THE PROSPECTIVE STUDY OF RELATIONSHIP BETWEEN LOW SELENIUM AND KASHIN-BECK DISEASE

The relationship of causeresult between low selenium (Se) and KashinBeck disease (KBD) was probed by the prospective study of epidemiological method with regarding lowSe as an exposure factor in this paper. 597 healthy children lived in KBD areas with low, middle and high prevalence were divided into the lowSe exposed group and the nonlowSe exposed group according to their Se content in hair. The lowSe exposed group was divided into three subgroups, such as Se content in hair110 ng/g, 110 ng/g<Se content in hair150 ng/g and 150 ng/g<Se content in hair200 ng/g, respectively. Six new cases of the total with KBD (incidence was 0574% personyear) were found in the lowSe exposed group during three years period of the investigation. No new case was found in the non lowSe exposed group . KBD incidence was not significantly different between those two groups. Two new cases were found in children with Se content in hair kept below 110 ng/g during three years (incidence: 121% personyear). SMR in each group indicated that the new cases observed in the lowSe exposed group was remarkable lower than the new cases expected. It was not observed that the doseresponse relationship between lowSe and KBD, and was not supported that the lowSe was a predominant factor to cause KBD.

Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.

Hybrid argon plasma coagulation for the treatment of Barrett’s esophagus:A prospective,multicenter study

BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.

Who can benefit more from its twelve-week treatment:A prospective cohort study of blonanserin for patients with schizophrenia

BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 participants were evaluated in a 12-week,prospective,multicenter,open-label post-marketing surveillance study of BNS.Brief psychiatric rating scale(BPRS)scores were calculated to evaluate the effectiveness of BNS,and its safety was assessed with the incidence of adverse drug reactions.Linear regression was used to screen the influencing factors for the reduction of BPRS total score,and logistic regression was used to identify patients with a better response to BNS.RESULTS The baseline BPRS total score(48.8±15.03)decreased to 27.7±10.08 at 12 weeks(P<0.001).Extrapyramidal symptoms(14.6%)were found to be the most frequent adverse drug reactions.The acute phase,baseline BPRS total score,current episode duration,number of previous episodes,dose of concomitant antipsychotics,and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation.Specifically,patients in the acute phase with baseline BPRS total score≥45,current episode duration<3 months,and≤3 previous episodes derived greater benefit from 12-week treatment with BNS.CONCLUSION Patients in the acute phase with more severe symptoms,shorter current episode duration,fewer previous episodes,and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.

Arthroscopic findings after manipulation under anesthesia in idiopathic capsulitis of the shoulder:A prospective study

BACKGROUND Manipulation under anesthesia(MUA)of the shoulder joint is a commonly used method for the treatment of adhesive capsulitis.Though it has been known to be associated with a variety of complications,there is a paucity of studies describing the arthroscopic findings after MUA.AIM To describe the arthroscopic findings in patients with idiopathic adhesive capsulitis of the shoulder after MUA.METHODS We recruited 28 patients with idiopathic adhesive capsulitis who underwent arthroscopic capsular release.Manipulation of the shoulder was performed under anesthesia in all of these patients before capsular release.Intra-articular findings were recorded during arthroscopic capsular release in these patients.RESULTS All patients showed the presence of synovitis.Twenty-seven patients showed tears in the capsule on the anterior aspect.One patient had an avulsion of the anterior rim of the glenoid and labrum following the manipulation.Four patients had partial rotator cuff tears,and one patient showed a superior labrum anterior posterior lesion,which was not diagnosed preoperatively on magnetic resonance imaging.CONCLUSION MUA leads to rupture of the capsule,which is the desired outcome.However,the site of rupture of the capsule is dependent on the maneuvers of MUA.In addition,partial tears of the rotator cuff and osteochondral fractures of the glenoid can also occur.

Reduction of the incidence and mortality of rectal cancer bypolypectomy:a prospective cohort study in Haining County

AIM: To reduce the incidence and mortality of rectal cancer and address the hypothesis that colorectal cancer often arise from precursor lesion(s), either adenomas or non-adenomatous polyps, by conducting a population-based mass screening for colorectal cancer in Haining County, Zhejiang, PRC. METHODS: From 1977 to 1980, physicians screened the population of Haining County using 15 cm rigid endoscopy. Of over 240000 participants, 4076 of them were diagnosed with precursor lesions, either adenomas or non-adenomatous polyps, which were then removed surgically. All individuals with precursor lesions were followed up and reexamined by endoscopy every two to five years up to 1998. RESULTS: After the initial screening, 953 metachronous adenomas and 417 non-adenomatous polyps were detected and removed from the members of this cohort. Further, 27 cases of colorectal cancer were detected and treated. Log-rank tests showed that the survival time among those cancer patients who under went mass screening increased significantly compared to that of other colorectal cancer patients (P【0.0001). According to the population-based cancer registry in Haining County, age-adjusted incidence and mortality of rectal cancer decreased by 41% and 29% from 1977-1981 to 1992-1996, respectively. Observed cumulative 20-year rectal cancer incidence was 31% lower than the expected in the screened group; the mortality due to rectal cancer was 18% lower than the expected in the screened group. CONCLUSION:Mass screening for rectal cancer and precursor lesions with protocoscopy in the general population and periodical following-up with routine endoscopy for high-risk patients may decrease both the incidence and mortality of rectal cancer.

Inflammatory bowel disease in Estonia:a prospective epidemiologic study 1993-1998a

INTRODUCTIONThe incidence of ulcerative colitis (UC) and Crohn,s disease (CD)in Estonia 1993-1998 was investigated prospectively .The mean annual incidence of UC was 1.7 per 100 000,and that of CD1.4 per 100 000.This population-based study showed much lower incidence of UC and CD than those reported for western and northern Europe .

Human umbilical cord mesenchymal stem cells to treat spinal cord injury in the early chronic phase: study protocol for a prospective, multicenter, randomized, placebo-controlled, single-blinded clinical trial

Human umbilical cord mesenchymal stem cells(hUC-MSCs)support revascularization,inhibition of inflammation,regulation of apoptosis,and promotion of the release of beneficial factors.Thus,they are regarded as a promising candidate for the treatment of intractable spinal cord injury(SCI).Clinical studies on patients with early chronic SCI(from 2 months to 1 year post-injury),which is clinically common,are rare;therefore,we will conduct a prospective,multicenter,randomized,placebo-controlled,single-blinded clinical trial at the Third Affiliated Hospital of Sun Yat-sen University,West China Hospital of Sichuan University,and Shanghai East Hospital,Tongji University School of Medicine,China.The trial plans to recruit 66 early chronic SCI patients.Eligible patients will undergo randomization at a 2:1 ratio to two arms:the observation group and the control group.Subjects in the observation group will receive four intrathecal transplantations of stem cells,with a dosage of 1×106/kg,at one calendar month intervals.Subjects in the control group will receive intrathecal administrations of 10 mL sterile normal saline in place of the stem cell transplantations.Clinical safety will be assessed by the analysis of adverse events and laboratory tests.The American Spinal Injury Association(ASIA)total score will be the primary efficacy endpoint,and the secondary efficacy outcomes will be the following:ASIA impairment scale,International Association of Neural Restoration-Spinal Cord Injury Functional Rating Scale,muscle tension,electromyogram,cortical motor and cortical sensory evoked potentials,residual urine volume,magnetic resonance imaging–diffusion tensor imaging,T cell subtypes in serum,neurotrophic factors and inflammatory factors in both serum and cerebrospinal fluid.All evaluations will be performed at 1,3,6,and 12 months following the final intrathecal administration.During the entire study procedure,all adverse events will be reported as soon as they are noted.This trial is designed to evaluate the clinical safety and efficacy of subarachnoid transplantation of hUC-MSCs to treat early chronic SCI.Moreover,it will establish whether cytotherapy can ameliorate local hostile microenvironments,promote tracking fiber regeneration,and strengthen spinal conduction ability,thus improving overall motor,sensory,and micturition/defecation function in patients with early chronic SCI.This study was approved by the Stem Cell Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University,China(approval No.[2018]-02)on March 30,2018,and was registered with ClinicalTrials.gov(registration No.NCT03521323)on April 12,2018.The revised trial protocol(protocol version 4.0)was approved by the Stem Cell Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University,China(approval No.[2019]-10)on February 25,2019,and released on ClinicalTrials.gov on April 29,2019.

Peanut consumption and reduced risk of colorectal cancer in women:A prospective study in Taiwan

AIM： To examine whether peanut consumption is associated with a reduced risk of colorectal cancer in a prospective cohort with a 10-year follow-up. METHODS： In 1990-1992, residents （12026 men and 11917 women aged 30 to 65 years） in 7 townships, Taiwan, were interviewed and recruited into a cancerscreening cohort and annually followed up. Colorectal cancer cases in this cohort were identified from cancer registry and death certificates. Incidence rates of this disease by the end of 2001 were calculated by gender for the primary study variable and covariates. The dietary intake was assessed by means of weekly food frequency measures, including frequently consumed food groups and folk dishes including sweet potato, bean products, peanut products, pickled foodstuffs, nitrated or smoked foodstuffs. RESULTS： During the study period, 107 new colorectal cancer cases （68 men and 39 women） were confirmed. The multivariate Cox＇s proportional hazard model showed that the relative risk （RR） of peanut consumption was 0.73 [95% confidence interval （CI） = 0.44-1.21] for men and 0.42 （95% CI = 0.21-0.84） for women. However, frequent intake of pickled foodstuffs was harmful for women （RR= 2.15, 95% CI=0.99-4.65）. The risk of colorectal cancer was also elevated among cigarette smokers but not significant （P〈 0.05）.CONCLUSION： This study suggests that frequent intake of peanut and its products may reduce colorectal cancer risk in women, demonstrating the anti-proliferating effect of peanut intake.

Could saline irrigation clear all residual common bile duct stones after lithotripsy?A self-controlled prospective cohort study

BACKGROUND A previous study showed that irrigation with 100 mL saline reduced residual common bile duct(CBD)stones,which potentially cause recurrent stones after endoscopic retrograde cholangiopancreatography.AIM To determine whether saline irrigation can improve CBD clearance after lithotripsy.METHODS This prospective self-controlled study enrolled patients receiving mechanical lithotripsy for large(>1.2 cm)CBD stones.After occlusion cholangiography confirmed CBD stone clearance,peroral cholangioscopy(POC)was performed to determine clearance scores based on the number of residual stones.The amounts of residual stones spotted via POC were graded on a 5-point scale(score 1,worst;score 5,best).Scores were documented after only stone removal(control)and after irrigation with 50 mL and 100 mL saline,respectively.The stone composition was analyzed using infrared spectroscopy.RESULTS Between October 2018 and January 2020,47 patients had CBD clearance scores of 2.4±1.1 without saline irrigation,3.5±0.7 with 50 mL irrigation,and 4.6±0.6 with 100 mL irrigation(P<0.001).Multivariate analysis showed that CBD diameter>15 mm[odds ratio(OR)=0.08,95%confidence interval(CI):0.01-0.49;P=0.007]and periampullary diverticula(PAD)(OR=6.51,95%CI:1.08-39.21;P=0.041)were independent risk factors for residual stones.Bilirubin pigment stones constituted the main residual stones found in patients with PAD(P=0.004).CONCLUSION Irrigation with 100 mL of saline may not clear all residual CBD stones after lithotripsy,especially in patients with PAD and/or a dilated(>15 mm)CBD.Pigment residual stones are soft and commonly found in patients with PAD.Additional saline irrigation may be required to remove retained stones.

Recovery from prolonged disorders of consciousness:A dual-center prospective cohort study in China

BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness(DoC).Data are lacking regarding the long-term outcomes of those patients in China.It is necessary to study the long-term outcomes of patients with prolonged DoC in light of many factors likely to influence crucial decisions about their care and their life.AIM To present the preliminary results of a DoC cohort.METHODS This was a two-center prospective cohort study of inpatients with vegetative state(VS)/unresponsive wakefulness syndrome(UWS).The study outcomes were the recovery from VS/UWS to minimally conscious state(MCS)and the long-term status of patients with prolonged DoC considered in VS/UWS or MCS for up to 6 years.The patients were evaluated using the Glasgow coma scale,coma recovery scale-revised,and Glasgow outcome scale.The endpoint of follow-up was recovery of full consciousness or death.The changes in the primary clinical outcome improvement in clinical diagnosis were evaluated at 12 mo compared with baseline.RESULTS The study population included 93 patients(62 VS/UWS and 31 MCS).The postinjury interval range was 28-634 d.Median follow-up was 20 mo(interquartile range,12-37 mo).At the endpoint,33 transitioned to an emergence from MCS or full consciousness,eight had a locked-in syndrome,and there were 35 patients remaining in a VS/UWS and 11 in an MCS.Seven(including one locked-in syndrome)patients(7.5%)died within 12 mo of injury.Compared with the unresponsive group(n=52)at 12 mo,the responsive group(n=41)had a higher proportion of males(87.8%vs 63.5%,P=0.008),shorter time from injury(median,40.0 d vs 65.5 d,P=0.006),higher frequency of vascular etiology(68.3%vs 38.5%,P=0.007),higher Glasgow coma scale score at admission(median,9 vs 6,P<0.001),higher coma recovery scale-revised score at admission(median,9 vs 2.5,P<0.001),at 1 mo(median,14 vs 5,P<0.001),and at 3 mo(median,20 vs 6,P<0.001),lower frequency of VS/UWS(36.6%vs 90.0%,P<0.001),and more favorable Glasgow outcome scale outcome(P<0.001).CONCLUSION Patients with severe DoC,despite having strong predictors of poor prognosis,might recover consciousness after a prolonged time of rehabilitation.An accurate initial diagnosis of patients with DoC is critical for predicting outcome and a long-term regular follow-up is also important.

Combined Effects of Family History of Cardiovascular Disease and Serum C-reactive Protein Level on the Risk of Stroke: A 9.2-year Prospective Study among Mongolians in China

Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Methods A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels. Results We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio（HR） of 1.78 [95% confidence interval（CI）, 1.03‐3.07; P = 0.039] of stroke, and an HR of 2.14（95% CI, 1.09‐4.20; P = 0.027） of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant（all P 〉 0.05）. Conclusion Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.

Combined Influence of Insulin Resistance and Inflammatory Biomarkers on Type 2 Diabetes:A Population-based Prospective Cohort Study of Inner Mongolians in China

This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.

Quality of life after colorectal surgery:A prospective study of patients compared with their spouses

BACKGROUND Although radical surgery for colorectal cancer improves the oncological outcomes,a significant portion of patients suffer from alterations in their quality of life(QoL).There are many studies investigating the QoL of patients who have colorectal cancer but none of these focus on the QoL of spouses.AIM To compare the QoL of patients after colorectal surgery to the QoL of spouses.METHODS This prospective study consisted of patients who were married and who underwent surgery at the University of Ankara,Department of Surgery between March 2006 and November 2010.Patients’spouses were also enrolled.The study was approved by the Ethics Committee of the Faculty of Medicine,Ankara University,and all patients provided written informed consent.The study included patients who underwent curative surgery for colorectal carcinoma[n=100;abdominoperineal excision(n=33),low anterior resection(n=33),left hemicolectomy(n=34)]and their spouses(n=100).The patients and spouses completed the Medical Outcome Study 36-item Short Form Survey(SF-36)and the World Health Organization Disability Assessment Schedule II(WHODAS-II)preoperatively and at postoperative months 15 to 18.RESULTS During this 4.5-year study period,273 patients with sigmoid or rectal cancer were admitted to the hospital.Of these patients,119 were eligible and willing to participate.Eleven patients had either systemic or locally inoperable disease,three patients had a severe surgical complication,and five patients were lost to followup.Therefore,a total of 100 patients completed the follow-up period.There was a statistically significant positive correlation between the disability scores of patients and the scores of their spouses for some of the WHODAS-II subscales,such as“self-care,”“life activities,”and“participation in society,”as well as for the total WHODAS-II score.There was also a positive correlation between the QoL of patients and the QoL of their spouses in most of the SF-36 subscales.Statistically significant correlations were observed for the“bodily pain,”“general health,””vitality,”“social function,”“emotion,”“mental health,”and mental component summary score subscales of the SF-36.When gender differences were evaluated,the QoL of male patients’spouses changed more when compared with female patients’spouses for all of the WHODAS-II subscales.Colorectal cancer surgery has a significant effect on the QoL of both patients and their spouses,these effects were more significant among male patients’spouses.CONCLUSION Preoperative counseling regarding potential problems should therefore collectively address patient and their spouse as a couple rather than the patient alone,particularly for patients undergoing low anterior resection and abdominoperineal resection procedures.

Interferon plus ribavirin and interferon alone in preventing hepatocellular carcinoma: A prospective study on patients with HCV related cirrhosis

AIM:To determine the role of interferon(IFN)with or withoutribavirin in preventing or delaying hepatocellular carcinoma(HCC)development in patients with hepatitis C virus(HCV)related cirrhosis.Data on the preventive effect of IFN plusribavirin treatment are lacking.METHODS:A total of 101 patients(62 males and 39 females,mean age 55.1±1.4 years)with histologically proven HCVrelated liver cirrhosis plus compatible biochemistry andultrasonography were enrolled in the study.Biochemistryand ultrasonography were performed every 6 mo.Ultrasoundguided liver biopsy was performed on all detected focallesions.Follow-up lasted for 5 years.Cellular proliferation,evaluated by measuring Ag-NOR proteins in hepatocytesnuclei,was expressed as AgNOR-Proliferative index(AgNOR-PI)(cut-off=2.5).Forty-one patients(27 males,14 females)were only followed up after the end of anyearly treatment with IFN-alpha2b(old treatment controlgroup=OTCG).Sixty naive patients were stratified accordingto sex and AgNOR-PI and then randomized in two groups:30 were treated with IFN-alpha2b+ribavirin(treatmentgroup=TG),the remaining were not treated(control group=CG).Nonresponders(NR)or relapsers in the TG receivedfurther IFN/ribavirin treatments after a 6 mo of withdrawal.RESULTS:AgNOR-PI was significantly lowered by IFN(P<0.001).HCC incidence was higher in patients withAgNOR-PI>2.5(26% vs3%,P<0.01).Two NR in the OTCG,none in the TG and 9 patients in the CG developed HCCduring follow-up.The Kaplan-Mayer survival curves showedstatistically significant differences both between OTCG andCG(P<0.004)and between TG and CG(P<0.003).CONCLUSION:IFN/ribavirin treatment associated with re-treatment courses of NR seems to produce the best resultsin terms of HCC prevention.AgNOR-PI is a useful markerof possible HCC development.

Characteristics and Risk factors of Psychosomatic Symptoms Related to Female Tubal Sterilization in Rural Area in Hunan Province, China: A Prospective Study

Objectives To study characteristics of psychosomatic symptoms related to sterilization, to find out risk factors and their roles ascribed to psychosomatic symptoms, and to establish a mathematic model for screening out susceptible women. Methods: This study enrolled 776 women in rural area at three counties of Linxiang, Qiyang, Changsha of Hunan province in China between February 1990 and April 1992. Brief Neurosis Screening Scale (BNSS), Symptom Checklist 90 (SCL-90), sensitivity to pain, suggestibility were used to indicate subjects' psychological status. Logistic regression model and retrograde discriminant analysis were applied to develop a mathematical model. Results: Prevalence of psychosomatic reactions or symptoms was 54.8% before sterilization, 26.6% at three months and 16.4% at one year after operation respectively. Psychosomatic symptoms were verified to be the result of joint effects of multiple risk factors. The following risk factors were associated with postoperative symptoms: anger-hostility (RR=33.71), high suggestibility (RR=4.53), high neuroticism (RR=3.44), sensitivity to pain (RR=2.14) and operative sites (RR=2.05). A mathematical model to estimate the probability of developing psychosomatic symptoms in sterilization was established.Conclusions: More than half of women suffered from psychosomatic reactions before operation, and some of them did not recover after operation. The postoperative psychosomatic symptoms are the joint effect of multiple risk factors.

Effect of Tongluo Shenggu Prescription on ARCO Stage Ⅱ non-traumatic femoral head necrosis: A prospective study

Objective:To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.

Association between gastrointestinal heat retention syndrome and respiratory tract infections in children:A prospective cohort study

Objective:To explore the relationship between gastrointestinal heat retention syndrome and the incidence of pneumonia and recurrent respiratory tract infections(RRTIs)in children.Methods:A prospective cohort study was conducted in the pediatric outpatient department of Beijing Dongfang Hospital.Children without respiratory tract infections(RTIs)were consecutively recruited according to the selection criteria.A semi-structured questionnaire was used to record traditional Chinese medicine(TCM)symptoms and demographic and physiological characteristics.Gastrointestinal heat retention syndrome was considered to be a predisposing factor and was diagnosed according to a scale with reliability and validity.The participants were followed up for 12 months.Participants and their parents or guardians were contacted via clinical interviews and telephone every 6 months.Episodes of pneumonia and RTIs were recorded in detail.Results:A total of 420 children were included.Of participants,370(88.10%)were followed up for 12 months.The mean number of RTI episodes per participant was 5.37(95%CI:5.14 to 5.60).In total,186 participants in the gastrointestinal heat retention syndrome group and 184 participants in the nongastrointestinal heat retention syndrome group completed the 12-month follow-up period.The baseline of both groups was comparable.The incidence of RRTIs in children with gastrointestinal heat retention syndrome was 1.27(95%CI:1.01 to 1.59)times that in children without gastrointestinal heat retention syndrome.Logistic regression analysis revealed that abnormally increased appetite with frequent hunger,foul breath,dry stools,and dark red or purple fingerprints were positively correlated with the incidence of pneumonia.Irascibility and feverish feelings in the palms and soles were positively correlated with the occurrence of RRTI.Conclusions:Gastrointestinal heat retention syndrome is a risk factor for RRTIs in children.Studies with larger sample sizes and longer follow-up time are warranted to confirm the degree of causal risk associated with RTIs.