4.Discussion on the Pathogenesis and Treatment of Children Enuresis Based on the Theory "Kidney-Marrow-Brain" Axis and "Yin Heel Channel (阴跷脉)"
Bo ZHANG ; Xianqing REN ; Wen FU ; Yuying SUN ; Xiaoyu LIU ; Chundong SONG ; Xia ZHANG ; Qingyin GUO ; Ying DING
Journal of Traditional Chinese Medicine 2024;65(9):909-914
Guided by the theory of "kidney generates marrow", the study elaborates the viewpoint that the route of Yin Heel Channel (阴跷脉) is consistent with the "kidney-marrow-brain" axis from the perspective of the circulation of the meridians and the relationship between the zang-fu organs. Accordingly, it is believed that disease of Yin Heel Channel and dysfunction of the "kidney-marrow-brain" axis are the core pathogenesis of children enuresis, and it is elaborated from the following three major aspects, firstly, insufficient kidney essence, dysfunction of the "kidney-marrow-brain" axis, secondly, disease of Yin Heel Channel and deficiency and cold in lower jiao, and thirdly, disease of Yin Heel Channel and loss of nourishment of Chong Vessel. It is proposed to use the mode of "firstly needle, secondly moxibustion, and lastly consolidation" to treat children enuresis. Needle is to adjust yin and yang, warm yang and tonify kidney, and wake up the brain and open the orifices. The acupoints in Yin Heel Channel such as Zhaohai (KI 6), Jiaoxin (KI 8) and confluence points of the eight extraordinary vessels such as Waiguan (TE 5), Zulinqi (GB 41) are used, together with Baihui (GV 20), Yintang (EX-HN 3), Guanyuan (CV 4), Qixue (KI 13), Dazhong (KI 4). Moxibustion is to reinforce healthy qi and warm yang, bank up the root and consolidate the original qi by moxibustion at Shenque (CV 8), Mingmen (GV 4), and Xuanshu (GV 5). Consolidation is to use acupoints application to consolidate the therapeutic effect, and Guanyuan (CV 4) & Pangguangshu (BL 28), Qihai (CV 6) & Zhishi (BL 52), and Shenque (CV 8) & Ciliao (BL 32) are commonly used as the three groups of acupoints to warm the kidney and stop collapse, regulate and tonify the qi and blood.
5.Effect of Mahuang Xixin Fuzitang on Migration of Dendritic Cells in Mice by Regulating Rho/ROCK Signaling Pathway
Shuyue FAN ; Luwei WU ; Tongtong SUN ; Yuying NI ; Jing GAO ; Ying CUI ; Min LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):35-42
ObjectiveTo investigate the inhibitory effect of Mahuang Xixin Fuzitang on the migration of dendritic cells (DCs) in mice and its underlying mechanism. MethodMouse bone marrow-derived DCs were isolated and cultured. The morphological changes of the cells at different stages were observed under a microscope, and the CD11c+ proportion was detected by flow cytometry to identify DC purity. Cells were treated with Mahuang Xixin Fuzitang (1, 2, 5, 10, 20, 40, 50, 100 g·L-1) for 24 hours, and the effect of Mahuang Xixin Fuzitang on cell proliferation was assessed using the cell counting kit-8 (CCK-8) assay to determine the appropriate concentrations for treatment. After modeling by lipopolysaccharide (LPS) induction, DCs were divided into a blank group, a model group, and Mahuang Xixin Fuzitang groups (2, 4, 8 g·L-1). The expression of surface molecules CD80, CD86, and major histocompatibility complex-Ⅱ (MHC-Ⅱ) were detected by flow cytometry. Transwell chamber assay was used to observe cell migration. The levels of chemokine C-C-primitive receptor 7 (CCR7) and chemokine C-X-C-primitive receptor 4 (CXCR4) on the cell surface were detected by enzyme-linked immunosorbent assay (ELISA). The expression of filamentous actin (F-actin) in the cell microfilament cytoskeleton was detected by immunofluorescence (IF) staining. Real-time quantitative polymerase chain reaction (Real-time PCR) was employed to determine the mRNA expression levels of Ras homolog family member A (RhoA) and Rho-associated coiled-coil containing protein kinase 1 (ROCK1). Western blot analysis was performed to detect the protein expression of RhoA and ROCK1. ResultCompared with the blank group, the model group exhibited significantly higher expression levels of CD80, CD86, and MHC-Ⅱ (P<0.01), a significantly increased number of cells migrating to the lower chamber (P<0.01), and significantly elevated levels of CCR7 and CXCR4 (P<0.05, P<0.01). Additionally, F-actin expression was significantly increased (P<0.01), and both RhoA and ROCK1 mRNA and protein expression levels were significantly higher (P<0.05, P<0.01). Compared with the model group, treatment with Mahuang Xixin Fuzitang (2, 4, 8 g·L-1) for 24 hours resulted in significantly lower expression levels of CD80, CD86, and MHC-Ⅱ (P<0.01), a significantly reduced number of cells migrating to the lower chamber (P<0.05), and significantly decreased levels of CCR7 and CXCR4 (P<0.05, P<0.01). Furthermore, F-actin expression was significantly reduced (P<0.01), and both RhoA and ROCK1 mRNA and protein expression levels were significantly decreased (P<0.05, P<0.01). ConclusionMahuang Xixin Fuzitang can inhibit the migration of DCs in mice, and its mechanism of action may be related to reducing the activity of the Rho/ROCK signaling pathway, thereby affecting changes in the cell cytoskeleton.
6.Serum 25-hydroxyvitamin D, genetic susceptibility, and the risk of incident type 2 diabetes: A prospective cohort in East China
Ying SUN ; Haojie ZHANG ; Bin WANG ; Yuying WANG ; Chi CHEN ; Yi CHEN ; Yingli LU ; Ningjian WANG
Chinese Medical Journal 2024;137(8):972-979
Background::The serum vitamin D level varies widely by population, and studies have linked vitamin D levels with the risk of type 2 diabetes mellitus (T2DM). However, the relationship is inconsistent and the impact of vitamin D on T2DM among East Chinese adults is unclear. The study aimed to investigate the association between serum 25-hydroxyvitamin D (25[OH]D) levels and the risk of T2DM and evaluated whether the association is modified by genetic predisposition.Methods::In the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) cohort, 1862 participants free of T2DM at baseline were included. A weighted genetic risk score was calculated with 28 variants associated with T2DM. Hierarchical logistic models were used to examine the association of serum 25(OH)D and genetic risk with T2DM.Results::After a 5-year follow-up, 132 cases of T2DM were documented. We observed no significant association between quartiles of serum 25(OH)D and T2DM risk after multivariable adjustment (χ 2 = 0.571, Pfor trend = 0.426). Compared to those in the lowest quartile of 25(OH)D, the odds ratios (ORs) (95% confidence interval [CI]) for participants with increased quartiles were 1.29 (0.74-2.25), 1.35 (0.77-2.36), and 1.27 (0.72-2.24), respectively. We observed a positive association of glycated hemoglobin (HbA1c) with 25(OH)D at baseline (β = 1.752, P = 0.001) and after follow-up (β = 1.385, P = 0.003), and a negative association of ln conversion homeostasis model assessment (HOMA)-β with 25(OH)D at baseline (β = -0.982, P = 0.021). There was no significant interaction between 25(OH)D and diabetes genetic predisposition on the risk of T2DM (χ 2 = 2.710, Pfor interaction = 0.100). The lowest OR (95% CI) of T2DM was among participants with low genetic risk and the highest quartile of 25(OH)D (0.17 [0.05–0.62]). Conclusion::Serum 25(OH)D may be irrelevant to the risk of incident T2DM among East Chinese adults regardless of genetic predisposition.
7.Birth weight, ideal cardiovascular health metrics in adulthood, and incident cardiovascular disease
Ying SUN ; Bin WANG ; Yuefeng YU ; Yuying WANG ; Xiao TAN ; Jihui ZHANG ; Lu QI ; Yingli LU ; Ningjian WANG
Chinese Medical Journal 2024;137(10):1160-1168
Background::Prenatal and postnatal factors may have joint effects on cardiovascular health, and we aimed to assess the joint association of birth weight and ideal cardiovascular health metrics (ICVHMs) prospectively in adulthood with incident cardiovascular disease (CVD).Methods::In the UK Biobank, 227,833 participants with data on ICVHM components and birth weight and without CVD at baseline were included. The ICVHMs included smoking, body mass index, physical activity, diet information, total cholesterol, blood pressure, and hemoglobin A1c. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) in men and women.Results::Over a median follow-up period of 13.0 years (2,831,236 person-years), we documented 17,477 patients with incident CVD. Compared with participants with birth weights of 2.5-4.0 kg, the HRs (95% CIs) of CVD among those with low birth weights was 1.08 (1.00-1.16) in men and 1.23 (1.16-1.31) in women. The association between having a birth weight <2.5 kg and CVD risk in men was more prominent for those aged <50 years than for those of older age ( P for interaction = 0.026). Lower birth weight and non-ideal cardiovascular health metrics were jointly related to an increased risk of CVD. Participants with birth weights <2.5 kg and ICVHMs score 0-1 had the highest risk of incident CVD (HR [95% CI]: 3.93 [3.01-5.13] in men; 4.24 [3.33-5.40] in women). The joint effect (HR [95% CI]: 1.36 [1.17-1.58]) could be decomposed into 24.7% (95% CI: 15.0%-34.4%) for a lower birth weight, 64.7% (95% CI: 56.7%-72.6%) for a lower ICVHM score, and 10.6% (95% CI: 2.7%-18.6%) for their additive interaction in women. Conclusions::Birth weight and ICVHMs were jointly related to CVD risk. Attaining a normal birth weight and ideal ICVHMs may reduce the risk of CVD, and a simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases in women.
8.Life’s Essential 8 and risk of non-communicable chronic diseases: Outcome-wide analyses
Yuetian YU ; Ying SUN ; Yuefeng YU ; Yuying WANG ; Chi CHEN ; Xiao TAN ; Yingli LU ; Ningjian WANG
Chinese Medical Journal 2024;137(13):1553-1562
Background::Life’s Simple 7, the former construct of cardiovascular health (CVH) has been used to evaluate adverse non-communicable chronic diseases (NCDs). However, some flaws have been recognized in recent years and Life’s Essential 8 has been established. In this study, we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions (PAFs) of low-moderate CVH scores in the 44 NCDs.Methods::In the UK Biobank, 170,726 participants free of 44 common NCDs at baseline were included. The Life’s Essential 8 composite measure consists of four health behaviours (diet, physical activity, nicotine exposure, and sleep) and four health factors (body mass index, non-high density lipoprotein cholesterol, blood glucose, and blood pressure), and the maximum CVH score was 100 points. CVH score was categorized into low, moderate, and high groups. Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition (ICD-10) code using linkage to national health records until 2022. Cox proportional hazard models were used in this study. The hazard ratios (HRs) and PAFs of 44 NCDs associated with CVH score were examined.Results::During the median follow-up of 10.85 years, 58, 889 incident NCD cases were documented. Significant linear dose-response associations were found between higher CVH score and lower risk of 25 (56.8%) of 44 NCDs. Low-moderate CVH (<80 points) score accounted for the largest proportion of incident cases in diabetes (PAF: 80.3%), followed by gout (59.6%), sleep disorder (55.6%), chronic liver disease (45.9%), chronic kidney disease (40.9%), ischemic heart disease (40.8%), chronic obstructive pulmonary disease (40.0%), endometrium cancer (35.8%), lung cancer (34.0%), and heart failure (34.0%) as the top 10. Among the eight modifiable factors, overweight/obesity explained the largest number of cases of incident NCDs in endocrine, nutritional, and metabolic diseases (35.4%), digestive system disorders (21.4%), mental and behavioral disorders (12.6%), and cancer (10.3%); however, the PAF of ideal sleep duration ranked first in nervous system (27.5%) and neuropsychiatric disorders (9.9%).Conclusions::Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs. Among CVH metrics, avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases, NCDs in digestive system, mental and behavioral disorders, and cancer.
9.Interpretation of specification for service of cancer screening for workers
Hongda CHEN ; Bin LU ; Ying ZHENG ; Peng DU ; Xiao QI ; Kai ZHANG ; Yuying LIU ; Junli WEI ; Donghua WEI ; Jiyong GONG ; Yunchao HUANG ; Zhenya SONG ; Xi CHU ; Dong DONG ; Wenjing ZHENG ; Min DAI
Chinese Journal of Epidemiology 2024;45(4):486-489
As the backbone force of China's social and economic construction, the health status of workers is closely related to the nation's productivity and social development. Currently, cancers have become one of the major diseases threatening the health of workers. However, there are still many shortcomings in the cancer screening services for the workers. To standardize cancer screening services for workers, ensure the quality of screening services, and improve the overall screening effectiveness, 19 institutions, including Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, have jointly formulated the Group Standard "Specification for service of cancer screening for workers (T/CHAA 023-2023)". This standard follows the principles of "legality, scientific rigor, advancement, and feasibility" and combines the frontier scientific advances in cancer screening. It clarifies the relevant requirements for service principles, service design, service delivery, service management, service evaluation, and improving worker cancer screening. Implementing this group standard will help connect the common screening needs of workers, employers, and cancer screening service providers, standardize the screening process, improve screening quality, and ultimately increase the early diagnosis rate and survival rate of cancer patients. Consequently, this group standard will help safeguard workers' health rights and interests, ensure the labor force resources, promote the comprehensive coordinated and sustainable development of society, and contribute to realizing the "Healthy China 2030" strategic policy.
10.Ultrasonic elastography and superb microvascular imaging for diagnosing cervical cancer:Comparison on single method and their combination
Yuying HANG ; Ying ZHANG ; Hong WEI ; Binbin LI ; Chao WANG ; Yang JIANG ; Xin YANG
Chinese Journal of Medical Imaging Technology 2024;40(7):1087-1091
Objective To observe the value of shear wave elastography(SWE),superb microvascular imaging(SMI)and their combination with conventional ultrasound for diagnosing cervical cancer.Methods Data of 178 patients with cervical lesion confirmed by pathology were retrospectively analyzed.The patients were divided into malignant group(n=32)and benign group(n=146),and those in benign group were further divided into low-grade or high-grade cervical intraepithelial neoplasia subgroups,cervical leiomyosarcoma subgroup,cervical polyps subgroup and cervicitis subgroup.The manifestations of lesion on conventional ultrasound,SWE and SMI were observed,and the mean value of Young's modulus(Emean)and SMI flow index(Ratio)were collected.The optimal cut-off value of SWE Emean and SMI Ratio were obtained with receiver operating characteristic(ROC)curves,and the classification of benign or malignant lesions were predicted.The consistency of predictive results and pathology results were assessed with the Kappa test.The diagnostic efficacies of conventional ultrasound,SWE and SMI alone and their combination were compared.Results The age of patients in malignant group was higher than that in benign group(P<0.05).SWE Emean and SMI Ratio were both higher in malignant group than those in each benign subgroup(all P<0.05).Taken 44.35 kPa and 3.95% as the best cut-off values,the consistency of SWE Emean classification results and pathological results was good(Kappa=0.818),while of SMI Ratio was moderate(Kappa=0.453).The efficacy of conventional ultrasound,SWE and SMI alone for classifying benign and malignant cervical lesions(AUC=0.845,0.914,0.892)were all higher than that of their combination(AUC=0.806,all adjusted P<0.05).The sensitivity of SWE and SMI for diagnosing cervical cancer was 90.60% and 93.78% respectively,with specificity of 95.20% and 72.60%,respectively.Conclusion SWE hag higher efficacy for diagnosing cervical cancer,while SMI had better sensitivity but lower specificity.Combination of conventional ultrasound,SWE and SWI did not increase the efficacy of ultrasound for diagnosing cervical cancer.

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