Nationwide survey of physicians' familiarity and awareness of diabetes guidelines in China: a cross-sectional study.

OBJECTIVE: This study aims to investigate physicians' familiarity and awareness of four diabetes guidelines and their practice of the recommendations outlined in these guidelines. DESIGN: A cross-sectional study. SETTING: An online questionnaire survey was conducted among physicians affiliated with the Specialist Committee for Primary Diabetes Care of China Association of Chinese Medicine, using the snowball sampling method to ensure a broader representation of physicians. PARTICIPANTS: 1150 physicians from 192 cities across 30 provinces in China provided complete data. RESULTS: Tertiary care hospital physicians (TCPs) exhibited the highest familiarity with the Guideline for the Prevention and Treatment of Type 2 Diabetes Mellitus in China (91.3%), followed by the National Guidelines for the Prevention and Control of Diabetes in Primary Care (76.8%), the Standards of Medical Care in Diabetes (72.2%) and the Guidelines for Prevention and Treatment of Diabetes in Chinese Medicine (63.8%). Primary care practitioners (PCPs) exhibited familiarity with these four guidelines at about 50% or less. Self-reported reference to modern diabetes guidelines by physicians is more frequent than traditional Chinese medicine (TCM) diabetes guidelines, with rates at 73.2% and 33.8%, respectively. Approximately 90% of physicians provided instructions on self-monitoring of blood glucose to their patients with diabetes. Less than one-third of physicians referred patients to a specialised nutritionist. In terms of health education management, TCPs reported having a diabetes health management team at the rate of 75.7%, followed by secondary care hospital physicians at 57.0% and PCPs at 27.5%. Furthermore, approximately 40% of physicians did not fully grasp hypoglycaemia characteristics. CONCLUSIONS: Familiarity and awareness of the screening guidelines varied among physicians in different hospital settings. Importantly, significant discrepancies were observed between physicians' awareness and their self-reported reference to modern medicine guidelines and TCM guidelines. It is essential to consistently provide education and training on diabetes management for all physicians, particularly PCPs.

Activation of Liver X Receptors and Peroxisome Proliferator-Activated Receptors by Lipid Extracts of Brown Seaweeds: A Potential Application in Alzheimer's Disease?

The nuclear liver X receptors (LXRα/ß) and peroxisome proliferator-activated receptors (PPARα/γ) are involved in the regulation of multiple biological processes, including lipid metabolism and inflammation. The activation of these receptors has been found to have neuroprotective effects, making them interesting therapeutic targets for neurodegenerative disorders such as Alzheimer's Disease (AD). The Asian brown seaweed Sargassum fusiforme contains both LXR-activating (oxy)phytosterols and PPAR-activating fatty acids. We have previously shown that dietary supplementation with lipid extracts of Sargassum fusiforme prevents disease progression in a mouse model of AD, without inducing adverse effects associated with synthetic pan-LXR agonists. We now determined the LXRα/ß- and PPARα/γ-activating capacity of lipid extracts of six European brown seaweed species (Alaria esculenta, Ascophyllum nodosum, Fucus vesiculosus, Himanthalia elongata, Saccharina latissima, and Sargassum muticum) and the Asian seaweed Sargassum fusiforme using a dual luciferase reporter assay. We analyzed the sterol and fatty acid profiles of the extracts by GC-MS and UPLC MS/MS, respectively, and determined their effects on the expression of LXR and PPAR target genes in several cell lines using quantitative PCR. All extracts were found to activate LXRs, with the Himanthalia elongata extract showing the most pronounced efficacy, comparable to Sargassum fusiforme, for LXR activation and transcriptional regulation of LXR-target genes. Extracts of Alaria esculenta, Fucus vesiculosus, and Saccharina latissima showed the highest capacity to activate PPARα, while extracts of Alaria esculenta, Ascophyllum nodosum, Fucus vesiculosus, and Sargassum muticum showed the highest capacity to activate PPARγ, comparable to Sargassum fusiforme extract. In CCF-STTG1 astrocytoma cells, all extracts induced expression of cholesterol efflux genes (ABCG1, ABCA1, and APOE) and suppressed expression of cholesterol and fatty acid synthesis genes (DHCR7, DHCR24, HMGCR and SREBF2, and SREBF1, ACACA, SCD1 and FASN, respectively). Our data show that lipophilic fractions of European brown seaweeds activate LXRs and PPARs and thereby modulate lipid metabolism. These results support the potential of brown seaweeds in the prevention and/or treatment of neurodegenerative diseases and possibly cardiometabolic and inflammatory diseases via concurrent activation of LXRs and PPARs.

Research Progress in High-Efficiency Utilization of Nitrogen in Rapeseed.

Nitrogen (N) is one of the most important mineral elements for plant growth and development and a key factor for improving crop yield. Rapeseed, Brassica napus, is the largest oil crop in China, producing more than 50% of the domestic vegetable oil. However, high N fertilizer input with low utilization efficiency not only increases the production cost but also causes serious environmental pollution. Therefore, the breeding of rapeseed with high N efficiency is of great strategic significance to ensure the security of grain and oil and the sustainable development of the rapeseed industry. In order to provide reference for genetic improvement of rapeseed N-efficient utilization, in this article, we mainly reviewed the recent research progress of rapeseed N efficiency, including rapeseed N efficiency evaluation, N-efficient germplasm screening, and N-efficient physiological and molecular genetic mechanisms.

[Consideration of Supervision of Mesotherapy Needles for Cosmetic Injection].

With the development of medical aesthetics industry in China, sodium hyaluronic is injected into the facial dermis with multi needles to relieve wrinkles, thick pores, skin relaxation and other aging problems, is more and more popular nowadays. The wide application of mesotherapy for cosmetic injection and the subsequent adverse events are widely reported. This study attempts to explore the adverse events and countermeasures for the application of mesotherapy from the perspective of medical device supervision.

24(S)-Saringosterol Prevents Cognitive Decline in a Mouse Model for Alzheimer's Disease.

We recently found that dietary supplementation with the seaweed Sargassum fusiforme, containing the preferential LXRß-agonist 24(S)-saringosterol, prevented memory decline and reduced amyloid-ß (Aß) deposition in an Alzheimer's disease (AD) mouse model without inducing hepatic steatosis. Here, we examined the effects of 24(S)-saringosterol as a food additive on cognition and neuropathology in AD mice. Six-month-old male APPswePS1ΔE9 mice and wildtype C57BL/6J littermates received 24(S)-saringosterol (0.5 mg/25 g body weight/day) (APPswePS1ΔE9 n = 20; C57BL/6J n = 19) or vehicle (APPswePS1ΔE9 n = 17; C57BL/6J n = 19) for 10 weeks. Cognition was assessed using object recognition and object location tasks. Sterols were analyzed by gas chromatography/mass spectrometry, Aß and inflammatory markers by immunohistochemistry, and gene expression by quantitative real-time PCR. Hepatic lipids were quantified after Oil-Red-O staining. Administration of 24(S)-saringosterol prevented cognitive decline in APPswePS1ΔE9 mice without affecting the Aß plaque load. Moreover, 24(S)-saringosterol prevented the increase in the inflammatory marker Iba1 in the cortex of APPswePS1ΔE9 mice (p < 0.001). Furthermore, 24(S)-saringosterol did not affect the expression of lipid metabolism-related LXR-response genes in the hippocampus nor the hepatic neutral lipid content. Thus, administration of 24(S)-saringosterol prevented cognitive decline in APPswePS1ΔE9 mice independent of effects on Aß load and without adverse effects on liver fat content. The anti-inflammatory effects of 24(S)-saringosterol may contribute to the prevention of cognitive decline.

Therapeutic Potential of Trp-Rich Engineered Amphiphiles by Single Hydrophobic Amino Acid End-Tagging.

End-tagging with a single hydrophobic residue contributes to improve the cell selectivity of antimicrobial peptides (AMPs), but systematic studies have been lacking. Thus, this study aimed to systematically investigate how end-tagging with hydrophobic residues at the C-terminus and Gly capped at the N-terminus of W4 (RWRWWWRWR) affects the bioactivity of W4 variants. Among all the hydrophobic residues, only Ala end-tagging improved the antibacterial activity of W4. Meanwhile, Gly capped at the N-terminus could promote the helical propensity of the end-tagged peptides in dodecylphosphocholine micelles, increasing their antimicrobial activities. Of these peptides, GW4A (GRWRWWWRWRA) showed the best antibacterial activity against the 19 species of bacteria tested (GMMIC = 1.86 µM) with low toxicity, thus possessing the highest cell selectivity (TIall = 137.63). It also had rapid sterilization, good salt and serum resistance, and LPS-neutralizing activity. Antibacterial mechanism studies showed that the short peptide GW4A killed bacteria by destroying cell membrane integrity and causing cytoplasmic leakage. Overall, these findings suggested that systematic studies on terminal modifications promoted the development of peptide design theory and provided a potential method for optimization of effective AMPs.

[Basic Regularities and Characteristics of Compound Reinforcing--reducing Manipulation of Acu- puncture Revealed by Data Mining].

OBJECTIVE: To explore the regularities and features of compound reinforcing-reducing manipulation of acupuncture filiform needles in the treatment of clinical conditions or diseases by using data mining technique, so as to guide clinical practice. METHODS: At first, the data base about the reinforcing-reducing manipulation (CRRM) of filiform needles for different clinical problems was established by collection, sorting, screening, recording, collation, data extraction of the related original papers published in journals and conferences and related academic dissertations from Jan. 1 of 1950 to Jan. 31 of 2015 by using key words of "acupuncture" "moxibustion" "needling" "filiform needle", and according to the included and excluded standards. RESULTS: A total of 130 835 papers met the included standards were collected. Outcomes of data mining in the present study showed that (1) the ORRM is most frequently applied in the internal medicine, followed by surgery, gynecology, ophthalmology and otorhinolaryngology, dermatology, and pediatrics, successively, mostly for lumbago and leg pain; (2) the heat-producing needling manipulation is the most frequently applied technique, followed by cool-producing needling, dragon-tiger warring, yang occluding in yin, yin occluding in yang techniques; (3) the highest effective rate of CRRM is for problems of the pediatrics, followed by those of the internal medicine, surgery, ophthalmology and otorhinolaryngology, dermatology, and gynecology; (4) the most fre- quently used acupoints are Zusanli (ST 36), then Sanyinjiao (SP 6), stimulated by heat-producing needling, and Zusanli (ST 36), then Quchi (LI 11), stimulated by cool-producing needling, and Huantiao (GB 30), stimulated by dragon-tiger warring needling. CONCLUSION: The compound reinforcing-reducing manipulation of acupuncture is most frequently applied to problems in the inter- nal medicine, predominately for lumbago and leg pain, and the best effectiveness is for pediatric conditions. The heat-producing needling and cool-producing needling are most frequently applied at Zusanli (ST 36) and the dragon-tiger warring manipulation is most frequently applied at Huantiao (GB 30).

[Basic Characteristics of Simplex Reinforcing and Reducing Manipulations of Filiform Acupuncture Needle in Clinical Practice Based upon Data Mining].

OBJECTIVE: To explore the regularities and features of clinical application of simplex reinforcing or reducing manipulation of filiform acupuncture needles by data mining in order to guide clinical decision in a better way. METHODS: A database about simplex reinforcing and reducing manipulations of filiform acupuncture needle was established first after collection, sorting, screening, type-in, and collation of the related papers, academic dissertations and theses of academic conferences published from January 1st of 1950 to January 31 of 2015 by using key word "acupuncture" "acupuncture and moxibustion" "needle manipulation" and "filiform needle" from database of China National Knowledge Infrastructure (CNKI, a full-text database of Chinese journals), followed by data extraction and statistical analysis. RESULTS: A total of 1 304 articles were found to meet the standards formulated in the present study. Among them, 800 papers belong to the internal medicine covering apoplectic sequelae (153 papers), apoplexy (52), headache (63) and insomnia (60), 271 to surgery involving soft tissue injury (63) and backleg pain (46); 93 to five-sense-organs involving nasosinusitis (14), 64 gynecology involving dysmenorrhea (13), 41 to dematology involving struma (20), and 35 to pediatrics covering five kinds of tardy growth and five flaccid syndromes(8). These 1 304 papers contain 2 542 of simplex reinforcing and reducing manipulations, including 895 of twirling-thrusting reducing, 611 of twirling-rotating reinforcing, 571 of lifting-thrusting reducing, 303 of lifting-thrusting reinforcing, 32 of reinforcing and 32 of reducing in cooperation wihpatients' respiration, 23 open-close reducing, 12 open-close reinforcing, 21 reducing and 16 of reinforcing achieved by inserting the needle along or against the meridian, 14 rapid-slow reinforcing, and 12 rapid-slow reducing. Regarding the acupoint selection, distal and local acupoints are most frequently used, followed by symptoms-determined and syndrome-determined, respectively. The acupuncture needle retained time was from 0 min to 45 mn, and the therapeutic effect was relatively better for post-stroke. The totally therapeutic effects of the simplex reinforcing and reducing manipulations were 96.07% for problems of demotology, 94.19% for gynecology, 96. 58% for surgery, 92.85% for pediatrics, 91.78% for five-sense organs and 93. 70% for internal medicine, respectively. CONCLUSION: Simplex reinforcing and reducing manipulations of acupuncture has a definite effect in the treatment of different problems particularly in the internal medicine and surgery. Often, the twirling-rotating and lifting-thrusting reinforcing and reducing manipulations of acupuncture are employed in clinical practice.

[Comparison of different moxibustion techniques in clinical treatment of diseases based on data mining].

OBJECTIVE: To explore the specific efficacy of different moxibustion techniques in treatment of common diseases and clinical indications, and compare the specificity in clinical indications and efficacy among different moxibustion techniques so as to guide clinical practice better. METHODS: The modern computerization and data mining technology were adopted to set up moxibustion literature database. The relevant literature of moxibustion techniques in recent 60 years were collected, screened, examined, extracted and analyzed statistically so as to explore the advantages of different moxibustion techniques in clinical treatment. RESULTS: (1) Of 2,516 literature, moxa stick, moxe cone and moxa device were used in the highest frequency in internal medicine department, for 730 times, 278 times and 102 times respectively. The warm needling technique was used in the highest frequency, for 70 times in the surgical department. (2) In the dermatology department, the curative rate with moxa cone was the highest, 75%. In the ear-nose-throat department, the warm needing technique and moxa device achieved the highest curative rate, 49% for both of them. In the internal medicine department and surgical department, the curative rate of warm needling technique was 53% and 58% respectively. In the gynecology department, the curative rate of moxa device was the highest, 59%. In the pediatrics department, the curative rate of moxa cone was the highest, 80%. (3) The numbers of priority disorders, frequency ≥20 times: 24 kinds of disease for moxa stick, five kinds of disease for moxa cone, 2 kinds of disease for warm needling technqiue and one disorder for moxa device. Facial paralysis, diarrhea, lumbar and leg pain and elbow and knee swelling pain were of the highest priority, treated with these 4 moxibustion techniques, with a certain of literature research values. (4) The warm needling technique achieved the better efficacy on elbow and knee swelling pain, lumbar and leg pain and diarrhea compared with the other three techniques and the curative rate was higher. The moxa device tecnique achieved the higher curative rate for facial paralysis compared with the other three techniques. CONCLUSION: Through the comparison of application frequency, curative rate, clinical application frequency in disorders and the efficacy of priority disorders in the treatment with different moxibustion techniques, it is found that moxa stick, moxa cone and moxa device are simple in manipulation, safe and effective. Hence, they can be extensively used in the treatment of common disorders in every department in clinic. The warm needling technique acts on the body by the co-work of needling and warming stimulation of mugwort. It achieves the particular effect on the disorders with complicated etiologies compared with the other three techniques. It can be chosen in priority for the disorders caused by blockage in meridian and collateral and stagnation of qi and blood.

Comparison of different moxibustion techniques in clinical treatment of diseases based on data mining / 中国针灸

<p><b>OBJECTIVE</b>To explore the specific efficacy of different moxibustion techniques in treatment of common diseases and clinical indications, and compare the specificity in clinical indications and efficacy among different moxibustion techniques so as to guide clinical practice better.</p><p><b>METHODS</b>The modern computerization and data mining technology were adopted to set up moxibustion literature database. The relevant literature of moxibustion techniques in recent 60 years were collected, screened, examined, extracted and analyzed statistically so as to explore the advantages of different moxibustion techniques in clinical treatment.</p><p><b>RESULTS</b>(1) Of 2,516 literature, moxa stick, moxe cone and moxa device were used in the highest frequency in internal medicine department, for 730 times, 278 times and 102 times respectively. The warm needling technique was used in the highest frequency, for 70 times in the surgical department. (2) In the dermatology department, the curative rate with moxa cone was the highest, 75%. In the ear-nose-throat department, the warm needing technique and moxa device achieved the highest curative rate, 49% for both of them. In the internal medicine department and surgical department, the curative rate of warm needling technique was 53% and 58% respectively. In the gynecology department, the curative rate of moxa device was the highest, 59%. In the pediatrics department, the curative rate of moxa cone was the highest, 80%. (3) The numbers of priority disorders, frequency ≥20 times: 24 kinds of disease for moxa stick, five kinds of disease for moxa cone, 2 kinds of disease for warm needling technqiue and one disorder for moxa device. Facial paralysis, diarrhea, lumbar and leg pain and elbow and knee swelling pain were of the highest priority, treated with these 4 moxibustion techniques, with a certain of literature research values. (4) The warm needling technique achieved the better efficacy on elbow and knee swelling pain, lumbar and leg pain and diarrhea compared with the other three techniques and the curative rate was higher. The moxa device tecnique achieved the higher curative rate for facial paralysis compared with the other three techniques.</p><p><b>CONCLUSION</b>Through the comparison of application frequency, curative rate, clinical application frequency in disorders and the efficacy of priority disorders in the treatment with different moxibustion techniques, it is found that moxa stick, moxa cone and moxa device are simple in manipulation, safe and effective. Hence, they can be extensively used in the treatment of common disorders in every department in clinic. The warm needling technique acts on the body by the co-work of needling and warming stimulation of mugwort. It achieves the particular effect on the disorders with complicated etiologies compared with the other three techniques. It can be chosen in priority for the disorders caused by blockage in meridian and collateral and stagnation of qi and blood.</p>

Diseases treated by moxibustion and fire needling in clinical practice based on data mining: a comparison study / 中国针灸

<p><b>OBJECTIVE</b>To discuss the specificity of diseases treated by moxibustion and fire needling in clinical practice, so as to provide references for clinical treatment.</p><p><b>METHODS</b>With data mining of modern computer technique, journal and literature databases regarding moxibustion and fire needling were established, respectively. Literature regarding moxibustion and fire needling for the past 60 years has been collected, screened, included, reviewed and abstracted. The utility rate of moxibustion and fire needling in each department was calculated, frequency of diseases in clinical practice was summarized, and diseases which had differences in clinical practice in each department were screened; also the advantages of disease categories and clinical practice between two kinds of therapies in each department were compared.</p><p><b>RESULTS</b>(1) The utility rate of moxibustion was highest in department of internal medicine and surgery, which were 43.6% and 28.1%, respectively; the utility rate of fire needling was highest in surgery and dermatological department, which were 53.7% and 23.8%, respectively. (2) According to the comparison and analysis on diseases treated by two therapies in clinic, among 26 kinds of gynecology diseases that were treated by moxibustion, 20 kinds were not involved with fire needling; among 22 kinds of pediatrics diseases that were treated by moxibustion, 20 kinds were not involved with fire needling. It was certain that the difference of the two therapies in clinical application was more significant in gynecology and pediatrics than that in the rest four departments. (3) Among the diseases which had differences in clinical practice in each department, the ones involved with moxibustion alone were insomnia, distention and fullness, consumptive fatigue in the department of internal medicine, blood-vessel Bi, stiff neck and hernia in surgery department, urticarial, skin Bi and skin cancer in dermatological department, malposition, infertility and amenorrhea in gynecology department, diarrhea, indigestion and stomachache in pediatrics department, blepharoptosis, blurred vision and dryness syndrome in ENT department; the ones involved with fire needling alone were numbness, coldness syndrome and acute renal colic in the department of internal medicine, lipoma, soft tissue injury and papilloma in surgery department, bromhidrosis, freckle and erysipelas in dermatological department, uterine fibroid in gynecology department, umbilical polyp in pediatrics department, auricle pseudocyst, starred nebula and phlegmatic mass in ENT department.</p><p><b>CONCLUSION</b>Moxibustion is frequently applied in department of internal medicine and surgery, while fire needling is frequently used in surgery and dermatological department; the application of moxibustion is broader than that of fire needling in gynecology and pediatrics department. Among the diseases which have differences in clinical practice in each department, moxibustion is commonly seen for clinical symptoms featured with deficiency syndrome, while fire needling is commonly applied for the diseases that have obvious local symptoms.</p>

[Diseases treated by moxibustion and fire needling in clinical practice based on data mining: a comparison study].

OBJECTIVE: To discuss the specificity of diseases treated by moxibustion and fire needling in clinical practice, so as to provide references for clinical treatment. METHODS: With data mining of modern computer technique, journal and literature databases regarding moxibustion and fire needling were established, respectively. Literature regarding moxibustion and fire needling for the past 60 years has been collected, screened, included, reviewed and abstracted. The utility rate of moxibustion and fire needling in each department was calculated, frequency of diseases in clinical practice was summarized, and diseases which had differences in clinical practice in each department were screened; also the advantages of disease categories and clinical practice between two kinds of therapies in each department were compared. RESULTS: (1) The utility rate of moxibustion was highest in department of internal medicine and surgery, which were 43.6% and 28.1%, respectively; the utility rate of fire needling was highest in surgery and dermatological department, which were 53.7% and 23.8%, respectively. (2) According to the comparison and analysis on diseases treated by two therapies in clinic, among 26 kinds of gynecology diseases that were treated by moxibustion, 20 kinds were not involved with fire needling; among 22 kinds of pediatrics diseases that were treated by moxibustion, 20 kinds were not involved with fire needling. It was certain that the difference of the two therapies in clinical application was more significant in gynecology and pediatrics than that in the rest four departments. (3) Among the diseases which had differences in clinical practice in each department, the ones involved with moxibustion alone were insomnia, distention and fullness, consumptive fatigue in the department of internal medicine, blood-vessel Bi, stiff neck and hernia in surgery department, urticarial, skin Bi and skin cancer in dermatological department, malposition, infertility and amenorrhea in gynecology department, diarrhea, indigestion and stomachache in pediatrics department, blepharoptosis, blurred vision and dryness syndrome in ENT department; the ones involved with fire needling alone were numbness, coldness syndrome and acute renal colic in the department of internal medicine, lipoma, soft tissue injury and papilloma in surgery department, bromhidrosis, freckle and erysipelas in dermatological department, uterine fibroid in gynecology department, umbilical polyp in pediatrics department, auricle pseudocyst, starred nebula and phlegmatic mass in ENT department. CONCLUSION: Moxibustion is frequently applied in department of internal medicine and surgery, while fire needling is frequently used in surgery and dermatological department; the application of moxibustion is broader than that of fire needling in gynecology and pediatrics department. Among the diseases which have differences in clinical practice in each department, moxibustion is commonly seen for clinical symptoms featured with deficiency syndrome, while fire needling is commonly applied for the diseases that have obvious local symptoms.

[Data mining-based research on regularities and characteristics of application of moxibustion therapy for different clinical disorders].

OBJECTIVE: To explore the regularities and characteristics of application of moxibustion therapy for different clinical problems or diseases by using data mining technique. METHODS: A database on moxibustion therapy was established first by collection, sorting, screening, recording, collation, data extraction of the related literatures published in recent 60 years. By analyzing the appearance-frequency of clinical disorders treated by moxibustion and their effective rates, the regularities and characteristics were summed up. RESULTS: Moxibustion therapy has been used to treat 193 types of clinical disorders or diseases up to now, mostly in internal medicine for 72 types (accounting for 37%). Of the collected 2 516 articles about moxibustion therapy, 1 107 are for problems of the internal medicine, accounting for 44% ; those of facial paralysis and uroschesis are 139 and 108 respectively. The second and third mostly seen articles are surgery and gynecology respectively. Analysis on the therapeutic effect showed that moxibustion therapy is effective for relieving many types of clinical conditions or diseases, particularly those of pediatrics, surgery and dermatology. By taking both the appearing frequency and efficacy into account, analysis on the therapeutic effect shows that a total of 29 types of clinical disorders are preferably treated by moxibustion, including 12 types (41. 4%) attributed to the department of internal medicine, 10 types (34. 5%) to the department of surgery, 2 types to the department of dermatology, 3 types to the department of gynecology, one to the pediatrics and one to the department of five-organs. CONCLUSION: Moxibustion therapy is effective for many clinical disorders, particularly for those of the department of internal medicine and surgery.