Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

Objective:To analyze and compare the salt iodine content and iodine nutrition status of pregnant women in Ningxia Hui Autonomous Region (Ningxia for short), and to provide basis for formulation of prevention and control measures.Methods:From 2017 to 2020, 100 pregnant women were surveyed each year in 22 counties (cities, districts) in Yinchuan, Shizuishan, Wuzhong, Guyuan and Zhongwei of Ningxia, salt samples and urine samples were collected for salt iodine and urinary iodine detection.Results:Totally 8 807 salt samples were collected, the median salt iodine was 24.6 mg/kg. The qualified rate of iodized salt was 91.59% (7 838/8 558), the coverage rate of iodized salt was 97.17% (8 558/8 807), and the consumption rate of qualified iodized salt was 89.00% (7 838/8 807). The consumption rate of qualified iodized salt increased year by year (χ 2trend = 248.47, P < 0.001). There were statistical differences in salt iodine levels in different years and regions ( H = 259.14, 37.09, P < 0.001). Totally 8 107 urine samples were collected, the median urinary iodine of pregnant women was 165.00 μg/L, which reached the appropriate level. The median and composition of urinary iodine were statistically different in different regions and pregnancies ( H = 28.87, 17.91, P < 0.001; χ 2 = 85.89, 20.59, P < 0.05). Conclusions:The coverage rate of iodized salt among pregnant women in Ningxia is high, and the urinary iodine level is generally in a suitable state. However, for pregnant women at risk of iodine deficiency, special attention should be paid and targeted iodine supplementation measures should be taken.

【Objective】 To compare the clinical efficacy of robot-assisted and open surgery in the treatment of renal carcinoma with inferior vena cava cancer thrombus, and to analyze the safety and feasibility of robot-assisted radical nephrectomy. 【Methods】 Clinical data of 55 patients surgically treated for renal carcinoma with Mayo Ⅰ-Ⅲ inferior vena cava tumor thrombus during Dec.2015 and Dec.2021 were retrospectively analyzed. Based on the operation methods, the patients were divided into the robotic surgery group (n=36) and open surgery group (n=19). The perioperative data, oncological results and survival of the two groups were compared. 【Results】 All operations were successful. The median operation time was 176 (IQR:137-234) min, and grade Ⅲ and above complications occurred in 9(16.4%) cases. The robotic surgery group had lower intraoperative blood loss [300 (IQR:200-625) mL vs.1 000 (IQR:600-1 184) mL] and blood transfusion ratio [(20/36) vs. (18/19)] than the open surgery group, but higher postoperative hemoglobin level[109(98-120) g/L vs. 90(84-100) g/L]. During a median follow-up of 26 (IQR:19-39) months, 19(34.5%) patients developed new metastases and 12(21.8%) patients died. The postoperative tumor-specific survival (HR=0.39, 95%CI:0.13-1.16, P=0.090) and overall survival (HR=0.71, 95%CI:0.22-2.23,P=0.554) were not significantly different between the two groups. 【Conclusion】 There are no significant differences in the incidence of postoperative complications, tumor-specific survival and overall survival between robot-assisted and open surgery for Mayo Ⅰ-Ⅲ inferior vena cava tumor thrombus, but the intraoperative blood loss in robotic group is lower than that in the open surgery group.

Introduction: SABINA III assessed short-acting β2-agonist (SABA) prescription patterns and their association with asthma-related outcomes globally. Herein, we examined SABA prescription and clinical outcomes in the Malaysian cohort of SABINA III. Methods: In this observational, cross-sectional study, patients (≥12 years) were recruited between July and December 2019 from 15 primary and specialty care centres in Malaysia. Prescribed asthma treatments and severe exacerbation history within 12 months prior and asthma symptom control during the study visit were evaluated. Associations of SABA prescription with asthma control and severe exacerbation were analysed using multivariable regression models. Results: Seven hundred thirty-one patients (primary care, n=265 [36.3%]; specialty care, n=466 [63.7%]) were evaluated. The prevalence of SABA over-prescription (≥3 SABA prescriptions/year) was 47.4% (primary care, 47.1%; specialty care, 47.6%), 51.8% and 44.5% among all patients and patients with mild and moderate-to-severe asthma, respectively. Altogether 9.0% (n=66) purchased SABA without a prescription; among them, 43.9% (n=29) purchased ≥3 inhalers. The mean (standard deviation) number of severe asthma exacerbations was 1.38 (2.76), and 19.7% (n=144) and 25.7% (n=188) had uncontrolled and partly controlled symptoms, respectively. Prescriptions of ≥3 SABA inhalers (vs 1–2) were associated with lower odds of at least partly controlled asthma (odds ratio=0.42; 95% confidence interval [CI]=0.27–0.67) and higher odds of having severe exacerbation(s) (odds ratio=2.04; 95% CI=1.44–2.89). Conclusion The prevalence of SABA over-prescription in Malaysia is high, regardless of the prescriber type, emphasising the need for healthcare providers and policymakers to adopt latest evidence-based recommendations to address this public health concern.
Asthma ; Malaysia

Objective:To evaluate the recovery of daytime and nighttime urinary continence in patients with robotic-assisted radical cystectomy and ileal orthotopic neobladder from 1 to 60 months after surgery, and systematically analyze the influencing factors of daytime and nighttime urinary continence recovery.Methods:The convenient sampling method was used to select clinical data of 60 patients who underwent robotic-assisted radical cystectomy and ileal orthotopic neobladder by a single operator from December 2014 to January 2020 and they were followed up for daytime and nighttime use of urine pads and prognosis. A total of 44 patients were eligible for follow-up data. Satisfactory recovery of daytime and nighttime urinary continence was defined as the use of less than or equal to 1 pad, and complete recovery of daytime and nighttime urinary continence was defined as no urine leakage. The daytime and nighttime urinary continence recovery in patients with robotic-assisted radical cystectomy and ileal orthotopic neobladder was assessed at 1, 3, 6, 12, 24, 36, and 60 months. Cox regression was used to analyze the influencing factors of postoperative urinary continence recovery.Results:Cox regression multivariate analysis showed that preservation of neurovascular bundles was associated with satisfactory recovery of daytime urinary continence, satisfactory recovery of nighttime urinary continence and complete recovery of daytime urinary continence ( P<0.05) . Clevien grading of complications within 90 d could affect the satisfaction of daytime urinary control recovery. Preoperative hydronephrosis was an independent factor affecting the satisfaction of nighttime urinary continence recovery. Conclusions:Preserving neurovascular bundles is an influencing factor in promoting postoperative urinary continence recovery in patients with robotic-assisted radical cystectomy and ileal orthotopic neobladder. In addition, postoperative complications and preoperative hydronephrosis are independent factors affecting the satisfaction of daytime and nighttime urinary continence recovery, respectively, but it need to be further confirmed by multicenter prospective studies.

Objective: To explore the analgesic effects and uterine hemodynamics of perpendicular needling (PN) and transverse needling (TN) at SP 6 in patients with primary dysmenorrhea (PD). Methods: In this randomized controlled trial, patients with PD diagnosed with cold-dampness con-gealing pattern were randomly assigned in a ratio of 1:1 to receive PN or TN at bilateral SP 6 for 10 min. Acupuncture was performed when the menstrual pain score was over 40 mm on the first day of menstruation, as measured using the visual analog scale for pain (VAS-P). The primary outcome was average menstrual pain (VAS-P). Secondary outcomes included the pulsatility index (PI), resistance index (RI), and systolic-diastolic peaks ratio (S/D) in uterine arteries as measured using color Doppler ultra-sonography;anxiety as assessed using the Hamilton Anxiety Rating Scale (HAMA), blood pressure (BP), and heart rate (HR). Results: Forty-eight patients completed the study. The TN group exhibited a significant reduction in VAS-P scores (-5.71 mm, 95％ confidence interval (CI): -8.78, -2.63, P = .001), RI values (-0.05, 95％ CI:-0.09,-0.01, P=.015), and HAMA values (-2.50, 95％CI:-4.78,-0.22, P=.032) when compared with the PN group. No significant differences in PI, S/D, BP, or HR values were observed between the two groups (P>.05). Conclusion: TN at SP 6 was superior to PN in alleviating menstrual pain and anxiety in patients with PD. This analgesic effect of TN may be due to its better ability to improve uterine arterial blood flow via decreases in RI values.

Objective: To understand the iodine content of drinking water in Ningxia, and provide a basis for promoting scientific iodine supplementation. Methods: In 2017, 22 counties (cities, districts) of Ningxia Hui Autonomous Region were surveyed by township (town, street office) as the unit. Water samples were collected and iodine content was detected according to the unified centralized water supply, mixed water supply and all the scattered water supply methods. Among them, the investigation at township (town and street office) level found that the median of iodine in water was > 10 μg/L, and then the water samples were collected in administrative villages (neighborhood committees) and the content of iodine in water was detected. Results: A total of 242 townships (town, street office) were surveyed at the township level water iodine, and a total of 1 048 water samples were collected, the median water iodine was 6.6 μg/L, the range was 0.0-97.8 μg/L. There were 75 townships with a median water iodine > 10 μg/L, and an administrative village level water iodine survey was conducted. A total of 1 169 water samples were collected, the median water iodine was 14.5 μg/L, and the range was 0.0-97.4 μg/L. The median water iodine at the township level, unified centralized water supply, mixed water supply, and all the scattered water supply was 6.9, 6.8, and 4.5 μg/L, respectively. The difference was statistically significant (χ² = 7.08, P < 0.05). The median water iodine at the administrative village level, unified centralized water supply, mixed water supply, and all the scattered water supply was 15.8, 8.4, and 11.6 μg/L, respectively. The difference was statistically significant (χ² = 35.23, P < 0.05). Conclusion The iodine content of drinking water in Ningxia residents is low, which is consistent with the fact that Ningxia is in the iodine deficient area.