Baseline Findings of PreventE4: A Double-Blind Placebo Controlled Clinical Trial Testing High Dose DHA in APOE4 Carriers before the Onset of Dementia.

INTRODUCTION: Lower blood levels of the omega-3 polyunsaturated fatty acid docosahexaenoic acid (DHA) are correlated with worse cognitive functions, particularly among APOE ε4 carriers. Whether DHA supplementation in APOE ε4 carriers with limited DHA consumption and dementia risk factors can delay or slow down disease progression when started before the onset of clinical dementia is not known. METHODS: PreventE4 is a double-blind, single site, randomized, placebo-controlled trial in cognitively unimpaired individuals with limited omega-3 consumption and dementia risk factors (n=368). Its objectives are to determine (1) whether carrying the APOE ε4 allele is associated with lower delivery of DHA to the brain; and (2) whether high dose DHA supplementation affects brain imaging biomarkers of AD and cognitive function. RESULTS: 365 cognitively unimpaired individuals between 55 and 80 (mean age 66) were randomized to 2 grams of DHA per day or identically appearing placebo for a period of 2 years. Half the participants were asked to complete lumbar punctures at baseline and 6-month visits to obtain cerebrospinal fluid (CSF). The primary trial outcome measure is the change in CSF DHA to arachidonic acid ratio after 6 months of the intervention (n=181). Secondary trial outcomes include the change in functional and structural connectivity using resting state functional MRI at 24 months (n=365). Exploratory outcomes include the change in Repeatable Battery of the Assessment of Neuropsychological Status at 24 months (n=365). CONCLUSIONS: Findings from PreventE4 will clarify the brain delivery of DHA in individuals carrying the APOE ε4 allele with implications for dementia prevention strategies. Trial was registered as NCT03613844.

[Study on female doctors in Xin'an District in the Ming and Qing Dynasties].

The Xin'an female doctors in the Ming and Qing Dynasties could be divided into 4 categories: viz., those who provide general medical services for women patients; those who provide supplementary services for delivery women; those who serve as an assistant of their practicing husband; and those who continued to practice medicine after their husband's death. Although the latter two types could be respected by their families and praised by the society, these female medical practitioners were undervalued and overlooked generally in the society where males were the main body of the medical circle and, moreover, they were not well educated, as well as the influence of Confucianist thoughts of "honorable men and humble women" , hence, their deeds were rarely seen in historical records. However, the emergence of female doctors had certain social causes, and their contributions to local health care should not be ignored.

[Analysis of Xin'an imperial medical officials in the Ming and Qing Dynasties].

Xin'an imperial medical officials of the Ming and Qing Dynasties was a special group of Xin'an doctors. It had exerted a positive and active impact on the development of traditional Chinese medicine. Rooted in the Xin'an region, with higher literacy and noble medical ethics and medical knowhow, through the imperial enlistment, examination, and other ways to enter the palace as imperial medical officials. During their tenure, they wrote books and communicated and merged with the folk medicine actively. After retiring, they were still involved actively in folk medicine activities, thus promoting and influencing the development of local medicine. The formation of Xin'an community of imperial medical officials in the Ming and Qing Dynasties was closely related to the prosperity of regional culture and commerce, and the development of medicine in Xin'an region.