Effects of antibiotic cocktail on the fecal microbiota and their potential correlation of local immune response.

BACKGROUND: The guts of mammals are home to trillions of microbes, forming a complex and dynamic ecosystem. Gut microbiota is an important biological barrier for maintaining immune homeostasis. Recently, the use of antibiotics to clear gut microbiota has gained popularity as a low cost and easy-to-use alternative to germ-free animals. However, the effect of the duration of the antibiotic cocktail on the gut microbiome is unclear, and more importantly, the effect of dramatic changes in the gut microbiota on intestinal tissue morphology and local immune response is rarely reported. RESULTS: We observed a significant reduction in fecal microbiota species and abundance after 1 week of exposure to an antibiotic cocktail, gavage twice daily by intragastric administration. In terms of composition, Bacteroidetes and Firmicutes were replaced by Proteobacteria. Extending antibiotic exposure to 2-3 weeks did not significantly improve the overall efficiency of microbiotal consumption. No significant histomorphological changes were observed in the first 2 weeks of antibiotic cocktail exposure, but the expression of inflammatory mediators in intestinal tissue was increased after 3 weeks of antibiotic cocktail exposure. Mendelian randomization analysis showed that Actinobacteria had a significant causal association with the increase of IL-1ß (OR = 1.65, 95% CI = 1.23 to 2.21, P = 0.007) and TNF-α (OR = 1.81, 95% CI = 1.26 to 2.61, P = 0.001). CONCLUSIONS: Our data suggest that treatment with an antibiotic cocktail lasting 1 week is sufficient to induce a significant reduction in gut microbes. 3 weeks of antibiotic exposure can lead to the colonization of persistant microbiota and cause changes in intestinal tissue and local immune responses.

Association between oxidative balance score and skeletal muscle mass and strength: NHANES from 2011 to 2018.

Objective: Oxidative stress is a risk factor for sarcopenia. The Oxidative Balance Score (OBS) is a widely employed tool for evaluating the oxidative stress-related exposures from dietary and lifestyle factors. In this study, we aimed to conducted to explore the relationship between OBS and skeletal muscle mass and strength. Methods: 6,438 subjects from 2011 to 2018 and 5,414 from 2011 to 2014 from the National Health and Nutrition Examination Survey (NHANES) were selected for analysis. The correlations between OBS and skeletal muscle mass and handgrip strength were investigated using multivariate logistic regression and linear regression analysis. Results: Compared with lowest OBS, participants with OBS in the highest quartile had lower risk of low skeletal muscle mass (OR = 0.173 (0.120 ~ 0.248), p < 0.0001) and low handgrip strength (ß = 0.173 (0.120 ~ 0.248), p = 0.011). The negative association also were found between dietary/lifestyle OBS and skeletal muscle mass (OR = 0.268 (0.178 ~ 0.404), p < 0.0001; OR = 0.231 (0.130 ~ 0.410), p < 0.0001) and handgrip strength (ß = 1.812 (0.555 ~ 3.071), p = 0.008; ß = -2.255 (-3.430 ~ -1.079), p < 0.001) independently. The positive association remains significant, especially among men and those with higher education levels by subgroup analysis. Conclusion: All of these results indicated a negative association between OBS and low skeletal muscle mass and handgrip strength. An antioxidant-rich diet and healthy lifestyle are crucial for enhancing skeletal muscle mass and strength.

The prevalence and effects of sarcopenia in patients with metabolic dysfunction-associated steatotic liver disease (MASLD): A systematic review and meta-analysis.

BACKGROUND AND AIMS: Sarcopenia is a common complication in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, the prevalence and its impact on the survival of sarcopenia in patients with MASLD is unknown. In this study, we aimed to assess the prevalence and effects of sarcopenia in patients with MASLD. METHODS: Systematic review and meta-analysis of full texts of relevant studies were searched from inception until June 12, 2024 in five databases (PubMed, Cochrane Library, Embase, Web of Science, and the China National Knowledge Infrastructure). Next, we assessed the prevalence of sarcopenia in MASLD, and calculated the ORs and HRs between sarcopenia and MASLD based on the adjusted data from individual studies. Statistical analyses were performed using Stata 11.0. RESULTS: Of the 2984 records considered, 29 studies recruiting 63,330 patients were included. The pooled prevalence of sarcopenia in patients with MASLD was 23.5% overall (95% CI; 19.1%-27.9%, I2 = 99.6%), and was higher in Asian patients, male, cross-sectional studies, when BIA were employed to measure muscle mass, one criterion of diagnosis sarcopenia, MASLD was diagnosed employing MRI, and moderate-quality studies. Sarcopenia was associated with MASLD patients (adjusted odds ratio [aOR] 2.08, 95% CI 1.58-2.74, I2 = 93.6%) with similar findings in subgroups stratified by age, study design, methods for measuring muscle mass, assessment method to detect sarcopenia, and study quality. The association between all-cause mortality further supports the association between sarcopenia and poor prognosis with MASLD (aHR 1.59, 95% CI 1.33-1.91, I2 = 0%). CONCLUSIONS: Sarcopenia was strongly associated with MASLD progression and was a risk factor not only for MASLD pathogenesis but was also markedly correlated with MASLD-associated mortality.

Urban-rural differences in the prevalence and associated factors of sarcopenia: A systematic review and meta-analysis.

BACKGROUND: Loss of muscle mass, muscle strength, and/or physical performance due to aging is known as sarcopenia. Regardless of how serious this illness is, no single diagnostic criteria have been established. Much research conducted recently has demonstrated differences between built environment characteristics (i.e., urban and rural) and the occurrence of sarcopenia; however, variations in sarcopenia prevalence in urban-rural areas around the world have been reported by fewer studies. This work sought to determine how sarcopenia prevalence varied between urban and rural areas and to explore the associated influencing factors. METHODS: Using the pertinent MESH phrases and free words, PubMed, Web of Science, Embase, and China national knowledge infrastructure databases were scanned for core sarcopenia literature up to February 26, 2023. Observational studies involving urban-rural patients with sarcopenia published in Chinese and English, and assessing muscle mass via computed tomography, bioelectrical impedance, or dual-energy X-ray absorption techniques were considered as inclusion criteria. The meta-analysis involved analysis of the urban-rural prevalence in subgroups by diagnostic criteria, tools for assessing muscle mass and study type, as well as the factors related to urban-rural differences in the occurrence of sarcopenia. STATA version 11.0 was used to perform the statistical analysis. RESULTS: Sixty-six articles involving 433,091 participants were included for analysis: of which 27 were analyzed for both prevalence and related factors whereas 39 were for only prevalence. The meta-analysis revealed the prevalence of sarcopenia to be 0.18 (95 % CI 0.14-0.22), with significant heterogeneity (P < 0.001; I2 = 99.9 %). Moreover, the prevalence of sarcopenia in urban group [0.16 (I2 = 99.9 %, 95 % CI 0.1-0.22)] was lower than in rural group [0.2 (I2 = 99.6 %, 95 % CI 0.16-0.25)] and urban-rural group [0.21 (I2 = 97.5 %, 95 % CI 0.16-0.25)]. Besides, the factors significantly associated with sarcopenia in urban-rural areas were age, gender, BMI, malnutrition, physical activity, and polypharmacy. There was significant heterogeneity between these factors and the association of sarcopenia. CONCLUSIONS: Sarcopenia is associated with aspects of the built environment, and studies have revealed that sarcopenia is more common in rural than in urban populations with influencing factors including age, gender, BMI, poor nutrition, insufficient physical activity, and polypharmacy. The lack of uniform diagnostic criteria makes a robust and comprehensive assessment difficult. Therefore, the formation of certain universal and standardized diagnostic criteria will help future research on sarcopenia.

Experience of life quality from patients with aplastic anemia: a descriptive qualitative study.

BACKGROUND: Despite the increasing incidence of aplastic anemia in China, few studies have explored its effect on the patients' quality of life from the perspective of these patients. In fact, patients with aplastic disorder live with the disease for a long time, and need to face a variety of difficult realities, including multiple disease symptoms and drug side effects, heavy burden of medical costs, difficulties in social reintegration, and negative emotional distress. Therefore, this study used descriptive qualitative research to explore the direct and rich quality-of-life experiences of patients with aplastic anemia. METHODS: A total of 19 patients with aplastic anemia were recruited in this study using purposive sampling combined with maximum variation strategy. 5 of the patients with AA were from northern China, and the others were from southern China. Data were collected using semi-structured interviews and analyzed using the conventional content analysis method. RESULTS: This study yielded important information about the experiences of patients with aplastic anemia in China. The content analysis method finally identified 3 themes and 9 sub-themes, including: physical symptoms (declining physical capacity, treatment-related symptoms, changes in body image), psychological symptoms (mood changes related to the stage of the disease, change in self-image, growth resulting from the disease experience), social burden (decline in career development, perceived burden to the family, social stigma). Patients with AA from different regions didn't show much difference in quality of life. CONCLUSIONS: Aplastic anemia affects the physical, psychological, and social aspects of patients' lives. Therefore, health care providers need to consider the patients' physical response and psychological feelings to provide relevant medical guidance and multi-channel social support that would improve their confidence and quality of life. CLINICAL TRIAL REGISTRATION: Name: Development and preliminary application of Quality of Life Scale for Patients with Aplastic Anemia. Number: ChiCTR2100047575. URL: http://www.chictr.org.cn/login.aspx?referurl=%2flistbycreater.aspx .

Effects of technology-assisted rehabilitation for patients with hip arthroplasty: A meta-analysis.

BACKGROUND: To investigate the efficacy of technology-assisted rehabilitation compared to that of usual care programs after total hip arthroplasty (THA) through randomized controlled trials (RCTs). METHODS: The Medline (PubMed), Cochrane Library, Embase and Web of Science databases were searched for RCTs regarding the efficacy of technology-assisted rehabilitation following THA. Data were analyzed using Stata 12.0 software. RESULTS: Eleven RCTs involving 1327 patients were included in the meta-analysis. The pooled effect size showed that compared to usual care, telerehabilitation significantly improved the Harris score (standardized mean difference [SMD] 0.74, 95% confidence interval [CI] 0.58 to 0.90) and functional independence measure (FIM) score (SMD 1.26, 95% CI 0.48 to 2.03). In addition, video-based therapy could significantly improve walk test results (SMD 0.43, 95% CI 0.11 to 0.75). CONCLUSION: The findings suggest that technology-assisted rehabilitation, especially telerehabilitation, have been shown to improve the physical function of patients following THA compared to conventional rehabilitation. More robust studies are needed to validate the long-term efficacy and safety of innovative technology-assisted training strategies.

Grip Strength is a Predictor for Subsyndromal Delirium Among Older Adults Following Joint Replacement.

Background: Delirium is common in older patients during the postoperative period, increasing the number of adverse events, and grip strength is associated with delirium. Subsyndromal delirium (SSD) is a prostate of clinical delirium; nevertheless, the relationship between grip strength and SSD has not been elucidated. This study aimed to examine the association between grip strength and SSD in the elderly after arthroplasty. Methods: A total of 181 patients were recruited from two Chinese hospitals. SSD and delirium were evaluated before the surgery and the first week after surgery using the confusion assessment method. The Mini-mental State Examination was used to assess patients' cognitive function, and their grip strength was evaluated with an electronic hand dynamometer before surgery. Logistic regression and ROC curve analysis were conducted to determine the odds ratio and predictive value of grip strength for SSD. Results: The incidence of SSD and postoperative delirium (POD) was 41.44% and 14.36% for the elderly following arthroplasty respectively, and approximately 1/3 of SSD progressed into POD. Older age, declined cognitive function, fall history, and lower grip strength were risk factors for SSD (P<0.05). The area under the ROC curve of grip strength was 0.863 and 0.900 for males and females respectively, and the cut-off point of it was determined to be 22.050 kg for men and 18.050 kg for women. Conclusion: SSD and POD are common among older people. Decreased grip strength, advanced age, lower cognitive function, and fall history were independent risk factors for SSD, and grip strength was a significant predictor for SSD in aged patients after the arthroplasty.

Interleukin-10 is not associated with obstructive sleep apnea hypopnea syndrome: A meta-analysis and meta-regression.

BACKGROUND: This study was conducted to explore the potential relationship between interleukin-10 (IL-10) and obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: All the related research articles published before October 2022 were retrieved through the online database (EMBASE, VIP, Wan Fang, Web of Science, PubMed, and CNKI). Stata 11.0 software was used to calculate the standard mean difference (SMD) of the continuous variable and 95% confidence interval (CI). Expression profiles GSE38792 and GSE135917 were acquired from Gene Expression Omnibus (GEO) database, respectively. The expression of IL-10 mRNA in subcutaneous adipose tissue and visceral adipose tissue of OSAHS patients and healthy subjects was extracted by R software to verify the difference in IL-10 between the 2 groups. RESULTS: The IL-10 level in the plasma of people with and without OSAHS (STD Mean Difference (SMD) = -0.68, 95% CI = -1.58 to 0.21, I2 = 94.3%, P = .136) was the same. There was also no difference in IL-10 levels in serum between people with and without OSAHS (SMD = -0.12, 95% CI = -0.55 to 0.32, I2 = 94.4%, P = .591). In addition, the subjects were divided into different subgroups for meta-analysis according to race, body mass index, age, study type, and disease severity. Based on the outcomes, no notable difference was observed in the plasma/serum IL-10 level between the OSAHS subgroups and the control group. The results of bioinformatics analysis indicated that there was no significant difference in the expression of IL-10 mRNA in subcutaneous adipose tissue and visceral adipose tissue between patients with OSAHS and those in the control group. CONCLUSION: The current meta-analysis highlighted that IL-10 levels between patients with OSAHS and healthy people had no difference.

The Use of an Iterative Strategy of Cognitive Interview and Expert Consultation to Revise the Quality of Life Scale for Patients with Aplastic Anemia (QLS-AA).

Background: Aplastic anemia is characterized by anemia, hemorrhage and infection, and is accompanied by a variety of complications and psychological burden. Therefore, the quality of life of AA patients is not optimistic. Our team is committed to developing an assessment tool for the quality of life of AA patients, and adopting an iterative strategy of cognitive interview and expert consultation to solve the challenges encountered in item revision. Purpose: We aim to use the strategy of cognitive interview and expert consultation to inform revision of the QLS-AA into a user-friendly tool with unambiguous items and improve the content validity of the scale. Methods: We used an iterative strategy of cognitive interview and expert consultation. Two rounds of cognitive interview were conducted to identify problems with item comprehension, recall and other cognitive processes. As well as, a multi-disciplinary group of expert consultation was consulted to review the rationality of item revisions. Results: In the first round of cognitive interview, 16 participants responded to 107 items. Among them, the most common problems were "clarification" and "item duplication". Based on the results of the first round of interview, an expert consultation was organized. A total of 16 amendments were put forward by the expert and 14 were adopted. In the second round of cognitive interviews, A total of 5 participants were included and 64 items were evaluated. Two items were suggested to be revised, and the remaining items were accurately understood and recognized by all participants. Couclusion: This study highlights the key issues to consider when incorporating patient perspectives into quality measurement. The revision of QLS-AA through the strategy of cognitive interview and expert consultation may provide valuable insights into the measurement of quality of life in aplastic patients. Trial Registration Number: ChiCTR2100047575.

The status of stigma in patients with type 2 diabetes mellitus and its association with medication adherence and quality of life in China: A cross-sectional study.

Type 2 diabetes mellitus (T2DM) is a chronic, lifelong disease that can negatively affect patients' mental health and quality of life (QoL). A notable proportion of patients with T2DM worldwide have experienced stigma through instances of discrimination, unfair social treatment and lack of promotion opportunities. Stigma refers to the negative emotional experience of people with illness, often mixed with self-stigmatization. Stigma remains an obstacle to patients' self-management, its association with patients with T2DM on medication adherence and QoL in China are unknown. Therefore, the objective of the study was to analyze the status of stigma in patients with T2DM and its association with medication adherence and QoL in China. A cross-sectional, observational study among 346 inpatients with T2DM in 2 tertiary-level hospitals in Chengdu, China, was conducted using a general data questionnaire, Chinese version type 2 diabetes stigma scale (DSAS-2), Morisky medication adherence scale (MMAS-8) and diabetic QoL specificity scale by convenient sampling method from January to August 2020. The total score and scores for the 3 dimensions of stigma, treated differently, blame and judgment, and self-stigma, were 54.30 ± 12.22, 16.57 ± 4.06, 20.92 ± 4.42, 16.82 ± 4.78, respectively. The scores for medication adherence and QoL were 5.43 ± 1.8 and 73.24 ± 9.38. Pearson correlation analysis showed that the total score of stigma and the scores of each dimension were negatively weak-correlated with the score of medication adherence (r = -0.158 to -0.121, P < .05), and positively moderate-correlated with the score of QoL (R = 0.073 to 0.614, P < .05). Stigma of patients with T2DM was negatively associated with medication adherence, and negatively associated with QoL, namely, the stronger the stigma, the worse the medication adherence and QoL. The results of the hierarchical regression analysis revealed that stigma independently explained 8.8% of the variation in medication adherence and 9.4% to 38.8% of the variation in QoL. The stigma of patients with T2DM was at a moderate degree and negatively correlated with medication adherence and QoL, it is necessary to pay more attention to relieve stigma and negative emotions timely, in order to improve patients' mental health and QoL.

Sleep Duration and Sarcopenia: An Updated Systematic Review and Meta-Analysis.

OBJECTIVES: In adults, short and long sleep duration has been associated with sarcopenia risk. Studies have shown that various factors, including biological and psychological factors, could be the underlying cause of the association between aberrant sleep duration and sarcopenia risk. In this study, we have qualitatively and quantitatively summarized previously published studies on sleep duration to assess the relationship between sleep duration and sarcopenia risk in adults. This would aid in enhancing our understanding of recent advancements in this field and the association between sleep duration and sarcopenia risk. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: In this review, we included studies evaluating the association between the duration of sleep and sarcopenia in adults in observational studies. METHODS: Five electronic databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Web of Science) were searched to April 20, 2023, to identify studies related to sarcopenia and sleep duration. Next, we calculated the odds ratios (ORs) for sarcopenia prevalence based on the adjusted data from individual studies. Statistical analyses were performed using Stata 11.0. RESULTS: Sarcopenia prevalence was high (18%) in adults with long sleep duration. Our results showed a significant association between short duration of sleep and high sarcopenia prevalence in older adults (OR 1.2, 95% CI 1.02-1.41, I2 = 56.6%). Furthermore, a significant association was observed between all participants with long-duration sleep and high sarcopenia prevalence (OR 1.53, 95% CI 1.34-1.75, I2 = 56.8%). We also observed significant heterogeneity in the adjusted ORs. CONCLUSIONS AND IMPLICATIONS: There was a correlation between sarcopenia and short or long sleep duration, especially in older adults. In adults with a long duration of sleep, sarcopenia prevalence was relatively high.

Transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program prevents subsyndromal delirium in older patients after joint replacement.

OBJECTIVES: This study aimed to develop transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program and evaluate its effects on preventing subsyndromal delirium (SSD) and postoperative delirium (POD) in older patients after joint replacement surgery. METHODS: Participants were randomly divided into two groups, the experimental group (n = 48) was given transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program based on the routine care of the control group (n = 49). The incidence of SSD and POD in a week after surgery was recorded. Assessments of delirium severity, cognition, anxiety, and depression were also conducted at baseline and on postoperative day 7. RESULTS: The findings indicate that the intervention program had significant advances in alleviating the severity of delirium, cognitive impairment, anxiety, and depression but failed to reduce the incidence of SSD and POD. CONCLUSIONS: Our study indicated that TEAS combined with an integrated perioperative nursing program has a beneficial effect on alleviating symptoms of delirium, cognitive dysfunction, anxiety, and depression in older adults after joint replacement surgery.

Perception and knowledge of dementia prevention and its associated socio-demographic factors in China: A community-based cross-sectional study.

Background: Although considerable progress has been made on the risk factors of dementia, less is known about the extent of the gaps between the general public's understanding of dementia prevention and contemporary scientific evidence. This study aimed to determine the beliefs and knowledge of dementia prevention among the Chinese general public and examine the socio-demographic factors of the belief and knowledge of dementia prevention. Methods: The study adopted a cross-sectional design. A total of 358 Chinese adults aged over 40 years were recruited from four healthcare centers. We designed questionnaires that include items on the belief of dementia prevention, risk factors for dementia, and health education needs regarding dementia prevention based on previous literature. Descriptive statistics and multivariate regression analyses were conducted. Results: Only 32.4% of the respondents agreed that dementia is preventable. Less participants were able to correctly identify cardiovascular risk factors (i.e., obesity, diabetes, dyslipidemia, hypertension, unhealthy diet, smoking, and alcohol) as part of dementia risk factors. Younger age, higher education, and having contact with patients with dementia are associated with stronger belief that dementia is preventable. Older age, higher income, higher education, having memory complaint, and having contact with patients with dementia are associated with a better understanding of dementia risk factors. A total of 88.9% respondents thought that they are not well informed of dementia from public education, and most respondents (65%) prefer receiving dementia-related health advice from primary care providers. Conclusion: The present study reveals the great gaps between the Chinese general public's knowledge of dementia prevention and the latest research evidence. Public health educational programs for all age groups are encouraged to close this knowledge gap. More attention and resources should be paid to individuals with low income and low education level as they have limited access to dementia prevention information. Researchers should work in partnership with primary care providers to help translate evidence into community practice with a special focus on the link between cardiovascular risk factors and dementia.

Causal association between rheumatoid arthritis and celiac disease: A bidirectional two-sample mendelian randomization study.

Objectives: Rheumatoid Arthritis (RA) has been associated with Celiac Disease (CD) in previous observational epidemiological studies. However, evidence for this association is limited and inconsistent, and it remains uncertain whether the association is causal or due to confounding or reverse causality. This study aimed to assess the bidirectional causal relationship between RA and CD. Methods: In this two-sample Mendelian randomization (MR) study, instrumental variables (IVs) for RA were derived from a genome-wide association studies (GWAS) meta-analysis including 58,284 subjects. Summary statistics for CD originated from a GWAS meta-analysis with 15,283 subjects. The inverse-variance weighted (IVW) method was used as the primary analysis. Four complementary methods were applied, including the weighted-median, weighted mode, MR pleiotropy residual sum and outlier (MR-PRESSO) test and MR-Egger regression, to strengthen the effect estimates. Results: Positive causal effects of genetically increased RA risk on CD were derived [IVW odds ratio (OR): 1.46, 95% confidence interval (CI): 1.19-1.79, p = 3.21E-04]. The results of reverse MR analysis demonstrated no significant causal effect of CD on RA (IVW OR: 1.05, 95% CI: 0.91-1.21, p = 0.499). According to the sensitivity analysis, horizontal pleiotropy was unlikely to distort the causal estimates. Conclusion: This study reveals a causality of RA on CD but not CD on RA among patients of European descent. This outcome suggests that the features and indicators of CD should regularly be assessed for RA patients.

Shenhuang plaster ameliorates the Inflammation of postoperative ileus through inhibiting PI3K/Akt/NF-κB pathway.

BACKGROUND: Although Shenhuang plaster (SHP) from traditional Chinese medicine prescriptions, has the potential to promote the recovery progression of postoperative ileus (POI), the underlying mechanism remains elusive. Along these lines, in this work, both in vivo and in vitro studies were conducted to systematically explore the regulatory effect and mechanism of SHP on the inflammatory response of the intestinal basal layer in the POI model mice. METHODS: Intestinal manipulation in mice was utilized for the POI model. The impact of SHP in response to POI was evaluated by carrying fluorescein-labeled dextran, histomorphology, immunohistochemistry, in combination with flow cytometry analysis and transcriptome RNA sequencing in vivo. Besides, the cytotoxicity of the SHP treatment on RAW264.7 cells was detected by cell counting kit-8 (CCK-8), the biological effects were assessed by polymerase chain reaction (PCR) and the potential influences on the PI3K/Akt/NF-κB pathway were identified through detecting the expression levels of P85, AKT, IKK and P65 by western blot in vitro. RESULTS: The implementation of the SHP treatment could significantly reduce the expressions of interleukin (IL)- 1ß and tumor necrosis factor (TNF)-α in the intestine, whereas the recovery of gastrointestinal motility is promoted. In addition, SHP can regulate the polarization of macrophages, indicating that the proportion of the M2 type is increased after the application of the SHP treatment. In addition, SHP inhibited the activity of PI3K/AKT/NF-κB signaling pathway-related proteins. CONCLUSION: SHP can significantly ameliorate the inflammatory response of POI and at the same time promote the recovery of gastrointestinal motility. Its mechanism may be mediated by the polarization of macrophages through the PI3K/AKT/NF-κB signaling pathway.

Moxibustion attenuates inflammation and alleviates axial spondyloarthritis in mice: Possible role of APOE in the inhibition of the Wnt pathway.

Background and aim: Moxibustion is widely used in China and other East Asian countries to manage the symptom of ankylosing spondylitis (AS). This study investigated the effects of moxibustion intervention on protein expression through proteomics analysis in AS mice. Experimental procedure: Proteoglycan-induced spondylitis (PGISp) was established in Balb/c mice. PGISp mice were intervened with daily moxibustion at ST36, BL23, and DU4 for four weeks. Various biochemical (including pro-inflammatory cytokines and bone metabolism indexes) and histopathological parameters were determined. The effects of moxibustion on protein changes in AS mice were analyzed using data-independent acquisition-mass spectrometry (DIA-MS). The target proteins were then confirmed by Western blot analysis. Results: Moxibustion significantly decreased pro-inflammatory cytokine expression including IL-1ß, TNF-α, IL-17, and IL-6, reduced the mRNA expression of RANKL, RANK, ALP, and OCN, and improved the histopathological examination in AS mice. DIA-MS proteomic technique has identified 25 candidate proteins involved in the mechanisms of moxibustion for AS mice, most of which are mainly associated with the regulation of Wnt/ß-catenin. Integrated pathway analysis revealed that glycine, serine and threonine metabolism together with lipid metabolism were the most important canonical pathways involved in the anti-AS effect of moxibustion. In line with the multi-omic data, the levels of BPGM, APOC2, APOE, and GPD1 modified in the AS mice, intervened with moxibustion as confirmed by Western blot. In particular, APOE may play a key role in linking the lipid metabolism and the Wnt/ß-catenin pathway of new bone formation. Conclusion: In conclusion, moxibustion may reduce pro-inflammatory cytokines and improve bone erosion for AS mice. The regulation of APOE by moxibustion may have a potential inhibitory effect on the Wnt/ß-catenin pathway in AS mice. However, due to the lack of silencing or overexpression of key molecules of the signal pathway, whether the beneficial and positive effect of moxibustion involved in the regulation of Wnt/ß-catenin signaling pathway by APOE or other aspects, needed to be explored in further study.

Shenhuang Plaster Application Improves Gastrointestinal Motility in Mice with Postoperative Ileus through Intestinal Microbiota.

Postoperative ileus (POI) is a common surgical complication, and its incidence remains high. Shenhuang Plaster (SHP) is a famous traditional Chinese medicine with a definite curative effect on postoperative intestinal dysfunction; however, the mechanisms involved in these effects are unclear. Accordingly, in this study, we constructed a POI mouse model and used the intestinal flora as the target to explore the regulatory effect of SHP on gastrointestinal motility. The results illustrated that SHP applied at the Shenque acupoint promoted the recovery of gastrointestinal motility, relieved intestinal villus atrophy and basal damage caused by POI, protected the integrity of intestinal tissue morphology, and alleviated the inflammatory response in the intestinal tissue of POI model mice. In addition, we clarified the role of the intestinal flora in the occurrence and development of POI, further evaluated the changes in the intestinal flora in each group of mice, and analysed the regulatory effect of SHP on the intestinal flora in mice with POI. The results suggested that SHP might improve gastrointestinal motility disorder in POI mice by effectively regulating intestinal flora.

Meanings and senses of organisational silence by male nurses in the emergency department: an interpretative phenomenological study protocol.

INTRODUCTION: The organisational silence of nursing teams has received increasing attention from managers. Chinese nurses have a relatively high score for organisational silence, and male nurses score higher than female nurses. Lack of professional empathy, high pressure in the work environment, and traditional Chinese cultural factors suggest that Chinese male nurses' experiences of and reasons for organisational silence are complex and unique. Taking male nurses in the emergency department as an example, this study explores the experience and meaning of male nurses' organisational silence and provides ideas for nursing managers to understand the silence of male nurses. METHODS AND ANALYSIS: An interpretative phenomenological approach underpins the study design. In this study, the purposive sampling method will be used to select male nurses who meet the inclusion criteria with maximum differentiation as a strategy. Face-to-face semistructured interviews and Van Manen analysis methods will be used for data collection and analysis. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (ethical approval ID: 2019-KL-036-01). Participants will provide informed consent, will be able to withdraw at any time and will have their contributions kept confidential. The findings of the study will be shared with relevant stakeholders and disseminated in conference presentations and journal publications. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR2100047057).

Evidence on Efficacy and Safety of Chinese Medicines Combined Western Medicines Treatment for Breast Cancer With Endocrine Therapy.

BACKGROUND: Breast cancer, a malignant disorder, occurs in epithelial tissue of the breast glands and ducts. Endocrine therapy is commonly applied as an important adjuvant treatment for breast cancer, but it usually induces a variety of side effects. Chinese Medicines (CM) has therapeutic effect on reducing adverse effects of the endocrine therapy in many clinical studies. But strong evidence is still limited on the efficacy and safety of CM combined western medicines (CM-WM) for breast cancer. OBJECTIVE: To study the efficacy and safety of CM-WM as an adjuvant treatment for reducing side effects induced by endocrine therapy in breast cancer patients. METHOD: We searched relevant clinical studies in PubMed and the Chinese National Knowledge Infrastructure (CNKI) databases up to February 28, 2021 and only Randomized Controlled Trials (RCTs) were included. There were no limitations on the languages. We extracted data from the included RCTs, assessed study quality, conducted meta-analyses by RevMan 5.4 and compared the pooled Risk Ratios (RR) or Mean Difference (MD) with 95% CIs. RESULTS: In total 28 trials involving 1,926 participants were included. Six RCTs compared CM-WM with CM placebo-WM, while 22 RCTs compared CM-WM with WM alone. No study compared CM-WM with no treatment. Meta-analysis showed that CM-WM treatment significantly improved quality of life (MD = 0.73, 95% CI = 0.11-1.35, P = 0.02) when compared with CM placebo-WM treatment. When compared with WM treatment alone, CM-WM treatment significantly improved bone mineral density (MD = 0.24, 95% CI = 0.13-0.35, P <0.0001), TCM syndrome score (MD = -5.39, 95% CI = -8.81 to -1.97, P = 0.0002), Kupperman Scale (MD = 0.24, 95% CI = -2.76 to -1.94, P <0.0001), Karnofsky Performance Scale (MD = 3.76, 95% CI = 1.64-5.88, P = 0.0005), quality of life (MD = 3.01, 95% CI = 1.00-5.02, P = 0.003), and pain relief (MD = 2.10, 95% CI = 0.72-3.48, P <0.0001). Compared with WM, CM-WM significantly decreased incidence of TCM symptoms (nausea, vomiting, fatigue, etc.) (RR = 1.60, 95% CI = 1.40-1.84, P <0.0001). For safety, serum calcium, estradiol, ALP, and blood CD3, CD4 and CD8 counts were not significantly difference between two treatments (P >0.05). Serious side effects or reactions were not reported in all included studies. CONCLUSION: The adjunctive use of CM reduced the endocrine therapy associated adverse events, including bone mineral density loss, perimenopausal symptoms, poor quality of life, pain and impaired immune function. But large-scale and high quality RCTs are needed to support the application of CM-WM therapy.