ObjectiveTo study the pharmacological substances and mechanisms through which sesquiterpene ZH-13 from Aquilariae Lignum Resinatum improves neuroinflammation. MethodsBV-2 microglial cells were stimulated with lipopolysaccharide （LPS） to induce neuroinflammation. The cells were divided into the normal group， the model group， and the ZH-13 low- and high-dose treatment groups （10， 20 μmol·L^-1）. The model group was treated with 1 μmol·L^-1 LPS. Cell viability was assessed using the cell proliferation and activity assay （CCK-8 kit）. Nitric oxide （NO） release in the cell supernatant was measured using a nitric oxide kit （Griess method）. The mRNA expression levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， inducible nitric oxide synthase （iNOS）， and interleukin-6 （IL-6） were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The phosphorylation of mitogen-activated protein kinase （MAPK） pathway proteins was assessed by Western blot. ResultsCompared with the model group， ZH-13 dose-dependently reduced NO release from BV-2 cells under LPS stimulation （P<0.05， P<0.01）. In the 20 μmol·L^-1 ZH-13 treatment group， the mRNA expression levels of IL-1β， TNF-α， iNOS， and IL-6 were significantly reduced compared to the model group （P<0.05， P<0.01）. In both the low- and high-dose ZH-13 groups， the expression of the inflammatory factor TNF-α and the phosphorylation of c-Jun N-terminal kinase （JNK） in the upstream MAPK pathway were significantly reduced （P<0.05）. After stimulation with the JNK agonist anisomycin （Ani）， both low- and high-dose ZH-13 treatment groups showed reduced phosphorylation of JNK proteins compared to the Ani-treated group （P<0.01）. ConclusionThe sesquiterpene compound ZH-13 from Aquilariae Lignum Resinatum significantly ameliorates LPS-induced neuroinflammatory responses in BV-2 cells by inhibiting excessive JNK phosphorylation and reducing TNF-α expression. These findings elucidate the pharmacological substances and mechanisms underlying the sedative and calming effects of Aquilariae Lignum Resinatum.

Objective To investigate the effects of different doses of atorvastatin calcium on carotid intima-media thickness(CIMT)and serum lipoprotein associated phospholipase A2(Lp-PLA2),oxidized low-density lipoprotein(ox-LDL)and homocysteine(Hey)levels in patients with atherosclerosis.Methods Patients with atherosclerosis were divided into low-dose group(atorvastatin calcium tablets,20 mg·d-1)and high-dose group(atorvastatin calcium tablets,40 mg·d-1)according to the treatment scheme.The levels of blood lipids[triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL)and low-density lipoprotein(LDL)],carotid atherosclerotic plaque characteristics(CIMT and plaque area),serum Lp-PLA2,ox-LDL and Hcy levels were compared between groups.Adverse drug reactions in two groups were recorded.Results There were 98 cases in low-dose group,102 cases in high-dose group.After treatment,the levels of TG in high-dose group and low-dose group were(3.75±0.59)and(5.36±0.83)mmol·L 1;the levels of TC were(4.07±0.98)and(4.52±1.02)mmol·L-1;the levels of LDL were(1.89±0.58)and(1.49±0.42)mmol·L-1;the levels of and HDL were(1.85±0.58)and(2.67±0.73)mmol·L-1;CIMT were(1.14±0.18)and(1.30±0.20)mm;plaque areas were(18.59±2.17)and(22.72±2.81)mm2;the levels of Lp-PLA2 were(116.27±28.46)and(135.74±25.03)μg·L-1;the levels of ox-LDL were(12.07±2.59)and(13.42±2.25)μg·L-1;the levels of Hcy were(11.92±3.12)and(15.21±3.06)μmol·L-1.The above indexes were significantly different between high-dose group and low-dose group(all P＜0.05).The total incidence rates of adverse drug reactions in high-dose group and low-dose group were 22.55％and 14.29％(P＞0.05).Conclusion Compared with low-dose atorvastatin calcium,high-dose atorvastatin calcium can better improve blood lipid level of patients with atherosclerosis,reduce plaques,inhibit inflammatory reaction and reduce the formation of atherosclerosis.The two are comparably safe.

Objective:To explore the incidence of chronic obstructive pulmonary disease (COPD) in a cohort aged 40 years and above in Songjiang District, Shanghai, and to analyze the association of Mediterranean diet pattern and dietary approaches in stopping hypertension pattern (DASH) with the risk of developing COPD.Methods:Based on a natural population cohort in Songjiang District, Shanghai, 27 474 adults aged 40 years and above who did not have COPD at baseline were enrolled in the study. The Cox proportional risk regression model was used to analyze the association of baseline Mediterranean diet pattern score and DASH score with the risk of COPD, and the hazard ratio ( HR) of the risk and its 95% CI were calculated. Restricted cubic spline was used to analyze the nonlinear association between the two diet scores and the risk of COPD. Stratified analyses were performed according to gender, age, smoking status, etcetera. Sensitivity analyses were conducted by censoring cases diagnosed within one year after the baseline survey or people with a history of malignant tumor disease. Results:As of June 30, 2023, after a median follow-up time of 6.21 years, there were 1 089 (4.0%) new COPD cases with an incidence density of 64.00 per 10 000 person-years. After adjusting for relevant confounders, in the Mediterranean tertile subgroups under diet pattern score, the risk of developing COPD could be reduced by approximately 14% in the intermediate scoring group ( HR=0.86, 95% CI: 0.75-0.99) and 15% in the highest scoring group ( HR=0.85, 95% CI: 0.72-0.99) compared to the lowest scoring group. The association remained after censoring cases diagnosed within one year of the baseline survey ( HR=0.82, 95% CI: 0.70-0.95; HR=0.82, 95% CI: 0.68-0.97) or censoring people with a history of malignant tumor disease ( HR=0.84, 95% CI: 0.73-0.97; HR=0.84, 95% CI: 0.71-0.99). No statistical association was found between the DASH score and the risk of COPD. Conclusions:The Mediterranean diet pattern was associated with a lower risk of COPD. Increasing the intake of vegetables, fruits, legumes, and whole grains and decreasing the intake of red meat and others can reduce the risk of COPD. No association was found between the DASH dietary pattern and the risk of COPD in this community population.

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Objective:To compare the safety of radial artery puncture in elderly patients aged 75 years and older who are undergoing neurointerventional procedures.Methods:A single-center retrospective study was conducted, involving 350 elderly patients aged 75 years and older who received neurointerventional treatment at Beijing Tiantan Hospital, Capital Medical University, from June to December 2022.The participants were divided into two groups based on the puncture site: femoral artery puncture and radial artery puncture.The safety indicators compared between the two groups included puncture failure, changes in puncture site, general puncture complications(such as subcutaneous bleeding, puncture site hematoma, and vasospasm), severe puncture complications(including distal limb ischemia and pseudoaneurysm), and lower limb venous thrombosis.Multivariate Logistic regression analysis was conducted to evaluate the impact of different puncture methods on the occurrence of complications.Results:Among the 350 patients, 280 underwent femoral artery puncture, while 70 underwent radial artery puncture.There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The proportions of patients using antiplatelet drugs prior to surgery, puncture failure rates, rates of change in puncture sites, and the incidence of severe complications-including distal limb ischemia and pseudoaneurysm-were not significantly different between the two groups( χ2=2.051, 0.075, 0.588, 3.175; P=0.152, 0.784, 0.443, 0.075).In the femoral artery puncture group, 20.4%(57 cases)of patients experienced general puncture complications(including subcutaneous bleeding, puncture site hematoma, and vasospasm), whereas only 8.6%(6 cases)in the radial artery puncture group experienced such complications, revealing a statistically significant difference between the two groups( χ2=5.720, P=0.022).Multivariate Logistic regression analysis indicated that, compared to femoral artery puncture, radial artery puncture was associated with a reduced risk of all complications( OR=0.272, 95% CI: 0.139-0.532, P<0.001), general puncture complications( OR=0.375, 95% CI: 0.153-0.919, P=0.032)and lower limb venous thrombosis( OR=0.219, 95% CI: 0.050-0.954, P=0.043). Conclusions:In elderly patients aged 75 years and older who are undergoing neurointerventional procedures, radial artery puncture is associated with a reduced incidence of general puncture complications and lower limb venous thrombosis when compared to femoral artery puncture, indicating a superior safety profile.

Carpal tunnel syndrome(CTS)is one of the most common peripheral nerve entrapment disorders,the elevated pressure in the carpal tunnel,high-intensity activities and obesity are the main causes,and the patients with mild to moderate CTS are more prevalent.The main pathogenesis of CTS involves the increasing of carpal tunnel pressure and impaired local blood oxygen supply leading to reduced nerve conduction.Currently,the clinical treatment methods for mild to moderate CTS mainly include surgical and nonsurgical treatments.Nonsurgical treatment is the preferable choice for the patients with mild to moderate CTS.The western medical treatment primarily rely on oral medications,but their long-term use is limited due to the certain adverse effects;the local blockade and extracorporeal shock wave therapies show better efficacy for the patients with frequent activities and severe symptoms;the traditional Chinese medicine treatment also becomes a choice for some CTS patients due to their advantages of less pain,lower medical costs,and significant effectiveness.This study reviews the recent advancements in the pathogenesis and treatment of mild to moderate CTS,in order to design the personalized treatment methods for the mild to moderate CTS patients based on their specific conditions in clinical settings and provide the references for precise treatment of the mild to moderate CTS patients.

Objectives:The purpose of this study was to investigate the clinical efficacy of percutaneous endoscopic transforaminal lumbar interbody fusion(PE-TLIF)in patients with single-segment lumbar spinal stenosis and explore the changes of paraspinal muscles and adjacent segmental facet joints of operative segement after PE-TLIF.Methods:28 patients with L4/5 lumbar spinal stenosis treated with PE-TLIF in Beijing Chaoyang Hospital from March 2017 to March 2019 were analyzed retrospectively.The patients consisted of 12 males and 16 females with an average age of 58.0±8.7 years(41-79 years)and were followed up for 40.7±3.6 months(36-58 months).The visual analogue scale(VAS)of low back pain(VAS-LBP)and VAS of leg pain(VAS-LP)were collected at pre-operation,postoperative 1-week follow-up,3-month follow-up,12-month follow-up and the final follow-up;Oswestry disability index(ODI)was evaluated at pre-operation,post-operative 3-month follow-up,12-month follow-up and the final follow-up.CT examination was performed at pre-operation,postoperative 12-month follow-up,24-month follow-up and the final follow-up,the cross-sec-tional area(CSA)and fat infiltration(FI)score of multifidus(MF)were measured,and the degeneration degree of adjacent segmental facet joints was evaluated according to the score of facet joint degeneration.The differ-ences of MF CSA and FI score,as well as adjacent segmental facet joint degeneration were compared be-tween preoperation and postoperation.Results:The VAS-LBP score was 3(2,3)at 1-week follow-up,1(1,2)at 3-month follow-up,1(0,2)at 12-month follow-up,and 1(0,1)at the final follow-up,which was signif-icantly improved compared with the preoperative score of 7(7,8)(P＜0.05);the VAS-LP score was 2(1,3)at 1-week follow-up,1(1,2)at 3-month follow-up,1(0,1)at 12-month follow-up,and 0(0,1)at the final fol-low-up,which were significantly improved compared with the preoperative score of 6(5,7)(P＜0.05);The ODI at 3-month follow-up was 23％(19％,31％),at 12-month follow-up was 12％(8.5％,17.5％),and at the final follow-up was 7％(4％,15.6％),all significantly improved compared with the ODI before operation of 61％(55％,67％)(P＜0.05).The postoperative MF CSAs of 547.12±53.31mm2(12-month follow-up),558.35±52.37mm2(24-month follow-up),and 531.21±56.12mm2(final follow-up)were not significantly changed from the preoper-ative MF CSA of 557.06±46.72mm2(P＞0.05).There was no significant difference in FI score between pre-op-eration of 2(2,3)and 12-month follow-up of 3(2,3),24-month follow-up of 3(2,3)and the final follow-up of 3(3,3)(P＞0.05).The postoperative facet joint degeneration scores of upper segment facet joint(USFJ)of 5(4,6)at 12-month follow-up,5(4,5)at 24-month follow-up,and 5(4,6)at final follow-up were not signifi-cantly changed from the preoperative 5(4,6)(P＞0.05).And there was no significant difference either in facet joint degeneration score of lower segment facet joint(LSFJ)between pre-operation of 5(4,6)and 12-month follow-up of 5(4,5),24-month follow-up of 5(4,6)and the final follow-up of 5(4,7)(P＞0.05).Conclusions:PE-TLIF can achieve satisfactory clinical outcomes in the treatment of single-segment lumbar spinal stenosis,which has no significant effect on multifidus in the surgical segment and adjacent segmental facet joints in the mid-to long-term.

Objective:To develop a Pediatric Nursing Care Deficiency Scale (PNCDS) and evaluate its reliability and validity.Methods:Based on theories of nursing care deficiency and considering pediatric nursing characteristics, the scale was developed following standard procedures and principles. This included semi-structured interviews, expert evaluations, a pilot survey, and a large-scale survey to finalize the scale.Results:The final version of the PNCDS comprised four dimensions with 25 items. The content validity index (CVI) of the overall scale was 0.937, with item-level CVIs ranging from 0.857 to 1.000. Exploratory factor analysis revealed that the factor loadings for all items were greater than 0.5, and the four factors accounted for a cumulative variance of 66.456%. Confirmatory factor analysis indicated a good model fit for the final scale. The overall Cronbach's α coefficient for the scale was 0.917, while the Cronbach's α coefficients for the four dimensions were 0.861, 0.923, 0.881, and 0.909, respectively.Conclusions:The PNCDS demonstrated good reliability and validity and provides a useful tool for assessing pediatric nursing care deficiencies and aiding in the development of intervention strategies.

Objective To analyze Professor Zhang Binghou's medication experience in the treatment of diabetic kidney disease using data mining methods;To screen the core medicinal pairs and medicinal groups.Methods Prescriptions of diabetic kidney disease of Professor Zhang Binghou from the outpatient department of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University were selected from January 2014 to December 2021.TCM Inheritance Platform System 2.5,SPSS Modeler 18 and SPSS Statistics 21 software were used for association rules,clustering analysis and factor analysis to summarize the medication frequency,properties and tastes and meridians,and medicinal pairs and combinations.Results A total of 161 prescriptions were included,involving 188 kinds of Chinese materia medica,with a total frequency of 2 220 time.The kinds of Chinese materia medica with higher frequency were Rehmannize Radix et Praeparata,Testudinis Carapax et Plastrum,Astragali Radix,Rehmannine Radix,etc.The main properties were cold and warm,the main tastes were sweet and bitter,and the main meridians were kidney,liver and spleen meridians.A total of 14 drug pair association rules were obtained,with 27 commonly used drug combinations.Clustering analysis extracted 10 combinations based on the spectrum,and factor analysis extracted 14 common factors.Conclusion Professor Zhang Binghou's treatment for diabetic kidney disease takes nourishing the true yin and clearing away damp-heat as the main treatment method,and at the same time,it pays attention to tonifying kidney,consolidating essence,nourishing yin and containing yang,promoting blood circulation and removing blood stasis,etc.,which embodies Professor Zhang Binghou's unique academic thought of treating diabetic kidney disease.

BACKGROUND: Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function. Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia. In this study, we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts. METHODS: We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend (WCHAT) study. For external validation, we used the Xiamen Aging Trend (XMAT) cohort. We compared the support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGB), and Wide and Deep (W&D) models. The area under the receiver operating curve (AUC) and accuracy (ACC) were used to evaluate the diagnostic efficiency of the models. RESULTS: The WCHAT cohort, which included a total of 4057 participants for the training and testing datasets, and the XMAT cohort, which consisted of 553 participants for the external validation dataset, were enrolled in this study. Among the four models, W&D had the best performance (AUC = 0.916 ± 0.006, ACC = 0.882 ± 0.006), followed by SVM (AUC =0.907 ± 0.004, ACC = 0.877 ± 0.006), XGB (AUC = 0.877 ± 0.005, ACC = 0.868 ± 0.005), and RF (AUC = 0.843 ± 0.031, ACC = 0.836 ± 0.024) in the training dataset. Meanwhile, in the testing dataset, the diagnostic efficiency of the models from large to small was W&D (AUC = 0.881, ACC = 0.862), XGB (AUC = 0.858, ACC = 0.861), RF (AUC = 0.843, ACC = 0.836), and SVM (AUC = 0.829, ACC = 0.857). In the external validation dataset, the performance of W&D (AUC = 0.970, ACC = 0.911) was the best among the four models, followed by RF (AUC = 0.830, ACC = 0.769), SVM (AUC = 0.766, ACC = 0.738), and XGB (AUC = 0.722, ACC = 0.749). CONCLUSIONS: The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness. It could be widely used in primary health care institutions or developing areas with an aging population. TRIAL REGISTRATION Chictr.org, ChiCTR 1800018895.
Humans ; Aged ; Sarcopenia/diagnosis* ; Deep Learning ; Aging ; Algorithms ; Biomarkers