BACKGROUND Previous studies have shown that patients with diabetes mellitus(DM) respond poorly to clopidogrel treatment.AIM To systematically evaluate the efficacy of clopidogrel for the treatment of acute coronary sy...BACKGROUND Previous studies have shown that patients with diabetes mellitus(DM) respond poorly to clopidogrel treatment.AIM To systematically evaluate the efficacy of clopidogrel for the treatment of acute coronary syndromes or ischemic stroke in patients with or without DM.METHODS Pub Med,the Cochrane Central Register of Controlled Trials,and EMBASE were searched from 1980 on 27 June 2019 to identify relevant randomized controlled trials that compared the effect of a combination of clopidogrel and aspirin with aspirin alone.A random-effects meta-analysis was used to estimate the hazard ratio(HR) and its 95% confidence interval(CI).Sensitivity analysis was performed using a fixed-effect model.The I2 statistic was used to evaluate the heterogeneity of the study data.RESULTS Six randomized controlled trials,comprising 43352 participants(13491 with and 29861 without DM) who had received antiplatelet therapy for≥3 mo,were included in the meta-analysis.Compared with aspirin alone,a combination of clopidogrel and aspirin significantly reduced the risk of any cardiovascular event in patients without DM(HR=0.78,95%CI:0.71–0.86,P<0.001;I2=23%,P=0.26).Clopidogrel plus aspirin also significantly reduced cardiovascular risk in patients with DM,although the effect was smaller(HR=0.89,95%CI:0.81–0.99,P=0.030;I2=0%,P=0.74).Nevertheless,there was no significant difference in the efficacy of clopidogrel at reducing the risk of cardiovascular events in patients with DM vs those without(P for interaction=0.062).CONCLUSION Thus,the present study shows that the addition of clopidogrel to aspirin significantly lowers cardiovascular risk in patients with or without DM who have experienced ischemic cardiovascular disease.The beneficial effect of the addition of clopidogrel to aspirin for patients with DM was lower than that in patients without DM,although the modifying effect of DM did not reach significance.展开更多
An optical length measuring system base on all-fiber optic interferometer is proposed. The theoretical analysis indicates that, when the two branches of the interferometer are equal, the output have the maximum cohere...An optical length measuring system base on all-fiber optic interferometer is proposed. The theoretical analysis indicates that, when the two branches of the interferometer are equal, the output have the maximum coherent intensity. Therefore, the optical length can be obtained by measuring the distance of collimator movement. Through the experiment and simulation, the impact of the signal-to-noise ratio and fluctuation of the coupling efficiency on null error has been obtained.展开更多
The solar grating spectrometer is an essential tool to study the thermodynamics properties of the solar atmosphere with different height distributions, but its imaging performance will be degraded by the wavefront abe...The solar grating spectrometer is an essential tool to study the thermodynamics properties of the solar atmosphere with different height distributions, but its imaging performance will be degraded by the wavefront aberration generalized by the atmospheric turbulence. On the other hand, the narrow slit of the grating spectrometer will filter the wavefront aberration to some extent. The influence of the filter slit on the wavefront aberration and the correction requirement of the adaptive optics are analyzed theoretically and experimentally. We demonstrate that the influence of filter slit on the different types and magnitudes of wavefront aberration is different, and the RMS value of the wavefront aberration less than 0.3λ is down to below almost 60% after the filter slit, and it can lower the correction range requirement of the adaptive optics. The numerical simulation and experiment results show that: after the adaptive optics correction, the influence of the wavefront aberration on the spectral resolution is neglected, and the energy utilization is considerably improved;both numerical simulation and experiment results are in good agreement.展开更多
Usually, electromagnetic evanescent waves are some kinds of near fields. However, it looks as if the evanescent waves inside a cut-off waveguide had nothing to do with any near field. In this paper, we will show that ...Usually, electromagnetic evanescent waves are some kinds of near fields. However, it looks as if the evanescent waves inside a cut-off waveguide had nothing to do with any near field. In this paper, we will show that the evanescent waves inside a cut-off waveguide can also be regarded as the near fields of an aerial array.展开更多
Hand,foot and mouth disease(HFMD)is a major public health problem among children in the Asia-Pacific region.The optimal specimen for HFMD virological diagnosis remains unclear.Enterovirus A71(EV-A71)neutralizing antib...Hand,foot and mouth disease(HFMD)is a major public health problem among children in the Asia-Pacific region.The optimal specimen for HFMD virological diagnosis remains unclear.Enterovirus A71(EV-A71)neutralizing antibody titres detected in paired sera were considered the reference standard for calculating the sensitivity,specificity,positive and negative predictive value of throat swabs,rectal swabs,stool,blood samples and cerebrospinal fluid(CSF)by RT-PCR or ELISA assay.In this study,clinical samples from 276 HFMD patients were collected for analysing the sensitivity of different kind of specimens.Our results showed that stool had the highest sensitivity(88%,95%CI:74%–96%)and agreement with the reference standard(91%).The order of diagnostic yield for EV-A71 infection was stool samplerectal swab>throat swab>blood sample>CSF sample,and using a combination of clinical samples improved sensitivity for enterovirus detection.The sensitivity of ELISA for IgM antibody detection in sterile-site specimens was significantly higher than that of RT-PCR(serum/plasma:62%vs.2%,CSF:47%vs.0%)(P<0.002).In conclusion,our results suggest that stool has the highest diagnostic yield for EV-A71-infected HFMD.If stool is unavailable,rectal swabs can be collected to achieve a similar diagnostic yield.Otherwise,throat swabs may be useful in detecting positive samples.Although IgM in blood or CSF is diagnostically accurate,it lacks sensitivity,missing 40%–50%of cases.The higher proportion of severe cases and shorter interval between onset and sampling contributed to the increase in congruency between clinical testing and the serological reference standard.展开更多
Objective:To observe the clinical therapeutic effect of adjuvant treatment with heat-sensitive moxibustion for coronavirus disease 2019(COVID-19)of the ordinary type.Methods:A total of 42 patients with COVID-19 of the...Objective:To observe the clinical therapeutic effect of adjuvant treatment with heat-sensitive moxibustion for coronavirus disease 2019(COVID-19)of the ordinary type.Methods:A total of 42 patients with COVID-19 of the ordinary type were adopted.Shenque(神阙CV8)and Tianshu(天枢ST25)were selected.Heat-sensitive moxibustion was operated according to the required standard,40 min to 60 min each time,once daily.Before and after moxibustion,the improvements in clinical symptoms were evaluated,such as chest oppression,poor appetite,lassitude and negative emotions.Results:(1)The number of cases and the incidence was 21 cases(50.0%),24 cases(57.1%)and 26 cases(61.9%)for chest oppression,poor appetite and lassitude before heat-sensitive moxibustion.The number of cases was reduced to be 10 cases(23.8%),7 cases(16.7%)and 4 cases(9.5%)after the 1 st treatment of heat-sensitive moxibustion for chest oppression,poor appetite,and lassitude.It was reduced to be 11 cases(26.2%),8 cases(19.0%)and 4 cases(9.5%)after the 2 nd treatment of moxibustion and it was reduced to be 18 cases(42.9%),10 cases(23.8%)and 6 cases(14.3%)after the 3 rd treatment of moxibustion.The incidences of the symptoms were all reduced obviously as compared with those before treatment.(2)Before treatment with heat-sensitive moxibustion,there were 24 cases of negative emotions(57.1%).It was reduced to be 16 cases(38.1%),11 cases(26.2%)and 3 cases(7.1%)after the 1 st,2 nd and 3 rd treatment of heat-sensitive moxibustion successively.The incidences were all reduced obviously as compared with those before treatment.(3)After the 1 st treatment,the active acceptance rate of heat-sensitive moxibustion was 100%(42/42)in the patients,higher than 11.9%(5/42)before treatment.Conclusion:Adjuvant treatment with heat-sensitive moxibustion effectively relieves the symptoms of COVID-19 such as chest oppression,poor appetite and lassitude,and alleviates the negative emotions,such as tension and anxiety.This therapy improves the therapeutic effect of COVID-19 and deserves to be promoted in clinical practice.展开更多
Objective:To determine whether pretreatment moxibustion prevents asthma by down-regulating the lung RhoA/ROCK pathway in rats with bronchial asthma and benignly mediating the lung inflammatory response.Methods:Twenty ...Objective:To determine whether pretreatment moxibustion prevents asthma by down-regulating the lung RhoA/ROCK pathway in rats with bronchial asthma and benignly mediating the lung inflammatory response.Methods:Twenty Sprague Dawley(SD)rats were randomly divided into normal control group(C),asthma model group(M),suspended moxibustion 40 min+asthma group(SM40),and suspended moxibustion 10 min+asthma group(SM10).Ovalbumin was used as a sensitizer.The two moxibustion groups completed moxibustion treatment lasted 40 min or 10 min respectively 30 min before modeling onset,and was repeated five times in each modeling cycle,for a total of 15 times.Samples were harvested on day 30.Results:Lung impairment was significant in the M group,whereas pretreatment with SM10 and SM40 dramatically attenuated the injury.After modeling,mRNA expression of RhoA and ROCK2 in the lung tissue was significantly higher than that in C group(both P<0.001),resulting in significant increase in protein levels of IL-17 A(P<0.001).Significant decrease in RhoA and ROCK2 mRNA expression was seen in the SM10(P<0.001,P<0.01)and SM40(both P<0.001)groups compared to that with M rats.The differential trend in the SM40 group was more evident than that in the SM10 group.Regarding IL-10 or IL-17 A protein concentration,an upregulation or down-regulation was observed in both SM10(P<0.05,P<0.01)and SM40 groups(both P<0.001)compared to that with the M group.Conclusions:Moxibustion pretreatment significantly prevented pulmonary inflammation in asthmatic rats,potentially via inhibition of the RhoA/ROCK pathway.The efficacty of moxibustion appeared to be significantly associated with the duration of intervention with moxibustion.展开更多
Background: There is no absolute consensus for the best time for triggering. The aim of this study was to investigate the effect of different proportion of dominant follicles (PDF) on the human chorionic gonadotropin ...Background: There is no absolute consensus for the best time for triggering. The aim of this study was to investigate the effect of different proportion of dominant follicles (PDF) on the human chorionic gonadotropin (HCG) day for the clinical outcomes in patients with polycystic ovary syndrome (PCOS) of different ovarian stimulation protocols. Methods: A total of 371 cycles of the gonadotropin-releasing hormone (GnRH) agonist long protocol and 347 cycles of GnRH antagonist protocol from January 2014 to December 2016 were included in this retrospective study. Based on the PDF on the day of the HCG administration, the included patients were divided into three groups: Group A (low PDF), PDF <20%;Group B (medium PDF), 20%≤ PDF ≤40%;Group C (high PDF), PDF >40%. The measurements regarding ovarian stimulation characteristics, fertilization rate, top quality embryo rate, clinical pregnancy rate, and ovarian hyperstimualtion syndrome (OHSS) rate were compared in different PDF groups with different protocols. Results: In both the GnRH antagonist protocol and GnRH agonist long protocol, the characteristics such as mean age, anti-Mullerian hormone, antral follicle count (AFC), and body mass index were comparable between groups. The number of oocytes retrieved decreased statistically significantly as the PDF and rate of matured oocytes increased. In the GnRH agonist long protocol, the rate of normally fertilized oocytes was highest in Group A (59.74 ± 31.21 vs. 49.70 ± 37.95, 49.67 ± 36.62;F = 3.743, P = 0.025). There were no significant differences in the rate of top-quality embryos and the clinical pregnancy rate between the groups. The clinical pregnancy rate was similar in the three groups (63.6%, 62.5%, 67.5%, respectively,χ2 = 0.989, P = 0.911). The moderate and severe OHSS rate increased statistically significantly when the PDF increased, which was highest in group C (1.4%, 3.1%, 6.7%, respectively,χ2 = 12.014, P = 0.017). In the GnRH antagonist protocol, there were no significant differences in the rate of top-quality embryos, the rate of normally fertilized oocytes, the clinical pregnancy rate, and the moderate and severe OHSS rate between the groups. The clinical pregnancy rate in Group C was higher than that in Group A (57.9% vs. 46.6%,χ2 = 10.850, P = 0.093). Conclusions: In the GnRH antagonist protocol, PDF on the HCG day of less than 20% may be unfavorable to the clinical pregnancy rate in PCOS. In the GnRH agonist long protocol, delaying the HCG trigger timing has no good effect on clinical pregnancy and the risk of OHSS might increase in patients with PCOS.展开更多
Enteroviruses(EVs)species A are a major public health issue in the Asia–Pacific region and cause frequent epidemics of hand,foot and mouth disease(HFMD)in China.Mild infections are common in children;however,HFMD can...Enteroviruses(EVs)species A are a major public health issue in the Asia–Pacific region and cause frequent epidemics of hand,foot and mouth disease(HFMD)in China.Mild infections are common in children;however,HFMD can also cause severe illness that affects the central nervous system.To molecularly characterize EVs,a prospective HFMD virological surveillance program was performed in China between 2013 and 2016.Throat swabs,rectal swabs and stool samples were collected from suspected HFMD patients at participating hospitals.EVs were detected using generic real-time and nested reverse transcription-polymerase chain reactions(RT-PCRs).Then,the complete VP1 regions of enterovirus A71(EV-A71),coxsackievirus A16(CVA16)and CVA6 were sequenced to analyze amino acid changes and construct a viral molecular phylogeny.Of the 2836 enrolled HFMD patients,2,517(89%)were EV positive.The most frequently detected EVs were CVA16(32.5%,819),CVA6(31.2%,785),and EV-A71(20.4%,514).The subgenogroups CVA16B1 b,CVA6D3 a and EV-A71C4 a were predominant in China and recombination was not observed in the VP1 region.Sequence analysis revealed amino acid variations at the 30,29 and 44 positions in the VP1 region of EV-A71,CVA16 and CVA6(compared to the respective prototype strains Br Cr,G10 and Gdula),respectively.Furthermore,in 21 of 24(87.5%)identified EV-A71 samples,a known amino acid substitution(D31 N)that may enhance neurovirulence was detected.Our study provides insights about the genetic characteristics of common HFMD-associated EVs.However,the emergence and virulence of the described mutations require further investigation.展开更多
Background:Few studies have investigated the effects of blood glucose(BG)on cognitive function in communitydwelling elderly individuals carrying the apolipoprotein E(APOE)ε3 allele.Objective:To explore the effect of ...Background:Few studies have investigated the effects of blood glucose(BG)on cognitive function in communitydwelling elderly individuals carrying the apolipoprotein E(APOE)ε3 allele.Objective:To explore the effect of high BG levels on cognitive function in APOEε3-carrying,non-demented,community-dwelling older adults,as compared to their counterparts carrying the APOEε4 or APOEε2 alleles.Methods:Within the China Longitudinal Ageing Study,we recruited 282 elderly adults without dementia.Data collected included demographic information;psychological measures;laboratory test results,including BG and plasma lipid levels;and APOE genotypes.We divided the participants into APOEε2(ε2/ε2,ε2/ε3),ε3(ε3/ε3),andε4(ε3/ε4,ε4/ε4)groups.Partial correlation analyses and multivariate linear regression analyses were utilized to compare the cognitive function and laboratory data between the APOE groups.White matter hyperintensity(WMH)was measured on magnetic resonance images in 77 participants.Results:With adjustment for age,sex,education,and diabetes,higher BG in non-demented community-dwelling older adults was associated with cognitive decline in immediate memory and executive function.In the APOEε3 group,elevated BG was associated with cognitive decline in immediate memory,executive function,and perceptual reasoning.In the APOEε4 group,higher BG was also correlated with a decline in abstract reasoning.There was a trend for association between higher BG and more severe WMHs.Conclusion:Worse cognitive function was correlated withApoEε3/ε3 genotype carriers with higher BG in community-dwelling older adults.展开更多
Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescripti...Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescription preferences for treating patients with AD.Methods:This study surveyed neurologists,psychiatrists,and general physicians(GPs)in Shanghai who had outpatients with AD,using a questionnaire asking about their prescription preferences for these patients.Results:Among the 148 clinicians in the study,26.4%were psychiatrists,44.6%were neurologists,and 29.1%were GPs.The groups did not differ significantly in age,gender,or their monthly cases of new patients with mild or moderate AD(P>0.05).Most clinicians prescribed Cholinesterase inhibitors(ChEIs),including Huperzine A,but there were significant group-differences in prescribing specific ChEIs(P<0.05).The daily dosages of ChEI and Memantine prescribed by all three groups were small(P>0.05),and all three groups prescribed piracetam,ergot,and ginkgo biloba drugs.All three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics,although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs(P<0.05).Conclusion:Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD.A relatively high proportion also prescribed cognitive enhancers,which lack evidence-based support of their use,and antipsychotics.There is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.展开更多
Treatment of unprotected left main coronary artery(ULMCA)disease with coronary artery bypass grafting(CABG)or percutaneous coronary intervention(PCI)has developed rapidly during the past decades.The optimal revascular...Treatment of unprotected left main coronary artery(ULMCA)disease with coronary artery bypass grafting(CABG)or percutaneous coronary intervention(PCI)has developed rapidly during the past decades.The optimal revascularization strategy has been a subject of debate,with several randomized controlled trials and metaanalyses comparing outcomes of CABG and PCI.展开更多
基金Supported by the National Natural Science Foundation of China,No.81974490Fundamental Research Funds for the Central Universities of China,No.BMU2017YJ005。
文摘BACKGROUND Previous studies have shown that patients with diabetes mellitus(DM) respond poorly to clopidogrel treatment.AIM To systematically evaluate the efficacy of clopidogrel for the treatment of acute coronary syndromes or ischemic stroke in patients with or without DM.METHODS Pub Med,the Cochrane Central Register of Controlled Trials,and EMBASE were searched from 1980 on 27 June 2019 to identify relevant randomized controlled trials that compared the effect of a combination of clopidogrel and aspirin with aspirin alone.A random-effects meta-analysis was used to estimate the hazard ratio(HR) and its 95% confidence interval(CI).Sensitivity analysis was performed using a fixed-effect model.The I2 statistic was used to evaluate the heterogeneity of the study data.RESULTS Six randomized controlled trials,comprising 43352 participants(13491 with and 29861 without DM) who had received antiplatelet therapy for≥3 mo,were included in the meta-analysis.Compared with aspirin alone,a combination of clopidogrel and aspirin significantly reduced the risk of any cardiovascular event in patients without DM(HR=0.78,95%CI:0.71–0.86,P<0.001;I2=23%,P=0.26).Clopidogrel plus aspirin also significantly reduced cardiovascular risk in patients with DM,although the effect was smaller(HR=0.89,95%CI:0.81–0.99,P=0.030;I2=0%,P=0.74).Nevertheless,there was no significant difference in the efficacy of clopidogrel at reducing the risk of cardiovascular events in patients with DM vs those without(P for interaction=0.062).CONCLUSION Thus,the present study shows that the addition of clopidogrel to aspirin significantly lowers cardiovascular risk in patients with or without DM who have experienced ischemic cardiovascular disease.The beneficial effect of the addition of clopidogrel to aspirin for patients with DM was lower than that in patients without DM,although the modifying effect of DM did not reach significance.
基金financially supported by Shanghai Clinical Center for Mental Disorders(2014)the Medical Guidance Program of Shanghai Science and Technology Committee(No.15411961400)
基金supported by the Fundamental Research Funds for the Central Universities under Grant No.E022050205
文摘An optical length measuring system base on all-fiber optic interferometer is proposed. The theoretical analysis indicates that, when the two branches of the interferometer are equal, the output have the maximum coherent intensity. Therefore, the optical length can be obtained by measuring the distance of collimator movement. Through the experiment and simulation, the impact of the signal-to-noise ratio and fluctuation of the coupling efficiency on null error has been obtained.
文摘The solar grating spectrometer is an essential tool to study the thermodynamics properties of the solar atmosphere with different height distributions, but its imaging performance will be degraded by the wavefront aberration generalized by the atmospheric turbulence. On the other hand, the narrow slit of the grating spectrometer will filter the wavefront aberration to some extent. The influence of the filter slit on the wavefront aberration and the correction requirement of the adaptive optics are analyzed theoretically and experimentally. We demonstrate that the influence of filter slit on the different types and magnitudes of wavefront aberration is different, and the RMS value of the wavefront aberration less than 0.3λ is down to below almost 60% after the filter slit, and it can lower the correction range requirement of the adaptive optics. The numerical simulation and experiment results show that: after the adaptive optics correction, the influence of the wavefront aberration on the spectral resolution is neglected, and the energy utilization is considerably improved;both numerical simulation and experiment results are in good agreement.
文摘Usually, electromagnetic evanescent waves are some kinds of near fields. However, it looks as if the evanescent waves inside a cut-off waveguide had nothing to do with any near field. In this paper, we will show that the evanescent waves inside a cut-off waveguide can also be regarded as the near fields of an aerial array.
基金supported by the National Natural Science Fund for Distinguished Young Scholars of China(No.81525023)in whole or in part,by a Wellcome Trust fellowship awarded to LT[205228/Z/16/Z]supported by the National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections(grant no.NIHR200907)at University of Liverpool in partnership with Public Health England(PHE),in collaboration with Liverpool School of Tropical Medicine and the University of Oxford.LT is based at the University of Liverpool.
文摘Hand,foot and mouth disease(HFMD)is a major public health problem among children in the Asia-Pacific region.The optimal specimen for HFMD virological diagnosis remains unclear.Enterovirus A71(EV-A71)neutralizing antibody titres detected in paired sera were considered the reference standard for calculating the sensitivity,specificity,positive and negative predictive value of throat swabs,rectal swabs,stool,blood samples and cerebrospinal fluid(CSF)by RT-PCR or ELISA assay.In this study,clinical samples from 276 HFMD patients were collected for analysing the sensitivity of different kind of specimens.Our results showed that stool had the highest sensitivity(88%,95%CI:74%–96%)and agreement with the reference standard(91%).The order of diagnostic yield for EV-A71 infection was stool samplerectal swab>throat swab>blood sample>CSF sample,and using a combination of clinical samples improved sensitivity for enterovirus detection.The sensitivity of ELISA for IgM antibody detection in sterile-site specimens was significantly higher than that of RT-PCR(serum/plasma:62%vs.2%,CSF:47%vs.0%)(P<0.002).In conclusion,our results suggest that stool has the highest diagnostic yield for EV-A71-infected HFMD.If stool is unavailable,rectal swabs can be collected to achieve a similar diagnostic yield.Otherwise,throat swabs may be useful in detecting positive samples.Although IgM in blood or CSF is diagnostically accurate,it lacks sensitivity,missing 40%–50%of cases.The higher proportion of severe cases and shorter interval between onset and sampling contributed to the increase in congruency between clinical testing and the serological reference standard.
基金Key Research and Development Project of Traditional Chinese Medicine in Jiangxi Province:2020J007。
文摘Objective:To observe the clinical therapeutic effect of adjuvant treatment with heat-sensitive moxibustion for coronavirus disease 2019(COVID-19)of the ordinary type.Methods:A total of 42 patients with COVID-19 of the ordinary type were adopted.Shenque(神阙CV8)and Tianshu(天枢ST25)were selected.Heat-sensitive moxibustion was operated according to the required standard,40 min to 60 min each time,once daily.Before and after moxibustion,the improvements in clinical symptoms were evaluated,such as chest oppression,poor appetite,lassitude and negative emotions.Results:(1)The number of cases and the incidence was 21 cases(50.0%),24 cases(57.1%)and 26 cases(61.9%)for chest oppression,poor appetite and lassitude before heat-sensitive moxibustion.The number of cases was reduced to be 10 cases(23.8%),7 cases(16.7%)and 4 cases(9.5%)after the 1 st treatment of heat-sensitive moxibustion for chest oppression,poor appetite,and lassitude.It was reduced to be 11 cases(26.2%),8 cases(19.0%)and 4 cases(9.5%)after the 2 nd treatment of moxibustion and it was reduced to be 18 cases(42.9%),10 cases(23.8%)and 6 cases(14.3%)after the 3 rd treatment of moxibustion.The incidences of the symptoms were all reduced obviously as compared with those before treatment.(2)Before treatment with heat-sensitive moxibustion,there were 24 cases of negative emotions(57.1%).It was reduced to be 16 cases(38.1%),11 cases(26.2%)and 3 cases(7.1%)after the 1 st,2 nd and 3 rd treatment of heat-sensitive moxibustion successively.The incidences were all reduced obviously as compared with those before treatment.(3)After the 1 st treatment,the active acceptance rate of heat-sensitive moxibustion was 100%(42/42)in the patients,higher than 11.9%(5/42)before treatment.Conclusion:Adjuvant treatment with heat-sensitive moxibustion effectively relieves the symptoms of COVID-19 such as chest oppression,poor appetite and lassitude,and alleviates the negative emotions,such as tension and anxiety.This therapy improves the therapeutic effect of COVID-19 and deserves to be promoted in clinical practice.
基金Supported by National Natural Science Foundation of China:82060893Health Commission of Jiangxi Province:2021A384。
文摘Objective:To determine whether pretreatment moxibustion prevents asthma by down-regulating the lung RhoA/ROCK pathway in rats with bronchial asthma and benignly mediating the lung inflammatory response.Methods:Twenty Sprague Dawley(SD)rats were randomly divided into normal control group(C),asthma model group(M),suspended moxibustion 40 min+asthma group(SM40),and suspended moxibustion 10 min+asthma group(SM10).Ovalbumin was used as a sensitizer.The two moxibustion groups completed moxibustion treatment lasted 40 min or 10 min respectively 30 min before modeling onset,and was repeated five times in each modeling cycle,for a total of 15 times.Samples were harvested on day 30.Results:Lung impairment was significant in the M group,whereas pretreatment with SM10 and SM40 dramatically attenuated the injury.After modeling,mRNA expression of RhoA and ROCK2 in the lung tissue was significantly higher than that in C group(both P<0.001),resulting in significant increase in protein levels of IL-17 A(P<0.001).Significant decrease in RhoA and ROCK2 mRNA expression was seen in the SM10(P<0.001,P<0.01)and SM40(both P<0.001)groups compared to that with M rats.The differential trend in the SM40 group was more evident than that in the SM10 group.Regarding IL-10 or IL-17 A protein concentration,an upregulation or down-regulation was observed in both SM10(P<0.05,P<0.01)and SM40 groups(both P<0.001)compared to that with the M group.Conclusions:Moxibustion pretreatment significantly prevented pulmonary inflammation in asthmatic rats,potentially via inhibition of the RhoA/ROCK pathway.The efficacty of moxibustion appeared to be significantly associated with the duration of intervention with moxibustion.
文摘Background: There is no absolute consensus for the best time for triggering. The aim of this study was to investigate the effect of different proportion of dominant follicles (PDF) on the human chorionic gonadotropin (HCG) day for the clinical outcomes in patients with polycystic ovary syndrome (PCOS) of different ovarian stimulation protocols. Methods: A total of 371 cycles of the gonadotropin-releasing hormone (GnRH) agonist long protocol and 347 cycles of GnRH antagonist protocol from January 2014 to December 2016 were included in this retrospective study. Based on the PDF on the day of the HCG administration, the included patients were divided into three groups: Group A (low PDF), PDF <20%;Group B (medium PDF), 20%≤ PDF ≤40%;Group C (high PDF), PDF >40%. The measurements regarding ovarian stimulation characteristics, fertilization rate, top quality embryo rate, clinical pregnancy rate, and ovarian hyperstimualtion syndrome (OHSS) rate were compared in different PDF groups with different protocols. Results: In both the GnRH antagonist protocol and GnRH agonist long protocol, the characteristics such as mean age, anti-Mullerian hormone, antral follicle count (AFC), and body mass index were comparable between groups. The number of oocytes retrieved decreased statistically significantly as the PDF and rate of matured oocytes increased. In the GnRH agonist long protocol, the rate of normally fertilized oocytes was highest in Group A (59.74 ± 31.21 vs. 49.70 ± 37.95, 49.67 ± 36.62;F = 3.743, P = 0.025). There were no significant differences in the rate of top-quality embryos and the clinical pregnancy rate between the groups. The clinical pregnancy rate was similar in the three groups (63.6%, 62.5%, 67.5%, respectively,χ2 = 0.989, P = 0.911). The moderate and severe OHSS rate increased statistically significantly when the PDF increased, which was highest in group C (1.4%, 3.1%, 6.7%, respectively,χ2 = 12.014, P = 0.017). In the GnRH antagonist protocol, there were no significant differences in the rate of top-quality embryos, the rate of normally fertilized oocytes, the clinical pregnancy rate, and the moderate and severe OHSS rate between the groups. The clinical pregnancy rate in Group C was higher than that in Group A (57.9% vs. 46.6%,χ2 = 10.850, P = 0.093). Conclusions: In the GnRH antagonist protocol, PDF on the HCG day of less than 20% may be unfavorable to the clinical pregnancy rate in PCOS. In the GnRH agonist long protocol, delaying the HCG trigger timing has no good effect on clinical pregnancy and the risk of OHSS might increase in patients with PCOS.
基金supported by the National Science and Technology Major Project of China(No.2018ZX10201001-010,No.2017ZX10103009-005,No.2018ZX10713001-007)the National Natural Science Fund for Distinguished Young Scholars of China(No.81525023)+4 种基金the National Natural Science Foundation of China(No.81473031)the Program of Shanghai Academic/Technology Research Leader(No.18XD1400300)the Li Ka Shing Oxford Global Health Programme(No.B9RST00-B900.57)the Chinese Preventive Medicine Association(No:20101801)supported by CAS Pioneer Hundred Talents Program
文摘Enteroviruses(EVs)species A are a major public health issue in the Asia–Pacific region and cause frequent epidemics of hand,foot and mouth disease(HFMD)in China.Mild infections are common in children;however,HFMD can also cause severe illness that affects the central nervous system.To molecularly characterize EVs,a prospective HFMD virological surveillance program was performed in China between 2013 and 2016.Throat swabs,rectal swabs and stool samples were collected from suspected HFMD patients at participating hospitals.EVs were detected using generic real-time and nested reverse transcription-polymerase chain reactions(RT-PCRs).Then,the complete VP1 regions of enterovirus A71(EV-A71),coxsackievirus A16(CVA16)and CVA6 were sequenced to analyze amino acid changes and construct a viral molecular phylogeny.Of the 2836 enrolled HFMD patients,2,517(89%)were EV positive.The most frequently detected EVs were CVA16(32.5%,819),CVA6(31.2%,785),and EV-A71(20.4%,514).The subgenogroups CVA16B1 b,CVA6D3 a and EV-A71C4 a were predominant in China and recombination was not observed in the VP1 region.Sequence analysis revealed amino acid variations at the 30,29 and 44 positions in the VP1 region of EV-A71,CVA16 and CVA6(compared to the respective prototype strains Br Cr,G10 and Gdula),respectively.Furthermore,in 21 of 24(87.5%)identified EV-A71 samples,a known amino acid substitution(D31 N)that may enhance neurovirulence was detected.Our study provides insights about the genetic characteristics of common HFMD-associated EVs.However,the emergence and virulence of the described mutations require further investigation.
基金This work was supported by grants from the National Key R&D Program of China(No.2017YFC1310500)National Natural Science Foundation of China(No.81671402)the Shanghai Science&Technology Committee(No.15411961400).
文摘Background:Few studies have investigated the effects of blood glucose(BG)on cognitive function in communitydwelling elderly individuals carrying the apolipoprotein E(APOE)ε3 allele.Objective:To explore the effect of high BG levels on cognitive function in APOEε3-carrying,non-demented,community-dwelling older adults,as compared to their counterparts carrying the APOEε4 or APOEε2 alleles.Methods:Within the China Longitudinal Ageing Study,we recruited 282 elderly adults without dementia.Data collected included demographic information;psychological measures;laboratory test results,including BG and plasma lipid levels;and APOE genotypes.We divided the participants into APOEε2(ε2/ε2,ε2/ε3),ε3(ε3/ε3),andε4(ε3/ε4,ε4/ε4)groups.Partial correlation analyses and multivariate linear regression analyses were utilized to compare the cognitive function and laboratory data between the APOE groups.White matter hyperintensity(WMH)was measured on magnetic resonance images in 77 participants.Results:With adjustment for age,sex,education,and diabetes,higher BG in non-demented community-dwelling older adults was associated with cognitive decline in immediate memory and executive function.In the APOEε3 group,elevated BG was associated with cognitive decline in immediate memory,executive function,and perceptual reasoning.In the APOEε4 group,higher BG was also correlated with a decline in abstract reasoning.There was a trend for association between higher BG and more severe WMHs.Conclusion:Worse cognitive function was correlated withApoEε3/ε3 genotype carriers with higher BG in community-dwelling older adults.
基金This study was supported by grants for National Key Clinical Disciplines to the Shanghai Mental Health Center(Office of Medical Affairs,Ministry of Health,2011–873,OMA-MH,2011–873)the Shanghai Clinical Center for Mental Disorders(2014),Shanghai Science&Technology Committee(No.15411961400).
文摘Background:China has more cases of Alzheimer’s disease(AD)than any other country in the world.As training to recognize and manage dementia is in its early stage,it is important to study clinicians’current prescription preferences for treating patients with AD.Methods:This study surveyed neurologists,psychiatrists,and general physicians(GPs)in Shanghai who had outpatients with AD,using a questionnaire asking about their prescription preferences for these patients.Results:Among the 148 clinicians in the study,26.4%were psychiatrists,44.6%were neurologists,and 29.1%were GPs.The groups did not differ significantly in age,gender,or their monthly cases of new patients with mild or moderate AD(P>0.05).Most clinicians prescribed Cholinesterase inhibitors(ChEIs),including Huperzine A,but there were significant group-differences in prescribing specific ChEIs(P<0.05).The daily dosages of ChEI and Memantine prescribed by all three groups were small(P>0.05),and all three groups prescribed piracetam,ergot,and ginkgo biloba drugs.All three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics,although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs(P<0.05).Conclusion:Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD.A relatively high proportion also prescribed cognitive enhancers,which lack evidence-based support of their use,and antipsychotics.There is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.
文摘Treatment of unprotected left main coronary artery(ULMCA)disease with coronary artery bypass grafting(CABG)or percutaneous coronary intervention(PCI)has developed rapidly during the past decades.The optimal revascularization strategy has been a subject of debate,with several randomized controlled trials and metaanalyses comparing outcomes of CABG and PCI.