BACKGROUND Mesenchymal stem cells(MSCs)as living biopharmaceuticals with unique properties,i.e.,stemness,viability,phenotypes,paracrine activity,etc.,need to be administered such that they reach the target site,mainta...BACKGROUND Mesenchymal stem cells(MSCs)as living biopharmaceuticals with unique properties,i.e.,stemness,viability,phenotypes,paracrine activity,etc.,need to be administered such that they reach the target site,maintaining these properties unchanged and are retained at the injury site to participate in the repair process.Route of delivery(RoD)remains one of the critical determinants of safety and efficacy.This study elucidates the safety and effectiveness of different RoDs of MSC treatment in heart failure(HF)based on phase II randomized clinical trials(RCTs).We hypothesize that the RoD modulates the safety and efficacy of MSCbased therapy and determines the outcome of the intervention.AIM To investigate the effect of RoD of MSCs on safety and efficacy in HF patients.METHODS RCTs were retrieved from six databases.Safety endpoints included mortality and serious adverse events(SAEs),while efficacy outcomes encompassed changes in left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),and pro-B-type natriuretic peptide(pro-BNP).Subgroup analyses on RoD were performed for all study endpoints.RESULTS Twelve RCTs were included.Overall,MSC therapy demonstrated a significant decrease in mortality[relative risk(RR):0.55,95%confidence interval(95%CI):0.33-0.92,P=0.02]compared to control,while SAE outcomes showed no significant difference(RR:0.84,95%CI:0.66-1.05,P=0.11).RoD subgroup analysis revealed a significant difference in SAE among the transendocardial(TESI)injection subgroup(RR=0.71,95%CI:0.54-0.95,P=0.04).The pooled weighted mean difference(WMD)demonstrated an overall significant improvement of LVEF by 2.44%(WMD:2.44%,95%CI:0.80-4.29,P value≤0.001),with only intracoronary(IC)subgroup showing significant improvement(WMD:7.26%,95%CI:5.61-8.92,P≤0.001).Furthermore,the IC delivery route significantly improved 6MWD by 115 m(WMD=114.99 m,95%CI:91.48-138.50),respectively.In biochemical efficacy outcomes,only the IC subgroup showed a significant reduction in pro-BNP by-860.64 pg/mL(WMD:-860.64 pg/Ml,95%CI:-944.02 to-777.26,P=0.001).CONCLUSION Our study concluded that all delivery methods of MSC-based therapy are safe.Despite the overall benefits in efficacy,the TESI and IC routes provided better outcomes than other methods.Larger-scale trials are warranted before implementing MSC-based therapy in routine clinical practice.展开更多
Objective: To summarize the common constitutional types in patients with gallstone disease and analyze influencing factors. Research Hypothesis: Qi stagnation constitution may be a potential predisposing constitution ...Objective: To summarize the common constitutional types in patients with gallstone disease and analyze influencing factors. Research Hypothesis: Qi stagnation constitution may be a potential predisposing constitution for gallstone disease, whereas the Balanced Constitution and Yin deficiency constitution have a lower tendency towards the development of the disease;gallstone disease is more prevalent among young men engaged in mental labor. Methods: A retrospective study was conducted on 180 patients with gallstone disease who were hospitalized in the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine (TCM), from July 2017 to July 2023. Additionally, 180 healthy individuals undergoing physical examinations at the Health Examination Center of the same hospital were selected as the normal control group. Both groups underwent general condition surveys, TCM constitution scales, Eysenck Personality Questionnaires, Brief Coping Styles Questionnaires, and Social Support Rating Scales to determine risk factors and common types. Results: Independent variables such as gender, Qi stagnation constitution, Balanced Constitution, negative coping scores, positive coping scores, and stressful life events were included in the model. The OR values for Balanced Constitution, gender, positive coping style, and overall social support were all less than 1, and the maximum value of the 95% confidence interval was also less than 1. After selecting the intercept into the model and analyzing the standardized regression coefficients, it was found that negative coping scores had a significant impact on the model, while stressful life events showed extremely high relevance to the study. Compared with the normal group, the frequency of Qi stagnation constitution in the study group significantly increased, with a significant difference (P χ2 = 11.109, P = 0.0009, indicating a significant difference (P χ2 = 4.0890, P = 0.0432, indicating a significant difference (P 0.05). However, when comparing mental workers with physical workers within the patient group, the frequency of Qi stagnation constitution in mental workers was significantly higher, with χ2 = 6.8467, P = 0.012, indicating a significant difference (P Conclusion: Qi stagnation constitution is a potential predisposing constitution for gallstone disease, whereas the tendency to develop the disease is relatively low for Balanced Constitution and Yin deficiency constitution. Gallstone disease is more commonly found in young male mental workers.展开更多
Objective To cater to the demands for personalized health services from a deep learning per-spective by investigating the characteristics of traditional Chinese medicine(TCM)constitu-tion data and constructing models ...Objective To cater to the demands for personalized health services from a deep learning per-spective by investigating the characteristics of traditional Chinese medicine(TCM)constitu-tion data and constructing models to explore new prediction methods.Methods Data from students at Chengdu University of Traditional Chinese Medicine were collected and organized according to the 24 solar terms from January 21,2020,to April 6,2022.The data were used to identify nine TCM constitutions,including balanced constitution,Qi deficiency constitution,Yang deficiency constitution,Yin deficiency constitution,phlegm dampness constitution,damp heat constitution,stagnant blood constitution,Qi stagnation constitution,and specific-inherited predisposition constitution.Deep learning algorithms were employed to construct multi-layer perceptron(MLP),long short-term memory(LSTM),and deep belief network(DBN)models for the prediction of TCM constitutions based on the nine constitution types.To optimize these TCM constitution prediction models,this study in-troduced the attention mechanism(AM),grey wolf optimizer(GWO),and particle swarm op-timization(PSO).The models’performance was evaluated before and after optimization us-ing the F1-score,accuracy,precision,and recall.Results The research analyzed a total of 31655 pieces of data.(i)Before optimization,the MLP model achieved more than 90%prediction accuracy for all constitution types except the balanced and Qi deficiency constitutions.The LSTM model's prediction accuracies exceeded 60%,indicating that their potential in TCM constitutional prediction may not have been fully realized due to the absence of pronounced temporal features in the data.Regarding the DBN model,the binary classification analysis showed that,apart from slightly underperforming in predicting the Qi deficiency constitution and damp heat constitution,with accuracies of 65%and 60%,respectively.The DBN model demonstrated considerable discriminative power for other constitution types,achieving prediction accuracy rates and area under the receiver op-erating characteristic(ROC)curve(AUC)values exceeding 70%and 0.78,respectively.This indicates that while the model possesses a certain level of constitutional differentiation abili-ty,it encounters limitations in processing specific constitutional features,leaving room for further improvement in its performance.For multi-class classification problem,the DBN model’s prediction accuracy rate fell short of 50%.(ii)After optimization,the LSTM model,enhanced with the AM,typically achieved a prediction accuracy rate above 75%,with lower performance for the Qi deficiency constitution,stagnant blood constitution,and Qi stagna-tion constitution.The GWO-optimized DBN model for multi-class classification showed an increased prediction accuracy rate of 56%,while the PSO-optimized model had a decreased accuracy rate to 37%.The GWO-PSO-DBN model,optimized with both algorithms,demon-strated an improved prediction accuracy rate of 54%.Conclusion This study constructed MLP,LSTM,and DBN models for predicting TCM consti-tution and improved them based on different optimisation algorithms.The results showed that the MLP model performs well,the LSTM and DBN models were effective in prediction but with certain limitations.This study also provided a new technology reference for the es-tablishment and optimisation strategies of TCM constitution prediction models,and a novel idea for the treatment of non-disease.展开更多
Objective:To reveal the distribution characteristics and demographic factors of traditional Chinese medicine(TCM)constitution among elderly individuals in China.Methods: Elderly individuals from seven regions in China...Objective:To reveal the distribution characteristics and demographic factors of traditional Chinese medicine(TCM)constitution among elderly individuals in China.Methods: Elderly individuals from seven regions in China were selected as samples in this study using a multistage cluster random sampling method.The basic information questionnaire and Constitution in Chinese Medicine Questionnaire(Elderly Edition)were used.Descriptive statistical analysis,chi-squared tests,and binary logistic regression analysis were used.Results: The single balanced constitution(BC)accounted for 23.9%.The results of the major TCM constitution types showed that BC(43.2%)accounted for the largest proportion and unbalanced constitutions ranged from 0.9%to 15.7%.East China region(odds ratio[OR]=2.097;95%confidence interval[CI],1.912 to 2.301),married status(OR=1.341;95%CI,1.235 to 1.457),and managers(OR=1.254;95%CI,1.044 to 1.505)were significantly associated with BC.Age>70 years was associated with qi-deficiency constitution and blood stasis constitution(BSC).Female sex was significantly associated with yang-deficiency constitution(OR=1.646;95%CI,1.52 to 1.782).Southwest region was significantly associated with phlegm-dampness constitution(OR=1.809;95%CI,1.569 to 2.086).North China region was significantly associated with inherited special constitution(OR=2.521;95%CI,1.569 to 4.05).South China region(OR=2.741;95%CI,1.997 to 1.3.763),Central China region(OR=8.889;95%CI,6.676 to 11.835),senior middle school education(OR=2.442;95%CI,1.932 to 3.088),and managers(OR=1.804;95%CI,1.21 to 2.69)were significantly associated with BSC.Conclusions: This study defined the distribution characteristics and demographic factors of TCM constitution in the elderly population.Adjusting and improving unbalanced constitutions,which are correlated with diseases,can help promote healthy aging through the scientific management of these demographic factors.展开更多
Objective To construct a precise model for identifying traditional Chinese medicine(TCM)constitutions;thereby offering optimized guidance for clinical diagnosis and treatment plan-ning;and ultimately enhancing medical...Objective To construct a precise model for identifying traditional Chinese medicine(TCM)constitutions;thereby offering optimized guidance for clinical diagnosis and treatment plan-ning;and ultimately enhancing medical efficiency and treatment outcomes.Methods First;TCM full-body inspection data acquisition equipment was employed to col-lect full-body standing images of healthy people;from which the constitutions were labelled and defined in accordance with the Constitution in Chinese Medicine Questionnaire(CCMQ);and a dataset encompassing labelled constitutions was constructed.Second;heat-suppres-sion valve(HSV)color space and improved local binary patterns(LBP)algorithm were lever-aged for the extraction of features such as facial complexion and body shape.In addition;a dual-branch deep network was employed to collect deep features from the full-body standing images.Last;the random forest(RF)algorithm was utilized to learn the extracted multifea-tures;which were subsequently employed to establish a TCM constitution identification mod-el.Accuracy;precision;and F1 score were the three measures selected to assess the perfor-mance of the model.Results It was found that the accuracy;precision;and F1 score of the proposed model based on multifeatures for identifying TCM constitutions were 0.842;0.868;and 0.790;respectively.In comparison with the identification models that encompass a single feature;either a single facial complexion feature;a body shape feature;or deep features;the accuracy of the model that incorporating all the aforementioned features was elevated by 0.105;0.105;and 0.079;the precision increased by 0.164;0.164;and 0.211;and the F1 score rose by 0.071;0.071;and 0.084;respectively.Conclusion The research findings affirmed the viability of the proposed model;which incor-porated multifeatures;including the facial complexion feature;the body shape feature;and the deep feature.In addition;by employing the proposed model;the objectification and intel-ligence of identifying constitutions in TCM practices could be optimized.展开更多
BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unkno...BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.展开更多
On March 14,2004,the Second Session of the 10th National People’s Congress of China adopted the fourth amendment to the Chinese Constitution,the most noticeable highlight of which is the addition of the paragraph“th...On March 14,2004,the Second Session of the 10th National People’s Congress of China adopted the fourth amendment to the Chinese Constitution,the most noticeable highlight of which is the addition of the paragraph“the state respects and protects human rights”as the third clause in Article 33 of Chapter II“Basic Rights and Obligations of Citizens”in the Constitution.The inclusion of the clause of human rights in the Constitution is considered an important milestone in the history of human rights development in the People’s Republic of China.The implementation of the human rights clause not only showcases the values of the Party and the state in respecting and protecting human rights,but also promotes the development of human rights,shapes the culture of human rights,and endows the rule of law with a rich humanistic spirit.Over the past 20 years,the publicity,research and practice of the human rights clause have made the Chi-nese people realize that human rights are not only a“great term”,but also a common value shared by mankind.Amid the once-in-a-century changes of the world,although the development of human rights is facing various challenges,the humanistic spirit contained in the hu-man rights clause has become the internal driving force for building consensus in the whole of society.Reinterpreting the significance and value of the human rights clause can help us conscientiously draw on the experience in the implementation of the clause over the past 20 years and contribute Chinese wisdom and experience to global human rights governance with a more open mind and inclusive attitude.展开更多
Abstract:For departmental legal norms concerning citizens’basic rights,when multiple interpretations are possible based on indi-vidual case circumstances,interpreters representing public authority need to apply the m...Abstract:For departmental legal norms concerning citizens’basic rights,when multiple interpretations are possible based on indi-vidual case circumstances,interpreters representing public authority need to apply the method of constitutional interpretation to screen out the interpretation conclusions that do not violate the Constitution.This means selecting interpretations at the constitutional level that do not overly restrict citizens’basic rights and understanding the specific connotations of legal norms with the principle of“not infringing on citizens’basic rights.”The Constitution,as a framework order,does not require interpreters to choose the most constitutionally aligned interpretation among various constitutional interpretations.If a legal norm does not have a constitutional interpretation conclusion in an individual case circumstance,it indicates that the application of that norm in the case is unconstitutional,and the interpreter should avoid applying the legal norm in that case.Regarding judgment standards,interpreters should apply the principle of proportionality to deter-mine whether each legal interpretation conclusion concerning basic rights-related legal norms complies with the Constitution.Out of respect for the legislature,the application of the sub-principles of pro-portionality should consider the boundaries of interpretative actions.展开更多
The inclusion of the human rights clause in the Chi-nese Constitution is the core normative manifestation of the constitu-tionalization of human rights,and points to the relationship between international law and the ...The inclusion of the human rights clause in the Chi-nese Constitution is the core normative manifestation of the constitu-tionalization of human rights,and points to the relationship between international law and the Constitution in the sense of positive law.The inclusion of the human rights clauses in the Chinese Constitution itself is an inherent part of the development of China’s socialist constitution,and socialism has already contributed valuable concepts and practices of human rights protection to the modern world in its early stage.The constitutionalization of human rights protection does not necessarily lead to the superiority of international law over the constitutional order of a country,but rather to the convergence of international law and domestic law through the constitutional order.The relevant rules of international law will be effective only when they are transformed into domestic law through the Constitution and the human rights clause in the Constitution.Correspondingly,the domestic legal order is brought into line with the international legal order through the Con-stitution and its human rights clause.Behind the system of fundamen-tal rights in the constitutional order is the value foundation of the en-tire legal system.The advancement of foreign-related rule of law has brought new opportunities for China’s judicial practice to further pro-mote the protection of human rights.In the future,we should further integrate the human rights values embedded in socialism into China’s constitutional practice,enhance human rights protection around the country,and take a more active part in global human rights gover-nance.展开更多
Objective:To explore the development and hotspots in the field of traditional Chinese medicine(TCM)constitution identification since the year 2000.Methods:Using CiteSpace and VOSviewer software,literature from five pr...Objective:To explore the development and hotspots in the field of traditional Chinese medicine(TCM)constitution identification since the year 2000.Methods:Using CiteSpace and VOSviewer software,literature from five prominent databases including VIP,WanFang,China National Knowledge Infrastructure(CNKI),PubMed,and Web ofScience was analyzed.Visual methods were used to examine the annual publications,keywords,authors,and collaborative networks.Results:After deduplication with EndNotes,a total of 5,747 articles meeting the criteria were included.Since 2000,the publications of TCM constitution identification shown three major stages:a significant increasing trend with the year before 2016,a fluctuating trend from 2016 to 2021,and a decreasing trend with the year after 2021.The co-occurrence analysis ofkeywords revealed health management,hypertension,and constitution as hot directions in this field of research.CiteSpace was used for keyword clustering and burst analysis,health management,medical life,and constitution emerged as the latest hotspots in the past three years,which will be the main development directions in the future.Clusters such as hypertension,preventive treatment,and health management were identified,representing the main research themes at present.VOSviewer and CiteSpace were used for co-occurrence and clustering analysis of authors,revealing collaborative research networks,with prominent groups represented by WANG Qi,WANG Ji,LI Lingru,HOU Shujuan,ZHU Yanbo,etc.Conclusion:Research related to TCM constitution identification is developing rapidly,involving various aspects of medical care and daily life.However,there is still a need to build an extensive academic platform,strengthen the dissemination of Chinese medicine culture,standardize,intellectualize and universalize the identification of TCM constitution assessments,and construct a health service system with Chinese characteristics.展开更多
Objective:Through literature research,the distribution of TCM constitution of nonalcoholic fatty liver(NAFLD)was discussed,the common constitution types of the disease were determined,and medical evidence was provided...Objective:Through literature research,the distribution of TCM constitution of nonalcoholic fatty liver(NAFLD)was discussed,the common constitution types of the disease were determined,and medical evidence was provided for the prevention and treatment of NAFLD by traditional Chinese medicine.Methods:The literatures on the correlation between NAFLD and TCM constitution published in domestic journals from the database establishment to April 2020 were searched with"non-alcoholic fatty liver disease and TCM constitution"as the search term,and screening,quality evaluation and data extraction were conducted according to the na exclusion criteria.Statistical software stata16.0 was used for meta analysis of the included literature.Results:Sixteen studies were included.The results showed that the proportions of TCM constitution types and 95%CI of NAFLD patients were phlegm-dampness0.28(0.24,0.31),moisture-heat0.16(0.13,0.20),qi-asthenia0.13(0.10,0.16),qi-stagnation0.11(0.06,0.17),qi-stagnation0.08(0.06,0.10),yi-stagnation0.08(0.06,0.10),yi--stagnation0.08(0.06,0.10),blood stasis0.07(0.04,0.08),yang-asthenia0.06(0.04,0.08),and special report 0.02(0.01,0.02).Conclusion:The common constitution types of patients with nonalcoholic fatty liver are phlegm-dam-pness,damp-heat,q-asthenia,and mild,especially phlegm-dampness,which are most closely related to nonalcoholic fatty liver.展开更多
BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft ...BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft dysfunction.Nevertheless,circumstances may arise where selecting the RK over the left kidney(LK)is unavoidable.Consequently,it is crucial to thoroughly examine the implications of such a choice on the overall transplant outcome.AIM To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these outcomes.METHODS We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December 2023.We included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based volumetry.The variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)trends.We used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney side.RESULTS Of the 250 transplants performed during the period,56(22%)were RKs.The recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for RKs.TGL and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being insignificant.These complications,however,were not related to the venous anastomosis.One RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical technique.The post-transplant SC trend and mean SC at the last follow-up were similar across both kidney sides.CONCLUSION The donor kidney side has little impact on post-transplant adverse events and graft function in LD transplants,provided that careful patient selection and precise surgical techniques are employed.展开更多
From the perspective of culture-based source,the author considered that the ancient Chinese poetry and paintings not only embodied the harmony and unity thought of man and nature,but also were the emotional attachment...From the perspective of culture-based source,the author considered that the ancient Chinese poetry and paintings not only embodied the harmony and unity thought of man and nature,but also were the emotional attachment of Chinese literati.As a diverse and comprehensive aesthetic art,landscape expressed material and spiritual culture doubly,the spiritual connotation of which was inextricably linked within ancient Chinese poetry and paintings.In addition,ancient Chinese poetry and paintings can be directly used in landscape composition,such as the widely used in plaques,inscriptions,couplets,poems and inscriptions,carved beams and painted pillars,painting with words and so on.Chinese literati integrated the ethereal realm of poetry and paintings into garden art,making landscape endow with poetic charm.Therefore,the landscape revealed the traces of literature and arts in aesthetic idea and taste,pushing Chinese garden to a higher aesthetic realm.This study pointed the right way to the future of modern landscape which advocated ecological and harmonious development.展开更多
Living donor liver transplantation(LDLT) has beenwidely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver t...Living donor liver transplantation(LDLT) has beenwidely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional gray-scale and Doppler ultrasonography play important roles in identifying vascular complications in the early postoperative period and during the follow-up. Recently, with the detailed vascular tracing and perfusion visualization, contrastenhanced ultrasound(CEUS) has significantly improved the diagnosis of postoperative vascular complications. This review focuses on the role of conventional grayscale ultrasound, Doppler ultrasound and CEUS for early diagnosis of vascular complications after adult LDLT.展开更多
With the increasing prevalence of living-donor liver transplantation(LDLT) for patients with hepatocellular carcinoma(HCC),some authors have reported a potential increase in the HCC recurrence rates among LDLT recipie...With the increasing prevalence of living-donor liver transplantation(LDLT) for patients with hepatocellular carcinoma(HCC),some authors have reported a potential increase in the HCC recurrence rates among LDLT recipients compared to deceased-donor liver transplantation(DDLT) recipients.The aim of this review is to encompass current opinions and clinical reports regarding differences in the outcome,especially the recurrence of HCC,between LDLT and DDLT.While some studies report impaired recurrence- free survival and increased recurrence rates among LDLT recipients,others,including large database studies,report comparable recurrence- free survival and recurrence rates between LDLT and DDLT.Studies supporting the increased recurrence in LDLT have linked graft regeneration to tumor progression,but we found no association between graft regeneration/initial graft volume and tumor recurrence among our 125 consecutive LDLTs for HCC cases.In the absence of a prospective study regarding the use of LDLT vs DDLT for HCC patients,there is no evidence to support the higher HCC recurrence after LDLT than DDLT,and LDLT remains a reasonable treatment option for HCC patients with cirrhosis.展开更多
文摘BACKGROUND Mesenchymal stem cells(MSCs)as living biopharmaceuticals with unique properties,i.e.,stemness,viability,phenotypes,paracrine activity,etc.,need to be administered such that they reach the target site,maintaining these properties unchanged and are retained at the injury site to participate in the repair process.Route of delivery(RoD)remains one of the critical determinants of safety and efficacy.This study elucidates the safety and effectiveness of different RoDs of MSC treatment in heart failure(HF)based on phase II randomized clinical trials(RCTs).We hypothesize that the RoD modulates the safety and efficacy of MSCbased therapy and determines the outcome of the intervention.AIM To investigate the effect of RoD of MSCs on safety and efficacy in HF patients.METHODS RCTs were retrieved from six databases.Safety endpoints included mortality and serious adverse events(SAEs),while efficacy outcomes encompassed changes in left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),and pro-B-type natriuretic peptide(pro-BNP).Subgroup analyses on RoD were performed for all study endpoints.RESULTS Twelve RCTs were included.Overall,MSC therapy demonstrated a significant decrease in mortality[relative risk(RR):0.55,95%confidence interval(95%CI):0.33-0.92,P=0.02]compared to control,while SAE outcomes showed no significant difference(RR:0.84,95%CI:0.66-1.05,P=0.11).RoD subgroup analysis revealed a significant difference in SAE among the transendocardial(TESI)injection subgroup(RR=0.71,95%CI:0.54-0.95,P=0.04).The pooled weighted mean difference(WMD)demonstrated an overall significant improvement of LVEF by 2.44%(WMD:2.44%,95%CI:0.80-4.29,P value≤0.001),with only intracoronary(IC)subgroup showing significant improvement(WMD:7.26%,95%CI:5.61-8.92,P≤0.001).Furthermore,the IC delivery route significantly improved 6MWD by 115 m(WMD=114.99 m,95%CI:91.48-138.50),respectively.In biochemical efficacy outcomes,only the IC subgroup showed a significant reduction in pro-BNP by-860.64 pg/mL(WMD:-860.64 pg/Ml,95%CI:-944.02 to-777.26,P=0.001).CONCLUSION Our study concluded that all delivery methods of MSC-based therapy are safe.Despite the overall benefits in efficacy,the TESI and IC routes provided better outcomes than other methods.Larger-scale trials are warranted before implementing MSC-based therapy in routine clinical practice.
文摘Objective: To summarize the common constitutional types in patients with gallstone disease and analyze influencing factors. Research Hypothesis: Qi stagnation constitution may be a potential predisposing constitution for gallstone disease, whereas the Balanced Constitution and Yin deficiency constitution have a lower tendency towards the development of the disease;gallstone disease is more prevalent among young men engaged in mental labor. Methods: A retrospective study was conducted on 180 patients with gallstone disease who were hospitalized in the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine (TCM), from July 2017 to July 2023. Additionally, 180 healthy individuals undergoing physical examinations at the Health Examination Center of the same hospital were selected as the normal control group. Both groups underwent general condition surveys, TCM constitution scales, Eysenck Personality Questionnaires, Brief Coping Styles Questionnaires, and Social Support Rating Scales to determine risk factors and common types. Results: Independent variables such as gender, Qi stagnation constitution, Balanced Constitution, negative coping scores, positive coping scores, and stressful life events were included in the model. The OR values for Balanced Constitution, gender, positive coping style, and overall social support were all less than 1, and the maximum value of the 95% confidence interval was also less than 1. After selecting the intercept into the model and analyzing the standardized regression coefficients, it was found that negative coping scores had a significant impact on the model, while stressful life events showed extremely high relevance to the study. Compared with the normal group, the frequency of Qi stagnation constitution in the study group significantly increased, with a significant difference (P χ2 = 11.109, P = 0.0009, indicating a significant difference (P χ2 = 4.0890, P = 0.0432, indicating a significant difference (P 0.05). However, when comparing mental workers with physical workers within the patient group, the frequency of Qi stagnation constitution in mental workers was significantly higher, with χ2 = 6.8467, P = 0.012, indicating a significant difference (P Conclusion: Qi stagnation constitution is a potential predisposing constitution for gallstone disease, whereas the tendency to develop the disease is relatively low for Balanced Constitution and Yin deficiency constitution. Gallstone disease is more commonly found in young male mental workers.
基金National Natural Science Foundation of China(81904324)Sichuan Science and Technology Department Project(2022YFS0194).
文摘Objective To cater to the demands for personalized health services from a deep learning per-spective by investigating the characteristics of traditional Chinese medicine(TCM)constitu-tion data and constructing models to explore new prediction methods.Methods Data from students at Chengdu University of Traditional Chinese Medicine were collected and organized according to the 24 solar terms from January 21,2020,to April 6,2022.The data were used to identify nine TCM constitutions,including balanced constitution,Qi deficiency constitution,Yang deficiency constitution,Yin deficiency constitution,phlegm dampness constitution,damp heat constitution,stagnant blood constitution,Qi stagnation constitution,and specific-inherited predisposition constitution.Deep learning algorithms were employed to construct multi-layer perceptron(MLP),long short-term memory(LSTM),and deep belief network(DBN)models for the prediction of TCM constitutions based on the nine constitution types.To optimize these TCM constitution prediction models,this study in-troduced the attention mechanism(AM),grey wolf optimizer(GWO),and particle swarm op-timization(PSO).The models’performance was evaluated before and after optimization us-ing the F1-score,accuracy,precision,and recall.Results The research analyzed a total of 31655 pieces of data.(i)Before optimization,the MLP model achieved more than 90%prediction accuracy for all constitution types except the balanced and Qi deficiency constitutions.The LSTM model's prediction accuracies exceeded 60%,indicating that their potential in TCM constitutional prediction may not have been fully realized due to the absence of pronounced temporal features in the data.Regarding the DBN model,the binary classification analysis showed that,apart from slightly underperforming in predicting the Qi deficiency constitution and damp heat constitution,with accuracies of 65%and 60%,respectively.The DBN model demonstrated considerable discriminative power for other constitution types,achieving prediction accuracy rates and area under the receiver op-erating characteristic(ROC)curve(AUC)values exceeding 70%and 0.78,respectively.This indicates that while the model possesses a certain level of constitutional differentiation abili-ty,it encounters limitations in processing specific constitutional features,leaving room for further improvement in its performance.For multi-class classification problem,the DBN model’s prediction accuracy rate fell short of 50%.(ii)After optimization,the LSTM model,enhanced with the AM,typically achieved a prediction accuracy rate above 75%,with lower performance for the Qi deficiency constitution,stagnant blood constitution,and Qi stagna-tion constitution.The GWO-optimized DBN model for multi-class classification showed an increased prediction accuracy rate of 56%,while the PSO-optimized model had a decreased accuracy rate to 37%.The GWO-PSO-DBN model,optimized with both algorithms,demon-strated an improved prediction accuracy rate of 54%.Conclusion This study constructed MLP,LSTM,and DBN models for predicting TCM consti-tution and improved them based on different optimisation algorithms.The results showed that the MLP model performs well,the LSTM and DBN models were effective in prediction but with certain limitations.This study also provided a new technology reference for the es-tablishment and optimisation strategies of TCM constitution prediction models,and a novel idea for the treatment of non-disease.
基金supported by the National Key R&D Program of China(2020YFC2003102).
文摘Objective:To reveal the distribution characteristics and demographic factors of traditional Chinese medicine(TCM)constitution among elderly individuals in China.Methods: Elderly individuals from seven regions in China were selected as samples in this study using a multistage cluster random sampling method.The basic information questionnaire and Constitution in Chinese Medicine Questionnaire(Elderly Edition)were used.Descriptive statistical analysis,chi-squared tests,and binary logistic regression analysis were used.Results: The single balanced constitution(BC)accounted for 23.9%.The results of the major TCM constitution types showed that BC(43.2%)accounted for the largest proportion and unbalanced constitutions ranged from 0.9%to 15.7%.East China region(odds ratio[OR]=2.097;95%confidence interval[CI],1.912 to 2.301),married status(OR=1.341;95%CI,1.235 to 1.457),and managers(OR=1.254;95%CI,1.044 to 1.505)were significantly associated with BC.Age>70 years was associated with qi-deficiency constitution and blood stasis constitution(BSC).Female sex was significantly associated with yang-deficiency constitution(OR=1.646;95%CI,1.52 to 1.782).Southwest region was significantly associated with phlegm-dampness constitution(OR=1.809;95%CI,1.569 to 2.086).North China region was significantly associated with inherited special constitution(OR=2.521;95%CI,1.569 to 4.05).South China region(OR=2.741;95%CI,1.997 to 1.3.763),Central China region(OR=8.889;95%CI,6.676 to 11.835),senior middle school education(OR=2.442;95%CI,1.932 to 3.088),and managers(OR=1.804;95%CI,1.21 to 2.69)were significantly associated with BSC.Conclusions: This study defined the distribution characteristics and demographic factors of TCM constitution in the elderly population.Adjusting and improving unbalanced constitutions,which are correlated with diseases,can help promote healthy aging through the scientific management of these demographic factors.
基金National Key Research and Development Program of China(2022YFC3502302)National Natural Science Foundation of China(82074580)Graduate Research Innovation Program of Jiangsu Province(KYCX23_2078).
文摘Objective To construct a precise model for identifying traditional Chinese medicine(TCM)constitutions;thereby offering optimized guidance for clinical diagnosis and treatment plan-ning;and ultimately enhancing medical efficiency and treatment outcomes.Methods First;TCM full-body inspection data acquisition equipment was employed to col-lect full-body standing images of healthy people;from which the constitutions were labelled and defined in accordance with the Constitution in Chinese Medicine Questionnaire(CCMQ);and a dataset encompassing labelled constitutions was constructed.Second;heat-suppres-sion valve(HSV)color space and improved local binary patterns(LBP)algorithm were lever-aged for the extraction of features such as facial complexion and body shape.In addition;a dual-branch deep network was employed to collect deep features from the full-body standing images.Last;the random forest(RF)algorithm was utilized to learn the extracted multifea-tures;which were subsequently employed to establish a TCM constitution identification mod-el.Accuracy;precision;and F1 score were the three measures selected to assess the perfor-mance of the model.Results It was found that the accuracy;precision;and F1 score of the proposed model based on multifeatures for identifying TCM constitutions were 0.842;0.868;and 0.790;respectively.In comparison with the identification models that encompass a single feature;either a single facial complexion feature;a body shape feature;or deep features;the accuracy of the model that incorporating all the aforementioned features was elevated by 0.105;0.105;and 0.079;the precision increased by 0.164;0.164;and 0.211;and the F1 score rose by 0.071;0.071;and 0.084;respectively.Conclusion The research findings affirmed the viability of the proposed model;which incor-porated multifeatures;including the facial complexion feature;the body shape feature;and the deep feature.In addition;by employing the proposed model;the objectification and intel-ligence of identifying constitutions in TCM practices could be optimized.
基金Supported by the Faculty of Medicine,Ramathibodi Hospital,Mahidol University。
文摘BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.
文摘On March 14,2004,the Second Session of the 10th National People’s Congress of China adopted the fourth amendment to the Chinese Constitution,the most noticeable highlight of which is the addition of the paragraph“the state respects and protects human rights”as the third clause in Article 33 of Chapter II“Basic Rights and Obligations of Citizens”in the Constitution.The inclusion of the clause of human rights in the Constitution is considered an important milestone in the history of human rights development in the People’s Republic of China.The implementation of the human rights clause not only showcases the values of the Party and the state in respecting and protecting human rights,but also promotes the development of human rights,shapes the culture of human rights,and endows the rule of law with a rich humanistic spirit.Over the past 20 years,the publicity,research and practice of the human rights clause have made the Chi-nese people realize that human rights are not only a“great term”,but also a common value shared by mankind.Amid the once-in-a-century changes of the world,although the development of human rights is facing various challenges,the humanistic spirit contained in the hu-man rights clause has become the internal driving force for building consensus in the whole of society.Reinterpreting the significance and value of the human rights clause can help us conscientiously draw on the experience in the implementation of the clause over the past 20 years and contribute Chinese wisdom and experience to global human rights governance with a more open mind and inclusive attitude.
文摘Abstract:For departmental legal norms concerning citizens’basic rights,when multiple interpretations are possible based on indi-vidual case circumstances,interpreters representing public authority need to apply the method of constitutional interpretation to screen out the interpretation conclusions that do not violate the Constitution.This means selecting interpretations at the constitutional level that do not overly restrict citizens’basic rights and understanding the specific connotations of legal norms with the principle of“not infringing on citizens’basic rights.”The Constitution,as a framework order,does not require interpreters to choose the most constitutionally aligned interpretation among various constitutional interpretations.If a legal norm does not have a constitutional interpretation conclusion in an individual case circumstance,it indicates that the application of that norm in the case is unconstitutional,and the interpreter should avoid applying the legal norm in that case.Regarding judgment standards,interpreters should apply the principle of proportionality to deter-mine whether each legal interpretation conclusion concerning basic rights-related legal norms complies with the Constitution.Out of respect for the legislature,the application of the sub-principles of pro-portionality should consider the boundaries of interpretative actions.
文摘The inclusion of the human rights clause in the Chi-nese Constitution is the core normative manifestation of the constitu-tionalization of human rights,and points to the relationship between international law and the Constitution in the sense of positive law.The inclusion of the human rights clauses in the Chinese Constitution itself is an inherent part of the development of China’s socialist constitution,and socialism has already contributed valuable concepts and practices of human rights protection to the modern world in its early stage.The constitutionalization of human rights protection does not necessarily lead to the superiority of international law over the constitutional order of a country,but rather to the convergence of international law and domestic law through the constitutional order.The relevant rules of international law will be effective only when they are transformed into domestic law through the Constitution and the human rights clause in the Constitution.Correspondingly,the domestic legal order is brought into line with the international legal order through the Con-stitution and its human rights clause.Behind the system of fundamen-tal rights in the constitutional order is the value foundation of the en-tire legal system.The advancement of foreign-related rule of law has brought new opportunities for China’s judicial practice to further pro-mote the protection of human rights.In the future,we should further integrate the human rights values embedded in socialism into China’s constitutional practice,enhance human rights protection around the country,and take a more active part in global human rights gover-nance.
基金supported by the National Natural Science Foundation of China Youth Program(81904324)。
文摘Objective:To explore the development and hotspots in the field of traditional Chinese medicine(TCM)constitution identification since the year 2000.Methods:Using CiteSpace and VOSviewer software,literature from five prominent databases including VIP,WanFang,China National Knowledge Infrastructure(CNKI),PubMed,and Web ofScience was analyzed.Visual methods were used to examine the annual publications,keywords,authors,and collaborative networks.Results:After deduplication with EndNotes,a total of 5,747 articles meeting the criteria were included.Since 2000,the publications of TCM constitution identification shown three major stages:a significant increasing trend with the year before 2016,a fluctuating trend from 2016 to 2021,and a decreasing trend with the year after 2021.The co-occurrence analysis ofkeywords revealed health management,hypertension,and constitution as hot directions in this field of research.CiteSpace was used for keyword clustering and burst analysis,health management,medical life,and constitution emerged as the latest hotspots in the past three years,which will be the main development directions in the future.Clusters such as hypertension,preventive treatment,and health management were identified,representing the main research themes at present.VOSviewer and CiteSpace were used for co-occurrence and clustering analysis of authors,revealing collaborative research networks,with prominent groups represented by WANG Qi,WANG Ji,LI Lingru,HOU Shujuan,ZHU Yanbo,etc.Conclusion:Research related to TCM constitution identification is developing rapidly,involving various aspects of medical care and daily life.However,there is still a need to build an extensive academic platform,strengthen the dissemination of Chinese medicine culture,standardize,intellectualize and universalize the identification of TCM constitution assessments,and construct a health service system with Chinese characteristics.
基金Shaanxi administration of traditional Chinese medicine-Changan medical school of Zhang's liver disease inheritance studio(2018).
文摘Objective:Through literature research,the distribution of TCM constitution of nonalcoholic fatty liver(NAFLD)was discussed,the common constitution types of the disease were determined,and medical evidence was provided for the prevention and treatment of NAFLD by traditional Chinese medicine.Methods:The literatures on the correlation between NAFLD and TCM constitution published in domestic journals from the database establishment to April 2020 were searched with"non-alcoholic fatty liver disease and TCM constitution"as the search term,and screening,quality evaluation and data extraction were conducted according to the na exclusion criteria.Statistical software stata16.0 was used for meta analysis of the included literature.Results:Sixteen studies were included.The results showed that the proportions of TCM constitution types and 95%CI of NAFLD patients were phlegm-dampness0.28(0.24,0.31),moisture-heat0.16(0.13,0.20),qi-asthenia0.13(0.10,0.16),qi-stagnation0.11(0.06,0.17),qi-stagnation0.08(0.06,0.10),yi-stagnation0.08(0.06,0.10),yi--stagnation0.08(0.06,0.10),blood stasis0.07(0.04,0.08),yang-asthenia0.06(0.04,0.08),and special report 0.02(0.01,0.02).Conclusion:The common constitution types of patients with nonalcoholic fatty liver are phlegm-dam-pness,damp-heat,q-asthenia,and mild,especially phlegm-dampness,which are most closely related to nonalcoholic fatty liver.
文摘BACKGROUND Transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft dysfunction.Nevertheless,circumstances may arise where selecting the RK over the left kidney(LK)is unavoidable.Consequently,it is crucial to thoroughly examine the implications of such a choice on the overall transplant outcome.AIM To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these outcomes.METHODS We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December 2023.We included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based volumetry.The variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)trends.We used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney side.RESULTS Of the 250 transplants performed during the period,56(22%)were RKs.The recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for RKs.TGL and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being insignificant.These complications,however,were not related to the venous anastomosis.One RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical technique.The post-transplant SC trend and mean SC at the last follow-up were similar across both kidney sides.CONCLUSION The donor kidney side has little impact on post-transplant adverse events and graft function in LD transplants,provided that careful patient selection and precise surgical techniques are employed.
文摘From the perspective of culture-based source,the author considered that the ancient Chinese poetry and paintings not only embodied the harmony and unity thought of man and nature,but also were the emotional attachment of Chinese literati.As a diverse and comprehensive aesthetic art,landscape expressed material and spiritual culture doubly,the spiritual connotation of which was inextricably linked within ancient Chinese poetry and paintings.In addition,ancient Chinese poetry and paintings can be directly used in landscape composition,such as the widely used in plaques,inscriptions,couplets,poems and inscriptions,carved beams and painted pillars,painting with words and so on.Chinese literati integrated the ethereal realm of poetry and paintings into garden art,making landscape endow with poetic charm.Therefore,the landscape revealed the traces of literature and arts in aesthetic idea and taste,pushing Chinese garden to a higher aesthetic realm.This study pointed the right way to the future of modern landscape which advocated ecological and harmonious development.
基金Supported by the Department of Science and technology of Sichuan ProvinceChina+2 种基金No.2013JY0147the National Natural Science Foundation of ChinaNo 81371556
文摘Living donor liver transplantation(LDLT) has beenwidely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional gray-scale and Doppler ultrasonography play important roles in identifying vascular complications in the early postoperative period and during the follow-up. Recently, with the detailed vascular tracing and perfusion visualization, contrastenhanced ultrasound(CEUS) has significantly improved the diagnosis of postoperative vascular complications. This review focuses on the role of conventional grayscale ultrasound, Doppler ultrasound and CEUS for early diagnosis of vascular complications after adult LDLT.
文摘With the increasing prevalence of living-donor liver transplantation(LDLT) for patients with hepatocellular carcinoma(HCC),some authors have reported a potential increase in the HCC recurrence rates among LDLT recipients compared to deceased-donor liver transplantation(DDLT) recipients.The aim of this review is to encompass current opinions and clinical reports regarding differences in the outcome,especially the recurrence of HCC,between LDLT and DDLT.While some studies report impaired recurrence- free survival and increased recurrence rates among LDLT recipients,others,including large database studies,report comparable recurrence- free survival and recurrence rates between LDLT and DDLT.Studies supporting the increased recurrence in LDLT have linked graft regeneration to tumor progression,but we found no association between graft regeneration/initial graft volume and tumor recurrence among our 125 consecutive LDLTs for HCC cases.In the absence of a prospective study regarding the use of LDLT vs DDLT for HCC patients,there is no evidence to support the higher HCC recurrence after LDLT than DDLT,and LDLT remains a reasonable treatment option for HCC patients with cirrhosis.