Meta-analysis of acupuncture intervening exercise-induced fatigue / 针灸推拿医学（英文版）

Objective: To systematically evaluate the impact of acupuncture on exercise-induced fatigue (EIF). Methods: Scopus, Springer Link, Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), and China Biology Medicine Disc (CBM) were systematically searched to identify randomized controlled trials (RCTs) studying acupuncture treatment of EIF from the inception till August 2020. The risk of bias in the included studies was assessed using the Cochrane handbook. RevMan 5.3 was used to conduct statistical analysis on the extracted data. Results: A total of 11 RCTs were included for meta-analysis, involving 531 patients. It was revealed that acupuncture produced more significant effects in alleviating subjective fatigue [standardized mean difference (SMD)=-3.08, 95％ confidence interval (CI) (-4.35, -1.81), P<0.001], increasing the hemoglobin content [weighted mean difference (WMD)=3.89, 95％CI (1.37, 6.42), P=0.003], reducing the lactate dehydrogenase content [WMD=-10.63, 95％CI (-17.67, -3.59), P=0.003], reducing the blood lactic acid content [SMD=-2.65, 95％CI (-4.47, -0.83), P=0.004], and down-regulating the levels of serum creatine kinase [SMD=-0.79, 95％CI (-1.10, -0.48), P<0.001] and blood urea nitrogen [WMD=-1.47, 95％CI (-1.84, -1.11), P<0.001] than the control groups. Conclusion: Based on the existing evidence, acupuncture can be recognized as effective in improving EIF and is worthy of promotion in clinical settings.

Fully automatic d-lactate assay using a modified commercially available method.

Intestinal infarction is the fast-evolving endpoint of impaired blood perfusion to an intestinal segment which may have fatal outcome. Early diagnosis and treatment within 6 h reduce mortality. Currently, d-lactate is a promising biomarker, however, not available in the acute clinical setting. The aim of this study is implementation of d-lactate analysis in a routine clinical setting. We used a spectrophotometric method, based on enzymatic oxidation of d-lactate by d-lactate dehydrogenase (D-LDH) coupled to the reduction of nicotinamide-adenine dinucleotide (NAD+). The amount of NADH formed in this reaction is equivalent to d-lactate. The primary concern in this method is interfering NADH formed by oxidation of l-lactate by l-lactate dehydrogenase (L-LDH). A commercially available kit for d-lactate measurement was implemented on our existing automated routine laboratory equipment including pH-inactivation of L-LDH. Our setup fulfilled clinical quality goals. We were able to measure d-lactate with an acceptable performance of the analysis and a short turn-around time. The method can be used to distinguish between the expected cut-off for intestinal ischemia around 0.3 mM and the upper reference limit of 0.05 mM. With a turnaround time of just 9 min, the analysis has potential as a readily available detection of circulating d-lactate for early diagnosis of intestinal ischemia.

Clinical value of differential diagnosis of matrix metalloproteinase-3 in benign and malignant hydrothorax and ascites / 中华检验医学杂志

Objective To investigate the levels of matrix metalloproteinases-3 (MMP-3), adenosine deaminase (ADA) and lactate dehydrogenase (LDH) in the hydrothorax and ascites, and to approach the diagnostic value of three combined indexes in benign and malignant hydrothorax and ascites. Methods Case-control study. A total of 278 patients with hydrothorax and ascites were enrolled in this study who were hospitalized in the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from August 2018 to July 2019 to detect the levels of MMP-3, ADA and LDH in the hydrothorax and ascites. The benign group (208 patients) and malignant group (70 patients) were compared with MMP-3, ADA, LDH, receiver operating characteristic (ROC) curve, sensitivity and specificity in the hydrothorax and ascites, and the results were compared comprehensively. Results (1)The MMP-3 level in the benign hydrothorax group was 89.21±61.93 ng/mL, the ADA level was (9.08±8.89) U/L, the LDH level was (143.34± 68.63) U/L, and the MMP-3 level in the malignant hydrothorax group was (205.63 ± 98.16) ng/mL, he ADA level was (10.96±5.04) U/L, the LDH level was (243.44±131.20) U/L. The MMP-3 level in the benign ascites group was (84.91±73.48) ng/mL, the ADA level was (3.48±2.80) U/L, the LDH level was (99.48±69.53) U/L, and the MMP-3 level in the malignant ascites group was (174.89 ± 82.48) ng/mL, the ADA level was (6.31 ± 4.42) U/L, the LDH level was (191.86±94.52) U/L. The levels of MMP-3, ADA and LDH in the hydrothorax and ascites of the malignant group were higher than those in the benign group, and the difference was statistically significant (Z1 values were 5.215, 2.549, 3.212, respectively, and Z2 values were 6.188, 4.524, 6.38, respectively, P1 and P2 were <0.05). (2)The area under the curve (AUC) of MMP-3 for diagnosis of hydrothorax, liver cancer ascites and gastric cancer ascites was 0.853, 0.826, and 0.763, respectively. The sensitivity was 76％, 96.9％, and 92.3％, respectively, and the specificity was 80％, 64.5％, 61.6％. The diagnostic efficacy of MMP-3 in lung cancer hydrothorax and liver cancer ascites was higher than ADA (AUC were 0.672, 0.691, respectively) and LDH (AUC were 0.717, 0.804, respectively), and the diagnostic efficacy of gastric cancer ascites was lower than ADA (AUC is 0.808) and LDH (AUC is 0.849), and LDH was the best. (3)The AUC of MMP-3, ADA and LDH combined diagnosis of lung cancer hydrothorax, liver cancer ascites and gastric cancer ascites were 0.861, 0.842, and 0.879, respectively. The sensitivities were 64％, 96.9％, and 84.6％, respectively, and the specificities were 92.9％, 63.8％, and 80.4％, respectively. In the lung cancer hydrothorax, liver cancer ascites and gastric cancer ascites, the combined efficacy of the three combined tests was better than the combined detection of MMP-3 and LDH (AUC were 0.86, 0.839, 0.872, respectively), combined detection of MMP-3 and ADA (AUC were 0.845, 0.831, 0.855, respectively), LDH and ADA combined detection (AUC were 0.713, 0.791, 0.846, respectively). Conclusions MMP-3 is important for the differential diagnosis of benign and malignant hydrothorax and ascites, and may be one of the important indicators for the differential diagnosis of benign and malignant hydrothorax and ascites. The diagnostic efficacy of MMP-3 combined with ADA and LDH and three combined detection is better than single index, which has certain clinical value for differential diagnosis of benign and malignant hydrothorax and ascites.

Clinical value of differential diagnosis of matrix metalloproteinase-3 in benign and malignant hydrothorax and ascites / 中华检验医学杂志

Objective@#To investigate the levels of matrix metalloproteinases-3 (MMP-3), adenosine deaminase (ADA) and lactate dehydrogenase (LDH) in the hydrothorax and ascites, and to approach the diagnostic value of three combined indexes in benign and malignant hydrothorax and ascites.@*Methods@#Case-control study. A total of 278 patients with hydrothorax and ascites were enrolled in this study who were hospitalized in the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from August 2018 to July 2019 to detect the levels of MMP-3, ADA and LDH in the hydrothorax and ascites. The benign group (208 patients) and malignant group (70 patients) were compared with MMP-3, ADA, LDH, receiver operating characteristic (ROC) curve, sensitivity and specificity in the hydrothorax and ascites, and the results were compared comprehensively.@*Results@#(1)The MMP-3 level in the benign hydrothorax group was 89.21±61.93 ng/mL, the ADA level was (9.08±8.89) U/L, the LDH level was (143.34±68.63) U/L, and the MMP-3 level in the malignant hydrothorax group was (205.63±98.16) ng/mL, he ADA level was (10.96±5.04) U/L, the LDH level was (243.44±131.20) U/L. The MMP-3 level in the benign ascites group was (84.91±73.48) ng/mL, the ADA level was (3.48±2.80) U/L, the LDH level was (99.48±69.53) U/L, and the MMP-3 level in the malignant ascites group was (174.89±82.48) ng/mL, the ADA level was (6.31±4.42) U/L, the LDH level was (191.86±94.52) U/L. The levels of MMP-3, ADA and LDH in the hydrothorax and ascites of the malignant group were higher than those in the benign group, and the difference was statistically significant (Z1 values were 5.215, 2.549, 3.212, respectively, and Z2 values were 6.188, 4.524, 6.38, respectively, P1 and P2 were <0.05). (2)The area under the curve (AUC) of MMP-3 for diagnosis of hydrothorax, liver cancer ascites and gastric cancer ascites was 0.853, 0.826, and 0.763, respectively. The sensitivity was 76%, 96.9%, and 92.3%, respectively, and the specificity was 80%, 64.5%, 61.6%. The diagnostic efficacy of MMP-3 in lung cancer hydrothorax and liver cancer ascites was higher than ADA (AUC were 0.672, 0.691,respectively) and LDH (AUC were 0.717, 0.804, respectively), and the diagnostic efficacy of gastric cancer ascites was lower than ADA (AUC is 0.808) and LDH (AUC is 0.849), and LDH was the best. (3)The AUC of MMP-3, ADA and LDH combined diagnosis of lung cancer hydrothorax, liver cancer ascites and gastric cancer ascites were 0.861, 0.842, and 0.879, respectively. The sensitivities were 64%, 96.9%, and 84.6%, respectively, and the specificities were 92.9%, 63.8%, and 80.4%, respectively. In the lung cancer hydrothorax, liver cancer ascites and gastric cancer ascites, the combined efficacy of the three combined tests was better than the combined detection of MMP-3 and LDH (AUC were 0.86, 0.839, 0.872, respectively), combined detection of MMP-3 and ADA (AUC were 0.845, 0.831, 0.855, respectively), LDH and ADA combined detection (AUC were 0.713, 0.791, 0.846, respectively).@*Conclusions@#MMP-3 is important for the differential diagnosis of benign and malignant hydrothorax and ascites, and may be one of the important indicators for the differential diagnosis of benign and malignant hydrothorax and ascites. The diagnostic efficacy of MMP-3 combined with ADA and LDH and three combined detection is better than single index, which has certain clinical value for differential diagnosis of benign and malignant hydrothorax and ascites.

Lingual flange protrusion: diagnostic marker for metastatic liver cancer.

OBJECTIVE: To investigate the diagnostic significance of lingual flange protrusion for liver metastasis of patients with malignant neoplasia. METHODS: The data of 191 patients with malignant neoplasia were analyzed. All photos of patients' tongue image were recorded and lingual flange protrusion was the positive standard. χ2 test for paired data and Kappa test were used to determine the diagnostic value of lingual flange protrusion for metastatic liver cancer. Mann-Whitney U test was used to compare the levels of liver serological markers. The area under receiver operating characteristic curve (ROC) and logistic regression model were used to analyze the predictive values of lingual flange protrusion, alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) levels. RESULTS: Patients with lingual flange protrusion had a higher risk of liver metastasis than those without it (P < 0.001). There was no significant difference in diagnosis of liver metastasis between lingual flange protrusion and traditional diagnostic criteria (P = 0.541). Kappa was 0.738 (P < 0.001). Lingual flange protrusion was significantly correlated with increased serum ALP and LDH levels (P < 0.01). Comparison of ROC curves showed that the diagnostic value of lingual flange protrusion is better than ALP, LDH and the combination of ALP and LDH (P < 0.01). Furthermore, the combined diagnostic values of lingual flange protrusion and ALP, lingual flange protrusion and LDH, and lingual flange protrusion, ALP and LDH are not better than lingual flange protrusion alone (P > 0.05). CONCLUSION: Lingual flange protrusion is a potential diagnostic marker for liver metastasis of patients with malignant neoplasia.

Study of the anti-fatigue effects of amino acids and vitamins / 解放军医学杂志

Objective To investigate the anti-fatigue effects of amino acids and vitamins on rats after exhaustive exercise. In addition, the current research might provide a theoretical foundation for the future development of new anti-fatigue nutritional supplements. Methods Thirty-six male SD rats were randomly divided into three groups after adaptive swimming. Each group consisted of 12 rats, namely amino acids and vitamins capsule group (capsule group), control with bland water group (control group), and amino acid and fructose beverage group (granules group). Exhaustion was produced by non-load swimming. After 14 days of feeding with different beverages, the exhaustion time of swimming was recorded, and then all rats were killed to measure concentrations of muscle and hepatic glycogen, and contents of serum β-endorphin (β-EP), lactic acid (LA), lactate dehydrogenase (LDH), and creatine kinase (CK). Results The swimming time and the levels of the muscle and hepatic glycogen in the capsule and granules groups were longer or higher than those in the control group (P0.05). Conclusion Compound amino acids and vitamins can delay the occurrence of exhaustion after swimming in rats, increase hepatic and muscle glycogen contents, and decrease the generation of various metabolites during fatigue exercises, and hence giving anti-fatigue effects.