ObjectiveTo evaluate the efficacy and safety of Rongjin Tongbi decoction on sciatica caused by lumbar intervertebral disc herniation with liver and kidney deficiency type based on a randomized controlled study. MethodFrom January 2019 to July 2022， 90 patients in the department of Traditional Chinese medicine（TCM） of Beijing Jishuitan Hospital who met the inclusion criteria were selected and divided into two groups according to the random number table， with 45 patients in each group. During the study， 19 cases dropped out， with 41 cases included in the final observation group and 30 cases in the control group. The observation group was given Rongjin Tongbi decoction orally， and the control group was given Loxoprofen Sodium Tablets orally for 28 days. The differences in the visual analog scale （VAS） scores， the Japanese Orthopaedic Association （JOA） scores， activities of daily living （ADL） assessments， TCM clinical symptoms， subjective symptoms， and clinical signs scores between two groups before and after treatment were observed. Liver and kidney functions and gastrointestinal adverse reactions were detected for safety evaluation. ResultBefore treatment， there was no statistically significant difference in scores between the observation group and the control group. After treatment， the absolute values of the differences in VAS and ADL scores in the observation group were higher than those in the control group （P<0.05）. There was no statistically significant difference in the absolute value of the difference in JOA scores between two groups. The absolute value of the difference in TCM clinical symptom scores in the observation group was higher than that in the control group （P<0.01）. There was no statistically significant difference in the absolute values of the differences in subjective symptom and clinical sign scores between two groups. The levels of liver and kidney function indicators in both groups before and after the experiment were normal， and there was no significant difference in gastrointestinal reactions. ConclusionRongjin Tongbi decoction can significantly improve the symptoms of sciatica patients caused by lumbar intervertebral disc herniation with liver and kidney deficiency type. After treatment， the patients exhibited significant improvements in pain， activity and other aspects， and it is proven to be safe and reliable， which is conducive to the recovery of physical function.

Objective:To conduct a scoping review on the application of family resilience intervention in adults with chronic disease.Methods:Related studies published from database establishment to October 30, 2023 were systematically searched on PubMed, Web of Science, Cochrane Library, PsycINFO, CINAHL, Scopus, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biomedical Database. The included literature was summarized and analyzed.Results:A total of 9 articles were included. The intervention elements for family resilience included increasing awareness of diseases and family characteristics, solving and responding to family problems, engaging in family interaction and communication, integrating internal and external resources, and providing psychological and technical support. The outcome indicators were the level of family resilience and effectiveness.Conclusions:The intervention of family resilience in adults with chronic disease has certain effectiveness and clinical significance, but research is still in the exploratory stage. Further high-quality research is needed to verify the long-term intervention effect and feasibility, and to construct a diversified family resilience intervention program suitable for China.

Objective:To understand the current state of financial toxicity and suicide risk in head and neck cancer patients, to investigate the correlation between the level of financial toxicity and suicide risk in head and neck cancer patients, and to provide a basis for reducing the level of financial toxicity and the risk of suicide in head and neck cancer patients.Methods:A cross-sectional survey was conducted, from March 1 to July 31, 2022, 150 head and neck cancer patients were selected from Oncology Department of East Hospital Affiliated to Tongji Universityby by convenient sampling method. The survey was carried out by means of the general questionnaire, Comprehensive Score for Financial Toxicity based on the Patient-Reported Outcome Measures (COST-PROM), Cancer Suicide Risk Scale (CSRS), and then analysis the datum.Results:The score of COST-PROM of 150 head and neck cancer patients was (18.00 ± 6.12) points, and the score of CSRS of head and neck cancer patients was (36.31 ± 8.51) points. The total score of economic toxicity was significantly negatively correlated with the total score of suicide risk and its dimensions ( r values were -0.446 to 0.235, all P<0.05). The total score of suicide risk was negatively correlated with the total score of economic toxicity and the scores of each dimension ( r values were -0.446 to -0.251, all P<0.05). Conclusions:Patients with head and neck cancer were at higher risk of suicide, and financial toxicity was a significant contributing factor to suicide risk, with higher levels of financial toxicity associated with a higher risk of suicide. Reducing the level of financial toxicity in patients with head and neck cancer has important implications for reducing their risk of suicide.

BACKGROUND: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH. METHODS: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded. RESULTS: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH. CONCLUSIONS: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients. TRIAL REGISTRATION ClinicalTrials.gov, NCT02164526.
Coronary Artery Disease/epidemiology* ; Creatinine ; Heart Failure/complications* ; Humans ; Hypertension, Pulmonary/complications* ; Nitrates ; Prevalence ; Prognosis ; Prospective Studies ; Registries ; Risk Factors ; Stroke Volume ; Ventricular Function, Left

Objective:To establish and validate the prediction model for postoperative sleep disturbance (PSD) in patients undergoing non-cardiac surgery.Methods:A total of 454 patients of both sexes, aged≥18 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, underwent non-cardiac surgery under general anesthesia from November 2019 to September 2020 were selected.The perioperative data were collected.The patients were divided into training set and validation set with a ratio of 7∶3 by using a simple random sampling method.The characteristic variables of PSD were selected using LASSO regression analysis and the independent risk factors were identified using multivariate logistic regression analysis in training set.Akaike′s information criterion was used to evaluate the quality of fit of the model.The nomogram of PSD in non-cardiac surgery patients was constructed based on the identified factors.The discrimination of the model was evaluated using receiver operating characteristic (ROC) curve, and the agreement of the model was evaluated using Hosmer-Lemeshow goodness-of-fit test and Brier score.Results:Seven risk factors (gender, preoperative anxiety, satisfaction with the ward environment, anesthesia time, the intraoperative consumption of midazolam and sufentanil and numerical rating scale (NRS) score at 3 days after operation) and two related factors (preoperative NRS score and general anesthesia combined with nerve block) were used to establish and verify the PSD nomogram.The area under the ROC curve was 0.805 (95% confidence interval [CI] 0.721-0.848) in training set.The area under the ROC curve was 0.773 (95% CI 0.684-0.876) in validation set.In training and validation sets, the calibration curves were tested by Hosmer-Lemeshow good of fit test, the P values were 0.590 and 0.950, respectively, and the Brier scores were 0.154 and 0.156, respectively.The nomogram predicated that the sensitivity (95% CI) and specificity (95%CI) were 81.83% (60.32%-95.14%) and 78.15% (71.83%-83.25%), respectively, in training set, and the sensitivity (95% CI) and specificity (95%CI) were 77.86% (39.84%-97.25%) and 78.15% 77.86% (68.74%-85.48%), respectively, in validation set.The optimal cut-off value of nomogram score was 113. Conclusion:In this study, the nomogram prediction model for PSD in patients undergoing non-cardiac surgery has been successfully established, which can visually and individually predict the risk of PSD.

This article reports the clinical data, diagnosis and treatment plan and prognosis of 3 patients with breast cancer under 20 years old. The clinical pathological features, treatment and prognosis were discussed in the literature, and compared with the biological characteristics of young (under 35 years old) breast cancer patients, providing a reference for the clinical individualized treatment of the disease.

Objective To analyze the unreasonable elements in prescriptions from outpatient department through the intervention of unreasonable prescriptions;To provide evidence for reasonable usage of medicine in outpatient department.Methods Prescriptions were examined by senior pharmacists. If they found any unreasonable elements, they would consult doctors, and record all the unreasonable elements in the prescriptions to avoid unreasonable prescriptions. A total of 663 unreasonable prescriptions from Jan. 2011 to May 2013 were analyzed.Results A total of 709 unreasonable elements were found in these prescriptions. The man elements were following three types:overdose of toxic decoction pieces (73.76%), incompatible prescriptions without signature (12.13%), wrong inputting of prescription and decoction (7.76%).Conclusion With early intervention in prescriptions, the quality of prescriptions and the safety and effectiveness of medication can be improved.

Objective To study the efficacy of alendronate in treatment of postoperative residual pain with osteoporotic vertebral compression fractures(OVCF) of vertebroplasty.Methods 62 patients with OVCF from September 2013 to October 2014 were divided into observation group and control group, each had 31 cases.All patients were given calcium carbonate D3 tablets 1 day after surgery, observation group were given alendronate on this basis.The degree of pain score between two groups pre-and post-treatment two weeks, one month, two months were observed and compared.Pain improvement in two groups were observed, and activity ability score, painkiller use and bone mineral density between two groups pre-and post-treatment were compared.Results The pain scores in observation group a month postoperative was (0.8 ±0.4) points and (0.4 ±0.2) points after two months, were significantly lower than those in control group[(1.6 ±0.7) points, (1.1 ±0.8) points, P<0.05].The excellent rate of pain improvement in observation group(83.87%) was significantly higher than that in control group (58.06%, P <0.05) .After treatment, activity ability score in observation group was (1.13 ±0.53) points and painkiller usage was (0.44 ±0.07) times per day, all significantly lower than those in control group [(1.79 ±0.89) points, (0.89 ±0.12) times per day, P<0.05].BMD level in observation group was (5.78 ±1.02)%, higher than that in control group[(3.21 ±0.79)%, P<0.05].Conclusion Alendronate in treatment of osteoporotic vertebral compression fractures vertebroplasty postoperative residual pain has good early outcome and low adverse reactions, and security is relatively high.

Mycosin-1 protease (MycP1) is a serine protease anchored to the inner membrane of Mycobacterium tuberculosis, and is essential in virulence factor secretion through the ESX-1 type VII secretion system (T7SS). Bacterial physiology studies demonstrated that MycP1 plays a dual role in the regulation of ESX-1 secretion and virulence, primarily through cleavage of its secretion substrate EspB. MycP1 contains a putative N-terminal inhibitory propeptide and a catalytic triad of Asp-His-Ser, classic hallmarks of a subtilase family serine protease. The MycP1 propeptide was previously reported to be initially inactive and activated after prolonged incubation. In this study, we have determined crystal structures of MycP1 with (MycP1²⁴⁻⁴²²) and without (MycP1⁶³⁻⁴²²) the propeptide, and conducted EspB cleavage assays using the two proteins. Very high structural similarity was observed in the two crystal structures. Interestingly, protease assays demonstrated positive EspB cleavage for both proteins, indicating that the putative propeptide does not inhibit protease activity. Molecular dynamic simulations showed higher rigidity in regions guarding the entrance to the catalytic site in MycP1²⁴⁻⁴²² than in MycP1⁶³⁻⁴²², suggesting that the putative propeptide might contribute to the conformational stability of the active site cleft and surrounding regions.
Amino Acid Sequence ; Bacterial Proteins ; chemistry ; Bacterial Secretion Systems ; Crystallography, X-Ray ; Humans ; Molecular Dynamics Simulation ; Molecular Sequence Data ; Mycobacterium smegmatis ; metabolism ; Protein Precursors ; chemistry ; Protein Structure, Tertiary ; Subtilisins ; chemistry

OBJECTIVE: To evaluate the efficacy of specific immunotherapy (SIT) with standardized house dust mite allergen preparation for allergic rhinitis (AR). METHOD: Fifty-five patients with allergic rhinitis caused by house dust mites were selected in this self-control study. Clinical efficacy was evaluated by symptom and sign score after two years of specific immunotherapy and compared with pre-treatment scores. RESULT: After completing the study, a clinically significant reduction in symptom and sign score in these patients was noted, compared with that of pretreatment. And the difference was statistically significant (P < 0.01). CONCLUSION Standardized house dust mite allergen preparation is an effective treatment in patients suffering from allergic rhinitis due to house dust mites.
Allergens ; therapeutic use ; Animals ; Antigens, Dermatophagoides ; therapeutic use ; Female ; Humans ; Immunotherapy ; methods ; Male ; Pyroglyphidae ; immunology ; Rhinitis, Allergic ; therapy ; Treatment Outcome