Effects of Depth of Needle Insertion with Risperidone Long-Acting Injectable in Persons with Schizophrenia: A Randomized Double-Blind Study

In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is deeper than anticipated, needle penetration may cause damage to nerves, arteries and veins. Few clinical studies were done to evaluate the depth of needle length insertion reaching the intended gluteal muscle. The aim of this study was to evaluate the suitable depth of injecting RLAI. Twenty-six patients with schizophrenia were treated with RLAI, and randomly divided into two groups: 50 mm needle inserted group (Group-D, deep insertion, n = 13) and 20 mm needle insertion group (Group-S, shallow insertion, n = 13). For Group-S, the needle length was marked with a spacer at exactly 20 mm. Injections were performed by the psychiatrist or nurse, alternating between the two gluteal sites by double-cross method every two weeks. Clinical psychotic symptoms and injection site reactions were recorded throughout the study period. Experienced psychologists who were blinded from the needle-length experimental variable evaluated patients’ psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS) every two weeks. The plasma 9-hydroxyrisperidone (9-OH-RIS) concentrations were measured every two weeks;comparison data were determined on the 8th week and the 14th week. No significant difference was observed in 9-OH-RIS concentrations, psychotic symptoms, injection site skin reactions of subjects in both groups. However, in Group-D, injection site adverse reactions were confirmed in two subjects (15%). In Group-S, injection site reactions were confirmed in six subjects (46%). Although effective 9-OH-RIS concentrations were obtained with the insertion using both depth, it was concluded that the 50 mm insertion length was more suitable for dorsogluteal IM injections in adult patients with schizophrenia as demonstrated by the incidence of local adverse skin reactions.

Inflammatory Bowel Disease and Dementia:Evidence Triangulation from a Meta-Analysis of Observational Studies and Mendelian Randomization Study

Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.

Exploring the Path of Shantytown Renewal Based on the Theory of Environment-behavior Studies: A Case Study of the Northwest Area of Saihantala in Baotou City

The application of environment-behavior studies plays an important role in studying the renewal of shantytowns.One of the most humane ways of renewal is designing and constructing the necessary urban spatial environment from the perspective of human daily behavior.Most of the shantytown renovation projects currently carried out in China are mainly focused on demolition and reconstruction,which not only incurs high costs but also damages the original social structure and economic model.During the process of shantytown renewal,it should improve the urban landscape,living environment,and life quality of residents,and ensure the daily life of shantytown residents without increasing their economic burden,and preserve the traces of urban development.In order to achieve this goal,it should explore the renewal strategies of shantytowns from the perspective of environment-behavior studies through behavior maps,on-site research,and literature review.Updating and design from a human perspective often achieve faster and better development;the renewal of shantytowns should be a bottom-up approach and start from a grassroots perspective,completing the renovation design through the composition of the population and behavioral patterns.

Prevalence of Helicobacter pylori infection in Chinese military personnel:A cross-sectional,multicenter-based study

BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.

Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine

BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohort study on mCRC conducted by our team,it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival(OS)of patients with colorectal cancer.Therefore,we further explored the survival benefits in the population with BRAF V600E mutant mCRC.AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022.The patients were divided into two cohorts.RESULTS A total of 34 cases were included,with 23 in Chinese-Western medicine cohort(cohort A)and 11 in Western medicine cohort(cohort B).The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B,with a statistically significant difference(P=0.038,hazard ratio=0.46).The 1-3-year survival rates were 95.65%(22/23),39.13%(9/23),and 26.09%(6/23)in cohort A,and 63.64%(7/11),18.18%(2/11),and 9.09%(1/11)in cohort B,respectively.Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon,liver metastasis,chemotherapy,and first-line treatment subgroups(P<0.05).CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer,with more pronounced benefits observed in patients with right colon involvement,liver metastasis,combined chemotherapy,and first-line treatment.

Association between Non-high-density Lipoprotein Cholesterol to High-density Lipoprotein Cholesterol Ratio(NHHR)and Stroke among Adults in the USA:A Cross-Sectional NHANES Study

Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between the adult NHHR and stroke occurrence in the United States of America(USA).Methods To clarify the relationship between the NHHR and stroke risk,this study used a multivariable logistic regression model and a restricted cubic spline(RCS)model to investigate the association between the NHHR and stroke,and data from the National Health and Nutrition Examination Survey(NHANES)from 2005 to 2018.Subgroup and sensitivity analyses were conducted to test the robustness of the results.Results This study included 29,928 adult participants,of which 1,165 participants had a history of stroke.Logistic regression analysis of variables demonstrated a positive association between NHHR and stroke(OR 1.24,95%CI:1.03-1.50,P=0.026).Compared with the lowest reference group of NHHR,participants in the second,third,and fourth quartile had a significantly increased risk of stroke after full adjustments(OR:1.35,95%CI:1.08-1.69)(OR:1.83,95%CI:1.42-2.36)(OR:2.04,95%CI:1.50-2.79).In the total population,a nonlinear dose-response relationship was observed between the NHHR and stroke risk(P non-linearity=0.002).This association remained significant in several subgroup analyses.Further investigation of the NHHR may enhance our understanding of stroke prevention and treatment.Conclusion Our findings suggest a positive correlation between the NHHR and an increased prevalence of stroke,potentially serving as a novel predictive factor for stroke.Timely intervention and management of the NHHR may effectively mitigate stroke occurrence.Prospective studies are required to validate this association and further explore the underlying biological mechanisms.

Perspectives of high-risk pregnant women on home care program in high-risk pregnancies: A multicenter, qualitative study

Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.

Decreased desire to have children: A qualitative study

Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was conducted from December 2021 to July 2022.The population consisted of working women and midwives.Data collection was conducted using semi-structured interviews and continued until data saturation was achieved.Through purposeful sampling,10 women and 11 midwives were selected as the sample.The data were analyzed by Graneheim and Lundman content analysis approach.For more rigorous,Nvivo 14 software was also used for data management,analysis,coding and organization of data.Results:This study included 21 women(10 women employees and 11 midwives)aged 25-43 years(for women employees)and 27-56 years(for midwives)with 1 to 34 years of job experience.In examination of participant’views about the barriers to childbearing,1124 codes were identified,of which we managed to extract six subthemes and two themes.Two themes emerged:“lack of social support and lack of family support”.Subthemes of“lack of social support”were“inadequate leave,long distance from workplace,and insufficient wages”.Subthemes of“lack of family support”were“lack of spouse support,lack of spouse's family support,and lack of their family support”.Conclusions:Different socioeconomic factors influence childbearing tendency in working women.Social and family supports play an important role in this regard.It is important to take these factors into account at the time of policymaking in the field of midwifery.

Association between Fish Consumption and Stroke Incidence Across Different Predicted Risk Populations:A Prospective Cohort Study from China

Objective The relationship between fish consumption and stroke is inconsistent,and it is uncertain whether this association varies across predicted stroke risks.Methods A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted.A standardized questionnaire was used to collect data on fish consumption.Participants were stratified into low-and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores.Hazard ratios(HRs)and 95%confidence intervals(CIs)were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy index(SI).Results During 703,869 person-years of follow-up,2,773 incident stroke events were identified.Higher fish consumption was associated with a lower risk of stroke,particularly among moderate-to-high-risk individuals(HR=0.53,95%CI:0.47-0.60)than among low-risk individuals(HR=0.64,95%CI:0.49-0.85).A significant additive interaction between fish consumption and predicted stroke risk was observed(RERI=4.08,95%CI:2.80-5.36;SI=1.64,95%CI:1.42-1.89;AP=0.36,95%CI:0.28-0.43).Conclusion Higher fish consumption was associated with a lower risk of stroke,and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.

Outcomes of bile duct cannulation using a novel contrast-enhanced catheter: A single-center, retrospective cohort study

BACKGROUND Endoscopic retrograde cholangiopancreatography is a challenging procedure involving bile duct cannulation.Despite the development of several cannulation devices,none have effectively facilitated the procedure.AIM To evaluate the efficacy of a recently developed catheter for bile duct cannulation.METHODS We retrospectively examined 342 patients who underwent initial cholangiopan-creatography.We compared the success rate of bile duct cannulation and the incidence of complications between the groups using existing and novel catheters.RESULTS The overall success rates of bile duct cannulation were 98.3%and 99.1%in the existing and novel catheter groups,respectively(P=0.47).The bile duct cannulation rate using the standard technique was 73.0%and 82.1%in the existing and novel catheter groups,respectively(P=0.042).Furthermore,when catheterization was performed by expert physicians,the bile duct cannulation rate was significantly higher in the novel catheter group(81.3%)than in the existing catheter group(65.2%)(P=0.017).The incidence of difficult cannulation was also significantly lower in the novel catheter group(17.4%)than in the existing catheter group(33.0%)(P=0.019).CONCLUSION The novel catheter improved the bile duct cannulation rate using the standard technique and reduced the frequency of difficult cannulation cases,valuable tool in endoscopic retrograde cholangiopancreatography procedures performed by experts.

Bibliometric analysis on the top one hundred cited studies on gastrointestinal endoscopy

BACKGROUND Gastrointestinal endoscopy has been widely used in the diagnosis and treatment of gastrointestinal diseases.A great many of studies on gastrointestinal endoscopy have been done.AIM To analyze the characteristics of top 100 cited articles on gastrointestinal endoscopy.METHODS A bibliometric analysis was conducted.The publications and their features were extracted from the Web of Science Core Collection,Science Citation Index-Expanded database.Excel,Web of Science database and SPSS software were used to perform the statistical description and analysis.VOSviewer software and Map-Chart were responsible for the visualizations.RESULTS The top 100 cited articles were published between 1976 and 2022.The guidelines(52%)and clinical trials(37%)are the main article types,and average publication year of the guidelines is much later than that of the clinical trials(2015 vs 1998).Among the clinical trials,diagnostic study(27.0%),cohort study(21.6%),case series(13.5%)and cross-sectional study(10.8%)account for a large proportion.Average citations of different study types and designs of the enrolled studies are of no significant differences.Most of the 100 articles were published by European authors and recorded by the endoscopic journals(65%).Top journals in medicine,such as the Lancet,New England Journal of Medicine and JAMA,also reported studies in this field.The hot spots of involved diseases include neoplasm or cancer-related diseases,inflammatory diseases,obstructive diseases,gastrointestinal hemorrhage and ulcer.Endoscopic surgery,endoscopic therapy and stent placement are frequently studied.CONCLUSION Our research contributes to delineating the field and identifying the characteristics of the most highly cited articles.It is noteworthy that there is a significantly smaller number of clinical trials included compared to guidelines,indicating potential areas for future high-quality clinical trials.

Metastatic lymph node distribution and pathology correlations in upper and lower gastric cancer patients:A multicenter retrospective study

BACKGROUND Gastric cancer(GC)poses a significant threat to public health.However,the clinicopathological features and tumor biological behaviors vary among the GC patients,leading to individual variations in lymph node metastasis.Consequently,the stratification of lymph node dissection according to the specific type,particularly upper GC,has emerged as a prominent area of research.AIM To investigate the distribution of metastatic lymph nodes in patients with upper and lower GC and to analyze the differences in related pathological elements and prognosis.METHODS Differential analysis between upper and lower GC patients with various clinicopathological factors was performed using the chi-square test and rank-sum regression models were used to analyze risk factors affecting patient prognosis.The Kaplan-Meier method was used to construct survival curves associated with prognostic risk factors for GC.RESULTS Significant differences were observed between the two GC populations regarding tumor diameter,histological grade,pT stage,pN stage,tumor-node-metastasis(pTNM)stage,vascular invasion,and adjuvant chemotherapy usage(all P<0.05).Lymph node metastasis rates were highest for Siewert type II patients in groups Nos.1,3,2 and 7;for Siewert type III patients in groups Nos.3,1,2 and 7;and for other/unclassified patients in groups Nos.1,3,7,2.In the lower GC samples,the sequences were Nos.3,6,7,4.Pathological type,pT stage,pTNM stage,and positive vascular invasion were independent risk factors for development of lymph node metastasis.Age,pathological type,pT stage,pN stage,pTNM stage,vascular invasion,and absence of adjuvant chemotherapy were identified as independent prognostic factors.CONCLUSION Upper GC showed a significantly higher malignancy grade and different lymph node metastasis pattern than lower GC.

Imaging characteristics of brain microstructure and cerebral perfusion in Crohn’s disease patients with anxiety: A prospective comparative study

BACKGROUND Anxiety is a common comorbidity in patients with Crohn’s disease(CD).Data on the imaging characteristics of brain microstructure and cerebral perfusion in CD with anxiety are limited.AIM To compare the imaging characteristics of brain microstructure and cerebral perfusion among CD patients with or without anxiety and healthy individuals.METHODS This prospective comparative study enrolled consecutive patients with active CD and healthy individuals who visited the study hospital between January 2022 and January 2023.Anxiety was measured using the Hospital Anxiety and Depression Scale-Anxiety.The imaging characteristics of brain microstructure and cerebral perfusion were measured by diffusion kurtosis imaging and intravoxel incoherent motion.RESULTSA total of 57 participants were enrolled. Among the patients with active CD, 16 had anxiety. Compared withhealthy individuals, patients with active CD demonstrated significantly lower radial kurtosis values in the rightcerebellar region 6, lower axial kurtosis (AK) values in the right insula, left superior temporal gyrus, and rightthalamus, and higher slow and fast apparent diffusion coefficients (ADCslow and ADCfast) in the bilateral frontal lobe,bilateral temporal lobe, and bilateral insular lobe (all P < 0.05). Compared with patients with CD without anxiety,patients with CD and anxiety exhibited significantly higher ADCslow values in the left insular lobe and lower AKvalues in the right insula and right anterior cuneus (all P < 0.05).CONCLUSIONThere are variations in brain microstructure and perfusion among CD patients with/without anxiety and healthyindividuals, suggesting potential use in assessing anxiety-related changes in active CD.

A cross-sectional study of the association between dietary inflammatory index and glaucoma prevalence in a US population

AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.

Comparative Studies on Tourist Satisfaction of World Heritage Sites——A Case Study of Huangshan Mountain,Lushan Mountain and Wuyi Mountain

Through the questionnaire survey and comparative studies on tourist satisfaction of tourism services among three world heritage sites,i.e.Huangshan Mountain,Lushan Mountain and Wuyi Mountain,this study pointed out the problems in tourism services of three scenic areas and then put forward relevant countermeasures for the management of scenic areas.

A Double-Blind, Randomized, Placebo-Controlled Nutritional Study Using an Insoluble Yeast Beta-Glucan to Improve the Immune Defense System

Purpose: In a placebo-controlled, double-blind, randomized clinical trial, the effect of an insoluble yeast beta-glucan preparation on the incidences of common colds and its effect on common cold symptoms were compared to placebo. Methods: 100 healthy participants with recurring infections were randomly assigned to receive either placebo or yeast beta-glucan (Yestimun?;n = 50 each group) over a period of 26 weeks. The subjects had to document each common cold episode in a diary, and rate 6 predefined infections symptoms on a 3-point rating scale during an infection period, resulting in an infection score. The common cold episodes were confirmed by the investigators. Results: A total of 171 common cold episodes were documented. Of these, 76 were experienced by 38 subjects in the beta-glucan group and 96 were experienced by 48 subjects in the placebo group (p = 0.406). The beta-glucan group had significantly more subjects without incidences of common cold than the placebo group (15.6% vs 2.0%;p = 0.019). During the most intense infection season (first 13 weeks of the study), the beta-glucan group had significantly less infections compared to placebo (p = 0.02). Beta-glucan significantly reduced the typical cold symptoms (“sore throat and/or difficulty swallowing”, “hoarseness and/or cough” and “runny nose”) as opposed to placebo. Conclusion: The present study demonstrates a prophylactic effect of yeast beta-glucan on the occurrence of common colds as opposed to placebo. In addition, when these episodes occurred, they were from the beginning less pronounced and subsided faster.

Pressure-flow studies in patients with benign prostatic hyperplasia:a study comparing suprapubic and transurethral methods

Aim： To compare the use of the suprapubic puncture method versus the transurethral method in pressure-flow studies in patients with benign prostatic hyperplasia. Methods： Twenty-three men with benign prostatic hyperplasia underwent both suprapubic and transurethral pressure-flow studies during a single session. Standard pressure-flow variables were recorded in all patients with both methods, enabling calculation of obstruction using commonly used grading systems, such as the urethral resistance algorithm, the Abrams-Griffith （AG） number and the Schaefer linear nomogram. Results： There were statistically significant differences between the methods in the mean values of maximum flow rate （P 〈 0.05）, detrusor pressure at the maximum flow （P 〈 0.01）, urethral resistance algorithm （P 〈 0.01）, AG number （P 〈 0.01） and maximum cystic capacity （P 〈 0.01）. Of the men in the study, 10 （43.5%） remained in the same Schaefer class with both methods and 18 （78.3%） in the same AG number area. Using the transurethral method, 12 （52.2%） men increased their Schaefer class by one and 1 （4.3%） by two. There were also differences between the suprapubic and transurethral methods using the AG number： 4 （17.4%） men moved from a classification of equivocal to obstructed and 1 （4.3%） from unobstructed to equivocal. Conclusion： The differences between the techniques for measuring intravesical pressure alter the grading of obstruction determined by several of the commonly used classifications. An 8 F transurethral catheter significantly increases the likelihood of a diagnosis of bladder outlet obstruction when compared with the suprapubic method.

Efficacy and tolerability of propolis special extract gh 2002 as a lip balm against herpes labialis: a randomized, double-blind three-arm dose finding study

A dose-finding study was performed with respect to the clinical applicability and tolerability of three different concentrations of propolis special extract GH 2002 in a lip balm (0.1%, 0.5% and 1%). The trial was designed as a double-blind, randomized dermatological study in 150 outpatients with Herpes labialis. The primary parameter was the duration in days until painless incrustation in 50% or 90% of the patients (observable in 121 patients). Secondary parameters were local pain (assessed on a visual analogue scale), itching, burning and tension/ swelling on a verbal rating scale, and tolerability. Visits were performed on days 2/3, 5/6 and 8/9. Best efficacy results with shortest healing time (3.4 and 5.4 days in the 50th and 90th percentile, respectively;p = 0.008 vs. 1% and 0.09 vs. 0.1%) and good tolerability were observed with the 0.5% concentration. All three concentrations achieved highly significant therapeutic results in comparison with baseline values (p < 0.0005) for all secondary parameters as early as day 2/3. Analgesia was the most prominent effect for the patients. Conclusion: The 0.5 % concentration of propolis special extract GH 2002 in a lip balm was found to have the best risk-benefit ratio for the treatment of Herpes labialis.

EFFECT OF ADDED DIETARY CALCIUM ON ESOPHAGEAL EPITHELIAL-CELL PROLIFERATION IN SUBJECTS AT HIGH RISK FOR ESOPHAGEAL CANCER: A DOUBLE-BLIND INTER-VENTION STUDY

A randomized double-blind intervention trial was carried determine whether oral calcium supplementation could lower the proliferation of epithelial cells of the esophagus. 41 subjects identified with precancerous lesions by histopathology were randomized to receive oral supplementation of their conventional diets with 0.6 g of calcium as calcium carbonate or placebo. Both at the entry to the study and at the end of the treatment, seven months later, the subjects were examined, with an emphasis on the frequency and distribution of proliferating epithelial cells of the esophagus. Patterns of cell proliferation was defined by dividing the esophageal epithelium into cell columns oriented perpendicularly to the basal cell layer and by comparing the numbers and fractions of tritiated thymidine-labeled epithelial cells in the various cell columns and cell compartments.Before dietary supplementation with calcium, the profile of proliferating epithelial cells in the esophageal compartments in calcium group is similar to that in the placebo group, which is comparable to that previously observed in subjects with high risk for esophageal cancer. Seven months after supplementation having been started, in calcium group, proliferation was significantly reduced and the profile of the esophageal columns approached to that previously observed in subjects at low risk for esophageal cancer, however, in the placebo group, the proliferation and profile maintain at the same level as that before supplementation. Our findings indicate that oral calcium supplementation induces a more quiescent equilibrium in epithelial-cell proliferation in the esophageal mucosa of the subjects at high-risk for esophageal cancer, similar to that observed in subjects at low risk.

Coffee consumption and risk of type 2 diabetes mellitus in Asians:A meta-epidemiological study of population-based cohort studies

BACKGROUND Previous systematic reviews have consistently reported that coffee consumption has a preventive effect on the occurrence of type 2 diabetes mellitus(T2DM).However,further evaluations between coffee consumption and the risk of T2DM in Asian populations are needed.AIM To conduct a meta-epidemiological study on systematic reviews evaluating the association between coffee consumption and the risk of T2DM in Asian people.METHODS The selection criterion was defined as a population-based prospective cohort study evaluating the association between coffee consumption and the risk of T2DM in Asian populations,reporting the adjusted relative risk(RR)and its 95%confidence interval(CI)for potential confounders.A fixed-effect model metaanalysis was applied to calculate the summary RR and its 95%CI in less than 50%of the I2 value indicating the level of heterogeneity.A two-stage fixed-effects doseresponse meta-analysis(DRMA)was performed to calculate the risk per unit dose(a cup per day).RESULTS A total of seven studies were selected in this meta-epidemiological study.The risk of T2DM in Asian populations was significantly reduced in the highest to the lowest dose group(summary RR=0.73,95%CI:0.66-0.82;I2 value=0.0%).The DRMA showed that drinking one cup of coffee per day reduced the risk of T2DM in Asian populations by 8%(RR=0.92,95%CI:0.90-0.95).CONCLUSION These findings support the conclusion that coffee consumption has a protective effect on the occurrence of T2DM in Asian men and women.