20 May 2022, Volume 25 Issue 15
Research Status and Thoughts on the Comparative Effect of Traditional Chinese Medicine in the Treatment of IBS-D
CHEN Min，XIE Xin，SHI Yunzhou，ZHENG Hui，WU Qiaofeng，ZHOU Haiyan，LI Zhigang，YU Shuguang
Background Diarrhea irritable bowel syndrome (IBS-D) is a common clinical disease with high prevalence and recurrent episodes. Patients with IBS-D often suffer from anxiety and depression, which bring a huge medical burden to the society. There are many clinical treatment options for IBS-D, especially in the field of traditional Chinese medicine (TCM)
What This Study Found By reviewing the comparative effect research (CER) application of clinical effect assessment in the treatment of IBS-D with TCM, combined with the methodological innovations of comparative effect research in the past five years.
Implications This article discusses the current status of CER in the treatment of IBS-D with TCM, and then considers how to design, implement and evaluate the comparative effect of TCM in real-world clinical research.
Research Progress of Traditional Chinese and Western Medicine in the Treatment of Irritable Bowel Syndrome Based on 5-hydroxytryptamine
WU Pengning，XIONG Shuai，JIANG Xiaohan，ZHANG Yi，LIANG Chao，CHEN Min
Background Irritable bowel syndrome (IBS) is a gastrointestinal disorder with no structural damage and biochemical abnormality, and its pathogenic mechanism is still unclear. Variety of drugs, psychotherapy, diet regulation and other methods have been used by modern medicine to relieve symptoms, but the effect is not satisfactory. In recent years,
What This Study This paper summarizes the main mechanisms and results of traditional Chinese medicine based on 5-HT in the treatment of IBS, in order to provide a reference for subsequent research.
Review of Complementary and Alternative Medicine Therapies for Irritable Bowel Syndrome
SHI Yunzhou，ZHENG Hui，CHEN Min，LI Zhigang，YU Shuguang
Background Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder frequently encountered clinically. Many IBS patients use complementary and alternative medicine (CAM) therapies for better treatment results when their conditions could not be improved by first-line drug treatment. However, due to limitations of quality and quantity of studies about CAM therapies, most of these therapies for IBS have not been recommended by relevant consensuses and guidelines.
What This Study The paper overviewed common CAM therapies for IBS, detailed three types, namely, natural products, psychosomatic therapies, and Chinese medicine, aiming at increasing clinical workers and patients' understanding and application of these therapies.
Implications Mechanism of Huangqi Jianzhong Decoction in Treating Diarrhea Predominant Irritable Bowel Syndrome Based on Network Pharmacology and Molecular Docking Technology
YE Kun，LEI Min，XIE Xin，ZHENG Hui，CHEN Min，YU Shuguang
Background Clinical treatment often achieves unsatisfactory effect for irritable bowel syndrome (IBS) , a common complex functional gastrointestinal disease. Huangqi Jianzhong Decoction is widely used for diarrhea IBS (IBS-D) , and its efficacy has been recognized, but the mechanism is unclear and relevant studies are rare.
What This Study The paper explored the potential mechanism of Huangqi Jianzhong Decoction in the treatment of IBS-D based on network pharmacology and molecular docking.
The research speculated that Huangqi Jianzhong Decoction may plays a role in the treatment of IBS-D by enhancing intestinal barrier function, reducing visceral hypersensitivity, reducing inflammatory response and regulating intestinal flora.
Implications Summary of the Best Evidence for Enteral Nutrition Support in Adults with Severe Brain Injury
GUO Wenchao，QIN Hanzhi，TENG Jiao，JIN Kui，SUN Jian，WANG Zhongli，JIANG Yan
Background Enteral nutrition support can effectively improve the nutritional status of patients with severe brain injury, which is beneficial to the prognosis of patients. However, the relevant literature in China and abroad lacks a systematic nutritional management plan for such patients, and there is rare summary of the best evidence for enteral nutrition support.
What This Study A total of 18 articles were included, including 5 clinical guidelines, 3 evidence summaries, 3 expert consensus, 2 systematic reviews, and 5 meta-analysis. Their methodological qualities were rated high overall. Finally 25 pieces of best evidence involving 8 aspects were nutrition screening, nutrition assessment, timing of initiating enteral nutrition, energy and protein requirements, enteral nutrition composition, feeding route, infusion method and complication management.
Implications When giving enteral nutrition to adult patients with severe brain injury, medical staff need to implement it based on the best evidence. At the same time, an individualized enteral nutrition support program should be formulated in combination with the current medical status and specific treatment goals in China to improve the effect of nutritional support, thereby improving the clinical outcome of patients.
Prevalence and Influencing Factors of Comprehensive Disability in Empty and Non-empty Nesters
CHENG Jiaojiao，LIU Beibei，SU Yun，ZHANG Yangyang，WANG Shuhan，ZHANG Han，OUYANG Zongshang，TIAN Qingfeng
Background Disability influences physical and mental health of older people, and causes a heavy burden on family and society. The increasing prevalence of empty-nested phenomenon has aroused wide concern for empty and non-empty nesters.
What This Study The associated factors of comprehensive disability prevalence for Henan's empty and non-empty nesters were not completely the same. Age, prevalence of disability, and accidents as well as number of chronic diseases were associated with comprehensive disability in both of them.
Implications Other associated factors of comprehensive disability were education level and financial support from children for empty nesters, and were marital status and monthly income for non-empty-nesters. So targeted interventions delivered to these two groups should be different.
Impact of Average Daily Temperature on Stroke Mortality in Community：a Time-series Analysis
CHEN Yichen，CHEN Hua，QU Xiaobin，SUN Lianghong，CHEN Hanyi，LI Xiaopan，PENG Li，XU Wanghong，ZHOU Yi
Background With the increasing frequency of extreme weather events due to global climate change, the impact of air temperature on stroke deaths is gaining increasing attention.
What This Study Both low and high temperatures were associated with the stroke mortality risk in Pudong New Area. Low temperature increased the risk of death from hemorrhagic stroke, while high temperature increased the risk of death from ischemic stroke.
Implications People with primary education or below were more likely to die from strokes in hot environments.
Relationship of Triglyceride-glucose Index with Coronary and Carotid Atherosclerosis
BAO Xin，LU Changhong，ZHAO Yuan，GUAN Xiaoli，NIE Qianwen，LIANG Wenxia，ZHANG Jing，ZHANG Zhengyi
Background Triglyceride-glucose (TyG) index is a relatively good predictor of insulin resistance, an indicator that is associated with atherosclerosis. There are few studies on the correlation between TyG index and symptomatic coronary artery disease (CAD) . And there is no evidence definitely determining the relationship between TyG index and carotid atherosclerosis in the elderly.
What This Study TyG index was correlated with coronary atherosclerosis, and its increase was associated with enhanced risk of CAD and obstructive CAD, but had no correlation with carotid atherosclerosis.
Implications The relationship between TyG index and carotid atherosclerosis still needs to be confirmed by prospective studies.
Mediating Effect Analysis of Visceral Adiposity Index on Serum Uric Acid to Creatinine Ratio and Metabolic Syndrome in People with Normal Thyroid Function
LIU Huanxin，MENG Cuiqiao，NIE Qian，YU Chunhong，XING Yuling，WANG Zhongli，LIU Chenghao1，MA Huijuan
Background The yearly prevalence of metabolic syndrome (MS) is increasing in China. Although the level of serum uric acid (SUA) is closely related to MS, due to the influence of renal function on SUA, standardized SUA 〔SUA/serum creatinine ratio (SUA/Scr) 〕 may be a better predictor for MS. Visceral adiposity index (VAI) , as an important indicator for estimating visceral fat accumulation, could be used to predict MS more directly.
What This Study Of the 10 042 participants, 1 833 (18.25%) had MS and 8 209 (81.75%) did not. Pearson correlation analysis showed that SUA/Scr ratio was positively associated with VAI (P<0.05) . Multivariate Logistic regression analysis indicated that compared with Q1 group, the risk of MS significantly increased in Q2 group〔OR=1.310, 95%CI (1.039, 1.651) 〕, Q3 group〔OR=1.372, 95%CI (1.089, 1.729) 〕, and Q4 group〔OR=1.744, 95%CI (1.381, 2.203) 〕 (P<0.05) . Compared with V1 group, the risk of MS notably increased in V3 group〔OR=6.721, 95%CI (4.600, 9.819) 〕 and V4 group〔OR=33.327, 95%CI (21.509, 51.640) 〕 (P<0.01) . Mediating effect analysis indicated that SUA/Scr ratio significantly, directly influenced MS prevalence〔β=0.154, 95%CI (0.104, 0.205) 〕, and VAI partly mediated the indirect effect of SUA/Scr ratio on MS prevalence〔β=0.183, 95%CI (0.156, 0.213) 〕, and the mediating effect accounted for 54.25% of the total effects.
Implications Both SUA/Scr ratio and VAI were predictors of MS, and VAI partly mediated the indirect effect of SUA/Scr ratio on MS prevalence in population with normal thyroid function.
Effect of Modified Tai Chi on Gait Balance and Fall Performancein Hemiplegic Patients in Convalescent Period of Stroke
TANG Qiang，WANG Xue，LI Bingyao，SHA Sha，ZHU Luwen
Background Hemiplegia patients in the convalescent period of stroke generally have gait, balance dysfunction and the risk of falling, which seriously affects their daily living ability and prognosis. Traditional exercise therapy such as Tai Chi can play its unique advantages as an intervention, but there are different practice routines and insufficient evidence of evidence-based medicine, which limit its clinical application.
What This Study There was no significant difference between the two groups on the results of LE-FMA, 6MWT, BBS, TUGT, MBI, step length, frequency and speed, and MFES before the treatment (P>0.05) . No significant difference was found in TUGT time and step length between the two groups after the treatment (P>0.05) . However, after the treatment, LE-FMA, BBS, MBI, MFES scores, step frequency and speed in the observation group were higher than those in the control group, and 6MWT walking distance was longer (P<0.05) . Furthermore, LE-FMA, BBS, MBI, MFES scores, step frequency and speed after treatment were higher than those before treatment, 6MWT walking distance was longer and TUGT time was shorter than that before treatment (P<0.05) .
Implications Modified Tai Chi can effectively improve gait and balance disorder and fall efficacy in patients with hemiparesis in the convalescent stage of stroke.
Association of Cyclic RNAs with the Risk of Type 2 Diabetes Mellitus in Han Chinese
KANG Jiehong，CHANG Xiangyun，ZHU Yurong，BA Tao，SUN Yuan
Background The prevalence of diabetes is increasing year-on-year. However, current diagnostic methods have many deficiencies in early identification of type 2 diabetes mellitus (T2DM) . Epigenetic factors may be associated with the development and secretory function of pancreatic islet β cells, which reduces the sensitivity of the body to the effects of insulin, ultimately leading to the development of T2DM.
What This Study hsa_circ_0032491 and hsa_circ_0002922 could be used as biomarkers for T2DM in Han Chinese. hsa_circ_0139634, hsa_circ_0032491 and hsa_circ_0002922 could be independent predictors of T2DM in Han Chinese population.
Implications An increase in the relative expression levels of hsa_circ_0032491 and hsa_circ_0002922 increased the risk of T2DM, suggesting that these three candidate circRNAs may play an important role in the development of T2DM.
Ultrasonographic Analysis of Primary Thyroid Lymphoma
OUYANG Xiangliu，GAO Bei，WANG Yanbin，LIU Liyun，GU Cheng，ZHENG Lichun
Background Primary thyroid lymphoma (PTL) is a rare type of extranodal lymphoma, which is prone to misdiagnosis and missed diagnosis due to atypical clinical and ultrasonic features.
What This Study PTL has specific ultrasonic manifestations. A diagnosis of PTL could be made when a patient manifests as thyroid enlargement, diffuse hypoechoic, non-calcified, regular-shaped lesions with well-defined margins and posterior echo enhancement, and high enhancement at arterial and venous phases.
Clinical Efficacy of Different Doses of Canagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus：a Meta-analysis
CHEN Yuying，LI Xiaodong，TANG Yunzhao，LI Daiqing
Background Canagliflozin (CANA) and metformin (MET) can both be used in the treatment of type 2 diabetes (T2DM) , but the clinical efficacy of combined use remains to be further clarified.
What This Study 100 mg and 300 mg of CANA combined with MET can effectively reduce HbA1c and FPG levels, body weight, blood pressure and TG levels, and increase LDL-C and HDL-C levels in T2DM patients.
Implications For patients with T2DM poorly controlled by MET, it may be considered in combination with CANA, but attention should be paid to infection of the reproductive system. Therefore, high-quality large-sample trials are still needed to confirm the long-term safety of different doses of CANA combined with MET.
Influence of Physical Exercise Interventions during Pregnancy on Natural Childbirth：a Meta-analysis
JI Moufang，LI Ruobing，WEI Kejing，ZENG Fanhua
Background Natural childbirth is a normal physiological approach of human reproduction, while in China, the cesarean section rate has exceeded the upper limit recommended by the WHO by more than two times. As a nonpharmaceutical intervention facilitating natural childbirth, physical exercise should be valued by relevant departments.
What This Study Proper physical exercise during pregnancy favorably affects the probability of natural childbirth. The natural childbirth probability could be positively influenced by some types of moderate-intensity physical exercise interventions, such as pelvic floor muscle training, general sports lessons, gymnastics, aerobic exercise, birthing ball movement, and yoga, if they are performed at least 12 times per week (30-<50 minutes each time) within 8 consecutive weeks after 24 weeks of gestation.
Advances in Diagnosis and Management of Acute Kidney Injury Induced by Crush Syndrome
WANG Jinxiang，DONG Yuxin，ZHAO Yibo，MENG Xianglong，CHAI Yanfen，JIN Heng
Crush syndrome (CS) often occurs in victims of natural disasters, trauma and traffic accidents, which mainly manifests as hypovolemic shock, acute kidney injury (AKI) , hyperkalemia, and acidosis, among which AKI is a major cause of the continuing high mortality of CS. Current treatments for AKI induced by CS include early rehydration, symptomatic treatment and renal replacement therapy, but the effects are not satisfactory. There are no standard treatment options for CS-related AKI, so identifying the pathogenesis of this disease and formulating an effective treatment regimen may be problems need to be solved urgently. This article reviews the latest advances in pathogenesis and treatment strategies of CS-related AKI.
New Developments in the Role of Lactobacillus Reuteri in Regulating Intestinal Barrier Function
CEN Qiuyu，PANG Rizhao，HU Xiaomin，CUI Yanru，ZHANG Anren
The intestinal barrier plays a role in maintaining the stability of the intestinal environment, which relies on the dynamic regulation of the intestinal microbiota. Lactobacillusreuteri (L.reuteri) is a lactic acid bacterium reported to be naturally present in the intestines of almost all vertebrates and mammals, and has been shown to affect the function of the intestinal barrier and safeguard the health of body through various pathways. This paper reviews the role and possible mechanisms of action of L.reuteri in regulating intestinal physical, chemical, immune and microbial barrier functions, with the aim of providing a theoretical basis and new ideas for the clinical application of L.reuteri in treating related diseases.