1.Causal association of obesity and chronic pain mediated by educational attainment and smoking: a mediation Mendelian randomization study
Yunshu LYU ; Qingxing LU ; Yane LIU ; Mengtong XIE ; Lintong JIANG ; Junnan LI ; Ning WANG ; Xianglong DAI ; Yuqi YANG ; Peiming JIANG ; Qiong YU
The Korean Journal of Pain 2025;38(2):177-186
Background:
Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship.
Methods:
This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders.
Results:
The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively.
Conclusions
The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.
2.Causal association of obesity and chronic pain mediated by educational attainment and smoking: a mediation Mendelian randomization study
Yunshu LYU ; Qingxing LU ; Yane LIU ; Mengtong XIE ; Lintong JIANG ; Junnan LI ; Ning WANG ; Xianglong DAI ; Yuqi YANG ; Peiming JIANG ; Qiong YU
The Korean Journal of Pain 2025;38(2):177-186
Background:
Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship.
Methods:
This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders.
Results:
The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively.
Conclusions
The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.
3.Causal association of obesity and chronic pain mediated by educational attainment and smoking: a mediation Mendelian randomization study
Yunshu LYU ; Qingxing LU ; Yane LIU ; Mengtong XIE ; Lintong JIANG ; Junnan LI ; Ning WANG ; Xianglong DAI ; Yuqi YANG ; Peiming JIANG ; Qiong YU
The Korean Journal of Pain 2025;38(2):177-186
Background:
Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship.
Methods:
This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders.
Results:
The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively.
Conclusions
The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.
4.Causal association of obesity and chronic pain mediated by educational attainment and smoking: a mediation Mendelian randomization study
Yunshu LYU ; Qingxing LU ; Yane LIU ; Mengtong XIE ; Lintong JIANG ; Junnan LI ; Ning WANG ; Xianglong DAI ; Yuqi YANG ; Peiming JIANG ; Qiong YU
The Korean Journal of Pain 2025;38(2):177-186
Background:
Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship.
Methods:
This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders.
Results:
The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively.
Conclusions
The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.
5.Causal association of obesity and chronic pain mediated by educational attainment and smoking: a mediation Mendelian randomization study
Yunshu LYU ; Qingxing LU ; Yane LIU ; Mengtong XIE ; Lintong JIANG ; Junnan LI ; Ning WANG ; Xianglong DAI ; Yuqi YANG ; Peiming JIANG ; Qiong YU
The Korean Journal of Pain 2025;38(2):177-186
Background:
Obesity and chronic pain are related in both directions, according to earlier observational research.This research aimed to analyze the causal association between obesity and chronic pain at the genetic level, as well as to assess whether common factors mediate this relationship.
Methods:
This study used bidirectional two sample Mendelian randomization (MR) technique to analyze the association between obesity and chronic pain. Obesity's summary genome-wide association data were obtained from European ancestry groups, as measured by body mass index (BMI), waist-to-hip ratio, waist circumference (WC), and hip circumference (HC), genome-wide association study data for chronic pain also came from the UK population, including chronic pain at three different sites (back, hip, and headache), chronic widespread pain (CWP), and multisite chronic pain (MCP). Secondly, a two-step MR and multivariate MR investigation was performed to evaluate the mediating effects of several proposed confounders.
Results:
The authors discovered a link between chronic pain and obesity. More specifically, a sensitivity analysis was done to confirm the associations between greater BMI, WC, and HC with an increased risk of CWP and MCP.Importantly, the intermediate MR results suggest that education levels and smoking initiation may mediate the causal relationship between BMI on CWP, with a mediation effect of 23.08% and 15.38%, respectively.
Conclusions
The authors’ findings demonstrate that the importance of education and smoking in understanding chronic pain’s pathogenesis, which is important for the primary prevention and prognosis of chronic pain.
6.Effect of Modified Shenhong Tongluo Prescription on Cell Apoptosis in Rats with Myocardial Ischemia-reperfusion Injury by Bcl-2/Bax/Caspase-3 Signaling Pathway
Yingrong LAI ; Qianlin ZHAO ; Lihong JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):104-110
ObjectiveTo investigate the mechanism of modified Shenhong Tongluo prescription on cell apoptosis in rats with myocardial ischemia-reperfusion injury (MIRI). MethodSixty Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, low-, medium-, and high-dose groups of modified Shenhong Tongluo prescription, and a simvastatin group. Except for the blank group, a rat model of MIRI was prepared by ligating the left anterior descending coronary artery. Starting from the first day after successful modeling, the blank group (1.0 mL·kg-1 physiological saline), model group (1.0 mL·kg-1 physiological saline), low-, medium-, and high-dose groups of modified Shenhong Tongluo prescription (1.031, 2.063, and 4.126 g·kg-1 Shenhong Tongluo prescriptiona standard concentrate), and simvastatin group (0.71 mg·kg-1 simvastatin) were orally administered once daily for 2 weeks. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of cardiomyocytes. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum creatine kinase isoenzyme (CK-MB), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). TdT-mediated dUTP nick-end labeling(TUNEL) staining was used to detect the apoptosis rate of rat cardiomyocytes. Western blot was used to detect the expression levels of apoptosis-related proteins B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), and caspase-3. ResultCompared with the blank group, in the model group, HE staining showed disturbed arrangement of cardiomyocytes, incomplete fibers, focal necrosis of cardiomyocytes, and inflammatory cell infiltration; serum CK-MB, IL-6, and TNF-α levels were significantly increased (P<0.05); apoptosis rate of cardiomyocytes was significantly increased (P<0.01), with significantly increased expression levels of Bax and Caspase-3 proteins, and significantly decreased Bcl-2 expression (P<0.05). Compared with the model group, the low-, medium-, and high-dose groups of modified Shenhong Tongluo prescription significantly reduced CK-MB, IL-6, and TNF-α levels (P<0.05), significantly downregulated cardiomyocyte apoptosis rate (P<0.05), significantly decreased Bax and Caspase-3 proteins, and significantly increased Bcl-2 expression levels (P<0.01). In the modified Shenhong Tongluo prescription groups, the expression levels of Bax and Caspase-3 proteins significantly decreased with increasing dosage, while the expression level of Bcl-2 significantly increased with increasing dosage of modified Shenhong Tongluo prescription (P<0.05). ConclusionShenhong Tongluo prescription can alleviate myocardial tissue pathological damage and reduce myocardial cell apoptosis, possibly by inhibiting Caspase-3 and Bax expression and promoting Bcl-2 expression.
7.Risk Factors and Prevention of Late-onset Bacterial Sepsis in Very Preterm Infants
Guangdong FANG ; Beibei JIA ; Changchun CHEN ; Shanyu JIANG
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(3):457-465
[Objective]To investigate the clinical features and high risk of very preterm infants with late-onset bacteri-al sepsis,so as to propose feasible prevention and treatment suggestions.[Methods]Totally 94 very preterm infants with late-onset bacterial sepsis from the Neonatology Department of Women's Hospital of Jiangnan University were recruited from February,2012 to January,2024.Their clinical data,including the perinatal situation,clinical symptoms,patho-gens,risk factors and treatment,were collected and analyzed.[Results]The incidence rate of very preterm infants with late-onset bacterial sepsis were 8.40 for 100 live birth babies.The major pathogens of the infections among these very pre-mature infants included gram-positive bacteria(71.1%).Logistic regression analysis showed that long term(≥7 d)use of antibiotics,invasive mechanical ventilation,indwelling central venous catheter(≥7 d),and vaginal delivery were high risk factors of very preterm infants with late-onset bacterial sepsis,the relative risk(OR)values were 2.787,4.243,3.033 and 2.174,respectively.[Conclusion]The gram-positive bacteria are the main pathogens of late-onset bacterial sepsis in very preterm infants.Long term(≥7 d)use of antibiotics,invasive mechanical ventilation,indwelling central ve-nous catheter(≥7 d)and vaginal delivery are high risk factors of very preterm infants with late-onset bacterial sepsis.The incidence of late-onset bacterial sepsis in very preterm infants can be reduced by strengthening perinatal management,shortening the time of antibiotic application and reducing invasive operations.
8.Effect of Buyang Huanwutang on Skeletal Muscle Injuries in Mouse Model of Type 2 Diabetes Mellitus
Yang WANG ; Lijuan JIANG ; Wei CUI ; Wenfeng ZHANG ; Yan WEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):10-16
ObjectiveTo study the effects of Buyang Huanwutang on the skeletal muscle injuries in type 2 diabetes mellitus from mitochondrial transport, glucose metabolism, oxidative stress, and inflammation. MethodA total of 60 SPF-grade male C57BL/6J mice were selected in this study. The mouse model of type 2 diabetes mellitus was established with a high-fat diet combined with intraperitoneal injection of streptozotocin. The mice were assigned by the random number table method into blank control, model, high-, medium-, and low-dose (86.5, 43.2, 21.6 g·kg-1, respectively) Buyang Huanwutang, and metformin (150 mg·kg-1) groups, 10 mice in each group. During the experiment period, blood glucose and other indicators of mice were measured regularly. At the end of the experiment, skeletal muscle samples were collected and frozen in 4% paraformaldehyde and -80 ℃, respectively. Blood samples were sent for examination. The skeletal muscle was stained with hematoxylin-eosin. The levels of inflammation indicators and reactive oxygen species (ROS) were determined by enzyme-linked immunosorbent assay. The expression of mitochondrial proteins was determined by Western blot and immunohistochemistry. ResultCompared with the blank control group, the model group showcased increased fasting blood glucose, water intake, and food intake (P<0.01) and decreased body weight (P<0.01). Compared with the model group, metformin and Buyang Huanwutang reduced the fasting blood glucose, water intake, and food intake (P<0.05, P<0.01) and increased the body weight (P<0.01). Compared with the blank control group, the model group showed rising levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and ROS (P<0.01), which were decreased by metformin and Buyang Huanwutang (P<0.05, P<0.01). The skeletal muscle fibers in the model group were generally atrophic and thin, which suggested atrophy and morphological changes of the skeletal muscle, while metformin and Buyang Huanwutang alleviated the pathological changes of the skeletal muscle and restored the morphology of fiber bundles. Compared with the blank control group, the modeling down-regulated the expression of the mitofusin2 (Mfn2) (P<0.01), which was up-regulated by metformin and Buyang Huanwutang (P<0.05, P<0.01). Compared with the blank control group, the modeling up-regulated the expression of the dynamin-related protein (Drp1) (P<0.01), which were down-regulated by metformin and Buyang Huanwutang (P<0.01). ConclusionBuyang Huanwutang can improve the body weight and attenuate the pathological changes of the skeletal muscle, reduce fasting blood glucose, food intake, and water intake, lower the levels of TNF-α, IL-6, and ROS, down-regulate the expression of Drp1, and up-regulate the expression of Mfn2 in the mouse model of type 2 diabetes mellitus.
9.Associations of the magnesium depletion score and magnesium intake with diabetes among US adults: an analysis of the National Health and Nutrition Examination Survey 2011-2018
Zhong TIAN ; Shifang QU ; Yana CHEN ; Jiaxin FANG ; Xingxu SONG ; Kai HE ; Kexin JIANG ; Xiaoyue SUN ; Jianyang SHI ; Yuchun TAO ; Lina JIN
Epidemiology and Health 2024;46(1):e2024020-
OBJECTIVES:
The magnesium depletion score (MDS) is considered more reliable than traditional approaches for predicting magnesium deficiency in humans. We explored the associations of MDS and dietary magnesium intake with diabetes.
METHODS:
We obtained data from 18,853 participants in the National Health and Nutrition Examination Survey 2011-2018. Using multivariate regression and stratified analysis, we investigated the relationships of both MDS and magnesium intake with diabetes. To compute prevalence ratios (PRs), we employed modified Poisson or log-binomial regression. We characterized the non-linear association between magnesium intake and diabetes using restricted cubic spline analysis.
RESULTS:
Participants with MDS ≥2 exhibited a PR of 1.26 (95% confidence interval [CI], 1.19 to 1.34) for diabetes. Per-standard deviation (SD) increase in dietary magnesium intake was associated with a lower prevalence of diabetes (PR, 0.91; 95% CI, 0.87 to 0.96). Subgroup analyses revealed a positive association between MDS ≥2 and diabetes across all levels of dietary magnesium intake, including the lowest (PR, 1.35; 95% CI, 1.18 to 1.55), middle (PR, 1.23; 95% CI, 1.12 to 1.35), and highest tertiles (PR, 1.25; 95% CI, 1.13 to 1.37; pinteraction<0.001). Per-SD increase in magnesium intake was associated with lower diabetes prevalence in participants with MDS <2 (PR, 0.92; 95% CI, 0.87 to 0.98) and those with MDS ≥2 (PR, 0.91; 95% CI, 0.84 to 0.98; pinteraction=0.030).
CONCLUSIONS
MDS is associated with diabetes, particularly among individuals with low magnesium intake. Adequate dietary magnesium intake may reduce diabetes risk, especially in those with high MDS.
10.Acupoint compatibility effect: increasing "effect value" and expanding "effect domain".
Hai-Lin JIANG ; Xiao-Hong XU ; Jin-Ying ZHAO ; Fu-Chun WANG
Chinese Acupuncture & Moxibustion 2023;43(11):1275-1278
By summarizing and exploring the theoretic connotation, key of functions and effect mechanism of acupoint compatibility, the effect of acupoint compatibility is concluded as the increase of "effect value" and the expansion of "effect domain". The increase of "effect value" is the concrete embodiment by the value of medical assessment scale, the value of objective index detection in clinical trial and the value of index detection in experiment research. The expansion of "effect domain" is the increase of effect target and the extension of effect scope. The paper interprets the scientific connotation of acupoint compatibility therapy from a new perspective, and emphasizes the innovative approaches to research while bringing forth new ideas on the research method. It is anticipated that a novel breakthrough can be achieved in the study of acupoint compatibility and the improvement of acupuncture-moxibustion efficacy.
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