1.Effect of Tongxinluo Capsules on TCM Syndrome Elements in Patients with Chronic Coronary Syndrome of Qi Deficiency and Blood Stasis Type: A Multicenter and Prospective Cohort Study
Jia WANG ; Xilun TAN ; Xuesen WANG ; Xiaohe YANG ; Meili GAO ; Yiying LIU ; Chenhao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):170-177
ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine (TCM) syndrome elements and major adverse cardiovascular events (MACEs) in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor, and the patients were divided into an exposure group (integrated traditional Chinese and western medicine treatment group) and a non-exposure group (western medicine treatment group). The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third, sixth, and twelfth months, and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included, with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group, the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved (P<0.05). Compared with the non-exposure group, the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period (P<0.01) and significantly reduced blood stasis syndrome scores in the sixth month (P<0.05). In the remaining follow-up period, there was no statistically significant difference between the two groups. Compared with that of the non-exposure group, during the treatment period (the third month), the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant (P<0.05, P<0.01). At the end of the follow-up period, patients in the non-exposure group had a MACE probability of 6.90% (4/58), higher than 3.13% in the exposure group (4/58). Compared with patients with angina pectoris who used conventional medicine, patients administered with Tongxinluo Capsules had a relative risk(RR) of 0.45 [95%confidence interval(95%CI) 0.12-1.75, P=0.26]. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term, and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year, the incidence of MACE in the exposure group was lower than that in the non-exposure group.
2.Effect of Tongxinluo Capsules on TCM Syndrome Elements in Patients with Chronic Coronary Syndrome of Qi Deficiency and Blood Stasis Type: A Multicenter and Prospective Cohort Study
Jia WANG ; Xilun TAN ; Xuesen WANG ; Xiaohe YANG ; Meili GAO ; Yiying LIU ; Chenhao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):170-177
ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine (TCM) syndrome elements and major adverse cardiovascular events (MACEs) in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor, and the patients were divided into an exposure group (integrated traditional Chinese and western medicine treatment group) and a non-exposure group (western medicine treatment group). The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third, sixth, and twelfth months, and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included, with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group, the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved (P<0.05). Compared with the non-exposure group, the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period (P<0.01) and significantly reduced blood stasis syndrome scores in the sixth month (P<0.05). In the remaining follow-up period, there was no statistically significant difference between the two groups. Compared with that of the non-exposure group, during the treatment period (the third month), the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant (P<0.05, P<0.01). At the end of the follow-up period, patients in the non-exposure group had a MACE probability of 6.90% (4/58), higher than 3.13% in the exposure group (4/58). Compared with patients with angina pectoris who used conventional medicine, patients administered with Tongxinluo Capsules had a relative risk(RR) of 0.45 [95%confidence interval(95%CI) 0.12-1.75, P=0.26]. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term, and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year, the incidence of MACE in the exposure group was lower than that in the non-exposure group.
3.Measles, rubella, and mumps antibody seroprevalence among the children aged 18 years and younger in Karamay City, Xinjiang Uygur Autonomous Region
Meili WU ; Xia LI ; Ling ZUO ; Liping RONG ; Jing WANG ; Feng WANG
Shanghai Journal of Preventive Medicine 2025;37(3):239-243
ObjectiveTo understand the measles, rubella, and mumps antibody seroprevalence among the children aged 18 years and younger in Karamay City, and to evaluate the effectiveness of vaccination. MethodsA stratified whole cluster random sampling method was used to investigate the antibody seroprevalence of measles, rubella, and mumps among the healthy children aged 18 years and younger in Karamay City, and to further analyze the positive antibody rates and the geometric mean concentration (GMC) of antibodies. ResultsA total of 620 people were investigated, and the positive rates of IgG to measles, rubella, and mumps were 72.74%,62.26%, and 86.45%, respectively, with a GMC of308.94 mIU·mL-1, 21.81 mIU·mL-1, and 249.10 U·mL-1. There were statistically significant differences in the positive rates of antibodies to measles, rubella, and mumps among different age groups (χ2measles=76.707, P<0.001; χ2rubella=60.804, P<0.001; χ2mumps=35.407, P<0.001). The differences in positive rates were statistically significant among individuals with different intervals from the time of their last dose vaccination (χ2measles=60.533, P<0.001; χ2rubella=46.331, P<0.001; χ2mumps=22.825, P<0.001). ConclusionThe antibody levels of measles, rubella and mumps among the people aged 18 years and younger in Karamay City are found to be low. Two doses of measles-mumps-rubella (MMR) vaccine should be given to children born before 2020, and if necessary, supplementary immunization with MMR vaccine should be carried out before they are enrolled in nursery and kindergarten. Additionally, regular population-based antibody surveillance should be conducted to promptly identify the people with weak immunity, which is conducive to effectively reducing and controlling the epidemic situation of measles, rubella and mumps in schools.
4.Epidemiological characteristics of varicella in Karamay City of Xinjiang from 2015 to 2022
Xia LI ; Meili WU ; Ling ZUO ; Liping RONG ; Jing WANG ; Feng WANG
Shanghai Journal of Preventive Medicine 2024;36(10):954-957
ObjectiveTo analyze the epidemiological characteristics of varicella in Karamay City, to inform the prevention and control of the local varicella epidemic, and to guide adjustments to the varicella vaccine immunization strategy. MethodsThe data on varicella cases from 2015 to 2022 in Karamay were collected and the epidemiological characteristics were analyzed. ResultsA total of 3 380 varicella cases were reported in Karamay from 2015 to 2022, with an average annual incidence rate of 94.91/105. The incidence of varicella showed a year-on-year downward trend from 2015 to 2022 (AAPC=-16.29%, P<0.05). Varicella cases demonstrated a seasonal variation, with peak incidence occurring from October to January of the following year and a slight increase from April to June. There were regional differences in the distribution of incidence rate, with 109.68/105 in Karamay District, followed by 89.06/105 in Baijiantan District, and 53.80/105 in Dushanzi District, respectively. The incidence rates in the 10‒14 and 5‒9 years age groups were higher than that in other age groups, with an incidence rate of 447.01/105 and 422.33/105 in each group, respectively. Most of the cases were students, accounting for 59.17% of the total cases, followed by preschool children (17.40%). There were 645 breakthrough cases of varicella, accounting for 19.08% of the total cases. The average interval between the onset of breakthrough cases and the most recent vaccination was (5.77±3.43) years. ConclusionVaricella cases mainly occurred in schools and childcare institutions in Karamay City, highlighting the need for enhanced prevention and control efforts in these settings. A second dose of varicella vaccine is recommended for children before primary school enrollment.
5.Efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy for the treatment of lung cancer brain metastases
Jing YANG ; Fang LIU ; Meili MA ; Dongshuai HUANG ; Junhua WANG
Journal of International Oncology 2024;51(10):609-613
Objective:To analyze the therapeutic effect and safety of simultaneous integrated boost intensity-modulated radiotherapy for lung cancer brain metastases.Methods:A total of 300 patients with lung cancer brain metastases admitted to the Department of Oncology, Qingdao Municipal Hospital from March 2021 to March 2023 were selected as the study objects. The patients were divided into control group ( n=150) and study group ( n=150) by random number table method. The control group received sequential three-dimensional conformal radiotherapy, while the study group received simultaneous integrated boost intensity-modulated radiotherapy. The short-term and medium-term efficacy, target dose, and adverse reactions were compared between the two groups. Results:The short-term and medium-term total effective rates of the study group were 73.33% (110/150) and 88.67% (133/150), respectively, which were higher than those of the control group [51.33% (77/150) and 71.33% (107/150) ] ( χ2=15.46, P<0.001; χ2=14.08, P<0.001). The D min in gross tumor planning target volume and whole brain clinical planning target volume of the study group were (23.78±1.11) and (58.46±0.55) Gy, respectively, which were higher than those in the control group [ (16.67±1.08) and (53.44±0.74) Gy], with statistically significant differences ( t=56.22, P<0.001; t=66.68, P<0.001). The D mean in gross tumor planning target volume and whole brain clinical planning target volume of the study group were (44.12±0.87) and (62.19±0.57) Gy, respectively, which were higher than those in the control group [ (37.55±0.89) and (57.78±0.82) Gy], with statistically significant differences ( t=64.65, P<0.001; t=54.08, P<0.001). The total incidence of adverse reactions was 30.67% (46/150) in the study group and 36.67% (55/150) in the control group, with no significantly significant difference ( χ2=1.20, P=0.271) . Conclusion:Compared with sequential three-dimensional conformal radiotherapy, simultaneous integrated boost intensity-modulated radiotherapy has better short-term and medium-term efficacy in patients with lung cancer brain metastases. Target dose can be increased without increasing adverse reactions.
6.Effect of Tongxinluo Capsules on Use of Anti-ischemic Drugs in Patients with Chronic Coronary Syndrome of Qi Deficiency and Blood Stasis: A Multicenter, Prospective Cohort Study
Chenhao ZHANG ; Jia WANG ; Yiying LIU ; Xiaohe YANG ; Xuesen WANG ; Meili GAO ; Yu DONG ; Xiaotao LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):149-156
ObjectiveTo investigate the effect of Tongxinluo capsules on the use of anti-ischemic drugs in patients with chronic coronary syndrome (CCS) of Qi deficiency and blood stasis. MethodA multicenter,prospective cohort study was conducted,with Tongxinluo capsules intervention as the exposure factor. Patients were divided into an exposed group (combination of traditional Chinese and western medicine) and a non-exposed group (western medicine alone),and followed up for one year. The use of anti-ischemic drugs was observed on the day of enrollment and at 3,6,12 months. ResultA total of 186 patients were enrolled,with 128 in the exposed group and 58 in the non-exposed group. There were no statistically significant differences in baseline characteristics between the two groups. At the 3-month follow-up,the types of first-line anti-ischemic drugs used in the exposed group were significantly fewer than those in the non-exposed group (P<0.01),and this difference remained statistically significant at 6 months (P<0.05) but was no longer significant at 12 months. At the 3- and 6-month follow-ups,there were no significant differences between the two groups in the types of second-line anti-ischemic drugs used. However,at the 12-month follow-up,the types of second-line anti-ischemic drugs used in the exposed group were significantly fewer than those in the non-exposed group (P<0.01). At the 3-month follow-up,both groups showed a reduction in the types of first-line anti-ischemic drugs used compared to baseline (P<0.05),with a more pronounced reduction in the exposed group (P<0.05). At the 6-month follow-up,the exposed group showed a significant reduction in the types of second-line anti-ischemic drugs used compared to baseline (P<0.05),while no significant changes were observed in the non-exposed group. At the 12-month follow-up,the difference in the types of second-line anti-ischemic drugs between the exposed and non-exposed groups was statistically significant (P<0.05),while there was no significant difference in the types of first-line anti-ischemic drugs. ConclusionTongxinluo capsules can effectively reduce the use of anti-ischemic drugs in patients with CCS of Qi deficiency and blood stasis.
7.Current status of tuberculosis burden in China
Xinyao WANG ; Meili JIANG ; Yuanjie PANG ; Dianjianyi SUN ; Canqing YU ; Lan WANG ; Jun LYU ; Liming LI
Chinese Journal of Epidemiology 2024;45(6):857-864
Tuberculosis, caused by Mycobacterium tuberculosis, is an infectious disease that most often affects the lungs. China is still among the high-burden tuberculosis countries in the world. Although the estimated incidence of tuberculosis in China has declined in recent years, the declining rate is slow. It still faces major issues such as a slower rate of decline, a widening gap between estimated and notified incidence, higher risk among middle-aged and older adults, a high number of cases among agriculture and related workers, and a heavier disease burden in the country's western regions. In addition, latent tuberculosis infection, drug-resistant tuberculosis, tuberculosis coinfection with HIV, and extrapulmonary tuberculosis have also exacerbated the disease burden of tuberculosis to some extent. This paper reviewed the epidemic characteristics of tuberculosis, the epidemiological triad, three links and two factors in the transmission process, the disease burden, and other aspects to provide a reference for formulating prevention and control strategies on tuberculosis.
8.Association of neutrophil gelatinase-associated lipocalin and severity of coronary stenosis in patients with stable coronary artery disease
Li ZHU ; Minghao HE ; Meili ZHOU ; Shengchao WANG ; Kun CHEN
China Modern Doctor 2024;62(23):57-62
Objective To investigate the association of neutrophil gelatinase-associated lipocalin(NGAL)and severity of coronary stenosis in patients with stable coronary artery disease(SCAD).Methods Totally 144 patients who underwent coronary angiography firstly due to suspected coronary artery disease were enrolled.The patients were divided into SCAD group(n=101)and non-CAD group(n=43),and the clinical data were compared.The SCAD group was fuether divided into three subgroups accoding to Gensini score:mild stenosis group(Gensini<16,n=32),moderate stenosis(16≤Gensini<30,n=33)and severe stenosis group(Gensini≥36,n=35).The clinical data of each group were compared.Odinal Logistic regression was used to analysis the influencing factors of severe stenosis.The receiver operating characteristic(ROC)curve was performed to evaluated the ability of NGAL in discriminating severe stenosis.Results Serum NGAL,high sensitive C-reactive protein(hs-CRP)level in SCAD group were higher than those in non-CAD group(P<0.01).Comparing with mild and moderate stenosis groups,NGAL and hs-CRP level were more higher in severe stenosis group(P<0.01).Multivariable Logistic regression analysis showed that NGAL and hs-CRP were independent risk factors for severe coronary stenosis(both P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under the curve of NGAL and hs-CRP were 0.771,0.702 respectively(both P<0.01).The difference between two AUCs was 0.069 which was insignificant(P>0.05).Conclusion Serum NGAL increased is closely associated with severe coronary stenosis in patients with SCAD,which has a certain ability of discriminating severity of coronary stenosis.
9.Establishment and validation of a sepsis 28-day mortality prediction model based on the lactate dehydrogenase-to-albumin ratio in patients with sepsis
Zhiyang WANG ; Fang HUANG ; Shifeng LI ; Xinyue LI ; Yujie LIU ; Bin SHAO ; Meili LIU ; Yunnan YAO ; Jun WANG
Chinese Critical Care Medicine 2024;36(11):1140-1146
Objective:To develop and validate a predictive model of 28-day mortality in sepsis based on lactate dehydrogenase-to-albumin ratio (LAR).Methods:Sepsis patients diagnosed in the department of intensive care medicine of the First Affiliated Hospital of Soochow University from August 1, 2017 to September 1, 2022 were retrospective selected. Clinical data, laboratory indicators, disease severity scores [acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment (SOFA)] were collected. Patients were divided into death group and survival group according to whether they died at 28 days, and the difference between the two groups was compared. The dataset was randomly divided into training set and validation set according to 7∶3. Lasso regression method was used to screen the risk factors affecting the 28-day death of sepsis patients, and incorporating multivariate Logistic regression analysis (stepwise regression) were included, a prediction model was constructed based on the independent risk factors obtained, and a nomogram was drawn. The nomogram prediction model was established. Receiver operator characteristic curve (ROC curve) was drawn to analyze and evaluate the predictive efficacy of the model. Hosmer-Lemeshow test, calibration curve and decision curve analysis (DCA) were used to evaluate the accuracy and clinical practicability of the model, respectively.Results:A total of 394 patients with sepsis were included, with 248 survivors and 146 non-survivors at 28 days. Compared with the survival group, the age, proportion of chronic obstructive pneumonia, respiratory rate, lactic acid, red blood cell distribution width, prothrombin time, activated partial thromboplastin time, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, blood potassium, blood phosphorus, LAR, SOFA score, and APACHEⅡ score in the death group were significantly increased, while oxygenation index, monocyte count, platelet count, fibrinogen, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and blood calcium were significantly reduced. In the training set, LAR, age, oxygenation index, blood urea nitrogen, lactic acid, total cholesterol, fibrinogen, blood potassium and blood phosphorus were screened by Lasso regression. Multivariate Logistic regression analysis finally included LAR [odds ratio ( OR) = 1.029, 95% confidence interval (95% CI) was 1.014-1.047, P < 0.001], age ( OR = 1.023, 95% CI was 1.005-1.043, P = 0.012), lactic acid ( OR = 1.089, 95% CI was 1.003-1.186, P = 0.043), oxygenation index ( OR = 0.996, 95% CI was 0.993-0.998, P = 0.002), total cholesterol ( OR = 0.662, 95% CI was 0.496-0.865, P = 0.003) and blood potassium ( OR = 1.852, 95% CI was 1.169-2.996, P = 0.010). A total of 6 predictor variables were used to establish a prediction model. ROC curve showed that the area under the curve (AUC) of the model in the training set and validation set were 0.773 (95% CI was 0.715-0.831) and 0.793 (95% CI was 0.703-0.884), which was better than APACHEⅡ score (AUC were 0.699 and 0.745) and SOFA score (AUC were 0.644 and 0.650), and the cut-off values were 0.421 and 0.309, the sensitivity were 62.4% and 82.2%, and the specificity were 82.2% and 68.9%, respectively. The results of Hosmer-Lemeshow test and calibration curve showed that the predicted results of the model were in good agreement with the actual clinical observation results, and the DCA showed that the model had good clinical application value. Conclusion:The prediction model based on LAR has a good predictive value for 28-day mortality in patients with sepsis and can guide clinical decision-making.
10.Scoping review of fatigue status and its influencing factors in patients receiving maintenance hemodialysis
Meili JIA ; Yiting NAN ; Shu WU ; Zhiyuan LIU ; Siyu LI ; Xiulan WANG ; Yanmei LANG
Chinese Journal of Modern Nursing 2024;30(24):3221-3231
Objective:To summarize the current research status, assessment tools, and influencing factors of fatigue in patients receiving maintenance hemodialysis (MHD) and provide a reference for the management of fatigue in this patient population.Methods:A literature search was conducted in databases including PubMed, Web of Science, ProQuest, Cochrane Library, Science Direct, Embase, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc for studies related to fatigue in patients receiving MHD. The search timeframe was from establishing the databases to January 23, 2024.Results:A total of 46 studies were included. Various assessment tools for fatigue in patients receiving MHD were identified, though specific tools were limited. The Short Form 36 Vitality Subscale (SF-36 VS) was the most commonly used assessment tool. The main factors influencing fatigue in these patients included sociodemographic, dialysis-related, disease-related, physical, nutritional, and psychological factors.Conclusions:Fatigue is a significant symptom in patients receiving MHD. Healthcare professionals must develop specific tools for accurately assessing fatigue in this population and explore standardized management plans.

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