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Objective: To propose a scoring system based on laryngoscopic characteristics for the differential diagnosis of benign and malignant vocal fold leukoplakia. Methods: Laryngoscopic images from 200 vocal fold leukoplakia cases were retrospectively analysed. The laryngoscopic signs of benign and malignant vocal fold leukoplakia were compared, and statistically significant features were assigned and accumulated to establish the leukoplakia finding score. Results: A total of five indicators associated with malignant vocal fold leukoplakia were included to construct the leukoplakia finding score, with a possible range of 0–10 points. A score of 6 points or more was indicative of a diagnosis of malignant vocal fold leukoplakia. The sensitivity, specificity and accuracy values of the leukoplakia finding score were 93.8 per cent, 83.6 per cent and 86.0 per cent, respectively. The consistency in the leukoplakia finding score obtained by different laryngologists was strong (kappa = 0.809). Conclusion: This scoring system based on laryngoscopic characteristics has high diagnostic value for distinguishing benign and malignant vocal fold leukoplakia. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the trajectory and predictors of family function in caregivers of stroke survivors during the first 6 months after the first episode of stroke. Design: Longitudinal study. Methods: A total of 288 primary caregivers of patients with first‐time stroke were recruited from seven tertiary hospitals in China between July 2020 and March 2021. The following characteristics were assessed by caregivers at hospitalization (T0) and at 1 month (T1), 3 months (T2) and 6 months (T3) after the stroke: family function, general self‐efficacy, social support, coping style, caregiver burden, and sociodemographic and clinical data. Results: Family function scores among caregivers of stroke survivors were highest in the resolve dimension and lowest in the growth and adaptation dimensions within the first 6 months. The percentages of families with low functioning were 34.7%, 33.3%, 24.8% and 17.7% at T0, T1, T2 and T3, respectively. The generalized estimating equation model revealed that family function in caregivers increased over the first 6 months (Exp(B) = 1.415–2.689, p <.05). The following factors were identified as predictors of family functioning: caregiver's age, education, residential district, self‐efficacy, social support utilization and caregiver burden. Conclusions: Family function of caregivers of stroke survivors gradually increased during the first 6 months after stroke. However, some families demonstrated poor functioning. Caregivers' age, education, caregiver burden, self‐efficacy and social support utilization could predict family function over time. Impact: Empirical data on family function in families of stroke survivors are important for developing psychosocial interventions that can help families adapt to stroke. This study found that families of stroke survivors were likely to be dysfunctional in the first 6 months after stroke, particularly in family growth and adaptation. Therefore, reducing caregiver burden and promoting self‐efficacy and social support utilization can help restore family functioning early after stroke. Patient or Public Contribution: Stroke caregivers from seven hospitals in China were involved in this study and had the right to be informed of the main findings. A few patients were informed of the research results, who contributed to the dissemination. [ABSTRACT FROM AUTHOR]

Background: Delirium is one of the most common complications in critically ill children. Once delirium occurs, it will cause physical and psychological distress in children and increase the length of their ICU stay and hospitalization costs. Understanding the risk factors for delirium in critically ill children can help develop targeted nursing interventions to reduce the incidence of delirium. Aims: To investigate the incidence and the risk factors of delirium in the paediatric intensive care unit (PICU). Study design: We performed a prospective observational study in critically ill patients in the PICU between February and July 2020. Delirium was diagnosed by the Cornell Assessment of Paediatric Delirium (CAPD) and the Richmond Agitation Sedation Scale and analysed via univariate analysis and multivariate logistic regression to determine the independent risk factors of delirium in critically ill children. Results: The study enrolled 315 patients ranging in age from 1–202 (65.3–54.3) months, with 56.2% (n = 177) being male. The incidence of delirium was 29.2% (n = 92) according to CAPD criteria. Among them, 33 cases (35.9%) were of hyperactive delirium, 16 cases (17.4%) were of hypoactive delirium, and 43 cases (46.7%) were of mixed delirium. By using stepwise logistic regression, the independent risk factors of delirium included mechanical ventilation (odds ratio [OR], 11.470; 95% confidence interval [CI], 4.283–30.721), nervous system disease (OR, 5.596; 95%CI, 2.445 to 12.809), developmental delay (OR, 5.157; 95% CI, 1.990–13.363), benzodiazepine (OR, 3.359; 95% CI 1.278–8.832), number of catheters (OR, 1.918; 95% CI, 1.425 to 2.582), and age (OR, 0.985; 95% confidence interval CI, 0.976–0.993). Conclusions: Delirium is a common complication in the PICU. The independent risk factors include mechanical ventilation, nervous system disease, developmental delay, benzodiazepines, higher number of catheters, and younger age. This study may help develop intervention strategies to reduce the incidence of delirium in critically ill children by targeting modifiable risk factors. Relevance to Clinical Practice: Recommendations for practice include paying attention to high‐risk children in the ICU who are prone to delirium, removing influencing factors as soon as possible, and providing targeted nursing interventions. [ABSTRACT FROM AUTHOR]

Objectives. Primary central nervous system lymphoma (PCNSL) usually has a poor prognosis. Cerebrospinal fluid (CSF) interleukin (IL)-10 has shown diagnostic, prognostic, and monitoring value in our previous studies. Cell-free circulating tumor DNA can be detected in the CSF of refractory/relapse cases and has also shown monitoring value. However, information about its monitoring value in newly diagnosed PCNSL patients and comparisons of CSF IL-10 and CSF cell-free DNA (cfDNA) are scarce. Methods. We performed next-generation sequencing on paraffin-embedded tissue and the serial CSF cfDNA of 10 newly diagnosed PCNSL patients and on the baseline CSF cfDNA of 11 other central nervous system lymphoma patients. We also monitored the CSF IL-10 levels of the 10 newly diagnosed PCNSL patients. Results. In seven newly diagnosed PCNSL patients with sufficient baseline CSF cfDNA, six had ≥1 mutated genes in their CSF cfDNA. The most common were MYD88(4/7), PIM1(3/7), MLL2(3/7), and ETV6(2/7). We also identified multiple somatic mutations, most commonly in PIM1. MYD88L265P can be detected in both tumor tissue and CSF cfDNA. The genomic profiles of CFS cfDNA were similar in PCNSL and PIOL patients. Newly diagnosed PCNSL patients with persistently positive cfDNA and negative IL-10 progressed quickly, while those with negative cfDNA and negative IL-10 were in maintenance therapy for more than 18 months. Two patients without cfDNA had increased CSF IL-10 concentrations before disease relapse. These results indicate that negative CSF cfDNA predicts better results, and persistently positive CSF cfDNA predicts disease progression earlier than conventional magnetic resonance imaging. Conclusion. In conclusion, CSF cfDNA is a potential predictor of relapse and progression, which complements the monitoring value of CSF IL-10 in newly diagnosed PCNSL patients. [ABSTRACT FROM AUTHOR]

Aim: Cancer patients have long been found to have multiple types of unmet needs during their survivorship. Composite psychological instruments are essential for measuring the unmet needs of cancer patients. The objective of this study was to evaluate the psychometric properties of the Short‐Form Survivor Unmet Needs Survey (SF‐SUNS)‐Chinese version. Design: A cross‐sectional survey. Methods: The Chinese version was developed using the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology and 428 Chinese cancer patients participated in the survey between 2016‐2017. Inter‐rater reliability, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were calculated. Results: Confirmatory factor analysis supported the four‐factor structure with good model fit. Cronbach's alpha of 0.894 for the overall scale and intra‐class correlation coefficients (0.869–0.884) indicated that reliability was satisfactory. The EFA extracted four factors with eigenvalues greater than 1 and these factors explained 50.68% of the total variance. The Chinese version of SF‐SUNS was confirmed to have the potential to become a useful and valid instrument. It could contribute to the assessment of unmet needs among Chinese cancer patients with accuracy and with respect to Chinese culture and context. This measurement of unmet needs may help promote cancer management and nursing quality. Clinical nurses and researchers could use the simple assessment tool to target the individual needs of Chinese cancer patients and then provide more personalized care efficiently. [ABSTRACT FROM AUTHOR]

Aims: To explore the level and associated factors of perceived participation and autonomy among stroke survivors in Shanghai, China. Design: Cross‐sectional explorative study. Methods: From January to December 2018, 431 patients presenting at the neurology departments of three hospitals with a confirmed diagnosis of stroke were recruited. Impact on Participation and Autonomy Questionnaire, modified Rankin Scale, Self‐efficacy for Managing Chronic Disease six‐item Scale, Medical Coping Modes Questionnaire and Multidimensional Scale of Perceived Social Support were applied to measure their participation, physical function, self‐efficacy, coping styles, and social support. Results: The average score of perceived participation and autonomy was 41.30 (SD 21.22); and 54.3%, 46.9%, 21.6%, and 7.7% of the participants reported poor participation in social relations, family role, autonomy indoors, and autonomy outdoors. Age, physical function, self‐efficacy, friend support, and knowledge of stroke were predictors of post‐stroke participation. Physical function and self‐efficacy were the most relevant factors of nearly all domains of participation except autonomy outdoors, while predictors of autonomy outdoors were social support, resignation coping style, and knowledge of stroke. Conclusion: The stroke patients experienced insufficient participation compared with previous studies in western countries. Patients' physical function and self‐efficacy were particularly important and contributed to their participation, while the patient's age, perceived social support, coping styles, and knowledge of stroke also played a role in formulating participation. Impact: The results may be used to provide nurses with a better understanding of the participation among stroke patients and assist them in promoting the post‐stroke participation. Nurses should pay special attention to those with older age, worse physical function, lower self‐efficacy, less support, little stroke‐related knowledge, or who applied resignation coping style since those patients might experience lower participation in their daily life. It needs further studies to explore the causal effects of self‐efficacy, coping styles, and social support on post‐stroke participation. [ABSTRACT FROM AUTHOR]

The accurate identification and prediction of high-cost Chronic obstructive pulmonary disease (COPD) patients is important for addressing the economic burden of COPD. The objectives of this study were to use machine learning approaches to identify and predict potential high-cost patients and explore the key variables of the forecasting model, by comparing differences in the predictive performance of different variable sets. Machine learning approaches were used to estimate the medical costs of COPD patients using the Medical Insurance Data of a large city in western China. The prediction models used were logistic regression, random forest (RF), and extreme gradient boosting (XGBoost). All three models had good predictive performance. The XGBoost model outperformed the others. The areas under the ROC curve for Logistic Regression, RF and XGBoost were 0.787, 0.792 and 0.801. The precision and accuracy metrics indicated that the methods achieved correct and reliable results. The results of this study can be used by healthcare data analysts, policy makers, insurers, and healthcare planners to improve the delivery of health services. [ABSTRACT FROM AUTHOR]

This article aims to estimate the effects of air pollutants (PM2.5, PM10, SO2, and NO2) on the hospitalization expenses of adult patients admitted due to asthma. The data is sourced from the medical health database of a city in Southwest China, which involves approximately 14 million residents. A generalized additive model using a Poisson distribution was utilized to identify the effects of air pollution on the cost of hospitalization due to asthma. Hospital admissions were stratified by sex, age, season, and type of medical insurance to specialize the results. Air pollution significantly affects hospitalization expenses for asthma. These effects were more significant in the male, non-senior subgroups than in the female, senior subgroups. The difference also significantly existed in different insurance type subgroups. Air pollution has adverse effects on hospitalization expenses for asthma. Climate change is now deeply affecting the world in the aspects of economy and health. Based on our research, policymakers can establish more effective air pollution reduction policies and measures that can control the levels of ambient air pollutants, which help save health care resources and improve the welfare of the population by easing the climate change. [ABSTRACT FROM AUTHOR]

With the development of Web 2.0 technologies, an increasing number of websites are providing online healthcare services, and they have potential to alleviate problems of overloaded medical resources in China. However, some patients are reluctant to trust and continue using online healthcare services, partly due to the immature development of healthcare websites. Previous research has argued that online trust is significantly associated with the risk or benefit perceived by users. This study aims to extend prior research and examine how perceptual factors influence patients' online trust and intention to continue using online healthcare services. We developed a model with the moderating role of purpose of use and tested it with data collected from 283 participants. The results support the validity of the model and most hypotheses. The moderating role of purpose of use between the perceived benefits/risks and patients' online trust is also highlighted. Theoretical and practical implications are also discussed. [ABSTRACT FROM AUTHOR]

Background and objectives: Stroke commonly results in physical dysfunction and seriously affects the quality of life. We aimed to estimate the prevalence and association of resilience with the quality of life among patients at hospitalization and whether the association was independent of physical function, anxiety, depression, and other population characteristics. Methods: A cross-sectional study at a tertiary hospital included 215 individuals. The Chinese version of the Connor-Davidson Resilience Scale was used to evaluate resilience. Stroke Scale Quality of life was used to measure the quality of life. Other validated questionnaires were used to assess physical function (Functional Independency Measure), anxiety, and depression (the Hospital Anxiety and Depression Scale). Hierarchical regression analysis was applied to determine the association between psychological factors and quality of life. Multiple linear regression was also used to examine whether resilience independently affects the quality of life. Results: The mean score of 215 participants' resilience was 62.36 ± 13.965. Resilience, anxiety, and depression were separately significantly associated with quality of life. Resilience was negatively associated with anxiety and depression. Subjects with high scores of resilience showed a higher quality of life at patients' hospitalization (Standardized Coefficients = 0.275) independent of physical function, anxiety, depression, disease-related characteristics, and sociodemographic characteristics. Discussion: Resilience was an independent predictor of quality of life beyond anxiety and depression in patients with ischemic stroke. Interventions aimed at improving resilience at acute hospitalization might be a worthwhile addition to improve quality of life early after stroke. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to explore the determinants of the online health information seeking (OHIS) and usage (OHIU) behaviours of consumers based on the perceived benefits and costs of such activities. Methods: This study applies questionnaires and empirical research methods. A questionnaire is designed according to the hypothesis model. A total of 282 questionnaires are obtained from patients and their accompanying families in two large hospitals, and the SPSS 17.0 and AMOS 17.0 (IBM, Almond, NY, USA) software are used to analyse the sample data and to test the research models. Results: Three key findings are obtained from the analysis. Firstly, functional, learning, social and personal integrative benefits positively affect the OHIS intent of consumers. Secondly, cognitive costs negatively influence the OHIU behaviour of consumers. Thirdly, personal integrative benefits and OHIS behaviour significantly influence the OHIU behaviour of consumers. Conclusion: This paper highlights the differences between OHIS and OHIU based on their impact factors and applies social exchange theory to understand such factors. Online health information providers must improve the ease of use of their websites or applications, enhance the quality of their health information and focus on their functionality. [ABSTRACT FROM AUTHOR]

Aim: This investigation aimed to study the general self‐efficacy level and its influential factors of breast cancer screening for the female college students in Changchun city of China. Methods: A three‐part questionnaire was designed to investigate 220 female college students' general self‐efficacy for breast cancer screening and its associated factors and knowledge of breast cancer screening. The data were analyzed with spss 23.0 using descriptive statistics, independent sample t‐tests and multiple regression analysis. Results: The mean total score of general self‐efficacy for breast cancer screening was 22.2 ± 5.213 (average ± standard deviation [SD])). About 37.7% of participants had lower level of general self‐efficacy for breast cancer screening. The average score of knowledge about breast cancer and screening was 5.26 ± 3.974 (average ± SD). About half (48.6%) of the students had poor breast cancer screening knowledge. Multivariate logistic regression analysis demonstrated that the level of breast cancer knowledge (P = 0.011) and sleep satisfaction (P = 0.008) were two predictive factors of good general self‐efficacy for breast cancer screening in female college students. Conclusion: Female college students in Changchun did not have enough knowledge and self‐efficacy to cope with the breast cancer screening through this survey. Therefore, primary healthcare professionals have the responsibility to improve their awareness of breast cancer screening by delivering enough breast cancer knowledge and implementing effective health promotion strategies to keep better health status and have satisfied sleep. [ABSTRACT FROM AUTHOR]

Postoperative cognitive dysfunction (POCD) is one of the major complications in patients who have undergone surgeries. Reduction of surgery-induced inflammation and perioperative stress responses may prevent the development of POCD. As recent experimental data have suggested, Shenmai and Shenfu injections, two ginseng containing formulations, may improve cognition. We designed this study using aged rats as an experimental model to determine the effect of combined perioperative Shenmai injection and Shenfu injection in preventing the development of POCD and exploring the underlying mechanism of this intervention. Aged rats were randomized into one of the two groups. Rats in the experiment group received preoperative Shenmai injection and postoperative Shenfu injection while those of the control group did not receive this treatment. Study results indicate that the memory and cognitive ability of rats in the experiment group were significantly better than those of the control group at postoperative day 1 as well as at day 3. Plasma levels of neuron-specific enolase (NSE), S-100 β protein, interleukin-6 (IL-6), tumor necrosis factor- α (TNF- α ), cortisol (COR), aldosterone (ALD), and adenocorticotropic hormone (ACTH) were significantly lower in the experiment group than in those of the control group (day 1 postoperatively). The plasma level of NSE on postoperative day 3 remained lower in the experimental group than in those of the control group. Our experimental results indicate that preoperative Shenmai and postoperative Shenfu injections facilitate conscious recovery and prevent postoperative cognitive decline. This anti-POCD effect may be a result of minimizing surgery-induced inflammation and reduction of perioperative stress responses by these injections. [ABSTRACT FROM AUTHOR]

Charcot-Marie-Tooth 1A (CMT1A) caused by peripheral myelin protein 22 (PMP22) gene duplication is the most common form of hereditary polyneuropathy. Twenty-four genetically confirmed CMT1A patients with sural nerve biopsies were enrolled in this study. The clinical picture included a great variability of phenotype with mean onset age of 22.2±14.5 years (1–55 years). Pathologically, we observed a severe reduction in myelinated fiber density showing three types of changes: pure onion bulb formation in 3 cases (12.5%), onion bulb formation with axonal sprouts in 10 cases (41.7%), and focally thickened myelin with onion bulb formation or/and axonal sprouts in 11 cases (45.8%). We observed no significant correlation between nerve fiber density and disease duration. There was no significant difference between the 3 pathological types in terms of clinical manifestations, nerve fiber density, and g-ratio. Our study indicates that there is marked variability in the age of onset of CMT1A, as well as significant pathological changes without deterioration with the development of the disease. Focally thickened myelin is another common morphological feature of demyelination. [ABSTRACT FROM AUTHOR]

Objective The objective of this study is to understand the rate of intention to undergo HIV testing and associated factors among women in a city with high HIV prevalence. Methods A cross-sectional study was conducted among 293 women HIV/AIDS patients who were newly examined with HIV infection and aged ≥18 years from September to December 2012. Multivariate logistic regression analyses were used to identify the factors associated with intention to undergo HIV testing. Results The rate of intention to undergo HIV testing was 12.3%. Nearly 90% of participants had no intention of getting HIV tested, and the main reasons were 'Never thought I would be HIV-infected' (78.2%) and 'I did not feel sick, and it was impossible to be HIV-infected' (19.8%). The awareness rate of HIV knowledge was 67.8%, and 34.1% had casual heterosexual partners. Those who had casual heterosexual partners or had better HIV knowledge were more likely to have intention of getting HIV tested. Conclusion The rate of intention to undergo HIV testing among women is low. AIDS health education programmess and public information campaigns should be initiated to improve knowledge about HIV and the risk of HIV infection, to encourage women to take HIV testing more promptly. It is also vital to take measures to reduce stigma against AIDS patients. [ABSTRACT FROM AUTHOR]

Expedited bone tissue engineering employs the biological stimuli to harness the intrinsic regenerative potential of skeletal muscle to trigger the reparative process in situ to improve or replace biological functions. When genetically modified with adenovirus mediated BMP2 gene transfer, muscle biopsies from animals have demonstrated success in regenerating bone within rat bony defects. However, it is uncertain whether the human adult skeletal muscle displays an osteogenic potential in vitro when a suitable biological trigger is applied. In present study, human skeletal muscle cultured in a standard osteogenic medium supplemented with dexamethasone demonstrated significant increase in alkaline phosphatase activity approximately 24-fold over control at 2-week time point. More interestingly, measurement of mRNA levels revealed the dramatic results for osteoblast transcripts of alkaline phosphatase, bone sialoproteins, transcription factor CBFA1, collagen type I, and osteocalcin. Calcified mineral deposits were demonstrated on superficial layers of muscle discs after an extended 8-week osteogenic induction. Taken together, these are the first data supporting human skeletal muscle tissue as a promising potential target for expedited bone regeneration, which of the technologies is a valuable method for tissue repair, being not only effective but also inexpensive and clinically expeditious. [ABSTRACT FROM AUTHOR]

Autophagy exists in vascular endothelial cells, but the relationship between autophagy and blood vessel dysfunction in hypertension remains elusive. This study aimed to investigate role of autophagy in vascular endothelial dysfunction in prehypertension and hypertension and the underlying mechanisms involved. Furthermore, we sought to determine if and how tetrahydroxystilbene glucoside (TSG), a resveratrol analogue and active ingredient of Polygonum multiflorum Thunb used for its cardiovascular protective properties in traditional Chinese medicine, influences vascular endothelial function. Male spontaneously hypertensive rats (SHRs) aged 4 weeks (young) and 12 weeks (adult) were studied and the vascular function of isolated aorta and mesenteric artery was assessed in vitro. Compared with Wistar Kyoto rats (WKY), young and adult SHRs showed endothelial dysfunction of the aorta and mesenteric artery, along with decreased pAkt, pmTOR, and autophagic marker protein p62 and increased LC3 II/I in microvascular but not aortic tissues. TSG administration for 14 days significantly improved mesenteric vascular endothelial function, increased levels of pAkt and pmTOR, and decreased autophagy. Pretreatment of young SHRs with the mTOR inhibitor rapamycin blocked the antiautophagic and vasodilative effects of TSG. Moreover, TSG significantly activated Akt-mTOR signaling in HUVECs and reduced the autophagic levels in vitro, which were almost completely blocked by rapamycin. In summary, mesenteric endothelial dysfunction in prehypertensive SHRs was at least partly attributable to excessive autophagy in vascular tissues. TSG partly restored microvascular endothelial dysfunction through activating the Akt/mTOR pathway, which consequently suppressed autophagy, indicating that TSG could be potentially applied to protect vascular function against subclinical changes in prehypertension. [ABSTRACT FROM AUTHOR]

Communicational signals (e.g. lights and horns) are imperative for on-road interaction between drivers. The aim of the present study was to explore how these signals affect drivers' subjective appraisal and visual attention, and how drivers decode the signals from other vehicles within a variety of interactive contexts. Twenty-five male participants (20 valid samples, ranging from 21 to 29 years of age) were recruited to watch film clips of pre-designed interactive scenarios involving common vehicle signals in a full-view simulator (i.e. including road view and mirror views). Participants' attitudes towards the interacting vehicle's behaviours, emotional responses, fixation metrics, and decoded meanings were recorded and analysed. The majority of tested signals, with the exception of the horn used in the behind vehicles, significantly improved drivers' attitudes and pleasure. All signals significantly increased emotional arousal, as well as the total fixation time and mean fixation duration on the interacting vehicle. When the interacting vehicle was visible in mirrors, the signal usage significantly increased the fixation frequency towards it. Meanwhile, a significant decrease in total fixation time and mean fixation duration on the road was reported. The results also demonstrated that the decoded signal contained several meanings simultaneously depending on both the signal type and its interactive context. This study quantified the communication process via vehicular signals under typical situations involving other vehicles, and also suggested new ideas on how to establish more advanced communication between drivers. [ABSTRACT FROM PUBLISHER]

Objectives. To explore effectiveness and mechanisms of electroacupuncture (EA) add-on treatment in Parkinson’s disease (PD) patients. Methods. Fifty PD patients were randomly assigned to drug plus EA (D + EA) group and drug alone (D) group. Subjects in D + EA group received stimulation in points of bilateral fengfu, fengchi, hegu, and central dazhui. Participants were evaluated by scales for motor and nonmotor symptoms. Levels of neuroinflammatory factors and neurotransmitters in serum were detected. Results. EA add-on treatment remarkably reduced scores of Unified Parkinson’s Disease Rating Scale (UPDRS) III and its subitems of tremor, rigidity, and bradykinesia and conspicuously decreased UPDRS III scores in patients with bradykinesia-rigidity and mixed types and mild severity. Depression and sleep disturbances were eased, which were reflected by decreased scores of Hamilton Depression Rating Scale, Pittsburgh Sleep Quality Index, and elevated noradrenaline level. Effects of EA add-on treatment on motor symptoms and sleep disturbances were superior to drug alone treatment, markedly improving life quality of PD patients. EA add-on treatment decreased nitric oxide level in serum. Conclusions. EA add-on treatment is effective on most motor symptoms and some nonmotor symptoms and is particularly efficacious in PD patients at early stage. Antineuroinflammation may be a mechanism of EA add-on treatment. [ABSTRACT FROM AUTHOR]

Objective: To explore characteristic of pulse signal to distinguish patients with coronary heart diseases (CHD) from patients without CHD and healthy adults, and accordingly evaluate the potential role of pulse signal to diagnosis CHD. Methods: Totally 407 patients enrolled from 4 collaborating medical centers were assigned to a CHD group (205 patients) and a non-CHD group (202 patients). The healthy control group (62 adults) enrolled from Shanghai University of Traditional Chinese Medicine. Pulse signals were collected using the synchronous multiplex pulse signal acquisition system. The pulse signals were analyzed and extracted using Hilbert-Huang transformation (HHT) and time-domain, respectively. The time-domain parameters of pulse signal were processed by the analysis of variance (SNK test). Results: Special patterns in the CHD group pulse signal were found in this study: (1) time-domain parameters of pulse signal, h, h, h, h/h, t, t/t were increased and w was wider; (2) 44% of C waves in HHT were chaotic and disordered and 72% of C waves were exhibited irregularly with average amplitude over 10 g-forces, which were all significantly different from controls. Conclusion: Characteristic wave and time-domain parameters of pulse signal were extracted using HHT and time-domain which could be served as a non-invasive approach for assessing patients with CHD. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of 2,3,4′,5-tetrahydroxystilbene-2-O-β-D-glucoside (TSG), an active component extracted from the root of Polygonum multiflorum, on angiotensin II (Ang II)-induced proliferation of cultured rat vascular smooth muscle cells (VSMCs) and to identify the potential mechanism. Methods: Cell proliferation and cell cycle were determined by cell counting, 5-bromo-2′-deoxyuridine incorporation assay, proliferating cell nuclear antigen protein expression and flow cytometry. Levels of phosphorylated extracellular signal-regulated kinase 1/2 (ERK1/2), mitogenic extracellular kinase 1/2 (MEK1/2) and Src in VSMCs were measured by Western blot. The expression of c-fos, c-jun and c-myc mRNA were measured by reverse transcription polymerase chain reaction (RT-PCR). Intracellular reactive oxygen species (ROS) was measured by fluorescence assay. Results: TSG significantly inhibited Ang II-induced VSMCs proliferation and arrested cells in the G /S checkpoint ( P<0.05 or P<0.01). TSG decreased the levels of phosphorylated ERK1/2, MEK1/2 and Src in VSMCs ( P<0.05 or P<0.01). TSG also suppressed c-fos, c-jun and c-myc mRNA expression <0.05 or P<0.01). In addition, the intracellular ROS was reduced by TSG ( P<0.01). Conclusions: TSG inhibited Ang II-induced VSMCs proliferation. Its antiproliferative effect might be associated with down-regulation of intracellular ROS, followed by the suppression of the Src-MEK1/2-ERK1/2 signal pathway, and hence, blocking cell cycle progression. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia ( VAIN) after hysterectomy in Chinese women and to identify factors affecting persistence/recurrence. Material and Methods Twenty-eight VAIN patients after hysterectomy due to cervical intraepithelial neoplasia (group 1) and 11 VAIN patients due to cervical cancer (group 2) were reviewed retrospectively. All patients were treated with at least one episode of laser vaporization between 2010 and 2011, and then followed up every 3 months for at least 1 year. Cox regression analysis was used to identify independent factors predicting persistence/recurrence. Results All VAIN patients achieved remission after two episodes of laser treatment, with 85.7% complete regression in group 1 and 54.5% in group 2. The first episode of the treatment had a significantly higher success rate in group 1 than in group 2 (46.2% vs 0.0%). All patients had no recurrence during a mean follow-up time of 22.8-27.8 months (range 12-39 months). However, infection persisted in 21 (61.8%) of 34 human-papillomavirus-positive patients after laser vaporization. Severity of VAIN was the only significant independent predictor of persistence/recurrence after one episode of the treatment (adjusted odds ratio, 4.08; 95% confidence interval, 1.28-12.96; P = 0.017). Laser treatments were well tolerated with no major side-effects. Conclusion Laser vaporization may be a useful option for the treatment of VAIN after hysterectomy. However, a follow-up is required to assess the long-term efficacy of laser treatment. [ABSTRACT FROM AUTHOR]

Purpose: As an inhibitor of HMG-CoA reductase that catalyses the first step of cholesterol synthesis, pitavastatin undergoes little hepatic metabolism; however, it is a substrate of uptake and efflux transporters. Since pitavastatin is potentially co-administered with agents that affect transporter activities, the pharmacokinetics of pitavastatin was investigated on the effects of a single-dose rifampin in healthy volunteers. Methods: Twelve Chinese healthy male volunteers took 4 mg pitavastatin orally with 150 ml water or with a single dose of 600 mg rifampin on separate occasions and the plasma concentrations of pitavastatin were measured over 48 h by HPLC-MS/MS. Results: A single dose of rifampin significantly increased the mean area under the plasma concentration-time curve(AUC) and C of pitavastatin by 573.5 %(95%CI, 373.3-773.7 %, p < 0.001) and 819.2 %(95 % CI, 515.4-1123.0 %, p < 0.001) respectively, while significantly decreased the t and CL/F of pitavastatin by 38.8 % (95 % CI, 18.2-59.4 %, p < 0.001) and 81.4 % (95 % CI, 75.0-87.7 %, p < 0.001) respectively. Conclusions: Co-administration of pitavastatin with a single dose of rifampin resulted in a significant increase in plasma levels of pitavastatin in Chinese healthy subjects. [ABSTRACT FROM AUTHOR]

Background: To evaluate the conditions of palliative chemotherapy in terminally ill patients with advanced non-small cell lung cancer (NSCLC), and to discuss the potential factors that affect the prognosis of these patients. Methods: All 205 terminally ill patients with advanced NSCLC, who died in our hospital during the period from 2006 to 2010, were included in the study. Basic information was collected and details for the treatment of patients, related to overall survival, were evaluated. Results: One hundred and fifty-nine out of 205 patients (77.6%) were treated with palliative chemotherapy. Of these, 59.7% patients were treated with palliative chemotherapy in the last three months and 27.7% patients in the last one-month, prior to their expiration, respectively. In addition, 22.0% of the 159 patients were treated with palliative chemotherapy for the first time in the last three months and 10.1% in the last month of their final days. We have shown that patients treated with palliative chemotherapy in their last three and final month had a shorter overall survival rate than those patients who were not treated with palliative chemotherapy. Conclusion: A large proportion of patients with advanced NSCLC received palliative chemotherapy near the end of their life. However, our results were not in favor of palliative chemotherapy in the last three or final month of life. [ABSTRACT FROM AUTHOR]

Purpose: Nateglinide is commonly used in the treatment of patients with type 2 diabetes mellitus. Our objective was to assess the association between CYP2C9 and SLCO1B1 polymorphisms and the metabolism of nateglinide in healthy Chinese male volunteers. Methods: A total of 35 healthy Chinese male volunteers with different CYP2C9 and SLCO1B1 genotypes were given a single oral dose of 120 mg nateglinide. Plasma concentrations of nateglinide and blood glucose level were measured up to 8 h. Results: In subjects with the CYP2C9*1/*3 & 521TT, CYP2C9*1/*1 & 521TC/CC and CYP2C9*1/*3 & 521TC genotype, AUC of nateglinide was 56 %, 34 % and 56 % higher ( P = 0.002, P = 0.041 and P = 0.013, respectively), and the CL/F of nateglinide was 35 %, 11 % and 36 % lower ( P = 0.000, P = 0.003 and P = 0.002, respectively) than that in the reference group. When only considering 521 T>C polymorphism, it had no significant association with the pharmacokinetics of nateglinide. CYP2C9*3 and 521 T>C polymorphisms were the significant predictors of the AUC and CL/F of nateglinide (adjusted multiple R = 34 % and 43 %, respectively) according to multiple linear regression analyses, but they have no significant association with changes in the blood glucose-lowering effect of nateglinide. Conclusions: Both SLCO1B1 521 T>C and the CYP2C9*3 polymorphisms can significantly affect the pharmacokinetics of nateglinide, but they could only partially explain the interindividual variability of plasma concentration of nateglinide. Moreover, 521 T>C and the CYP2C9*3 polymorphisms have no effect on pharmacodynamics of nateglinide in healthy Chinese male subjects. [ABSTRACT FROM AUTHOR]

Background: Traditional Chinese medicine (TCM) has been used to treat chronic obstructive pulmonary disease (COPD) for many years. This study aimed to evaluate the efficacy and safety of the comprehensive therapy based on the three common TCM patterns in stable COPD patients.Methods: A four-center, open-label randomized controlled method was conducted. A total of 352 patients were divided into the trial group (n = 176, treated with conventional Western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on the TCM patterns respectively) and the control group (n = 176, treated with conventional Western medicine). The frequency and duration of acute exacerbation, lung function, clinical symptoms, 6-minute walking distance (6MWD), dyspnea scale and quality of life were observed during a 6-month treatment period and at a further 12-month follow-up. Results: A total of 306 patients completed the study fully. The full analysis set (FAS) population was 350 and the per-protocol analysis set (PPS) population was 306. After the 6-month treatment and 12-month follow-up, there were significant differences between the trial and control group in the following: frequency of acute exacerbation (FAS: P = 0.000; PPS: P = 0.000); duration of acute exacerbation (FAS: P = 0.000; PPS: P = 0.001); FEV1 (FAS: P = 0.007;PPS: P = 0.008); symptoms (FAS: P = 0.001; PPS: P = 0.001); 6MWD (FAS: P = 0.045; PPS: P = 0.042); dyspnea scale (FAS: P = 0.002; PPS: P = 0.004); and physical domain (FAS: P = 0.000; PPS: P = 0.000), psychological domain (FAS: P = 0.008; PPS: P = 0.011), social domain (FAS: P = 0.001; PPS: P = 0.000) and environment domain (FAS: P = 0.015; PPS: P = 0.009) of the WHOQOL-BREF questionnaire. There were no differences between the trial and control group in FVC, FEV1% and adverse events. Conclusions: Based on the TCM patterns, Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules have beneficial effects on measured outcomes in stable COPD patients over the 6-month treatment and 12-month follow-up, with no relevant between-group differences in adverse events. Trial Registration: This trial was registered at Chinese Clinical Trial Register Center, ChiCTR-TRC-11001406. [ABSTRACT FROM AUTHOR]