Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Global research trends and prospects of cellular metabolism in colorectal cancer

BACKGROUND An increasing number of studies have focused on the role of cellular metabolism in the development of colorectal cancer(CRC).However,no work is currently available to synthesize the field through bibliometrics.AIM To analyze the development in the field of“glucose metabolism”(GM),“amino acid metabolism”(AM),“lipid metabolism”(LM),and“nucleotide metabolism”(NM)in CRC by visualization.METHODS Articles within the abovementioned areas of GM,AM,LM and NM in CRC,which were published from January 1,1991,to December 31,2022,are retrieved from the Web of Science Core Collection and analyzed by CiteSpace 6.2.R4 and VOSviewer 1.6.19.RESULTS The field of LM in CRC presented the largest number of annual publications and the fastest increase in the last decade compared with the other three fields.Meanwhile,China and the United States were two of the most prominent contri-butors in these four areas.In addition,Gang Wang,Wei Jia,Maria Notar-nicola,and Cornelia Ulrich ranked first in publication numbers,while Jing-Yuan Fang,Senji Hirasawa,Wei Jia,and Charles Fuchs were the most cited authors on average in these four fields,respectively.“Gut microbiota”and“epithelial-mesenchymal transition”emerged as the newest burst words in GM,“gut microbiota”was the latest outburst word in AM,“metastasis”,“tumor microenvironment”,“fatty acid metabolism”,and“metabolic reprogramming”were the up-to-date outbreaking words in LM,while“epithelial-mesenchymal transition”and“apoptosis”were the most recently occurring words in NM.CONCLUSION Research in“cellular metabolism in CRC”is all the rage at the moment,and researchers are particularly interested in exploring the mechanism to explain the metabolic alterations in CRC.Targeting metabolic vulnerability appears to be a promising direction in CRC therapy.

Quantitative proteomics analysis reveals the pathogenesis of obstructed defecation syndrome caused by abnormal expression of dystrophin

BACKGROUND Obstructed defecation syndrome(ODS)represents the most prevalent form of chronic constipation,affecting a diverse patient population,leading to numerous complications,and imposing a significant burden on healthcare resources.Most ODS patients have insufficient rectal propulsion,but the exact mechanism underlying the pathogenesis of ODS remains unclear.AIM To explore the molecular mechanism underlying the pathogenesis of ODS.METHODS A total of 30 pairs of rectal samples were collected from patients with ODS(ODS group)or grade IV prolapsed hemorrhoids without constipation(control group)for quantitative proteomic and bioinformatic analysis.Subsequently,50 pairs of paraffin-embedded rectal specimens were selected for immunohistochemistry and immunofluorescence studies to validate the analysis results.Human intestinal smooth cell contractile function experiments and electrophysiological experiments were conducted to verify the physiological functions of target proteins.Cellular ultrastructure was detected using transmission electron microscopy.RESULTS In comparison to the control group,the expression level of dystrophin(DMD)in rectal specimens from ODS patients was markedly reduced.This finding was corroborated using immunohistochemistry and immunofluorescence techniques.The diminished expression of DMD compromised the contractile function of intestinal smooth muscle cells.At the molecular level,nucleoporin protein 153 and L-type voltage-gated calcium channel were found to be overexpressed in intestinal smooth muscle cells exhibiting downregulated DMD expression.Electrophysiological experiments confirmed an excessive influx of calcium ions into these cells.Moreover,vacuolar-like structures which may be associated with excessive calcium influx were observed in the cells by transmission electron microscopy.CONCLUSION Decreased DMD expression in intestinal smooth muscle may upregulate L-type voltage-gated calcium channel expression,leading to excessive calcium influx which may cause a decrease in rectal propulsion,thereby contributing to the pathogenesis of ODS.

Two different autorefractors for vision screening in children and adolescents

AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.

Exploring the mechanism of active ingredients of Smilacis Glabrae Rhizoma in treating migraine headache through network pharmacology and animal experiments

Background:To explore the potential mechanism of action of the active ingredients of Smilacis Glabrae Rhizoma(SGR)in the treatment of migraine using network pharmacology and in vivo experiments.Methods:Through the search of Traditional Chinese Medicines Systems Pharmacology Database and Analysis Platform,Genecards,Drugbank and other databases,we obtained active ingredients,targets of SGR and related disease targets of migraine,and took the intersection for protein-protein interactions analysis.After constructing the network diagram,network topology analysis was performed to derive the core targets and key active ingredients,and Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed.Finally,molecular docking was performed and validated by in vivo experiments.In vivo experiments,18 male BALB/c mice were selected,and the SGR group was fed with SGR drinking tablet concentrate,and nitroglycerin injection was used to construct a mouse model of migraine.Enzyme-linked immunosorbent assay test was used to detect the levels of TNF-α,IL-1β,IL-6,and AKT1 in plasma.Results:The results showed that the core targets of SGR for the treatment of migraine were TNF-α,IL-1β,IL-6,and AKT1.These core targets and key active ingredients had better binding ability.Compared with the blank group,the number of head scratching in the model group increased.Compared with the model group,there was a significant reduction of the number of head scratching in the SGR group.In comparison with the blank group,the protein level in the plasma in the model group was markedly higher.Compared with the model group,the protein level in the SGR group was significantly lower.Conclusion:SGR has the characteristics of improving migraine based on multi-targets,multi-components and multi-pathways,and the mechanism of action may be related to the inhibition of the release of inflammatory factors,neuron protection,and interference with apoptosis and other processes.

Study on Yan-Xin Wang’s medication experience and regularity in treating Insomnia from the liver based on data mining

Background:Professor Yan-Xin Wang has been committed to the use of traditional Chinese medicine formulas to treat insomnia from the liver for many years,and has achieved excellent clinical results.In order to better inherit Yan-Xin Wang’s academic thoughts.The purpose of this study is to use clinical data to explore the clinical experience of Prof.Yan-Xin Wang in the application of Chinese medicine to treat insomnia patients from the liver,explore the compatibility and medication rules of traditional Chinese medicine,and give more clinical treatment ideas for insomnia.Methods:The general data and prescription information of insomnia patients treated with Chinese herbal medicine by Prof.Yan-Xin Wang from January 1,2021,to December 31,2021,were summarized according to the inclusion and exclusion criteria,and the data were subjected to frequency statistics and drug association rules,complex network diagram analysis and cluster analysis.Results:A total of 159 patients and prescriptions were included in the study,of which 81.1%were women and 18.9%were men,containing 128 herbs;the highest frequency of use was 91.8%for Bupleuri Radix.Six Chinese herbs were used more than 70%of the time,namely Bupleuri Radix,Scutellariae Radix,oyster shell,Glycyrrhizae Radix,Os Draconis,and Ziziphi Spinosae Semen.The top 20 herbs in terms of frequency of use were analyzed in terms of the four Qi,five flavours,and their attributions.The four Qi were mainly calm and warm,the five flavours were mainly bitter and acrid,followed by sweet,and the attributions were mainly to the liver,spleen,and heart meridians.The Chinese medicine association rules set the confidence level>80%and the support level>10%,resulting in 10 two-herb and three-herb associations with the highest confidence level,such as Os Draconis is associated with oyster shell,Platycodonis Radix is associated with Achyranthis Bidentatae Radix,Scutellariae Radix is associated with Bupleuri Radix,Os Draconis,Bupleuri Radix is associated with oyster shell,Os Draconis,Scutellariae Radix is associated with oyster shell,etc.Cluster analysis yielded 3 classes of drug formulas.The complex network diagram shows that the core prescription drugs are composed of Bupleuri Radix,Chuanxiong Rhizoma,Pseudostellariae Radix,Jujubae Fructus,Os Draconis,Coptidis Rhizoma,Scutellariae Radix,Ziziphi Spinosae Semen,Smilacis Glabrae Rhizoma,Cinnamomi Cortex,White Moutan Cortex,Atractylodis Rhizoma,Glycyrrhizae Radix,oyster shell,Rehmanniae Radix Praeparata,Tritici Levis Fructus,Pinelliae Rhizoma Praeparatum,and Cinnamomi Ramulus.Conclusion:Prof.Yan-Xin Wang believes that the main treatment for patients with insomnia is based on the liver,by tonifying the deficiency and supporting the righteousness,mutually regulating the liver and spleen,and calming the mind and nourishing the heart,while adding and subtracting appropriate herbs according to the patient’s co-morbidities,which can significantly improve the patient’s insomnia symptoms.

Investigation of the mechanism of action of Sanwu Huangqin Tang in the treatment of restless leg syndrome based on network pharmacology,molecular docking technology and molecular dynamics simulation

Background:Through the use of network pharmacology and molecular docking approaches,this study will examine the pharmacological effects of Sanwu Huangqin Tang on restless legs syndrome in order to better understand the mechanism of action of Traditional Chinese medicine(TCM)on RLS.Method:Utilise the TCMSP database to collect and select the drug components of Sanwu Huangqin Tang,and the Uniprot database to identify pertinent targets;RLS-related disease targets were obtained from GeneCards,DrugBank,and OMIM databases;and STRING and Cytoscape 3.9.1 software were used to generate an interaction network.KEGG pathway analysis and GO enrichment analysis were performed utilizing the DAVID database.Use Autodock for analyzing the relationships between targets and core components.Result:By using a network pharmacology approach,83 active ingredients and 50 drug-disease intersecting targets were derived for Sanwu Huangqin Tang.The molecular docking results showed that the drug components had strong affinity with the average target targets.Conclusions:This study provides new insights into the mechanism through which Traditional Chinese Medicine(TCM)treats Restless Legs Syndrome(RLS).Furthermore,it lays the foundation for additional research into the mechanism of treatment for RLS through the intervention that addresses various targets and pathways using the active ingredients identified by Sanwu Huangqin Tang.

高频振荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的研究

目的探讨高频振荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的疗效,以及对炎症因子、心肌损伤标志物、microRNA-21(miR-21)、呼吸力学指标、肺功能指标的影响。方法选取南通市妇幼保健院2018年1月-2020年12月收治的新生儿呼吸窘迫综合征患儿150例,按照治疗方法分为对照组与干预组,每组75例。对照组实施常规通气联合肺表面活性物质治疗,干预组实施高频振荡通气联合肺表面活性物质治疗。采用放射免疫测定肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平;采用酶联免疫吸附试验(ELISA)检测肌酸磷酸激酶同工酶(CK-MB)、氨基末端B型脑钠肽前体(NT-proBNP)水平;采用实时荧光定量聚合酶链反应(qRT-PCR)检测miR-21 mRNA相对表达量;检测并比较两组的呼吸力学指标、肺功能指标,比较两组的临床疗效和并发症总发生率。结果干预组治疗后7 d的TNF-α、IL-6、IL-8、CK-MB、NT-proBNP水平、miR-21 mRNA相对表达量、PaCO_(2)低于对照组(P<0.05);干预组PaO_(2)、氧合指数、每千克体重潮气量(TV)、达峰容积比(TPEF/TE)、达峰时间比(VPEF/VE)高于对照组(P<0.05);两组治疗有效率比较,差异无统计学意义(P>0.05);干预组并发症总发生率(5.33%)低于对照组(16.00%)(P<0.05)。结论高频振荡通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征疗效显著,改善患儿呼吸功能和肺功能,减轻炎症反应,保护心肌细胞,减少并发症。

中药“四黄清灵液”熏蒸联合人工泪液治疗干眼症的临床疗效

目的:观察中药"四黄清灵液"熏蒸联合人工泪液治疗干眼症的临床疗效,为临床治疗干眼症提供依据。方法:选取2016-06/12我院眼科就诊的干眼患者82例164眼,随机分为对照组与观察组。对照组41例82眼给予人工泪液滴双眼,4次/d;观察组41例82眼在给予人工泪液基础上增加自拟中药"四黄清灵液"(黄精、黄岑、黄连、菊花、薄荷)熏蒸双眼,1次/d。治疗前及连续治疗14d后,分别观察两组患者泪膜破裂时间(break-up time,BUT)、角膜荧光素染色(corneal fluorescein staining,FL)、基础泪液分泌试验(SchirmerⅠtest,SⅠt)以判断疗效变化。结果:治疗14d后,观察组总有效率为87.8%,对照组总有效率为70.7%,两组之间比较差异有统计学意义(P<0.05)。治疗14d后观察组SⅠt(8.43±2.51mm/5min)、BUT(8.60±2.47s)较对照组(6.38±2.52mm/5min、6.35±2.29s)升高,差异有统计学意义(P<0.05);治疗14d后观察组FL评分(0.84±0.75分)低于对照组(1.26±0.84分),差异有统计学意义(P<0.05)。结论:自拟中药"四黄清灵液"熏蒸联合人工泪液治疗干眼疗效优于单纯使用人工泪液,可有效改善干眼症患者的临床症状。

Relationship Between Programmed Death-ligand 1 and Clinicopathological Characteristics in Non-small Cell Lung Cancer Patients

Objective To evaluate the correlation between programmed death-ligand 1 （PD-L1） expression in primary lung cancer cells, tumor associated macrophages （TAM） and patients＇ clinicopathological characteristics. Methods From 2008 to 2010, 208 non-small cell lung cancer patients who underwent surgery or CT-guided biopsy were recruited from Huadong Hospital, Fudan University. Immunohistochemistry staining was performed to evaluate the PD-L1 expression in both primary lung cancer cells and CD68 positive TAM.

Elucidating the interaction of kansui and licorice by comparative plasma/tissue metabolomics and a heatmap with relative fold change

Although compatibility is highly advocated in traditional Chinese medicine (TCM), inappropriate combination of some herbs may reduce the therapeutic action and even produce toxic effects. Kansui and licorice, one of TCM “Eighteen Incompatible Medicaments”, are the most representative cases of improper herbal combination, which may still be applied simultaneously under given conditions. However, the potential mechanism of their compatibility and incompatibility is unclear. In the present study, two different ratios of kansui and licorice, representing their compatibility and incompatibility respectively, were designed to elucidate their interaction by comparative plasma/tissue metabolomics and a heatmap with relative fold change. As a result, glycocholic acid, prostaglandin F2a, dihydroceramide and sphinganine were screened out as the principal alternative biomarkers of compatibility group;sphinganine, dihydroceramide, arachidonic acid, leukotriene B4, acetoacetic acid and linoleic acid were those of incompatibility group. Based on the values of biomarkers in each tissue, the liver was identified as the compatible target organ, while the heart, liver, and kidney were the incompatible target organs. Furthermore, important pathways for compatibility and incompatibility were also constructed. These results help us to better understand and utilize the two herbs, and the study was the first to reveal some innate characters of herbs related to TCM “Eighteen Incompatible Medicaments”.

Association of sleep quality with myopia based on different genetic risk levels

AIM: To analyse the association of sleep quality with myopia under different genetic risk(GR) levels.METHODS: A cross-sectional survey of students aged 9-14 y in Wenzhou, China, was conducted. Refraction without cycloplegia and ocular parameters were measured. Sleep quality was assessed with the Pittsburgh Sleep Quality Index(PSQI). Seventeen single nucleotide polymorphisms(SNPs) were replicated by association analysis and used to compute the GR score(GRS). Possible confounders were assessed by a questionnaire that collected information about the children and their parents. Generalized linear models were used to analyse the sleep quality, the GR, and their interaction effects on the risk of myopia.RESULTS: Out of 1354 children included in this study, 353(26.07%) had sleep disturbances. The GRS ranged from 4.49 to 12.89 with a mean of 7.74±1.23, and the participants were divided into a low GR group, a moderate GR group and a high GR group according to the GRS quartile. In the generalized linear model, the children with sleep disturbances and high GR had a higher risk of myopia than those without sleep disturbances and with low GR(OR=1.59, 95%CI: 1.12-2.25;OR=1.88, 95%CI: 1.23-2.88, respectively). Compared to those with low GR and SDs, children with high GR with or without SDs had a higher risk of myopia(OR=4.88, 95%CI: 2.03-11.71;OR=1.70, 95%CI: 1.06-2.72, respectively).CONCLUSION: The prevalence of sleep disturbances in elementary school students in Wenzhou was 26.07%. There is a significant interaction between sleep disturbances and a high GR of myopia, suggesting that a high GR of myopia may increase children’s sensitivity to sleep disturbances. This study indicates that children with a high GR of myopia need to achieve adequate sleep duration and excellent sleep quality.

Elementary school comprehensive intervention and myopia development:the Wenzhou Epidemiology of Refraction Error Study

AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 participatingelementary students(730 girls,47.9%)in grades 1 to3 from three campuses of one school,aged 7.3±0.9y,who were examined twice every year for a 2.5y follow upperiod.Comprehensive intervention and other reminderswere given at school every semester for the interventiongroup.The control group did not receive comprehensiveintervention and did not have reminders of it.RESULTS:There were 651 students in the interventiongroup[mean age 7.3±0.9y;294(45.2%)girls]and 737students in the control group[mean age 7.2±0.9y;346(46.9%)girls].Overall mean myopia progression duringthe 2.5y follow-up was-0.49±1.04 diopters(D)in theintervention group and-0.65±1.08 D in the control group(P=0.004).The majority that not get myopia at baselinespherical equivalent(SE≤-1.0 D).Their mean myopiaprogression during the 2.5y follow-up was-0.37±0.89 Din the intervention group and-0.51±0.93 D in the controlgroup(27.5%reduction,P=0.009);Overall,mean axiallength elongation was less in the intervention group(0.56±0.32 mm)than in the control group(0.61±0.38 mm,10.5%reduction,P=0.009).The percentage of close reading distance(<30 cm)in the intervention group was less than in the control group(73.4%vs 76.2%,P<0.001),the percentage of everyday perform eye exercises in the intervention group was more than in the control group(27.8%vs 20.7%,P<0.001)30mo later.CONCLUSION:The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up,especially for those non-myopia at baseline.

A mass-conserved multiphase lattice Boltzmann method based on high-order difference

The Z–S–C multiphase lattice Boltzmann model [Zheng, Shu, and Chew(ZSC), J. Comput. Phys. 218, 353(2006)]is favored due to its good stability, high efficiency, and large density ratio. However, in terms of mass conservation, this model is not satisfactory during the simulation computations. In this paper, a mass correction is introduced into the ZSC model to make up the mass leakage, while a high-order difference is used to calculate the gradient of the order parameter to improve the accuracy. To verify the improved model, several three-dimensional multiphase flow simulations are carried out,including a bubble in a stationary flow, the merging of two bubbles, and the bubble rising under buoyancy. The numerical simulations show that the results from the present model are in good agreement with those from previous experiments and simulations. The present model not only retains the good properties of the original ZSC model, but also achieves the mass conservation and higher accuracy.

Effects of baffie and intraocular pressure on aerosols generated in the noncontact tonometer measurement during COVID-19

AIM: To investigate the effects of baffle and intraocular pressure(IOP) on the aerosols generated in the noncontact tonometer(NCT) measurement and provide recommendations for the standardized use of the NCT during coronavirus disease 2019(COVID-19). METHODS: This clinical trial included 252 subjects(312 eyes) in The Eye Hospital, Wenzhou Medical University from March 7, 2020, to March 28, 2020. Sixty subjects(120 eyes) with normal IOP were divided into two groups. One group used an NCT without a baffle, another group used an NCT with a baffle. Another 192 subjects(192 eyes) were divided into four groups: Group A;(without a baffle+normal IOP), Group A;(without a baffle+high IOP), Group B;(with a baffle+normal IOP) and Group B;(with a baffle+high IOP). Particulate matter(PM) 2.5 and PM10 generated by all subjects were quantified during the NCT measurement. The IOP values were recorded simultaneously. Effects of baffle and IOP on aerosols generated during the NCT measurement were analyzed.RESULTS: In the normal eye group with a baffle, the aerosol density decreased in a wave-like shape near the NCT with the increase in the number of people measured for IOP, demonstrating no cumulative effect. However, in the normal eye group without a baffle, there was a cumulative effect. PM2.5 and PM10 in Group A;were higher than Group A;(both P<0.001). The PM2.5 and PM10 in Group B;were higher than Group B;(P<0.01, P<0.001 respectively). The PM10 of Group B;was lower than Group A;(P<0.01). PM2.5 in Group B;were lower than Group A;(P<0.01). The median of per capita PM2.5 and PM10 in the combined Group A;+A;were 0.80 and 1.10 μg/m;respectively, which were higher than 0.20 and 0.60 μg/m;in the combined Group B;+B;(both P<0.01). The median of per capita PM2.5 and PM10 in the combined Group A;+B;were 0.10 and 0.20 μg/m;respectively, which were lower than 1.30 and 1.70 μg/m;in the combined Group A;+B;(both P<0.001).CONCLUSION: More aerosols could be generated in patients with high IOP. After the NCT is equipped with a baffle, per capita aerosol density generated decreased significantly near the NCT;And with the increase in the number of people measured for IOP, the aerosols gradually dissipated near the NCT, demonstrating no cumulative effect. Therefore, it is suggested that the NCT should be equipped with a baffle, especially for patients with high IOP.

Effect of psychological intervention on healthrelated quality of life in people with systemic lupus erythematosus: A systematic review

Objective:To objectively evaluate the effectiveness of psychological interventions for improving health-related quality of life in patients with systemic lupus erythematosus(SLE).Design and review methods:Databases including Ovid-Medline,PubMed,Web of Science,EBSCOhost,the Cochrane Library and Embase were electronically searched to identify randomized controlled trials published from inception through November 2013 involving psychological intervention in SLE patients.Studies that measured physiological function,life vitality,depression,pain degree,disease activity,severity of fatigue,and physical and mental component summaries as outcomes were included.Trials involving patients with multiple diseases or received simultaneous psychological interventions or combinations of other interventions were excluded.Two independent investigators screened the identified articles,extracted the data,and assessed the methodological quality of the included studies.Qualitative descriptions were conducted and quantitative analysis was performed with RevMan software(version 5.2).Results:A total of six randomized controlled trials comprising 394 participants were included in the study.Meta-analyses showed that psychological interventions significantly reduced the degree of depression(standard mean difference=-0.44,95%confidence interval[CI]:-0.78-0.10;P=0.01]and improved the status of the physical health component summary(mean difference=8.85,95%CI:3.69-14.00;P=0.00]in SLE patients.However,there was no significant effect of psychological intervention on disease activity,degree of pain,fatigue or the mental health component summary.Conclusions:The results show that psychological interventions can effectively improve the health-related quality of life in patients with SLE.The full benefit and clinical performance of psychological care requires further investigation by a series of multicenter,large-sample size randomized controlled trails.

Malignant transformation of biliary adenofibroma combined with benign lymphadenopathy mimicking advanced liver carcinoma:A case report

BACKGROUND Biliary adenofibromas(BAFs)are rare primary hepatic neoplasms,some of which can potentially undergo malignant transformation.Here,we describe a rare case of malignant transformation of BAF.CASE SUMMARY A 51-year-old female was referred to our hospital with epigastric pain.Computed tomography showed a solitary liver mass combined with the enlargement of multiple mediastinal and cervical lymph nodes,clinically mimicking a liver carcinoma with extensive lymph node metastasis.However,core needle biopsy suggested BAF with malignant transformation.Finally,the patient underwent curative resection of the neoplasm and was recurrence-free for 12 mo.CONCLUSION Our case serves as an example of a rare manifestation of BAF.Our report and the previously published experience,reinforce that curative resection should be considered the primary treatment for BAFs with malignant transformation,leading to a favorable prognosis.

Clinical observation of epiphora as sequela of peripheral facial paralysis treated with pricking technique of fire needling therapy at Chengqi(承泣ST1)

Objective:To compare the clinical therapeutic effect on epiphora as sequela of peripheral facial paralysis treated with pricking technqiue of fire needling therapy at Chengqi(承泣ST1)and acupuncture treatment at conventional acupoints.Methods:From September 2018 through to October 2018,64 cases of epiphora as sequela of peripheral facial paralysis were collected from the Department of Acupuncture-Moxibustion in Suzhou TCM Hospital.According to random number table,they were divided into an observation group and a control group,32 cases in each one.In the observation group,pricking technique of fire needling therapy was used at ST1,once every two days.In the control group,acupuncture with filiform needle was applied to Jingming(睛明BL1),Taiyang(太阳EX-HN5),Tongziliao(瞳子髎GB1),Sibai(四白ST2)and Quanliao(颧髎SI18)on the affected side as well as Hegu(合谷LI4)on the contralateral side,once per day.The 10-day treatment was as one 1 course and the consecutive 3 courses of treatment were required in either of the groups.Before and after treatment,Munk grade,clinical effective rate and the number of treatments were observed in the evaluation of therapeutic effect.Results:After treatment,Munk grade was improved in the patients of the two groups(both P<0.05).The improvement range in the observation group was larger than that of the control group(P<0.05).The treatment in either group achieved the obviously therapeutic effect on epiphora as sequela of peripheral facial paralysis.The effective rate in the observation group was 90.32%,higher than 61.29%in the control group(P<0.05).The mean number of treatments of the curative case were 5.11 in the observation group and were 13.73 in the control group,indicating the statistical significance in difference(P<0.05).Conclusion:Pricking technique of fire needling therapy at ST1 achieves the better effect on epiphora as sequela of peripheral facial paralysis as compared with acupuncture at conventional acupoints.

Cytotoxicity and enhancement activity of essential oil from Zanthoxylum bungeanum Maxim.as a natural transdermal penetration enhancer

The aim of this present study is to investigate the effect of Zanthoxylum bungeanum oil （essential oil from Z. bungeanum Maxim.） on cytotoxicity and the transdermal permeation of 5-fluorouracil and indomethacin. The cy- totoxicity of Z. bungeanum oil on dermal fibroblasts and epidermal keratinocytes was studied using an MTT （3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide） assay. The rat skin was employed to determine the percutaneous penetration enhancement effect of Z. bungeanum oil on hydrophilic and lipophilic model drugs, i.e., 5-fluorouracil and indomethacin. The secondary structure changes of the rat stratum comeum （SC） were determined using attenuated total reflectance-Fourier transform infrared spectroscopy （ATR-FTIR）, and saturated solubilities and SC/vehicle partition coefficients of two model drugs with and without Z. bungeanum oil were also measured to un- derstand its related mechanisms of action. It was found that the half maximal inhibitory concentration （ICs0） values of Z. bungeanum oil were significantly lower in HaCaT and CCC-ESF-1 cell lines compared to the well-established and standard penetration enhancer Azone. The Z. bungeanum oil at various concentrations effectively facilitated the percutaneous penetration of two model drugs across the rat skin. In addition, the mechanisms of permeation en- hancement by Z. bungeanum oil could be explained with saturated solubility, SC/vehicle partition coefficient, and secondary structure changes of SC.

Essential oil from Zanthoxylum bungeanum Maxim. and its main components used as transdermal penetration enhancers: a comparative study

Our previous studies had confirmed that the essential oil from Zanthoxylum bungeanum Maxim. （Z. bungeanum oil） could effectively enhance the percutaneous permeation of drug molecules as a natural transdermal penetration enhancer. The aim of the present study is to investigate and compare the skin penetration enhancement effect of Z. bungeanum oil and its main components on traditional Chinese medicine （TCM） active components. Toxicities of Z. bungeanum oil and three selected terpene compounds （terpinen-4-ol, 1,8-cineole, and limonene） in epidermal keratinocytes （HaCaT） and dermal flbroblast （CCC-ESF-1） cell lines were measured using an MTT （3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide） assay. Five model drugs in TCM external preparations, namely osthole （OT）, tetramethylpyrazine （TMP）, ferulic acid （FA）, puerarin （PR）, and geniposide （GP）, which were selected based on their lipophilicity denoted by IogKo^w, were tested using in vitro permeation studies in which vertical Franz diffusion ceils and rat abdominal skin were employed. The secondary structure changes of skin stratum corneum （SC） and drug thermodynamic activities were investigated to understand their mechanisms of action using Fourier transform infrared （FTIR） spectroscopy and saturation solubility studies, respectively. It was found that Z. bungeanum oil showed lower toxicities in both HaCaT cells and CCC-ESF-1 cells compared with three terpene compounds used alone. The enhancement permeation capacities by all tested agents were in the following increasing order： terpinen-4-ol=1,8-cineole〈limonene〈Z, bungeanum oil. The mechanisms of permeation enhancement suggested that these enhancers promoted the skin permeation of drugs mainly by affecting SC lipids. These results indicated that Z. bungeanum oil exhibited better performance in enhancing the skin permeation of active components in TCM preparations.