Prevalence and risk factors of osteoporosis detected by dual-energy X-ray absorptiometry among Chinese patients with primary biliary cholangitis

BACKGROUND Osteoporosis is an extrahepatic complication of primary biliary cholangitis(PBC)that increases the risk of fractures and mortality.However,Epidemiological studies of osteoporosis in patients with PBC in China and the Asia-Pacific region is lack.AIM To assess the prevalence and clinical characteristics of osteoporosis in Chinese patients with PBC.METHODS This retrospective analysis included consecutive patients with PBC from a tertiary care center in China who underwent bone mineral density(BMD)assessment using dual-energy X-ray absorptiometry between January 2013 and December 2021.We defined subjects with T-scores≤-2.5 in any sites(L1 to L4,femoral neck,or total hip)as having osteoporosis.Demographic,serological,clinical,and histological data were collected.Independent risk factors for osteoporosis were identified by multivariate logistic regression analysis.RESULTS A total of 268 patients with PBC[236 women(88.1%);mean age,56.7±10.6 years;163 liver biopsies(60.8%)]were included.The overall prevalence of osteoporosis in patients with PBC was 45.5%(122/268),with the prevalence of osteoporosis in women and men being 47.0%and 34.4%,respectively.The prevalence of osteoporosis in postmenopausal women was significantly higher than that in premenopausal women(56.3%vs 21.0%,P<0.001).Osteoporosis in patients with PBC is associated with age,fatigue,menopausal status,previous steroid therapy,body mass index(BMI),splenomegaly,gastroesophageal varices,ascites,Mayo risk score,histological stage,alanine aminotransferase,albumin,bilirubin,platelet and prothrombin activity.Multivariate regression analysis identified that older age,lower BMI,previous steroid therapy,higher Mayo risk score,and advanced histological stage as the main independent risk factors for osteoporosis in PBC.CONCLUSION Osteoporosis is very common in Chinese patients with PBC,allowing for prior screening of BMD in those PBC patients with older age,lower BMI,previous steroid therapy and advanced liver disease.

Analysis of the Clinical Effect of Chinese Medicine Combined with Acupuncture and Moxibustion on Insomnia

Objective:To explore and analyze the clinical efficacy of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia.Method:80 patients with primary insomnia were selected as the study sample,with 20 cases randomly selected as the control group and the rest as the observation group.The control group was treated with ordinary western medicine,while the observation group patients were treated with traditional Chinese medicine combined with acupuncture and moxibustion based on this syndrome differentiation.The comparison items were treatment effect,sleep quality,mental health,quality of life,specific sleep indicators,cerebral blood flow and neurotransmitters.Result:The treatment effectiveness showed that the observation group had a higher treatment effectiveness rate than the control group(P<0.05);The results of sleep quality showed that after treatment,the scores of the observation group were lower than those of the control group in seven dimensions:sleep quality,sleep time,sleep onset time,sleep efficiency,sleep disorders,hypnotic drugs,and daytime dysfunc‐tion score(P<0.05);The quality of life results showed that after treatment,the observa‐tion group had higher scores than the control group in eight dimensions:physiological function,physiological function,physical pain,health status,energy,social function,emotional function,and mental health(P<0.05);The results of slow wave sleep time and fast eye movement sleep time showed that after treatment,the HAMA and HAMD scores of the physiological mechanism in the observation group were lower than those in the control group(P<0.05);The results of cerebral blood flow and neurotransmitter indica‐tors show that after treatment,glutamateγ-The peak systolic blood flow velocity of ami‐nobutyric acid,vertebral artery,and basilar artery in the observation group was higher than that in the control group(P<0.05).Conclusion:The clinical treatment of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia patients can significantly improve the clinical treatment effect,and improve the cerebral hemorrhage and neurotransmitter status of patients,promote the improvement of their physical and mental status,can more significantly improve the quality of sleep,reduce sleep difficulties,reduce the dosage of sleeping pills,which has important clinical application value.

Updated Genetic Testing of Primary Hyperoxaluria Type 1 in a Chinese Population:Results from a Single Center Study and a Systematic Review

Primary hyperoxaluria type 1(PH1)is a rare but devastating autosomal recessive inherited disease caused by mutations in gene AGXT.Pathogenic mutations of AGXT were mostly reported in Caucasian but infrequently in Asian,especially in Chinese.To update the genotypes of PH1 in the Chinese population,we collected and identified 7 Chinese probands with PH1 from 2013 to 2017 in our center,five of whom had delayed diagnosis and failed in kidney transplantation.Samples of peripheral blood DNA from the 7 patients and their family members were collected and sequencing analysis was performed to test the mutations of gene AGXT.Western blotting and enzyme activity analysis were conducted to evaluate the function of the mutations.Furthermore,a systematic review from 1998 to 2017 was performed to observe the genetic characteristics between Chinese and Caucasian. The results showed that a total of 12 mutations were identified in the 7 pedigrees.To the best of ourknowledge,2 novel variants of A GXT,p.Gly41 Trp and p.Leu33Met,were first reported.Bioinformatics and functional analysis showed that only 7 mutations led to a reduced expression of alanine-glyoxylate amino transferase (AGT)at a protein level.The systematic review revealed significant population heterogeneity in PH1.In conclusion,new genetic subtypes and genetic characteristics of PH1 are updated in the Chinese population. Furthermore,a genotype-phenotype correlation is found in PH1.

CLINICAL STUDY ON IRRADIATION COMBINED WITH TRADITIONAL CHINESE MEDICINE IN THE TREATMENT OF LARGE PRIMARY LIVER CANCER

This paper resports the response of inoperable primary liver cancer to whole liver irradiation(WLI)by movingstrip technique(MST)during the period from 1980- 1988.The results showed that WLI by MST gave good response in this malignancy.The 5-year survival after treatment was 30.83% and median survival 25.8 months.The analysis of prognostic factors indicated that the higher the midplane tissue dose(mTD),the longer the survival(P<0.001),and that the survival of those patients tumor diameter was>8 to<13 cm and/or tumor volume>50% to <75% of liver volume was longer than that of there with tumor diameter of≥13 cm and/or tumor volume≥75% of the liver volume(P<0. 001 ).Traditional Chinese medicine is an indispensable therapy during the period of WLI by MST.Both clinical and experimental studies suggest that WLI by MST can enhance the therapeutic effect.

Management guidelines for primary lung cancer 2018: Chinese standards in clinical practice

Chinese guidelines for diagnosis and treatment of primary lung cancer 2018 are a set of clinical standards for screening, diagnosis and treatment of lung cancer in China (1). It covers the specialties of epidemiology, radiology, pathology, surgery, medical oncology, radiotherapy, endoscopy, nuclear medicine, and so on. The guidelines are referred to by physicians, medical students and patients, through providing comprehensive and detailed knowledge and recommendations in clinical practice on lung cancer diagnosis and treatment.

A comprehensive review of research progress in Chinese medicines for primary liver cancer treatment

Primary liver cancer seriously threatens human health,affects the quality of life,and has a high mortality rate.Traditional Chinese medicine(TCM)has long been used in the prevention,treatment,and adjuvant treatment of primary liver cancer.Clinical trials were conducted in recent years to evaluate the efficacy and safety of TCM.The mechanism of action of TCM in primary liver cancer treatment also received extensive attention.This study summarizes the common monomial Chinese herbal medicines and their components,formulae,and the proprietary Chinese medicines used to treat primary liver cancer.Common medicines include Chansu(Bufonis venenum),Kushen(Sophorae flavescentis radix),Renshen(Ginseng radix et rhizoma),and Jianghuang(Curcumae longae rhizoma).This study also reviewed the literature on liver cancer treatment using TCM.The results confirmed the safety and efficacy of TCM in liver cancer treatment.The possible mechanisms involved are also listed,including influencing the cell cycle,inducing cancer cell apoptosis and autophagy,inhibiting cancer cell angiogenesis and metastasis,regenerating the microenvironment and DNA methylation,and regulating the innate immune response.For primary liver cancer patients who often have a long disease course,Chinese herbal medicine often plays a role in protecting and conditioning the body.Research aimed at finding more traditional Chinese herbal medicines and their mechanisms of action should be promoted.This study aimed to provide a scientific reference for further research and the rational clinical application of TCM for primary liver cancer treatment.

Progress in clinical research on the integration of Chinese and Western medicines for treating primary liver cancer

Primary liver cancer(PLC) is one of the most common malignant tumors in China. PLC is characterized by insidious onset, rapid progress, poor quality of life, and short survival time. Notably, current treatment strategies remain unsatisfactory. Traditional Chinese medicines(TCM) have been used to treat a variety of diseases, including liver diseases, for more than 2000 years. In this study, we performed a review of the use frequency and clinical efficacy of TCM in treating PLC. Relevant literature from January 1, 2009, to January 1, 2021 was retrieved from network databases of China National Knowledge Infrastructure(CNKI), Chongqing VIP, Wanfang, PubMed, and SinoMed. The most frequently used TCM and their efficacy in PLC treatment were summarized. Based on the inclusion and exclusion criteria, 33 articles were selected. Overall, the efficacy of the combination of TCM and Western medicines in the treatment of PLC was higher than that in the control groups(i.e. treatment with Western medicines alone)(65.11% vs.44.31%, P <.05). Among the 33 selected articles, 11 were investigated for TCM preparation(marketed drugs) and 22 for TCM formulas. In total, 102 types of TCM(single herbs) were used to treat PLC. The top five most frequently used TCM were Poria(14.71%), Astragali radix(13.73%), Atractylodis Macrocephalae Rhizoma(12.75%), Bupleuri radix(12.75%), and Glycyrrhizae radix et Rhizoma(11.76%). Of the 102 types of TCM, tonics were the most frequently used categories, followed by heat-clearing medicines, blood-invigorating medicines, and stasis-resolving medicines. Of 207 papers, 174(84.06%) could not be subjected to statistical analysis due to research quality. Further high-quality research on herb sources, formula components and dosage, toxicology, and ethics of TCM is necessary. In conclusion, TCM play a promising role in the treatment and management of PLC, although further investigations are warranted.

Chinese Shale Gas Exploration Started Officially and Primary Results Achieved

Shale gas is a new, clean and efficient unconventional oil and gas resource, and it has become a new highlight of global oil and gas exploration and exploitation. In recent years, the Ministry of Land and Resources of The People＇s Republic of China launched the program Investigation and Evaluation of China Shale Gas Resources and Favorable Areas Preferred, which has evaluated the shale gas resource potential and selected potential areas for exploration and exploitation.

Effectiveness and Safety of Chinese Medicine in the Treatment of PostTACE Syndrome of Primary Hepatocellular Carcinoma:A Systematic Review

Objective:To systematically evaluate the effectiveness and safety of traditional Chinese medicine(TCM)in the treatment of posttransarterial chemoembolization(TACE)syndrome of primary liver cancer.Methods:CNKI,VIP database,Wanfang database,CBM,PubMed,MEDLINE,and Cochrane library were retrieved,and the RCTs of Chinese medicine in the treatment of primary liver cancer TACE postoperative syndrome were included from the establishment of the database to March 2022.The Cochrane bias risk tool was used to evaluate the quality of included articles.RevMan 5.4 software was used for metaanalysis of outcome indicators and GRADEprofiler 3.6 software was used to evaluate the quality of evidence.Results:A total of 3992 patients were included in 44 studies.Metaanalysis results showed that compared with conventional western medicine treatment,combined Chinese medicine treatment could reduce the incidence of fever[RR=1.45,95%CI(1.09,1.92)],nausea and vomiting[RR=1.47,95%CI(1.10,1.95)],liver pain[RR=1.21,95%CI(1.02,1.43)];shorten the duration of fever[SMD=2.11.95%CI(1.43,2.79)],nausea and vomiting[SMD=1.67,95%CI(1.22,2.11)],hepatic pain[SMD=1.90,95%CI(1.30,2.51)],abdominal distension and pain[SMD=1.27,95%CI(0.75,1.79)],loose stool[SMD=2.30,95%CI(1.24,3.36)],constipation[SMD=2.18,95%CI(1.52,2.84)]after TACE,also it can improve patient quality of life[RR=0.73,95%CI(0.65,0.82)],clinical TCM syndrome[RR=0.73,95%CI(0.65,0.82)],shortterm efficacy[RR=0.75,95%CI(0.66,0.85)],oneyear survival rate[RR=0.87,95%CI(0.78,0.96)]and liver function and immune function.There was no significant difference in the incidence of abdominal distension and abdominal pain.Conclusion:Compared with only symptomatic western medicine after surgery,the combination of Chinese medicine has a significant effect and good safety in the treatment of postTACE syndrome.

Chinese Guqin Music and Calligraphy for Treating Symptoms of Primary Insomnia

Purpose:To investigate the intervention effiects of using traditional Chinese Guqin music and Chinese Calligraphy handwriting(CCH)for patients with Primary Insomnia.Methods:A total of ninety patients were assigned to control group,Guqin group,and calligraphy group for 8 weeks.For 5 days a week,patients’heart rate variability(HRV)and frontal midline(FZ)electroencephalographic signals were recorded in a clinic during interventional period while either listening to Guqin music or writing calligraphy.Patients in the control group remained in rest condition.Results:For the Guqin group,the higher low-frequency-range HRV of coherence was found with marginal significance(P=0.055),and heart rate was significantly reduced(P<0.05)during Hie 4^th week in listening to Guqin music compared to the prerest period.For listening to Guqin music or calligraphy intervention,FZδ,FZθ,and FZα waves in the 8^th week compared to the 0^th week(Pre Intervention)showed a significantly enhanced effect(.P<0.05).Between the three groups,for heart rate and FZδ and FZθ waves,calligraphy group showed significantly increased heart rate than the Guqin group(P<0.001)and the control group(P=0.004);increased FZδ wave than die Guqin group(P<0.001)and the control group(P<0.001);and increased FZθ wave than the Guqin group(P=0.024)and the control group(P=0.008)respectively.Conclusion:Positive intervention effects on 11RV coherence of Guqin music;FZδ,FZθ,and FZα waves of Guqin music and calligraphy proved that Guqin music together with calligraphy training helping to promote physical and mental health,thereby it contributes to the clinical application of TCM Psychology for patients with insomnia syndrome.

Ziwan-Taoren herb pair can exert an therapeutical effect in primary Sjogren’s syndrome through inhibiting the TLR/NF-κB pathway

Background:Ziwan and Taoren(ZT)is a classic medicine pair in the formula of Mai Dong Di Shao Decoction,has been used to treat primary Sjogren’s syndrome(pSS)for more than 20 years.But its action mechanism is still unknown.This study is aimed to reveal the potential mechanism of ZT treated pSS and discover its active compounds of ZT and therapeutic target for pSS.Methods:Firstly,the potential pathways of ZT for pSS treatment were predicted through network pharmacology and GO and KEGG enrichment analysis.Secondly,the inter-structural relationships between active compounds of ZT and target proteins were visualized using molecular docking techniques.Finally,efficacy and mechanism were conducted through in vivo experiments,such as water intake,spleen index,hematoxylin-eosin staining pathological changes,ELISA,Western Blot analysis,and immunofluorescence staining.Results:Nine active compounds were extracted from network pharmacology,including quercitrin,luteolin,kaempferol,β-sitosterol,isorhamnetin,galangin,hederagenin,diosmetin and gibberellin 7.Seven disease targets were identified:RELA,TP53,AKT1,interleukin(IL)6,MAPK1,ESR1,IL10;with RELA being the most core target.KEGG and GO enrichment analysis indicated that ZT may act through the TLR/NF-κB/RELA inflammatory mechanism process.preliminary results of molecular docking showed that ZT’s active compounds bind well to the RELA(p65)receptor.In vivo results demonstrated that a high dose of ZT significantly improved water intake and reduced lymphocytes infiltration in submandibular gland pathology in NOD mice.The expression content of AQP5 and vasoactive intestinal peptide in the submaxillary gland was significantly increased,while levels of inflammatory factors such as tumor necrosis factor-α,IL-6,and IL-1βalong with protein expressions including toll-like receptor4,p-p65 and p-IKKα/βin NF-κB pathway were reduced.Conclusions:The ZT treatment exhibits a promising efficacy in mitigating dryness symptoms of pSS,potentially attributed to its capacity for suppressing the TLR/NF-κB inflammatory signaling pathway.

The Effect of a Visual Memory Training Program on Chinese Handwriting Performance of Primary School Students with Dyslexia in Hong Kong

This study investigated the effect of a visual memory training program on Chinese handwriting performance among primary school students with dyslexia in Hong Kong. Eight students of Grade 2 to 3 who were diagnosed with dyslexia were recruited. All participants received six sessions of training, which composed of 30-minute computerized game-based visual memory training and 30-minute Chinese character segmentation training. Visual perceptual skills and Chinese handwriting performance were assessed before and after the training, as well as three weeks after training using the Test of Visual Perceptual Skills (3rd edition) (TVPS-3) and the Chinese Handwriting Analysis System (CHAS). In comparing the pre- and post-training results, paired t-tests revealed significant improvements in visual memory skills, as well as handwriting speed, pause time and pen pressure after the training. There was no significant improvement in handwriting accuracy or legibility. The improved visual memory and handwriting performance did not show a significant drop at the follow-up assessments. This study showed promising results on a structured program to improve the Chinese handwriting performance, mainly in speed, of primary school children. The improvements appeared to be well-sustained after the training program. There is a need to further study the long-term effect of the program through a randomized controlled trial study.

Research based on data mining compatibility of traditional Chinese medicine with Professor WANG Dong-mei in the treatment of primary dysmenorrhea

Objective:To study the law of compatibility of traditional Chinese medicine in the treatment of primary dysmenorrhea by Professor WANG Dong-mei.Methods:This study collected the Professor WANG Dong-mei’s prescriptions for primary dysmenorrhea cases in the outpatient department,to establish a database by Excel 2015,and to use IBM SPSS statistics 24.0 and SPSS Clementine 12.0 software for clustering analysis and association rules data mining analysis.Results:A total of 106 cases were included,106 prescriptions were collected,114 kinds of drugs were used,nd the cumulative frequency of drug use was 1876 times;the top three drugs were white peony(89 times),Xiangfu(77 times),red peony(75 times);the drugs with the most drug properties and taste frequency were warm and sweet drugs,which were mainly liver meridian;four common pair-used drug groups were Xiangfu yanhusuo,angelica white peony etc.and six groups were common clustering groups.Conclusion:Professor WANG Dong-mei usually chooses the drugs of sweet,warm or spicy in the treatment of primary dysmenorrhea.In addition to the natural efficacy,Prof.Wang also considers modern pharmacological effect in the specific drug selection.The commonly used prescription combination is Shaofu Zhuyu Decoction,which embodies Professor WANG Dong-mei's academic thought of treating primary dysmenorrhea"mainly by warming and regulating qi and blood",and for patients with reproductive needs,in addition to promoting blood circulation and relieving pain,she also adds menstruation regulating and pregnancy aiding drugs,which can not only improve the symptoms of primary dysmenorrhea,but also meet their fertility desire.

Professor Liu Guobin used traditional Chinese medicine to cure a case of primary erythema limb pain

Primary erythema limb pain is a very rare disease,and its pathogenesis is not clear.Usually,the pain symptoms of patients exist for a long time,which seriously affect the daily life of patients and increase the economic burden of patients.Professor Liu Guobin,who has been engaged in the diagnosis and treatment of peripheral vascular diseases for nearly 30 years,believes that heat-toxin and blood stasis collaterals are closely related to the disease,and emphasizes the principle of heat-toxin and evil qi causing the disease.It is emphasized that clearing heat and detoxification,promoting blood circulation and dispersing blood stasis are the main treatment principles.This paper selects a typical case to describe Professor Liu's clinical experience in the treatment of primary erythema limb pain by oral and external use of traditional Chinese medicine,so as to provide an effective method of traditional Chinese medicine for the treatment of primary erythema limb pain.

Enhancement, Burden Alleviation, Flexibility and Innovation: Some Thoughts on the Preparation of Lower Grades' Chinese Examination Papers in Primary Schools

1. Introduction In the current educational status, the examination is a feasible and fair evaluation method, which can not only test teachers' teaching result and students' learning status, but serve as the baton to lead the teaching's developing direction. But no matter what kind of examination methods are carried out, written assessment is one of the indispensable and important forms. Although we do not advocate its "life-determining nature", we can not deny that an examination paper can still give a more objective assessment to a student's learning level in a relatively complete learning phase.

Visualization analysis of traditional Chinese medicine treatment for primary immune thrombocytopenia based on CiteSpace

Objective:To analyze the hot spot and frontier of traditional Chinese medicine treatment for primary immune thrombocytopenia with CiteSpace softwar for visualized analysis.Methods:The relevant literature about treatment for ITP through traditional Chinese medicine was retrieved from CNKI.The CiteSpace software was used to create visualization map for authors,institutions and keywords.Results:Through visualization analysis,121 authors and 36 institutions were included in the map.The main research hot spot is the clinical effect of traditional Chinese medicine and integrated traditional Chinese and Western medicine in the treatment for ITP.Conclusion:Ratio of research about traditional Chinese medicine treatment on ITP was relatively few.In addition,the cooperation and communication were also insufficient between teams and institutions.The research hot spot mostly focuses on clinical treatment,while theoretical research was very few.There is no deep investigation on treatment mechanism.

Effects of ginger moxibustion combined with Chinese medicine iontophoresis on patients with primary dysmenorrhea

Objective:To observe the effects of Ginger moxibustion combined with iontophoresis with traditional Chinese medicine on the improvement of symptoms, serum platelet activating factor (PAF) level and uterine artery pulsation index in patients with primary dysmenorrhea.Methods 114 patients with primary dysmenorrhea who were treated in our hospital from August 2017 to February 2019 were divided into two groups according to the different treatment schemes. 57 patients in the control group were treated with ibuprofen capsules, and 57 patients in the study group were treated with Ginger moxibustion combined with iontophoresis with traditional Chinese medicine. After three menstrual cycles of treatment, the curative effect was evaluated and the improvement of symptoms was counted. PAF, PAF-AH and platelet adhesion rate were compared, uterine artery hemodynamics was measured, and levels of serum hs-CRP and IL-6 were measured.Results The overall response rate of the study group was significantly higher than that of the control group (P < 0.05). After treatment, the scores of different symptoms in the two groups were significantly lower than those before treatment (P < 0.05), and the scores of different symptoms in the study group were significantly lower than those in the control group (P < 0.05). After treatment, PAF and platelet adhesion rate in the two groups were significantly lower than those before treatment (P < 0.05), PAF-AH was significantly higher than that before treatment (P < 0.05), and PAF and platelet adhesion rate in the study group were significantly lower than those in the control group (P < 0.05), PAF-AH was significantly higher than that in the control group (P < 0.05). After treatment, the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those before treatment (P < 0.05), and the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of serum hs-CRP and IL-6 in the two groups were significantly lower than those before treatment (P < 0.05), and the levels of serum hs-CRP and IL-6 in the study group were significantly lower than those in the control group (P < 0.05).Conclusions Ginger moxibustion combined with iontophoresis with traditional Chinese medicine is helpful to improve the overall response rate of primary dysmenorrhea treatment, reduce the score levels of different symptoms, rationally improve PAF, PAF-AH, platelet adhesion rate, and the pulse index, resistance index, peak systolic-diastolic ratio are decreased significantly, and serum hs-CRP and IL-6 levels tend to be normal.

A Comparison of the Character,Target and Content of Teaching Chinese as a Foreign Language and the Chinese Courses at Primary School

This article examines the opinion that teaching Chinese as a foreign language(TCFL)is equivalent to teaching Chinese at primary school by analyzing the differences between the character,target and content of the two courses and reasons for their differences to provide theories and practical support for a more reasonable and effective teaching.