognosis was assessed according to the modified Rankin scale (mRS) score 1 month after thrombolysis;the linear and linear combinations are used to evaluate the linear relationship between variables;the ROC curve was used to evaluate the predictive value of CTP parameters and EPA/AA in the short-term prognosis of patients. Results The reactive cerebral blood flow (rCBF),reactive cerebral blood volume (rCBV),CTP integration index and EPA/AA in the hemorrhage transformation group were significantly lower than those in the non-hemorrhage transformation group (P<0.05),while the relative time to peak (rTTP) was significantly longer than that in the non-hemorrhage transformation group (P<0.05). The incidence of hemorrhage transformation increased with the increase of leukoaraiosis degree (P<0.05). In the hemorrhage transformation group,rCBF,rCBV,CTP integration index and EPA/AA of patients with mild leukoaraiosis were higher than those of patients with moderate-severe leukoaraiosis (P<0.05). In patients with mild leukoaraiosis,the area under the curve (AUC) of rCBF and EPA/AA in predicting hemorrhage transforma-tion were 0.712 and 0.720,respectively (P<0.05);in patients with moderate-severe leukoaraiosis,the AUC of rCBF,rCBV,rTTP,CTP integration index and EPA/AA in predicting hemorrhage transformation were 0.738,0.714,0.717,0.739 and 0.742,respectively (P<0.05). Among the 98 patients received thrombolysis,35 patients had a poor prognosis. The AUC of rCBF,rCBV,CTP integration index and EPA/AA in predicting short-term prognosis were 0.742,0.732,0.704 and 0.738,respectively,and the AUC of the four combined prediction was 0.968. Conclusion CTP parameters and EPA/AA have a certain predictive value for the occurrence of hemorrhage transformation after thrombolysis in AIS patients with leukoaraiosis,and rCBV,rCBF,CTP integration index and EPA/AA are important influencing factors of the short-term prognosis for these patients.

Objective:To investigate the expression relationship of Survivin,Bad,Bax and Bcl-2 genes in esophageal squamous cell carcinoma patients and to explore their correlation with clinicopathological markers,moreover,compare with GEPIA cancer database.Methods:48 ESCC specimens were taken from patients and used in the study.Matched adjacent normal tissues were used as controls.The expression of Survivin,Bad,Bax,and Bcl-2 genes were detected by RT-PCR.Meanwile,genes expressions were analyzed with clinicopathological factors,including tumor differentiation degree,TNM classification,clinical stage and lymph node metastasis.GEPIA analyzes the correlation between Survivin,Bad,Bax and Bcl-2 online.Results:In 48 cases of cancer tissues,Survivin expression was detected in 85.4％(41/48)of cancer tissues and in 62.5％(30/48)of adjacent normal tissues,and Bad was 45.8％(22/48)and 25％(12/48)respectively.Survivin and Bad were both highly expressed in cancer tissues,and the difference was statistically significant(P＜0.05),but Bax and Bcl-2 genes had no statical significance(P＞0.05).The mRNA expression rates of Bad,Bax,and Bcl-2 increased with higher differentiation degree(P＜0.05),while the high expression rate of Survivin mRNA was correlated with lymph node metastasis(P＜0.05).However,none of these markers showed associations with TNM staging or clinical stage.The expression of Bad had a negative correlation with the expression of Survivin(r=-0.449,P＜0.05),but a positive correlation with the expression of Bcl-2(r=0.348,P＜0.05).The expressions of Bax,Bcl-2 and survivin were positively correlated(r=0.552,0.331,respectively,both P＜0.05).The results of the GEPIA cancer database show that Survivin was highly expressed in cancer tissues(P＜0.05),and the expressions of Bad,Bax and Survivin were negatively correlated(r=-0.19,-0.16,respectively,both P＜0.01).Conclusions:Survivin and Bad may synergistically promote esophageal squamous cell carcinogenesis,while Bad,Bax,and Bcl-2 are implicated in malignant transformation.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective:To investigate the expression relationship of Survivin,Bad,Bax and Bcl-2 genes in esophageal squamous cell carcinoma patients and to explore their correlation with clinicopathological markers,moreover,compare with GEPIA cancer database.Methods:48 ESCC specimens were taken from patients and used in the study.Matched adjacent normal tissues were used as controls.The expression of Survivin,Bad,Bax,and Bcl-2 genes were detected by RT-PCR.Meanwile,genes expressions were analyzed with clinicopathological factors,including tumor differentiation degree,TNM classification,clinical stage and lymph node metastasis.GEPIA analyzes the correlation between Survivin,Bad,Bax and Bcl-2 online.Results:In 48 cases of cancer tissues,Survivin expression was detected in 85.4％(41/48)of cancer tissues and in 62.5％(30/48)of adjacent normal tissues,and Bad was 45.8％(22/48)and 25％(12/48)respectively.Survivin and Bad were both highly expressed in cancer tissues,and the difference was statistically significant(P＜0.05),but Bax and Bcl-2 genes had no statical significance(P＞0.05).The mRNA expression rates of Bad,Bax,and Bcl-2 increased with higher differentiation degree(P＜0.05),while the high expression rate of Survivin mRNA was correlated with lymph node metastasis(P＜0.05).However,none of these markers showed associations with TNM staging or clinical stage.The expression of Bad had a negative correlation with the expression of Survivin(r=-0.449,P＜0.05),but a positive correlation with the expression of Bcl-2(r=0.348,P＜0.05).The expressions of Bax,Bcl-2 and survivin were positively correlated(r=0.552,0.331,respectively,both P＜0.05).The results of the GEPIA cancer database show that Survivin was highly expressed in cancer tissues(P＜0.05),and the expressions of Bad,Bax and Survivin were negatively correlated(r=-0.19,-0.16,respectively,both P＜0.01).Conclusions:Survivin and Bad may synergistically promote esophageal squamous cell carcinogenesis,while Bad,Bax,and Bcl-2 are implicated in malignant transformation.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective To investigate the value of CT perfusion imaging (CTP) combined with serum eicosapentaenoic acid (EPA)/arachidonic acid (AA) in predicting hemorrhage transformation and short-term prognosis after thrombolysis in acute ischemic stroke (AIS) patients with leukoaraiosis. Methods Ninety-eight AIS patients with leukoaraiosis admitted to the department of neurology of our hospital from January 2021 to December 2022 were selected and divided into the hemorrhage transformation group and non-hemorrhage transformation group according to whether hemorrhage transformation occurred after thrombolysis. The Fazekas scale was used to evaluate the leukoaraiosis of the patients. CTP parameters and EPA/AA were compared between patients in the two groups and patients with different degrees of leukoaraiosis in the hemorrhage transformation group. The predictive value of CTP parameters and EPA/AA on the occurrence of hemorrhage transformation was evaluated by receiver operating characteristic (ROC) curve. The prognosis was assessed according to the modified Rankin scale (mRS) score 1 month after thrombolysis;the linear and linear combinations are used to evaluate the linear relationship between variables;the ROC curve was used to evaluate the predictive value of CTP parameters and EPA/AA in the short-term prognosis of patients. Results The reactive cerebral blood flow (rCBF),reactive cerebral blood volume (rCBV),CTP integration index and EPA/AA in the hemorrhage transformation group were significantly lower than those in the non-hemorrhage transformation group (P<0.05),while the relative time to peak (rTTP) was significantly longer than that in the non-hemorrhage transformation group (P<0.05). The incidence of hemorrhage transformation increased with the increase of leukoaraiosis degree (P<0.05). In the hemorrhage transformation group,rCBF,rCBV,CTP integration index and EPA/AA of patients with mild leukoaraiosis were higher than those of patients with moderate-severe leukoaraiosis (P<0.05). In patients with mild leukoaraiosis,the area under the curve (AUC) of rCBF and EPA/AA in predicting hemorrhage transforma-tion were 0.712 and 0.720,respectively (P<0.05);in patients with moderate-severe leukoaraiosis,the AUC of rCBF,rCBV,rTTP,CTP integration index and EPA/AA in predicting hemorrhage transformation were 0.738,0.714,0.717,0.739 and 0.742,respectively (P<0.05). Among the 98 patients received thrombolysis,35 patients had a poor prognosis. The AUC of rCBF,rCBV,CTP integration index and EPA/AA in predicting short-term prognosis were 0.742,0.732,0.704 and 0.738,respectively,and the AUC of the four combined prediction was 0.968. Conclusion CTP parameters and EPA/AA have a certain predictive value for the occurrence of hemorrhage transformation after thrombolysis in AIS patients with leukoaraiosis,and rCBV,rCBF,CTP integration index and EPA/AA are important influencing factors of the short-term prognosis for these patients.