Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

Research Progress in Integrated Chinese and Western Medicine Health Management for School-Age Children with Asthma

Objective:The purpose of this study is to investigate the application of Chinese and Western medicine in the health management of school-age children with asthma and its research progress,with a view to providing a more comprehensive and effective management strategy for the clinic.Methods:Using the method of literature review,this study systematically searched and analyzed the relevant studies on the combination of Chinese and Western medicine in the health management of school-aged children with asthma in recent years,focusing on Chinese medicine treatment,Western medicine treatment,and the combined health management of Chinese and Western medicine.Results:Chinese medicine treatment,Western medicine treatment,and the health management mode of combining Chinese and Western medicine showed unique advantages in school-age asthmatic children.Through the comprehensive use of Chinese medicine’s diagnosis and treatment,Chinese medicine conditioning,Chinese medicine characteristic therapy,and Western medicine’s modern medical methods,it not only effectively relieved asthma symptoms but also significantly improved the quality of life of the children.At the same time,this management mode also focuses on the psychological guidance and family care of the children,forming an all-round and multi-level health management system.Conclusion:The health management strategy of combining Chinese and Western medicine has a broad application prospect in school-age asthmatic children,and its specific interventions and mechanisms of action should be further studied to provide more scientific and systematic guidance for clinical practice.

Research Progress on Combined Chinese and Western Medicine Treatment of Mycoplasma pneumoniae Pneumonia in Children

With the continuous development of medical technology,combined treatment of Chinese and Western medicine has gradually become a research hotspot.As a common disease in pediatrics,the treatment of Mycoplasma pneumoniae pneumonia(MPP)in children is also being explored and improved.This article summarizes the research progress of combined Chinese and Western medicine treatment of MPP in children in recent years,aiming to provide a useful reference for the combined treatment of MPP in children.The article firstly introduces the etiology and pathogenesis of MPP in children,thereafter briefly introduces the Western anti-infective treatment and traditional Chinese medicine(TCM)diagnosis and treatment of MPP in children,and lastly introduces the methods of combined treatment of TCM and Western medicine in detail.The article points out that the combination of Chinese and Western medicine can give full play to the overall regulation of Chinese medicine and the precise treatment advantages of Western medicine,improve the therapeutic effect,reduce the use of antibiotics,and lower the recurrence rate of the disease,which is worthy of further research and promotion.

Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.

Discussion and Practice on Talent Cultivation Model Based on OBE Concept in Veterinary Medicine Graduate Education

To address the challenges in training veterinary master’s students,it is essential to align with the core objectives of veterinary graduate education.This involves focusing on faculty development,course design,innovative teaching methods,university-industry collaboration,and reforming the evaluation system.By applying the outcome-based education model,new approaches to veterinary graduate training can be developed,particularly for applied talent development in agricultural universities serving local communities.This innovative model emphasizes ideological and political education,aiming to enhance students’abilities in knowledge and practical innovation,preparing them to be well-rounded professionals.The goal is to cultivate senior veterinary experts who are not only skilled in academic research and scientific inquiry but also committed to advancing agriculture,rural areas,and supporting rural revitalization.This approach provides a valuable framework for fostering highly qualified graduates who are both technically proficient and socially responsible.

Structural and functional characteristics of microbiota in oropharynx of sub-healthy children with gastrointestinal heat retention syndrome differentiated by traditional Chinese medicine

Objective:To explore the structural and functional characteristics of microbiota in oropharynx of subhealthy children with gastrointestinal heat retention syndrome(GHRS)differentiated by traditional Chinese medicine,and screen the biometric operational taxonomic units(OTUs)to assist the clinical diagnosis.Methods:We recruited children according to the“GHRS diagnostic scale”,collected their oropharyngeal swabs,and sequenced the 16 SrDNA V4 region.We described the bacterial structure with alpha-indexes,beta-distances,and relative abundances;moreover,we screened the differential genera/OTUs with Wilcoxon rank-sum test,Metagenome Seq analysis,and linear discriminant analysis effect size(LEf Se)analysis,in which biometric OTUs were selected to construct the receiver operating characteristic curve to verify the diagnostic value.The bacterial function was predicted with Kyoto Encyclopedia of Genes and Genomes pathways according to 16S rDNA gene by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.Results:The study population was composed of 10 children with GHRS and 10 healthy control children.GHRS children were more likely to overeat(gluttony,P=.033).Alpha-indexes,such as Sobs,abundancebased coverage estimator,Bootstrap,and Qstat,were significantly higher in the GHRS group,while betadistances did not exhibit any significant intergroup differences.There were 9 differently distributed nonpredominant genera between the groups in Wilcoxon rank-sum test,as well as 13 non-predominant genera in Metagenome Seq analysis and 3 non-predominant OTUs in LEfSe analysis.OTU44 and OTU196 were used to construct the receiver operating characteristic curve,and the area under curve was 0.92.Predicted functions showed that pathways related to oxidative phosphorylation and carbon metabolism were enriched in healthy control samples,while the pathway related to renin secretion was remarkably enriched in GHRS samples.Conclusion:Unique oropharyngeal microbial structure and function were identified in GHRS children.OTU44 and OTU196 were specific OTUs,which could be used as biomarkers of GHRS to assist clinical diagnosis.

Complementary and alternative medicine use by Japanese children with pediatric surgical diseases

Background: This study aimed to survey the use of complementary and alternative medicine (CAM) therapies in Japanese children with major pediatric surgical diseases. Methods: This survey was mailed to each family of 355 patients. Results: One hundred fifty-three (43%) of 355 mailed questionnaires were completely returned. Forty-one (27%) of 153 parents responded that they used CAM for their child. There was no significant difference in CAM use according to sex, mean age, follow-up duration, family CAM users, and associated disorders between CAM users and non-users. Children with inflammatory bowel disease (IBD) were significantly more likely to use CAM than children without IBD (65% vs 21%, p = 0.0001). Only 20% of parents informed the attending physicians about CAM before its use. Conclusions: It is important for physicians caring for children with pediatric surgical disease, especially IBD, to be familiar with common forms of CAM.

Meta-analysis on the treatment of adenoid hypertrophy in children with integrated traditional Chinese and western medicine

Objective: To evaluate the effect of combined Chinese and western medicine on children withadenoidal hypertrophy. Methods: System comprehensive retrieve hownet (CNKI), a database of ten thousand China (WanFang), Chinese biomedical database (CBM), weipu database (VIP), PubMed, Embase and Cochrane library database, retrieval time from March 1, 2009 to December 31, 2019, the use of "Cochrane bias risk assessment tools to have included in the quality of literature evaluation, and to use the literature on into RevMan 5.3 software for Meta quantitative analysis. A total of 10 references were included in this study, and a total of 464 clinical cases were included in the total sample size for meta-analysis, including 242 in the experimental group and 222 in the control group. Results: The statistical data show that the total effective rate of combined traditional Chinese and western medicine for the treatment of adenoid hypertrophy in children is higher than that of western medicine alone (OR = 4.27, 95% CI: 2.50, 7.13, P <0.00001) The effect of nasal congestion caused by adenoid hypertrophy in children is better than that of western medicine alone (MD =-0.64, 95% CI [-0.94, -0.35], P <0.0001);the effect of improving snoring symptoms in children Better than using western medicine alone, the difference is statistically significant (MD =-0.66, 95% CI [-1.11, -0.21], P <0.01);the effect of reducing the relative ratio of adenoid and posterior nostril is better than that of pure The difference was statistically significant when treated with Chinese or Western medicine (MD =-0.18, 95% CI [-0.24, -0.12], P <0.00001). Conclusion: Based on the existing data and methods, traditional Chinese medicine combined with western medicine has a reliable effect on adenoid hypertrophy in children. It is superior to western medicine alone in terms of treatment efficiency and improvement of clinical symptoms, without serious adverse reactions.

Availability,Management and Use of Priority Life-Saving Medicines for Under-Five Children in Two Health Districts in Senegal:A Cross-Sectional Study

Under-five mortality remains a major concern in the world and in Senegal. It is mainly due to preventable and treatable diseases with priority life-saving medicines for under-five children. This study evaluated the availability, management and use of these drugs in two health districts in Senegal. A descriptive cross-sectional study was conducted in the health districts of Guediawaye and Pete from 01 November 2018 to 31 January 2019. The health district of Guediawaye is in the region hosting the Senegalese capital while that of Pete is located in the region of Saint Louis, northern Senegal. Nine drugs that can prevent and treat malaria, diarrhea, pneumonia and malnutrition were selected. An inventory form and a self-administered questionnaire were used to collect data that was analyzed with SPSS and expressed as a percentage and average. Drug availability was 50.4% and 54.3% in Guediawaye and in Pete, respectively. Average stock-out duration in the past three months was estimated at 22.6 and 26 days, respectively. The drug management was marked, on the one hand, by a good availability of stock cards in the two districts with proportions equal to 100% and 94.1%, respectively, and on the other hand, by the presence of expired stocks in Pete (12.2%). About 79% and 88% of prescribers reported prescribing the basket drug, respectively. These results show that access to priority life-saving medicines for children remains a challenge. Measures to be taken should include improving the distribution channels and training of health professionals. Further studies should be conducted in other health districts to better understand the barriers to access to child health services.

Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine

AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients. METHODS: Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2 h and external use of Glauber's salt, once a day for 7 d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE Ⅱ scores were applied in analysis. RESULTS: On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group(P < 0.05). On days 3-5 of treatment, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores for the study and control groups were significantly different (P < 0.05). Both the effectiveness and outcome of the treatment with Da Cheng Qi Decoction on abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P < 0.05). The mortality rate for the two groups had no significant difference. CONCLUSION: Da Cheng Qi Decoction enema and external use of Glauber's salt combined with routine non-operative conservative treatment can decrease the intra-abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAP.

How do Chinese medicines that tonify the kidney inhibit dopaminergic neuron apoptosis?

Wistar rats were intragastrical y perfused with Chinese medicines used for tonifying the kidney. These included 0.180 g/mL of Herba Epimedi （Epimedium）, Semen Cuscutae （Dodder Seed）, or Herba Cistanches （Desertliving Cistanche）, 0.04 mg/mL monoamine oxidase-B inhibitor selegiline, or distil ed water for 14 consecutive days to prepare drug-containing serum or blank serum. MES23.5 cells in the logarithmic phase were cultured in media supplemented with 15%drug-containing serum for 24 hours, fol owed by incubation in culture solution containing 100μmol/L H2O2 for 3 hours. 3-（4,5-Dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） and flow tometry results showed that al drug-containing serums improved the survival rate of H 2 O 2-injured MES23.5 cells, inhibited pro-apoptotic FasL and caspase-3 expression, promoted anti-apoptotic Bcl-2 expression. However, drug-containing serums had little influence on Fas expression in H 2 O 2-injured MES23.5 cells. Enzyme-linked immunosorbent assay results showed that serum containing Herba Cistanches or Herba Epimedi increased the expression of nerve growth factor, brain-derived neurotrophic factor, and glial cellline-derived neurotrophic factor in injured MES23.5 cells;serum containing Semen Cuscutae only increased brain-derived neurotrophic factor expres-sion; while expression of the above neurotrophic factors remained the same in cells treated with serum containing selegiline. These findings indicate that Chinese medicines used to tonify the kid-ney can protect nerve cells by regulating the expression of apoptosis-related factors and neuro-trophic factors in MES23.5 cells.

Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports

BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been reported world-wide.In children,the clinical symptoms are similar to appendicitis.As most of the imaging features are nonspecific,the preoperative diagnosis is not precise.In addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric appendicitis.Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal bleeding.CASE SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular inflammation.All three patients,aged 11-12 years,had acute appendicitis as their initial clinical presentation.All were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also provided.CONCLUSION Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children.Laparoscopy combined with laparotomy is useful for diagnosis and treatment.

Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model

An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems.

Design of a Landscape Device for Children from the Perspective of Embodied Cognition in the New Era

In recent years,embodied cognition has ushered in a new research upsurge in the academic field,and has become a hot topic in the field of cognitive psychology.In this paper,from the perspective of embodied cognition,the interaction ways of a landscape device for children were discussed to achieve a more real and harmonious interaction between children and scenes.The research data of embodied cognition used by children was analyzed,and the drawbacks and breakthrough points of current landscape devices for children were discussed.The core characteristics of children’s growth period were extracted to establish children’s interaction model and summarize the interactive design methods of landscape devices for children.Embodied cognition has become the most intuitive way for children to know and understand the environment,and plays a pivotal role in children’s growth.Based on embodied cognition principle and interactive behavior mode,the interactive design of a landscape device for children was studied,and three interactive design modes,including simple and convenient interaction mode,multi-sensory interaction mode and game natural interaction mode were summarized.On the basis of this research,relevant design practice and research were carried out to bring a new vision to the design of children’s landscape.

Planning a Patient-Centered Parkinson’s Disease Support Program: Insights from Narrative Medicine

Background: We desired relevant information from patients with Parkinson’s disease (PD) and their caregivers for help in planning a long-term support program. Methods: We compared 3 ap-proaches: 1) a standard needs assessment questionnaire, the Camberwell assessment of need in the elderly, 2) an open-ended listing of needs, and 3) participation in a narrative medicine program in which health care professionals were involved. Results: On the questionnaire, patients reported physical needs as the most important while their caregivers were more concerned about psychological needs. The open-ended listings revealed additional needs, particularly access to re-liable information about PD and to opportunities to participate in clinical research. The narrative medicine process yielded a number of new insights and proposed solutions, particularly related to the heterogeneity of needs across individuals, the importance of providing hope, and the fact that caregivers expressed that their needs had been largely neglected. Participation in the narrative medicine sessions led to an increase in measured empathy by health care professionals, an im-provement in measured depression among PD patients, but a worsening of measured depression among the caregivers. Conclusions: We have identified important needs and potential solutions to be considered in providing long-term support to patients with PD and their caregivers.

Regulating effect of Chinese herbal medicine on the peritoneal lymphatic stomata in enhancing ascites absorption of experimental hepatofibrotic mice

AIM: To observe the regulatory effect of Chinese herbal medicine on peritoneal lymphatic stomata and its significance in treating ascites in liver fibrosis model mice. METHODS: Two Chinese herbal composite prescriptions were used separately to treat the carbon tetrachloride-induced mouse model of liver fibrosis. The histo-pathologic changes of the liver sections (HE and VG stainings) were observed. The peritoneal lymphatic stomata was detected by scanning electron microscopy and computer image processing. The changes of urinary volume and sodium ion concentration were measured. RESULTS: In the model group, lots of fibrous tissue formed in liver and extended into the hepatic lobules to separate them incompletely. In the treated and prevention groups, the histo-pathologic changes of liver was rather milder, only showed much less fibrous tissue proliferation in the hepatic lobules. The peritoneal lymphatic stomata enlarged with increased density in the experimental groups (diameter: PA, 3.07 +/- 0.69 microm; PB, 2.82 +/- 0.37 microm; TA, 3.25 +/- 0.82 microm and TB, 2.82 +/- 0.56 microm; density: PA, 7.11 +/- 1.90 stomata.1000 microm(-2); PB, 8.76 +/- 1.45 stomata.1000 microm(-2); TA, 6.55 +/- 1.44 stomata.1000 microm(-2)and TB, 8.76+/-1.79 stomata.1000 microm(-2)), as compared with the model group (diameter: 2.00+/-0.52 microm density: 4.45+/-1.05 stomata.1000 microm(-2)). After treatment, the urinary volume and sodium ion excretion increased in the experimental groups (PA, 231.28+/-41.09 mmol.L(-1); PB, 171.69 +/- 27.48 mmol.L(-1) and TA, 231.44 +/- 34.12 mmol.L(-1)), which were significantly different with those in the model group (129.33 +/- 36.75 mmol.L(-1)). CONCLUSION: Chinese herbal medicine has marked effects in alleviating liver fibrosis, regulating peritoneal lymphatic stomata, improving the drainage of ascites from peritoneal cavity and causing increase of urinary volume and sodium ion excretion to reduce the water and sodium retention, and thus have favorable therapeutic effect in treating ascites.

<i>Ratanasampil</i>(Tibetan Medicine, RNSP) Reduces <i>β</i>-Amyloid Protein (Aβ) and Pro-Inflammatory Factor Levels and Improves Cognitive Functions in Mild-to-Moderate Alzheimer’s Disease (AD) Patients Living at High Altitude

Ratanasampil (RNSP) is a traditional Tibetan medicine used for the treatment of stroke and cerebrovascular diseases. Previous discoveries that RNSP can reduce β-amyloid protein levels and increase learning and memory in Alzheimer’s mouse models (Tg2576) led us to investigate whether RNSP can improve cognitive functions in Alzheimer’s patients. In this study, 146 AD patients living in Qinghai province received either one gram or 0.33 gram daily of RNSP for 16 weeks. Placebo patients received Piracetam. Serum Aβ40 and Aβ42 levels were measured at the beginning of the study and after 4 and 16 weeks of treatment. Compared to the same group before treatment, MMSE scores, ADAS-cog scores and ADL scores were significantly improved (p 0.05, p > 0.05). After 16-week treatment, serum TNF-α, IL-1β, IL-6 and Aβ42 levels were significantly decreased (p < 0. 01) in the high-dose RNSP group, whereas no significant differences were found in the low-dose and placebo groups. The Aβ42/Aβ40 ratio was significantly decreased after 4-week and 16-week treatment in the high-dose RNSP group (p < 0. 05, p < 0.01). Furthermore, serum Aβ42 concentrations had a strong positive correlation with TNF-α, IL-1β and IL-6 levels. There were no observable adverse effects in either treatment or control groups. We conclude that further clinical trials of RNSP in Alzheimer disease are warranted.

Emergency medicine in the United States:a systemic review

BACKGROUND:Fifty years of our history in developing and advancing emergency medicine into an independent medical specialty will surely provide emergency medicine colleagues from all over the world with valuable suggestions and guidance.DATA SOURCES:This systemic review is based on the author's extensive experience through active involvement in the national and international development of emergency medicine.RESULTS:Emergency physicians in the U.S.emergency departments and sometimes other settings provide urgent and emergency care to patients of all ages,including definitive diagnosis of emergent conditions,prolonged stabilization of patients when necessary,airway management,and life-saving procedures using rapid sequence intubation and sedation.They use a multitude of diagnostic technologies including laboratory studies,bedside ultrasound and other sophisticated radiology,such as CT scan,and MRI.CONCLUSION:In the U.S.,emergency medicine fits extremely well into the overall medical system,and is clearly the most efficient way to provide emergency patient care.

Integration and implementation of precision medicine in the multifaceted inflammatory bowel disease

Inflammatory bowel disease(IBD)is a complex disease with variability in genetic,environmental,and lifestyle factors affecting disease presentation and course.Precision medicine has the potential to play a crucial role in managing IBD by tailoring treatment plans based on the heterogeneity of clinical and temporal variability of patients.Precision medicine is a population-based approach to managing IBD by integrating environmental,genomic,epigenomic,transcriptomic,proteomic,and metabolomic factors.It is a recent and rapidly developing medicine.The widespread adoption of precision medicine worldwide has the potential to result in the early detection of diseases,optimal utilization of healthcare resources,enhanced patient outcomes,and,ultimately,improved quality of life for individuals with IBD.Though precision medicine is promising in terms of better quality of patient care,inadequacies exist in the ongoing research.There is discordance in study conduct,and data collection,utilization,interpretation,and analysis.This review aims to describe the current literature on precision medicine,its multiomics approach,and future directions for its application in IBD.

On Translation of Children’s Literature Based on Reception Aesthetics:A Case Study of The Secret Garden

Grounded in reader-centered theories,Reception Aesthetics prioritizes the active engagement and acceptance of target readers.This study examines the translation of children’s literature through the lens of Reception Aesthetics,using Li Wenjun’s rendition of The Secret Garden as a case study.The objective is to scrutinize various aspects of the translation-including vocabulary,syntax,rhetorical devices,and cultural nuances-and to discern how the adaptation and application of diverse translation strategies cater to the aesthetic expectations.