Objective To investigate the relationship between factors related to the transforming growth factor β(TGF-β)/Aerine-threonine kinase receptors(Smads)signaling pathway and cognitive dysfunction in peripheral blood of patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 100 patients with aSAH admitted to Chongzuo City People's Hospital from October 2018 to March 2022 were retrospectively selected and grouped according to the patients'Montreal Cognitive Assessment Scale(MoCA)scores,including 54 cases with cognitive dysfunction and 46 cases without cognitive dysfunction.The clinical data,peripheral blood TGF-β,Smad1,Smad3,and Smad7 mRNA expression levels of the two groups were compared.The relationship between pathway-related factors and cognitive dysfunction in patients with aSAH was analyzed in a multifactorial manner.The predictive value of pathway-related factors for cognitive dysfunction in aSAH patients was assessed using the receiver operating characteristic(ROC)curve.Results Peripheral blood TGF-β,Smad1,Smad3,and Smad7 mRNA expression levels were higher in the cognitively impaired group than in the group without cognitive impairment(P<0.05).Multifactorial showed that pathway-related factors were significantly associated with cognitive impairment in patients with aSAH(P<0.05).The ROC showed that the area under the curve(AUC)of pathway-related factors jointly predicted cognitive dysfunction in patients with aSAH was superior to that predicted alone(P<0.05).Conclusion The high expression of factors related to the TGF-β/Smads signaling pathway in the peripheral blood of aSAH patients suggests that this pathway may be associated with cognitive dysfunction in patients.

Objective To observe the changes of cervical sagittal parameters of digital radiography(DR)at bilateral oblique position of cervical spine in patients with neck type cervical spondylopathy(NTCS)after cervical rotation and lifting manipulations,and to evaluate the clinical significance of cervical sagittal parameters in assessing the efficacy of NTCS by combining the pain score of visual analogue scale(VAS).Methods A retrospective analysis was carried out in 36 NTCS patients admitted to the outpatient clinic of the Tuina Department of Foshan Hospital of Traditional Chinese Medicine from November 2020 to May 2021.According to the treatment method,the patients were divided into the trial group and the control group,with 18 patients in each group.The trial group was treated with cervical rotation and lifting manipulations,and the control group was treated with cervical vertebra traction.The two groups were treated once every other day for 2 continuous weeks.The changes of VAS pain score and sagittal parameters of DR such as sagittal vertical axis of cervical vertebra 2-7(C2-7 SVA),the T1 slope(T1S),neck tilt(NT),and thoracic inlet angle(TIA)in the two groups were observed before and after treatment.Spearman correlation analysis was used to explore the correlation between VAS scores of pain level and cervical sagittal parameters.Results(1)Before treatment,there was no statistically significant difference in the VAS pain scores between the two groups(P＞0.05).After treatment,the VAS pain scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the scores in the trial group was significantly superior to that in the control group(P＜0.01).(2)Before treatment,there was no statistically significant difference in the values of cervical sagittal parameters of C2-7 SVA,T1S,NT,and TIA between the two groups(P＞0.05).After treatment,the C2-7 SVA,T1S,and TIA of the trial group were significantly improved compared with those before treatment(P＜0.05),but the improvement of NT was not obvious(P＞0.05);the cervical sagittal parameters of the control group were not significantly improved compared with those before treatment(P＞0.05).The intergroup comparison showed that the improvement of C2-7 SVA,T1S,and TIA in the trial group was significantly superior to that in the control group(P＜0.05 or P＜0.01),while the difference in NT between the two groups after treatment was not statistically significant(P＞0.05).(3)The results of Spearman correlation analysis showed that before treatment,VAS pain score had no correlation with C2-7 SVA,T1S,NT,and TIA(P＞0.05),C2-7 SVA was negatively correlated with NT(r=-0.502,P＜0.05),and T1S was positively correlated with NT(r=0.601,P＜0.05).After treatment,VAS pain score was negatively correlated with C2-7 SVA(r=-0.362,P＜0.05)and positively correlated with TIA(r=0.476,P＜0.05),C2-7 SVA was positively correlated with NT(r=0.928,P＜0.05),and T1S was positively correlated with TIA(r=0.623,P＜0.05).Conclusion Both cervical rotation and lifting manipulations and cervical traction can relieve the pain and adjust cervical sagittal parameters in the patients with NTCS,but cervical rotation and lifting manipulations are more effective in treating NTCS.And there may be a correlation between the VAS scores of pain level and cervical sagittal parameters in patients with NTCS.

Objective:To explore the effect of ointment massage on the postoperative recovery of newborns who had intestinal tract operation, aim to construct an effective post-operative ointment and massage scheme and to enrich the content of enhanced recovery after surgery in the field of newborns.Methods:Delphi expert inquiry method was used to construct the ointment message scheme. A total of 64 newborns undergone intestinal surgery from May 2022 to May 2023 in Guangdong Women and Children Hospital were selected as study subjects and divided into routine group (34 cases) and ointment group (30 cases) by random number table method. In addition to routine treatment and nursing, the newborns in the ointment group also received ointment massage. The postoperative gastrointestinal drainage volume, fasting days, the first feeding time, hospital stay and the number of cases of vomiting and abdominal distension between the two groups were compared.Results:A total of 16 experts with (38.93 ± 5.13) years old were inquired, 6 males and 10 females. The effective questionnaire response rates for the two rounds of expert inquiry were 16/16 and 15/16, the expert authority coefficients were both≥0.80, the Kendall′s W coefficients were 0.117 and 0.107, with statistically significant differences (both P<0.05). A ointment message scheme consisting of 8 acupoints and 7 kinds of traditional Chinese medicines was determined. In the routine group, there were 19 males and 15 females with (268.47 ± 11.27) gestational age. In the ointment group, there were 20 males and 10 femles with (271.93 ± 10.36) gestational age. The postoperative gastrointestinal drainage volume, fasting days, the first feeding time and the hospital stay in the ointment group were 74.0 ml, 6.0 d, 158.5 h and 13.0 d, which had significant differences with the 184.5 ml, 7.5 d, 192.0 h, 16.5 d in the routine group ( Z values were 2.07-2.45, all P<0.05). The incidence of vomiting and abdominal distension in the ointment group were both 8 cases, which were lower than the 19 and 18 cases in the routine group with a statistically significant difference ( χ2 = 5.58, 4.56, both P<0.05). Conclusions:The ointment massage in this study has a positive impact on the recovery of newborn infants after intestinal surgery, with high safety, in line with enhanced recovery after surgery concept, and is worthy of promotion.

Objective: To forecast mortality, age-standardized mortality, and probability of premature mortality from diabetes, and to simulate the impact of controlling risk factors by 2030 in China. Methods: We simulated the burden of disease from diabetes in six scenarios according to the development goals of risk factors control by the WHO and Chinese government. Based on the theory of comparative risk assessment and the estimates of the burden of disease for China from the Global Burden of Disease Study 2015, we used the proportional change model to project the number of deaths, age-standardized mortality, and probability of premature mortality from diabetes under different scenarios of risk factors control in 2030. Results: If the trends in exposures to risk factors from 1990 to 2015 continued. Mortality, age-standardized mortality, and probability of premature mortality from diabetes would increase to 32.57/100 000, 17.32/100 000, and 0.84% by 2030, respectively. During that time, mortality, age-standardized mortality and probability of premature mortality for males would all be higher than for females. If the goals of controlling risk factors were all achieved, the number of deaths from diabetes in 2030 would decrease by 62.10% compared to the predicted numbers based on the historical trends in exposure to risk factors, and the probability of premature mortality would drop to 0.29%. If only the exposure to a single risk factor were achieved by 2030, high fasting plasma glucose control would have the greatest impact on diabetes, resulting in a 56.00% reduction in deaths compared to the predicted numbers based on the historical trends, followed by high BMI (4.92%), smoking (0.65%), and low physical activity (0.53%). Conclusions: Risk factors control plays an important role in reducing the number of deaths, age-standardized mortality rate, and probability of premature mortality from diabetes. We suggest taking comprehensive measures to control relevant risk factors for certain populations and regions, to achieve the goal of reducing the burden of disease from diabetes as expected.
Male ; Female ; Humans ; Risk Factors ; Diabetes Mellitus/epidemiology* ; Mortality, Premature ; Smoking ; Cost of Illness ; China/epidemiology* ; Global Burden of Disease

Sepsis-induced liver injury (SILI) is an important cause of septicemia deaths. BaWeiBaiDuSan (BWBDS) was extracted from a formula of Panax ginseng C. A. Meyer, Lilium brownie F. E. Brown ex Miellez var. viridulum Baker, Polygonatum sibiricum Delar. ex Redoute, Lonicera japonica Thunb., Hippophae rhamnoides Linn., Amygdalus Communis Vas, Platycodon grandiflorus (Jacq.) A. DC., and Cortex Phelloderdri. Herein, we investigated whether the BWBDS treatment could reverse SILI by the mechanism of modulating gut microbiota. BWBDS protected mice against SILI, which was associated with promoting macrophage anti-inflammatory activity and enhancing intestinal integrity. BWBDS selectively promoted the growth of Lactobacillus johnsonii (L. johnsonii) in cecal ligation and puncture treated mice. Fecal microbiota transplantation treatment indicated that gut bacteria correlated with sepsis and was required for BWBDS anti-sepsis effects. Notably, L. johnsonii significantly reduced SILI by promoting macrophage anti-inflammatory activity, increasing interleukin-10⁺ M2 macrophage production and enhancing intestinal integrity. Furthermore, heat inactivation L. johnsonii (HI-L. johnsonii) treatment promoted macrophage anti-inflammatory activity and alleviated SILI. Our findings revealed BWBDS and gut microbiota L. johnsonii as novel prebiotic and probiotic that may be used to treat SILI. The potential underlying mechanism was at least in part, via L. johnsonii-dependent immune regulation and interleukin-10⁺ M2 macrophage production.

[This corrects the article DOI: 10.1016/j.apsb.2022.10.016.].

Humans ; Retrospective Studies ; Tetanus/epidemiology* ; China/epidemiology*

Objective:Investigate the safety and feasibility of using the new self-designed implanting applicator in vaginal three-dimensional intracavitary brachytherapy after hysterectomy for gynecological cancer, and to explore the clinical value of the self-designed implanting applicator.Methods:Sixty-two gynecological cancer patients who underwent brachytherapy in Sun Yat-sen University Cancer Center were selected in this study. Each patient received three-dimensional intracavitary brachytherapy because of the indication of postoperative radiotherapy. Each patient was treated with different types of self-designed implanting applicators according the condition of postoperative vagina,and the vaginal tube and implant needle were placed in the template according to the preset channnel. Based on the actual CT images, the high-risk clinical target volume (HR-CTV), and organs at risk were defined according to unified target area delineation criteria and then the brachytherapy plan was conducted. The prescription dose of high-risk clinical target volume (HR-CTV) was 5.5 Gy/time. The parameters such as target area, organs at risk volume and irradiated dose were evaluated by DVH diagram.Results:Sixty-two patients successfully completed brachytherapy under the guidance of self-designed implanting applicator. A total of 140 implantation treatments were performed. The total average dose of HR-CTV D90% was (575.48±22.30) cGy, the mean dose D 2cm3 of bladder, rectum and sigmoid colon were (328.69±102.71), (369.14±46.59) and (27.28±71.27) cGy, the small intestine did not drop the target area, so there was no statistics. There was statistical significance between target volume and organs at risk dose ( P<0.05). Conclusions:The new self-designed implanting applicator has obvious clinical advantages in vaginal three-dimensional intracavitary brachytherapy after hysterectomy for gynecological cancer, meets the requirements of the preset planning dose,and it is sample to operate and highly safe,which indicated a bright future of the clinical application.

Objective: Predictive models were used to evaluate the impact of common risk factors on the number of cardio-cerebrovascular deaths and the probability of premature death. Methods: Using the data for China estimated by the Global Burden of Disease study 2015 (GBD 2015), we calculated the population attribution fraction (PAF) of risk factors. The proportional change model was used to estimate the number of unattributable deaths by 2030, and to predict the number of deaths, mortality, standardized mortality and probability of premature death by 2030. Results: According to the natural change trend of risk factors from 1990 to 2015, the number of deaths and mortality would reach 6.12 million and 428.53/100 000 by 2030, with an increase of 59.92% and 52.87%. By 2030, the probability of premature death from cardio-cerebrovascular diseases among Chinese aged 30-70 years old would continue to decline, from 11.43% to 11.28% for men, and from 5.79% to 4.43% for women. If the goals of all included risk factors were reached by 2030, 2 289 200 cardio-cerebrovascular deaths would be avoided. If only the exposure to a single risk factor was achieved by 2030, blood pressure, total cholesterol, and fine particulate matter exposure were the three most important factors affecting cardio-cerebrovascular deaths, which would reduce 1 332 800, 609 100 and 306 800 deaths, respectively. Among the involved risk factors, the control of blood pressure would mostly decrease the number of deaths due to ischemic heart disease and hemorrhagic stroke, about 677 300 and 391 100 deaths, accordingly. Conclusion: The control of risk factors is of great significance in reducing deaths and probability of premature death due to cardio-cerebrovascular diseases. If the control targets of all risk factors could be achieved by 2030, the burden of cardio-cerebrovascular diseases would be reduced greatly.
Adult ; Aged ; Blood Pressure ; Cerebrovascular Disorders/epidemiology* ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Mortality, Premature ; Risk Factors

Objective: To analyze mortality and its trend of chronic respiratory diseases (CRD) in China from 1990 to 2019. Methods: Based on the provincial results of China from the 2019 Global Burden of Disease (GBD) study, the average annual percent change (AAPC) of standardized mortality rates of different CRDs were analyzed by using Joinpoint 4.8.0.1, and the age-standardized mortality rate of CRD was calculated by using the GBD 2019 world standard population. Based on the comparative risk assessment theory of GBD, the attributable deaths due to 12 CRD risk factors were estimated, including smoking, indoor air pollution, occupational gas exposure, particulates and smog exposure, environmental particulate pollution, low temperature, passive smoking, ozone pollution, occupational exposure to silica, occupational asthma, high body mass index, high temperature and occupational exposure to asbestos. Results: From 1990 to 2019, the number of deaths and standardized mortality of chronic obstructive pulmonary disease (COPD) showed a downward trend (P<0.001). The number of COPD deaths decreased from 1 244 000 (912 000 - 1 395 000) in 1990 to 1 037 000 (889 000 - 1 266 000) in 2019. AAPC=-0.9% (95%CI: -1.5% - -0.3%), P<0.001; The standardized mortality rate decreased from 217.9/100 000 (163.3/100 000 - 242.0/100 000) in 1990 to 65.2/100 000 (55.5/100 000 - 80.1/100 000) in 2019. AAPC= -4.2% (95%CI:-5.2% - -3.2%), P<0.001. The number of deaths from asthma decreased from 40 000 (30 000 - 58 000) in 1990 to 25 000 (20 000 - 31 000) in 2019. AAPC=-2.0% (95%CI: -2.6% - -1.4%), P<0.001; The standardized mortality rate of asthma decreased from 6.4/100 000 (4.7/100 000 - 9.5/100 000) in 1990 to 1.5/100 000 (1.2/100 000 - 1.9/100 000) in 2019. AAPC=-5.1% (95%CI: -5.8% - -4.4%), P<0.001. The number of pneumoconiosis deaths decreased from 11 000 (8 000 - 14 000) in 1990 to 10 000 (8 000 - 14 000) in 2019, AAPC=-0.2%(95%CI:-0.4% - 0.1%), P=0.200; The standardized mortality rate of pneumoconiosis decreased from 1.4/100 000 (1.0/100 000 - 1.7/100 000) in 1990 to 0.5/100 000 (0.4/100 000 - 0.7/100 000) in 2019. AAPC=-3.1% (95%CI: -3.4% - -2.8%), P<0.001. The number of deaths from pulmonary interstitial diseases and pulmonary sarcoidosis increased from 3 000 (3 000 - 6 000) in 1990 to 8 000 (6 000 - 10 000) in 2019, AAPC=3.5% (95%CI: 2.7% - 4.2%), P<0.001; The corresponding standardized mortality rate changed little from 1990 to 2019, and AAPC was not statistically significant.The age-standardized mortality rates of different CRDs were higher in men than those in women. In 1990 and 2019, the mortality rates of COPD, asthma, pneumoconiosis and interstitial pulmonary disease and pulmonary sarcoidosis increased with age. In 2019, the population attributable fractions (PAFs) for smoking, environmental particulate pollution, occupational gas exposure, particulate and smog exposure, low temperature exposure and passive smoking were 71.1% (68.0% - 74.3%), 24.7% (20.1% - 30.0%), 19.3% (13.0% - 25.4%), 15.7% (13.6% - 18.3%) and 8.8% (4.5% - 13.1%) respectively in men, and the PAFs for environmental particulate pollution, smoking, low temperature exposure, occupational gas exposure, particulate and smog exposure, and passive smoking were 24.1% (19.6% - 29.3%), 21.9% (18.7% - 25.2%), 16.4% (14.0% - 19.2%), 15.6% (10.2% - 21.1%) and 14.7% (7.9% - 21.3%) respectively in women. Conclusions: During 1990-2019, the overall death level of CRD decreased significantly in China, but it is still at high level in the world. Active prevention and control measures should be taken to reduce the death level caused by CRD.
Asthma ; China/epidemiology* ; Female ; Global Burden of Disease ; Humans ; Male ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Quality-Adjusted Life Years