OBJECTIVE:Elevated blood pressure increases the risk of cardiovascular diseases.Isometric exercise training has been shown to significantly reduce resting blood pressure,but the factors influencing its effectiveness remain unclear,and specific application guidelines are yet to be established.This study aims to evaluate the impact of isometric exercise training on resting blood pressure through meta-analysis,explore its moderating factors,and provide evidence-based recommendations based on its dose-response relationship.METHODS:Following the PRISMA guidelines,a systematic search was conducted in PubMed,Embase,Cochrane Library,Scopus,and Web of Science databases using keywords"Isometric exercise training,""Systolic blood pressure,"and"Diastolic blood pressure,"covering literature up to September 2024.Randomized controlled trials involving isometric exercise training and resting blood pressure were included.Three independent researchers performed literature screening and data extraction,assessing bias risk and quality grades using the Risk of Bias 2.0 tool and GRADE framework.Main effect pooling,publication bias assessment,subgroup,and regression analysis were conducted using R software(version 4.3.4).RESULTS:A total of 28 articles(comprising 32 randomized controlled trials)involving 977 participants were included.(1)Meta-analysis results indicated that isometric exercise training significantly reduced resting systolic blood pressure(MD=-8.01,95％CI=-9.22 to-6.80,P＜0.01,I2=18.20％,low evidence grade)and diastolic blood pressure(MD=-3.46,95％CI=-4.64 to-2.28,P＜0.01,I2=0％,moderate evidence grade)compared to no exercise.(2)Subgroup analysis results revealed significant influences of gender,health status,exercise modality,frequency,intensity,duration,sets per session,rest duration,and baseline blood pressure on the main effects for both systolic(P＜0.01)and diastolic blood pressure(P＜0.05).(3)Regression analysis results did not show any significant influencing factors,but body mass index(β=-4.11,P=0.091)showed a significant negative trend on the main effect for systolic blood pressure.(4)No significant publication bias was observed in the meta-analysis results(P＞0.05).CONCLUSION:(1)Isometric exercise training significantly lowers systolic(low evidence grade)and diastolic(moderate evidence grade)blood pressure with clinically meaningful thresholds.(2)Participant characteristics(gender,health status,baseline blood pressure,and body mass index)and isometric exercise training protocols(modality,frequency,intensity,duration,cycle,sets per session,and rest duration)influence its antihypertensive effects.(3)The article recommends the optimal blood pressure management prescription:three sessions per week,with four sets per session,each set lasting 2 minutes with a 2-minute rest,at an intensity of 95％HRpeak using isometric wall squat exercises;the intervention period can be adjusted around a 6-week node.Future high-quality research is urgently needed to further validate and support these conclusions.

OBJECTIVE:Elevated blood pressure increases the risk of cardiovascular diseases.Isometric exercise training has been shown to significantly reduce resting blood pressure,but the factors influencing its effectiveness remain unclear,and specific application guidelines are yet to be established.This study aims to evaluate the impact of isometric exercise training on resting blood pressure through meta-analysis,explore its moderating factors,and provide evidence-based recommendations based on its dose-response relationship.METHODS:Following the PRISMA guidelines,a systematic search was conducted in PubMed,Embase,Cochrane Library,Scopus,and Web of Science databases using keywords"Isometric exercise training,""Systolic blood pressure,"and"Diastolic blood pressure,"covering literature up to September 2024.Randomized controlled trials involving isometric exercise training and resting blood pressure were included.Three independent researchers performed literature screening and data extraction,assessing bias risk and quality grades using the Risk of Bias 2.0 tool and GRADE framework.Main effect pooling,publication bias assessment,subgroup,and regression analysis were conducted using R software(version 4.3.4).RESULTS:A total of 28 articles(comprising 32 randomized controlled trials)involving 977 participants were included.(1)Meta-analysis results indicated that isometric exercise training significantly reduced resting systolic blood pressure(MD=-8.01,95％CI=-9.22 to-6.80,P＜0.01,I2=18.20％,low evidence grade)and diastolic blood pressure(MD=-3.46,95％CI=-4.64 to-2.28,P＜0.01,I2=0％,moderate evidence grade)compared to no exercise.(2)Subgroup analysis results revealed significant influences of gender,health status,exercise modality,frequency,intensity,duration,sets per session,rest duration,and baseline blood pressure on the main effects for both systolic(P＜0.01)and diastolic blood pressure(P＜0.05).(3)Regression analysis results did not show any significant influencing factors,but body mass index(β=-4.11,P=0.091)showed a significant negative trend on the main effect for systolic blood pressure.(4)No significant publication bias was observed in the meta-analysis results(P＞0.05).CONCLUSION:(1)Isometric exercise training significantly lowers systolic(low evidence grade)and diastolic(moderate evidence grade)blood pressure with clinically meaningful thresholds.(2)Participant characteristics(gender,health status,baseline blood pressure,and body mass index)and isometric exercise training protocols(modality,frequency,intensity,duration,cycle,sets per session,and rest duration)influence its antihypertensive effects.(3)The article recommends the optimal blood pressure management prescription:three sessions per week,with four sets per session,each set lasting 2 minutes with a 2-minute rest,at an intensity of 95％HRpeak using isometric wall squat exercises;the intervention period can be adjusted around a 6-week node.Future high-quality research is urgently needed to further validate and support these conclusions.

Prostate cancer remains the second most common malignancy in men worldwide, is a global health issue, and poses a huge health burden. Precision medicine provides more treatment options for prostate cancer patients, but its popularity, drug resistance, and adverse reactions still need to be focused on. Chinese herbal medicines (CHMs) have been widely accepted as an alternative therapy for cancer, with the advantages of multiple targets, multiple pathways, and low toxicity. We searched the experimental research and clinical practice of CHMs for prostate cancer treatment published in PubMed, Embase, and Web of Science in the last five years. We found five CHM formulas and six single CHM extracts as well as 12 CHM-derived compounds, which showed induction of apoptosis, autophagy, and cell cycle arrest, suppression of angiogenesis, proliferation, and migration of prostate cancer cells, reversal of drug resistance, and enhancement of anti-tumor immunity. The mechanisms of action include the PI3K/Akt/mTOR, AR, EGFR and Wnt/β-catenin signaling pathways, which are commonly implicated in the development of prostate cancer. We also summarized the advantages of CHMs in patients with hormone-sensitive and castration-resistant prostate cancer and provided ideas for their further experimental design and application.

An 83-year-old male patient received IV infusions of linezolid 600 mg once per 12 hours and imipenem and cilastatin sodium 1 g once per 8 hours for incisional wound infection after cervical spinal fusion. Three days later, imipenem and cilastatin sodium was stopped according to the drug sensitive test result and linezolid was continued. Two weeks after the use of linezolid, the patient developed dry mouth, and abnormal sensation of tongue; and 18 days later, he developed black tongue coating in the center of the tongue, which could not relieved after drinking a lot of water. After that, the tooth root blackened and the denture pigmented gradually. It was considered as black hairy tongue, which might be associated with linezolid. Linezolid was stopped and compound chlorhexidine gargle was given for gargling. Twelve days later, the patient′s tongue coating returned to normal, the symptoms of dry mouth and thirst disappeared, and the color of tooth root became lighter.

An 83-year-old male patient received IV infusions of linezolid 600 mg once per 12 hours and imipenem and cilastatin sodium 1 g once per 8 hours for incisional wound infection after cervical spinal fusion. Three days later, imipenem and cilastatin sodium was stopped according to the drug sensitive test result and linezolid was continued. Two weeks after the use of linezolid, the patient developed dry mouth, and abnormal sensation of tongue; and 18 days later, he developed black tongue coating in the center of the tongue, which could not relieved after drinking a lot of water. After that, the tooth root blackened and the denture pigmented gradually. It was considered as black hairy tongue, which might be associated with linezolid. Linezolid was stopped and compound chlorhexidine gargle was given for gargling. Twelve days later, the patient′s tongue coating returned to normal, the symptoms of dry mouth and thirst disappeared, and the color of tooth root became lighter.

Objective To analyze the clinical characteristics of liver injury related to edaravone in treating patients with acute ischemic stroke (AIS). Methods Among the AIS patients treated with edaravone in Vascular Surgery ICU of Xuanwu Hospital Capital Medical University from January 2014 to October 2017,9 patients were diagnosed as having liver injury associated with edaravone by active monitoring. The total number of patients treated with edaravone at the same period in Vascular Surgery ICU were obtained from the hospital information system and the incidence of liver injury associated with edaravone was calculated. The clinical data of the 9 patients were collected and analyzed retrospectively. Results The incidence of liver injury associated with edaravone was 8.7% (9/103 ). The 9 patients included 6 males and 3 females. The age of the patients was 52-83 years and their average age was (65 ± 6)years. The time for the occurrence of liver injury was 3-9 days and the average time was (6 ± 2)days. The main manifestations of liver injury were increase of alanine aminotransferase (9 cases),aspartic aminotransferase (7 cases),alkaline phosphatase (4 cases),total bilirubin (2 cases),and accompanied by rash in 1 case. Using RUCAM scale,7 patients were classified as ＂highly probable＂ and 2 patients were classified as＂probable＂. Using ＂Grade of DILI severity＂＂ standard,all the 9 patients were diagnosed as ＂mild liver injury＂. After 4-13 days of edaravone withdrawal,8 patients had normal liver function and 1 case improved. Conclusions Edaravone might cause liver injury,mainly manifesting liver dysfunction. The degree of liver injury was mild,and the prognosis was good after timely intervention.

Objective To analyze the clinical characteristics of liver injury related to edaravone in treating patients with acute ischemic stroke (AIS). Methods Among the AIS patients treated with edaravone in Vascular Surgery ICU of Xuanwu Hospital Capital Medical University from January 2014 to October 2017,9 patients were diagnosed as having liver injury associated with edaravone by active monitoring. The total number of patients treated with edaravone at the same period in Vascular Surgery ICU were obtained from the hospital information system and the incidence of liver injury associated with edaravone was calculated. The clinical data of the 9 patients were collected and analyzed retrospectively. Results The incidence of liver injury associated with edaravone was 8.7% (9/103 ). The 9 patients included 6 males and 3 females. The age of the patients was 52-83 years and their average age was (65 ± 6)years. The time for the occurrence of liver injury was 3-9 days and the average time was (6 ± 2)days. The main manifestations of liver injury were increase of alanine aminotransferase (9 cases),aspartic aminotransferase (7 cases),alkaline phosphatase (4 cases),total bilirubin (2 cases),and accompanied by rash in 1 case. Using RUCAM scale,7 patients were classified as ＂highly probable＂ and 2 patients were classified as＂probable＂. Using ＂Grade of DILI severity＂＂ standard,all the 9 patients were diagnosed as ＂mild liver injury＂. After 4-13 days of edaravone withdrawal,8 patients had normal liver function and 1 case improved. Conclusions Edaravone might cause liver injury,mainly manifesting liver dysfunction. The degree of liver injury was mild,and the prognosis was good after timely intervention.