A qualitative study of user experience， knowledge and attitude of e-cigarette use in Shanghai / 上海预防医学

ObjectiveTo understand the experience， knowledge and attitudes of e-cigarette users in Shanghai， and to provide evidence for the development of intervention programs for e-cigarette use. MethodsThe Respondent-Driven Sampling （RDS） method was used to recruit 40 e-cigarette users for qualitative interviews from November 2020 to February 2021. NVivo （11.0） software was used to code interview records， and the thematic pattern and relationship analysis were conducted. ResultsIn terms of the reasons and user experience of e-cigarette use， most respondents used e-cigarettes for the first time after recommendation of friends； The reasons for the current use of e-cigarettes focus on the subjective feelings generated by the use of e-cigarettes （easy to use， replacing traditional tobacco， and having many flavors）. Compared with traditional tobacco use， respondents said e-cigarettes tasted good and had no physical impact （they could be used all the time without making them uncomfortable）. In terms of the awareness of e-cigarette use related knowledge， the respondents' opinions on whether e-cigarettes caused health risks were mostly based on their own experience of using them， and they said it was difficult to identify real information online. As for whether they were interested in relevant knowledge， most respondents said they wanted to learn about the professional knowledge related to e-cigarettes. Regarding the attitude related to the use of e-cigarettes， most respondents believed that e-cigarettes are addictive， e-cigarettes are not a safe alternative to traditional tobacco， ande-cigarettes couldn't help them quit smoking. Three out of ten respondents said they supported including e-cigarettes in the Regulation on Smoking Control in Public. ConclusionThere are certain characteristics of e-cigarette users' feelings， related knowledge and attitude towards e-cigarette use that should be targeted to carry out publicity， education and intervention.

Expert consensus for Jingtong Granules in treatment of cervical radiculopathy in clinical application / 中国中药杂志

With the effects of activating blood and resolving stasis, and moving Qi to relieve pain, Jingtong Granules is widely used in the treatment of cervical radiculopathy in China. Long-term clinical application and related evidence have shown that the prescription has ideal effect in alleviating the pain in neck, shoulder, and upper limbs, stiffness or scurrying numbness, and scurrying pain caused by this disease. However, there is a lack of consensus on the clinical application of Jingtong Granules. Therefore, clinical first-line experts and methodology experts from all over the country were invited to compile this expert consensus. This expert consensus is expected to guide clinicians to use Jingtong Granules in a standardized and reasonable way, improve clinical efficacy, reduce medication risks, and benefit patients. First, according to the clinical experience of experts and the standard development procedures, the indications, syndrome characteristics, clinical advantages, and possible adverse reactions of Jingtong Granules were summarized. Then, through face-to-face interview of clinical doctors in traditional Chinese medicine and western medicine and survey of the clinical application, the clinical problems were summed up, and the consensus was reached with the nominal group method to form the final clinical problems. Third, evidence retrieval was carried out for the clinical problems, and relevant evidence was evaluated. The GRADE system was employed to rate the quality of evidence. Fourth, 5 recommendation items and 3 consensuses items were summarized with the nominal group method. Opinions and peer reviews on the consensus content were solicited through expert meetings and letter reviews. The final consensus includes the summary of evidence on the clinical indications, effectiveness, and safety of Jingtong Granules, which can serve as a reference for clinicians in hospitals and primary health institutions.

Analysis of nutritional status in 22 609 children and adolescents aged 2-18 years in Southwest China / 国际儿科学杂志

Objective:To investigate the epidemiology, risk factors and biochemical indexes of nutritional status in children and adolescents aged 2~18 years in Southwest China.Methods:Children attending routine health checkups at the Children′s Hospital of Chongqing Medical University between April 2017 and March 2021 were enrolled in this study.Nutritional status was defined based on BMI cut-off values, and statistically analyzed based on gender, region and age.Its risk factors were analyzed by multivariate Logistic regression.Results:A total of 22 609 cases were recruited and the overall prevalence of wasting, overweight and obesity was 5.87%, 9.81% and 10.50%, respectively.The prevalence of obesity and wasting in boys was higher than that in girls ( χ2=24.79, 12.39, all P<0.05), and the prevalence of overweight in boys was lower than that in girls( χ2=4.32, P<0.05). The prevalence of overweight among boys in urban regions was higher than that in rural regions( χ2=4.68, P<0.05). Compared in three age groups, boys aged 12~18 years had the highest prevalence of obesity( χ2=12.49, P<0.01), while girls had the lowest prevalence of wasting( χ2=6.18, P<0.05). Compared with boys, girls had a lower risk of obesity and wasting ( OR=0.80, 95% CI: 0.73~0.87), ( OR=0.80, 95% CI: 0.71~0.90). Compared to children aged 12~18 years, children aged 2~<6 years had a lower risk of obesity ( OR=0.55, 95% CI: 0.46~0.67), while children aged 6~<12 years had a higher risk of wasting ( OR=1.70, 95% CI: 1.25~2.33). Significant differences were reported in ALT, AST, ALP, UA, UN, CRE, TG, TC, HDL-C and LDL-C levels in obese children (all P<0.05). Conclusion:The nutritional status of children and adolescents in Southwest China is comparable to that at the national level.The prevalence of obesity and wasting is associated with gender and age.Obese children are more likely to have biochemical abnormalities.

Chinese expert guidance on overall application of lenvatinib in hepatocellular carcinoma / 中华消化外科杂志

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4,2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Metformin in the treatment of psoriasis / 中华皮肤科杂志

Metformin, the first-line treatment of type 2 diabetes, has been also increasingly used in the treatment of some skin diseases, such as psoriasis. This review summarizes therapeutic mechanisms of and clinical research progress in metformin in the treatment of psoriasis, aiming to provide ideas and methods for the treatment of psoriasis, especially psoriasis complicated by metabolic diseases.

Expanded Applications of Traditional Chinese Medicine Four Examination Techniques in Asymptomatic Spleen-Stomach Diseases / 中医杂志

Asymptomatic spleen-stomach diseases refer to diseases without related symptoms and signs of abdo-minal pain， bloating， diarrhea an others in patients， but showing lesions or pathological changes discovered by modern medical techniques such as endoscopy， CT， MRI. The four examination techniques of traditional Chinese medicine （TCM） are based on symptoms and signs of patients， which are the advantage of TCM but also have certain limitations. In the context of the increasingly modernized diagnosis and treatment in TCM， it is proposed to expand the application of the four examination techniques from three aspects including microcosmic syndrome differentiation， data sharing， and artificial intelligence in asymptomatic spleen-stomach diseases， in order to achieve the goals of dynamically observing the disease process， collecting disease data in multiple dimensions， and intelligently processing disease data. This will strengthen the modern requirements of early diagnosis and treatment in TCM， and highlight the advantages of TCM in “treating disease before it arises and treating the symptoms beforehand”.

Electroacupuncture alleviates postoperative pain through inhibiting neuroinflammation via stimulator of interferon genes/type-1 interferon pathway / 中西医结合学报

OBJECTIVE@#This work explores the impact of electroacupuncture (EA) on acute postoperative pain (APP) and the role of stimulator of interferon genes/type-1 interferon (STING/IFN-1) signaling pathway modulation in the analgesic effect of EA in APP rats.@*METHODS@#The APP rat model was initiated through abdominal surgery and the animals received two 30 min sessions of EA at bilateral ST36 (Zusanli) and SP6 (Sanyinjiao) acupoints. Mechanical, thermal and cold sensitivity tests were performed to measure the pain threshold, and electroencephalograms were recorded in the primary somatosensory cortex to identify the effects of EA treatment on APP. Western blotting and immunofluorescence were used to examine the expression and distribution of proteins in the STING/IFN-1 pathway as well as neuroinflammation. A STING inhibitor (C-176) was administered intrathecally to verify its role in EA.@*RESULTS@#APP rats displayed mechanical and thermal hypersensitivities compared to the control group (P < 0.05). APP significantly reduced the amplitude of θ, α and γ oscillations compared to their baseline values (P < 0.05). Interestingly, expression levels of proteins in the STING/IFN-1 pathway were downregulated after inducing APP (P < 0.05). Further, APP increased pro-inflammatory factors, including interleukin-6, tumor necrosis factor-α and inducible nitric oxide synthase, and downregulated anti-inflammatory factors, including interleukin-10 and arginase-1 (P < 0.05). EA effectively attenuated APP-induced painful hypersensitivities (P < 0.05) and restored the θ, α and γ power in APP rats (P < 0.05). Meanwhile, EA distinctly activated the STING/IFN-1 pathway and mitigated the neuroinflammatory response (P < 0.05). Furthermore, STING/IFN-1 was predominantly expressed in isolectin-B4- or calcitonin-gene-related-peptide-labeled dorsal root ganglion neurons and superficial laminae of the spinal dorsal horn. Inhibition of the STING/IFN-1 pathway by intrathecal injection of C-176 weakened the analgesic and anti-inflammatory effects of EA on APP (P < 0.05).@*CONCLUSION@#EA can generate robust analgesic and anti-inflammatory effects on APP, and these effects may be linked to activating the STING/IFN-1 pathway, suggesting that STING/IFN-1 may be a target for relieving APP. Please cite this article as: Ding YY, Xu F, Wang YF, Han LL, Huang SQ, Zhao S, Ma LL, Zhang TH, Zhao WJ, Chen XD. Electroacupuncture alleviates postoperative pain through inhibiting neuroinflammation via stimulator of interferon genes/type-1 interferon pathway. J Integr Med. 2023; 21(5): 496-508.

5'-tiRNA-Gln inhibits hepatocellular carcinoma progression by repressing translation through the interaction with eukaryotic initiation factor 4A-I / 医学前沿

tRNA-derived small RNAs (tsRNAs) are novel non-coding RNAs that are involved in the occurrence and progression of diverse diseases. However, their exact presence and function in hepatocellular carcinoma (HCC) remain unclear. Here, differentially expressed tsRNAs in HCC were profiled. A novel tsRNA, tRNAGln-TTG derived 5'-tiRNA-Gln, is significantly downregulated, and its expression level is correlated with progression in patients. In HCC cells, 5'-tiRNA-Gln overexpression impaired the proliferation, migration, and invasion in vitro and in vivo, while 5'-tiRNA-Gln knockdown yielded opposite results. 5'-tiRNA-Gln exerted its function by binding eukaryotic initiation factor 4A-I (EIF4A1), which unwinds complex RNA secondary structures during translation initiation, causing the partial inhibition of translation. The suppressed downregulated proteins include ARAF, MEK1/2 and STAT3, causing the impaired signaling pathway related to HCC progression. Furthermore, based on the construction of a mutant 5'-tiRNA-Gln, the sequence of forming intramolecular G-quadruplex structure is crucial for 5'-tiRNA-Gln to strongly bind EIF4A1 and repress translation. Clinically, 5'-tiRNA-Gln expression level is negatively correlated with ARAF, MEK1/2, and STAT3 in HCC tissues. Collectively, these findings reveal that 5'-tiRJNA-Gln interacts with EIF4A1 to reduce related mRNA binding through the intramolecular G-quadruplex structure, and this process partially inhibits translation and HCC progression.

Correlation between lipoprotein-associated phospholipase A2 and albuminuria in patients with type 2 diabetes mellitus / 安徽医科大学学报

Objective@#To explore the correlation between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and albuminuria in patients with type 2 diabetes mellitus (T2DM) ．@*Methods @#200 T2DM patients were chosen to collect general data and relevant laboratory indicators． According to the urinary albumin / creatinine ratio ( UACR) ，they were divided into normal group (UACR＜30 mg / g，n = 66) ，microalbuminuria group (30 mg / g≤ UACR＜300 mg / g，n = 64) and macroalbuminuria group (UACR≥300 mg / g，n = 70) ．On the basis of Lp-PLA2 tertile，they were divided into low Lp-PLA2 group (Lp-PLA2 ＜104 ng / ml，n = 66) ，medium Lp-PLA2 group ( 104 ng / ml≤Lp-PLA2 ＜161 ng / ml，n = 67) and high Lp-PLA2 group (Lp-PLA2 ≥161 ng / ml，n = 67) ．Group differences were compared by analysis of variance and nonparametric test．Associations between Lp-PLA2 and other indicators were performed by Pearson correlation and Spearman correlation. Related factors of albuminuria in T2DM patients were explored by multivariate Logistic regression analysis． In addition ，receiver operating characteristic (ROC) curve analysis was applied to evaluate the predictive value of Lp-PLA2 for albuminuria in T2DM patients. @*Results@#Lp-PLA2 was significantly higher in the macroalbuminuria group than that in both the normal group and the microalbuminuria group，and the differences were statistically significant (P＜0. 05) ．Compared with the normal group，Lp-PLA2 in the microalbuminuria group increased(P＜0. 05) ．With the increase in Lp-PLA2 tertile， there was gradual increase in UACR , and the difference was statistically significant (P＜0. 05) ．Correlation analysis showed that Lp-PLA2 was positively correlated with duration of DM，systolic blood pressure (SBP) ，glycosylated hemoglobin (HbA1c) ，fasting blood glucose (FBG) ，blood urea nitrogen (BUN) ，serum creatinine (Scr) ，UACR and negatively correlated with estimated glomerular filtration rate ( eGFR) (P ＜0. 05 ) ． Multivariate Logistic regression analysis showed that Lp-PLA2 ［OR = 1. 046，95% CI( 1. 031，1. 060) ］was an independent risk factor for albuminuria (P＜0. 05) ．The AUC of Lp-PLA2 for predicting albuminuria was 0. 902 ［95% CI(0. 862，0. 942) ］. The cut-off value of Lp-PLA2was 148 ng / ml，the sensitivity was 65. 7% and specificity was 98. 5%．@*Conclusion@#Lp-PLA2 is closely related to the albuminuria in T2DM patients，which provides a new method for the diagnosis and treatment of diabetic kidney disease (DKD) .

Analysis of Kawasaki disease complicated with atlantoaxial rotatory subluxation / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristics of children with Kawasaki disease (KD) complicated with atlantoaxial rotatory subluxation (AARS).Methods:Clinical characteristics of 60 AARS patients complicated with KD (the atlantoaxial rotatory subluxation group) and 60 patients with KD only diagnosed (the control group)in the Children′s Hospital of Chongqing Medical University from December 2010 to December 2019 were retrospectively analyzed.Differences between groups were compared by the Chi- square test and the t test. Results:A total of 8 365 KD patients were diagnosed during the study period, involving 60 cases (0.72%) complicated with AARS.which usually occurred in the acute phase with the onset ages of 3 to 6 years ( P<0.001). Initial clinical symptoms of KD complicated with AARS included fever with restricted neck movement (100.00%), neck mass (66.67%), torticollis (21.67%) and neck pain (11.67%). CT or X-ray exa-mination of the neck indicated AARS, with thickening and swelling of the cervical soft tissues in some cases.Compared with those of control group, red, dry, cracked lips ( P=0.01) and cervical lymph node swollen ( P<0.001) were significantly pronounced in KD patients complicated with AARS.The absolute and relative count of neutrophils were significantly higher in KD patients complicated with AARS (all P< 0.05). Cervical soft tissue swelling and thickening in B-ultrasound were more obvious than those in the control group( P<0.05). However, there were no significant differences in coronary artery lesions and the response to intravenous immunoglobulin (IVIG) combined with Aspirin between groups ( P>0.05). Head traction could relieve neck symptoms to a certain extent, but there was no significant difference between groups ( P>0.05). Conclusions:Cervical lymphadenopathy, red, dry, cracked lips, increase of absolute and relative count of neutrophils, and swelling and thicke-ning of cervical soft tissues were the high-risk factors of KD complicated with AARS.The complication of AARS in KD patients did not increase the risk of coronary artery injury and IVIG resistance.IVIG combined with aspirin achieved a good prognosis in the majority of KD patients complicated with AARS.