Prevalence and Patterns of Multimorbidity Among Adults Aged 18 Years and Older - China, 2018.

What is already known about this topic?: Multimorbidity is becoming more common and poses a major challenge to healthcare systems. However, the prevalence and patterns of multimorbidity among Chinese adults aged ≥18 years are largely unknown. What is added by this report?: This study found that 46.5% of Chinese adults had multimorbidity in 2018. And the prevalence of multimorbidity prevalence is increased with age. Prevalence of multimorbidity was higher among men, Han Chinese, adults with lower educational level, and those with lower household income. The most common multimorbidity pattern is a combination of three chronic conditions, hypertension, dyslipidemia, and obesity. What are the implications for public health practices?: As multimorbidity diversifies characteristics and patterns, guideline development, clinical management, and public intervention should consider the complexity of multimorbidity.

Design and application of a kind of anti-bedsore turning pad / 中华危重病急救医学

Patients who are bedridden are for a long-time prone to develop bedsores, especially in the hip and sacral areas and limbs, which causes eczema, ulcers, infection and other complications, resulting in pain and more medical costs. Therefore, the medical staff of the Second Affiliated Hospital of Zunyi Medical University designed and developed a kind of anti-bedsore turning pad, and has obtained the national utility model patent (ZL 2021 2 3004923.9), which is suitable for various long-term bedridden patients. The anti-bedsore turning pad includes the center axis of the turning pad, and ventilation pad 1 and ventilation pad 2 designed on the left and right of turning pad center axis. Under the ventilation pad 1 and the ventilation pad 2, the air pad 1 and the air pad 2 are respectively designed. There is a bedspread connected with ventilation pad 1 and ventilation pad 2 on the inflatable pad 1 and the inflatable pad 2. Through the design of inflatable pad 1 and inflatable pad 2, the left and right of the anti-bedsore turning pad can be lowered or raised independently, which is convenient for the patient's body to tilt and turn over, and can significantly reduce the number of nursing staff and the burden of nursing staff when turning over. In addition, it is convenient to replace the force site at any time and reduce the occurrence of pressure ulcers caused by long-term pressure on the force site. Through the design of ventilation cushion 1 and ventilation cushion 2, the internal gas flow of the turning pad can be made, and the ventilation between the patient and the turning pad can be kept dry, so as to reduce the occurrence of eczema, ulcers or infection and other complications, and ultimately reduce the occurrence of bedsores. In addition, through the design of the most superficial limb pad, the patient's limb can be appropriately elevated or massaged, which increases the comfort of the patient. The anti-bedsore turning pad is simple and effective, and can be widely used in long-term bedridden patients.

Anti-inflammatory Therapy Progress in Major Adverse Cardiac Events after PCI: Chinese and Western Medicine / 中国结合医学杂志

Acute coronary syndrome (ACS) is one of the leading causes of death in cardiovascular disease. Percutaneous coronary intervention (PCI) is an important method for the treatment of coronary heart disease (CHD), and it has greatly reduced the mortality of ACS patients since its application. However, a series of new problems may occur after PCI, such as in-stent restenosis, no-reflow phenomenon, in-stent neoatherosclerosis, late stent thrombosis, myocardial ischemia-reperfusion injury, and malignant ventricular arrhythmias, which result in the occurrence of major adverse cardiac events (MACE) that seriously reduce the postoperative benefit for patients. The inflammatory response is a key mechanism of MACE after PCI. Therefore, examining effective anti-inflammatory therapies after PCI in patients with ACS is a current research focus to reduce the incidence of MACE. The pharmacological mechanism and clinical efficacy of routine Western medicine treatment for the anti-inflammatory treatment of CHD have been verified. Many Chinese medicine (CM) preparations have been widely used in the treatment of CHD. Basic and clinical studies showed that effectiveness of the combination of CM and Western medicine treatments in reducing incidence of MACE after PCI was better than Western medicine treatment alone. The current paper reviewed the potential mechanism of the inflammatory response and occurrence of MACE after PCI in patients with ACS and the research progress of combined Chinese and Western medicine treatments in reducing incidence of MACE. The results provide a theoretical basis for further research and clinical treatment.

Effect of Yiqi Liangxue Shengji Formula （益气凉血生肌方） on Recurrence of Angina Pectoris and Quality of Life after Percutaneous Coronary Intervention in Coronary Heart Disease Patients with Qi Deficiency and Blood Stasis Syndrome and Binding of Stasis and Heat Syndrome： A Randomized， Triple-blind， Placebo-controlled Parallel Trial / 中医杂志

ObjectiveTo observe the clinical effect of Yiqi Liangxue Shengji Formula （益气凉血生肌方， YLSF） on recurrence of angina pectoris and quality of life at eight weeks after perecutaneous coronary intervention （PCI）. MethodsEighty-two coronary artery disease （CAD） patients with qi deficiency and blood stasis and binding of stasis and heat syndrome who had underwent PCI were randomly divided into two groups with 41 patients each in the treatment group and the control group. Based on conventional western medicine after PCI， patients in the treatment group orally took YLSF granules while those in the control group were administered with placebo， one dose daily for 8 weeks. The recurrence rate of angina pectoris and readmission rate within eight weeks after PCI were recorded. Before and after treatment， total traditional Chinese medicine （TCM） syndrome score， Seattle Angina Questionnaire （SAQ） scores （physical limitation， angina stability， angina frequency， treatment satisfaction and disease perception）， and the SF-36 scores for quality of life （physical and mental health） were evaluated. The adverse reactions during medication in both groups were recorded. ResultsWithin eight weeks after PCI， the recurrence rate of angina pectoris in the treatment group （4/41， 9.76%） was significantly lower than that in the control group （11/41， 26.83%， P＜0.05）. The readmission rate in the treatment group was 2.44% （1/41）， while that in the control group was 12.20% （5/41）， with no significantly statistical difference （P＞0.05）. After treatment， total TCM syndrome score significantly decreased in both groups， while in terms of quality of life， the SAQ scores on domains of angina stability， angina frequency and disease perception as well as SF-36 total scores， physical health and mental health scores significantly increased （P＜0.05 or P＜0.01）. Compared between the two groups， total TCM syndrome score was significantly lower in the treatment group than the control group （P＜0.01）， while no significant differences were found in SAQ scores and SF-36 total， physical and mental health scores （P＞0.05）. No adverse reactions occurred in both groups during the treatment period. ConclusionYLSF can reduce the recurrence rate of angina pectoris within eight weeks after PCI for coronary artery disease， and can improve the TCM syndrome score， and have sound safety， with comparable effect to that of placebo in improving postoperative short-term quality of life.

Role of Mitophagy in Myocardial Ischemia/Reperfusion Injury and Chinese Medicine Treatment / 中国结合医学杂志

Mitophagy is one of the important targets for the prevention and treatment of myocardial ischemia/reperfusion injury (MIRI). Moderate mitophagy can remove damaged mitochondria, inhibit excessive reactive oxygen species accumulation, and protect mitochondria from damage. However, excessive enhancement of mitophagy greatly reduces adenosine triphosphate production and energy supply for cell survival, and aggravates cell death. How dysfunctional mitochondria are selectively recognized and engulfed is related to the interaction of adaptors on the mitochondrial membrane, which mainly include phosphatase and tensin homolog deleted on chromosome ten (PTEN)-induced kinase 1/Parkin, hypoxia-inducible factor-1 α/Bcl-2 and adenovirus e1b19k Da interacting protein 3, FUN-14 domain containing protein 1 receptor-mediated mitophagy pathway and so on. In this review, the authors briefly summarize the main pathways currently studied on mitophagy and the relationship between mitophagy and MIRI, and incorporate and analyze research data on prevention and treatment of MIRI with Chinese medicine, thereby provide relevant theoretical basis and treatment ideas for clinical prevention of MIRI.

Forkhead Box M1 Regulates the Proliferation,Invasion,and Drug Resistance of Gastric Cancer Cells via circ_NOTCH1 / 中国医学科学院学报

Objective To investigate the impacts of forkhead box M1(FOXM1)on the proliferation,invasion,and drug resistance of gastric cancer cells by regulating the circular RNA circ_NOTCH1.Methods Western blotting and real-time quantitative PCR were performed to determine the expression of FOXM1 protein and circ_NOTCH1,respectively,in the gastric cancer tissue,para-carcinoma tissue,human normal gastric mucosa epithelial cell line GES-1 and gastric cancer cell lines MGC-803,HGC-27,and BGC-823.BGC-823 cells were classified into the following groups:control,short hairpin RNA FOXM1(sh-FOXM1)and negative control(sh-NC),small interfering RNA circ_NOTCH1(si-circ_NOTCH1)and negative control(si-NC),and sh-FOXM1+circ_NOTCH1 overexpression plasmid(sh-FOXM1+pcDNA-circ_NOTCH1)and sh-FOXM1+negative control(sh-FOXM1+pcDNA).CCK-8 assay and clone formation assay were employed to measure the cell proliferation,and Transwell assay to measure cell invasion.After treatment with 1.0 mg/L adriamycin for 48 h,the cell resistance in each group was analyzed.Western blotting was employed to determine the expression levels of FOXM1,proliferating cell nuclear antigen(PCNA),Bax,multi-drug resistance-associated protein 1(MRP1),and multi-drug resistance gene 1(MDR1).RNA pull-down and RNA immunoprecipitation were employed to examine the binding of circ_NOTCH1 to FOXM1 protein.Results Compared with those in the para-carcinoma tissue,the expression levels of FOXM1 protein and circ_NOTCH1 in the gastric cancer tissue were up-regulated(all P<0.001).Compared with GES-1 cells,MGC-803,HGC-27,and BGC-823 cells showed up-regulated expression levels of FOXM1 protein and circ_NOTCH1(all P<0.001).Compared with the control group and sh-NC group,the sh-FOXM1 group with down-regulated expression of FOXM1 protein and circ_NOTCH1 showed decreased optical density value,clone formation rate,cell invasion number,and cell viability,down-regulated expression of PCNA,MRP1,and MDR1,and up-regulated expression of Bax protein in BGC-823 cells(all P<0.001).Compared with the control group and the si-NC group,the si-circ_NOTCH1 group with down-regulated expression of circ_NOTCH1 showed decreased optical density value,clone formation rate,cell invasion number,and cell viability,down-regulated expression of PCNA,MRP1,and MDR1,and up-regulated expression of Bax protein in BGC-823 cells(all P<0.001).Compared with sh-FOXM1 group and sh-FOXM1+pcDNA group,the sh-FOXM1+pcDNA-circ_NOTCH1 group with up-regulated expression of circ_NOTCH1 showed increased optical density value,clone formation rate,cell invasion number,and cell viability,up-regulated expression of PCNA,MRP1,and MDR1,and down-regulated expression of Bax protein(all P<0.001).FOXM1 protein was able to interact with circ_NOTCH1.Conclusion Interference with FOXM1 may inhibit the proliferation,invasion,and drug resistance of gastric cancer cells by silencing circ_NOTCH1 expression.

Using 16S rDNA Sequencing Technology to Preliminarily Analyze Intestinal Flora in Children with Mycoplasma pneumoniae Pneumonia / 生物医学与环境科学（英文）

Objective@#We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia (MPP).@*Methods@#Between September 2019 and November 2019, stool samples from 14 children with MPP from The Fourth Hospital of Baotou city, Inner Mongolia Autonomous Region, were collected and divided into general treatment (AF) and probiotic (AFY) groups, according to the treatment of "combined Bifidobacterium, Lactobacillus, Enterococcus, and Bacillus cereus tablets live". High-throughput 16S rDNA sequencing was used to identify intestinal flora.@*Results@#Intestinal flora abundance and diversity in children with MPP were decreased. Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls ( P < 0.05). When compared with healthy controls, the proportion of Enterorhabdus was lower in the AF group, while the proportion of Lachnoclostridium was higher ( P < 0.05). The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus, Lachnoclostridium, Roseburia, and Erysipelatoclostridium proportions were higher. The proportion of Escherichia coli- Shigella in the AFY group after treatment was decreased ( P < 0.05).@*Conclusions@#The intestinal flora of children with MPP is disturbed, manifested as decreased abundance and diversity, and decreased Bifidobacteria. Our probiotic mixture partly improved intestinal flora disorders.

A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine.

Background: Migraine is an intractable headache disorder, manifesting as periodic attacks. It is highly burdensome for patients and society. Acupuncture treatment can be beneficial as a supplementary and preventive therapy for migraine. Objectives: This systematic review and meta-analysis aimed to investigate the efficacy and safety of acupuncture for migraine, and to examine transcranial doppler changes after acupuncture. Methods: Reports, conference, and academic papers published before March 15, 2019 in databases including PubMed, Cochrane library, Embase, China National Knowledge Infrastructure, WANFANG Database, Chinese journal of Science and Technology, and China Biomedical were searched. Randomized controlled trials (RCTs) involving acupuncture, sham acupuncture, and medication in migraine were included. The Cochrane Collaboration software, RevMan 5.3, was used for data processing and migration risk analysis. Results: Twenty-eight RCTs were included. 15 RCTs included medication only, 10 RCTs included sham acupuncture only, and 3 RCTs included both. The study included 2874 patients, split into 3 groups: acupuncture treatment group (n = 1396), medication control group (n = 865), and sham acupuncture control group (n = 613). The results showed that treatment was more effective in the acupuncture group than in the sham acupuncture group (MD = 1.88, 95% CI [1.61, 2.20], P < 0.00001) and medication group (MD = 1.16, 95% CI [1.12, 1.21], P < 0.00001). Improvement in visual analog scale (VAS) score was greater in the acupuncture group than in the sham acupuncture group (MD = -1.00, 95% CI [-1.27,-0.46], P < 0.00001; MD = -0.59, 95% CI [-0.81,-0.38], P < 0.00001), and their adverse reaction rate was lower than that of the medication group (RR = 0.16, 95% CI [0.05, 0.52], P = 0.002). The improvement of intracranial blood flow velocity by acupuncture is better than that by medication, but the heterogeneity makes the result unreliable. Conclusions: Acupuncture reduced the frequency of migraine attacks, lowered VAS scores, and increased therapeutic efficiency compared with sham acupuncture. Compared with medication, acupuncture showed higher effectiveness with less adverse reactions and improved intracranial blood circulation. However, owing to inter-study heterogeneity, a prospective, multicenter RCT with a large sample is required to verify these results.

Associations of health literacy and screen time with non-suicidal self-injury behavior among middle school students in Shenyang / 中国学校卫生

Objective@#To examine the association of health literacy (HL) and screen time (ST) with non-suicidal self-injury (NSSI) in middle school students, and to provide guidance for prevention on self-injuries in adolescents.

Active loading of verteporfin into cationic liposome for neovasculature- and tumor-targeted photodynamic therapy / 药学学报

To target neovasculature and tumor cells, a novel cationic liposome with verteporfin (BPD) active-loaded in lumen (CLL) was designed and its basic in vitro and in vivo behaviors were evaluated in this study. Calcium acetate gradient loading method was applied to encapsulate BPD actively and cationic lipid (2,3-dioleoy-loxy-propyl)-trimethylammonium (DOTAP) was added by post-insertion for the positive charge of CLL. Results of characterization showed that the diameter and zeta-potential of CLL were around 100 nm and 28 mV, respectively. Compared with passive loading liposomes, CLL significantly enhanced the stability of BPD loading. What's more, the loaded BPD in lumen could switch off the fluorescence and photosensitization during blood circulation by homo-fluorescence resonance energy transfer (homo-FRET) effect, leading to the diminished phototoxicity to normal tissues. In vitro cellular uptake and cytotoxicity assay exhibited that positive charge dramatically enhanced the uptake of CLL both in vascular endothelial cells and tumor cells leading to superior therapeutic efficacy. In vivo study further showed that CLL reduced the clearance rate and increased tumor accumulation compared with passive loading group. Quantitative results of exvivo organ indicated that negligible CLL distributed in normal organs contributing to low phototoxicity. Animal experiments were conducted according to the Guidelines of the Experimental Animal Ethics Committee of Peking University Health Science Center and International Animal Experiments. In conclusion, we successfully designed a novel cationic targeting liposome that overcame the limitations of passive loading and significantly enhanced the efficacy of photodynamic therapy.

Anti-inflammatory Effect of Gentiopicroside in Adjuvant-induced Arthritis Rats / 中国实验方剂学杂志

Objective::To study the therapeutic and inflammatory effects of gentiopicroside(GPS) on adjuvant-induced arthritis (AA) rats. Method::The 36 male SD rats were randomly divided into six groups, namely the model group, GPS groups (low, medium and high dose), and the methotrexate (MTX) group, with six rats in each group. AA rats were induced through intradermal injection with 0.1 mL complete Freund's adjuvant (CFA) into the right hind paw, except the normal group. After modeling, rats in each group were treated with drugs for 7 days, once a day. The doses were 30, 60, 120 mg·kg-1 in the GPS groups, and 0.2 mg·kg-1 in the MTX group. The normal group and the model group were intragastrically treated with the same volume of normal saline. During the experiment, the paw thickness and paw volume of rats were recorded everyday by the digital vernier calipers and the toe volume measuring instrument. On the seventh day, X-ray and histopathological examination of the ankle joints were performed by the small animal living imaging instrument and hematoxylin eosin stain. Blood samples were collected from the abdominal aorta at the end of the experiment to determine the levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in serum by enzyme-linked immunosorbent assay(ELISA) kits. The mRNA levels of IL-6 and TNF-α in synovial tissues were determined by Real-time fluorescent quantitative polymerase chain reaction(Real-time PCR). Result::Compared with the normal group, the results of each index in the model group were significantly different (P<0.01). Compared with the model group, the results of paw volume and paw thickness decreased significantly (P<0.01), TNF-α level decreased significantly (P<0.01), and IL-6 and TNF-α mRNA levels decreased significantly (P<0.05, P<0.01) in drug treated groups. The results of X-ray and histopathological examinations indicated that GPS had a protective effect on the ankle joints of AA rats. Conclusion::GPS has the therapeutic effect on AA rats by inhibiting levels of proinflammatory cytokines in serum and relevant mRNA levels in synovial tissues.

Difficulties and strategies of public hospitals from the epicenter in their participation in the prevention and control of COVID-19 / 中华医院管理杂志

Outbreak of COVID-19 across the country has seriously threatened people′s lives and health, endangering smooth operation of the national economy and social stability. An all-out campaign to save these patients and reduce their mortality is not only one of the key tasks to fight against the epidemic, but also a major responsibility and mission of public hospitals. In view of the field practice of Wuhan Union Hospital in the epicenter, the authors described the challenges faced by such hospitals in the prevention and control, summarized its experiences and proposed improvement measures, for reference of other public hospitals and relevant authorities.

Difficulties and strategies of public hospitals in their participation in the prevention and control of novel coronavirus pneumonia / 中华医院管理杂志

Outbreak of the novel coronavirus pneumonia (NC) across the country has seriously threatened people's lives and health, endangering smooth operation of the national economy and social stability. An all-out campaign to save the NCP patients and reduce their mortality is not only one of the key tasks to fight against the epidemic, but also a major responsibility and mission of public hospitals. In view of the field practice of Wuhan Union Hospital in the epicenter, the authorsDescribed the challenges faced by such hospitals in the prevention and control, summarized its experiences and proposed improvement measures, for reference of other public hospitals and relevant authorities.

Overexpression of the ChVDE gene, encoding a violaxanthin de-epoxidase, improves tolerance to drought and salt stress in transgenic Arabidopsis.

To investigate the protective mechanism of violaxanthin de-epoxidase (VDE) zeaxanthin in Cerasus humilis under drought and salt-stress conditions, we cloned the entire cDNA sequence of ChVDE from C. humilis and generated ChVDE-overexpression (OE) and ChVDE-complementation (CE) Arabidopsis plants. The open reading frame of ChVDE contained 1,446 bp nucleotides and encoded 481 amino acids. The ChVDE showed the highest similarity with those of Camellia sinensis and Citrus sinensis. Subcellular localization analysis showed that ChVDE was located in the chloroplasts. OE plants showed stronger root growth and higher levels of total chlorophyll as compared to WT and VDE mutant (npq1-2) plants. Moreover, the relative de-epoxidation state of the xanthophyll cycle pigments (A + Z)/(V + A+Z) was higher in OE plants than in the controls. OE plants had enhanced photosynthetic rates, respiration rates, and transpiration rates compared with the WT or npq1-2 plants after drought or salt treatment. Collectively, our results demonstrate that ChVDE plays a positive role in both drought and salt tolerance.

The study of the relationship between mammographic features and histological findings of BIGRADS 3 ,4 / 实用放射学杂志

Objective To investigate the correlation between mammographic features in BIGRADS 3,4 and the corresponding histological findings.Methods 442 patients with 46 9 lesions categorized as 3 ,4 in BIGRADS on mammography from July 20 1 3 to February 20 1 5 were retrospectively analyzed.The correlation between mammographic features and histological findings was statistically analyzed.Results Among the 469 lesions,130 lesions were categorized as BIGRADS 3,with 13 pathologically confirmed malignant lesions and 117 benign lesions.There were 3 3 9 lesions in BIGRADS 4,with 9 8 malignant lesions and 241 benign lesions.There were statistical differences between benign and malignant lesions (P＜0.05)in mass morphology,mass margin,calcification morphology,calcification distribution,architectural distortion,asymmetries and axillary adenopthy.There were no statistically significant differences (P＞0.05 )in breast composition, mass density or location.The logistic regression analysis with above mentioned significance indexs showed that the F value was 4.3 1 1 , with the significance probability (P＜0.001 ).The mass shape,the edge of the mass,the calcification shape,the calcification distribution,the structure distortion,the asymmetrical compact shadow,and the axillary lymph node enlargement were all correlated with the benign and malignant of the tumors.Conclusion The mammographic features of BIGRADS category 3 and 4 including the mass morphology, margin,calcification morphology,calcification distrubution,architectural distortion,asymmetries,and axillary adenopthy could help us to improve the accuracy diagnoses between benign and malignant lesions.

Microwatts continuous-wave pumped second harmonic generation in few- and mono-layer GaSe.

We demonstrate the first achievement of continuous-wave (CW) pumped second harmonic generation (SHG) in few- and mono-layer gallium selenide (GaSe) flakes, which are coated on silicon photonic crystal (PC) cavities. Because of ultrahigh second order nonlinearity of the two-dimensional (2D) GaSe and localized resonant mode in the PC cavity, SHG's pump power is greatly reduced to microwatts. In a nine-layer GaSe coated PC cavity, while the optical power inside the GaSe flake is only 1.5% of that in the silicon PC slab, the SHG in GaSe is more than 650 times stronger than the third harmonic generation in silicon slab, indicating 2D GaSe's great potentials to strengthen nonlinear processes in silicon photonics. Our study opens up a new view to expand 2D materials' optoelectronic applications in nonlinear regime and chip-integrated active devices.

Effects of Synthetic Long-Chain Polyphosphate on Blood Coagulation and Platelet Aggregation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects of synthetic long-chain polyphosphate on blood coagulation and platelet aggregation.</p><p><b>METHODS</b>The effect of artificial synthetic long chain poly phosphate on blood coagulation and platelet aggregation was detected by coagulation tests, coagulation factor activity detection and platelet aggregation test, and its mechanism was explored by ELISA, flow cytometry and high content imaging system.</p><p><b>RESULTS</b>The long chain polyphosphates prolonged activated partial thromboplastin time, decreased coagulation factor FⅧ, FⅨ, FⅪ and FⅫ activity, blocked ADP-induced platelet aggregation, and decreased the concentration of calcium and TXA2 in platelet.</p><p><b>CONCLUSION</b>The synthetic long-chain polyphosphate can inhibit endogenous coagulation and inhibit platelet aggregation, which may be related with the inhibition of intracellular calcium and TXA2.</p>

Conventional Acupuncture for Cardiac Arrhythmia: A Systematic Review of Randomized Controlled Trials / 中国结合医学杂志

<p><b>OBJECTIVE</b>To exam the effect and safety of conventional acupuncture (CA) on cardiac arrhythmia.</p><p><b>METHODS</b>Nine medical databases were searched until February 2016 for randomized controlled trials. Heterogeneity was measured by Cochran Q test. Meta-analysis was conducted if I was less than 85% and the characteristics of included trials were similar.</p><p><b>RESULTS</b>Nine qualified studies involving 638 patients were included. Only 1 study had definitely low risk of bias, while 7 trials were rated as unclear and 1 as high. Meta-analysis of CA alone did not have a significant benefit on response rate compared to amiodarone in patients with atrial fibrillation (Af) and atrial flutter (AF) [relative risk (RR): 1.09; 95% confidence interval (CI): 0.79-1.49; P=0.61; I=61%, P=0.11]. However, 1 study with higher methodological quality detected a lower recurrence rate of Af in CA alone as compared with sham acupuncture plus no treatment, and benefits on ventricular rate and time of conversion to normal sinus rhythm were found in CA alone group by 1 study, as well as the response rate in CA plus deslanoside group by another study. Meta-analysis of CA plus anti-arrhythmia drug (AAD) was associated with a significant benefit on the response rate when compared with AAD alone in ventricular premature beat (VPB) patients (RR, 1.19, 95% CI: 1.05-1.34; P=0.005; I=13%, P=0.32), and an improvement in quality-of-life score (QOLS) of VPB also showed in 1 individual study. Besides, a lower heart rate was detected in the CA alone group by 1 individual study when compared with no treatment in sinus tachycardia patients (MD-21.84 [-27.21,-16.47]) and lower adverse events of CA alone were reported than amiodarone.</p><p><b>CONCLUSIONS</b>CA may be a useful and safe alternative or additive approach to AADs for cardiac arrhythmia, especially in VPB and Af patients, which mainly based on a pooled estimate and result from 1 study with higher methodological quality. However, we could not reach a robust conclusion due to low quality of overall evidence.</p>

Interpretation of the Guidance for Immune Thrombocytopenia-Review / 中国实验血液学杂志

Since the American Medical Association published the 2011 guidelines for immune thrombocytopenia, China has been the first to update the guidelines for immune thrombocytopenia based on evidence-based medicine. Recently, there have been many breakthroughs in clinical research published, especially the Chinese medical workers have made a prominent contribution to the treatment of the immune thrombocytopenia. However, the references of systematic drug introduction for children, adults, aged and pregnant women are still insufficient, and the first or second line treatment for some patients were ineffective. Therefore, we tried to combine the references to interpret the guidelines, to explore the advantages and disadvantages of each treatment, to find out the bottleneck of clinical treatment, so as to facilitate the implementation and understanding of the guidelines, then update the next guideline.

Hope level in stroke patients and the related factors / 现代临床护理

Objective To explore the hope 1evel in stroke patients and its influencing factors to provide theoretical basis for improving the hope 1evel of patients. Method The general information questionnaire, herth hope index and social support rating scale were used to investigate the hope levels and the related factors among 414 cases of patients with stroke. Results The level of hope for patients with stroke was (34.33±4.15) minutes, at a moderate level. The social support in patients with stroke was (37.95±7.37) minutes. 81.40%stroke patients were below average or below. Logistic regression analysis showed, marital status, stroke type and social support were independent influencing factors of the level of hope in stroke patients (P<0.05), explaining 27.10% of the total variation. Conclusions The main factors influencing the level of hope in stroke patients are marital status, stroke type and social support, according to the level of hope factors affecting the development of personalized intervention measures. The implementation of targeted psychological counseling and health education, social support system of play buffer disease, improve patient confidence to overcome the disease and the level of hope.