Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background Functional Dyspepsia（FD） is a common clinical disease with numerous guidelines and consensus，but the quality is uneven. Objective To explore current status of clinical guidelines and consensus of FD，to evaluate and analyze their quality and to provide a reference for future clinical decision-making and guideline revision. Methods China national knowledge internet，Wanfang Data Knowledge Service Platform，China Science and Technology Journal Database，PubMed，Web of Science，OVID，and Embase were searched from the time of construction to March 30，2024. Supplemental searches were conducted on Guidelines International Network，National Institute for Health and Care Excellence，Scottish Intercollegiate guidelines network，National guideline clearinghouse，Medlive guide and Chinese Medical Association. The AGREE Ⅱ and RIGHT checklists were used to evaluate the methodological and reporting quality of included studies by well-trained investigators with consistent understanding of the entries independently. Results A total of 17 guidelines and consensus were included. The results of AGREE Ⅱ quality evaluation showed that average scores for each of the 6 areas were scope and purpose（71.49%±2.38%），stakeholder involvement（42.48%±5.03%），rigour of development（36.00%±5.88%），clarity of presentation（60.29%±5.05%），applicability（20.47%±2.69%），and editorial independence 50.00%（0，57.29%）. 9 literatures were recommended as grade B，8 literatures as grade C，and no A-rated literature. The results of RIGHT evaluation showed that average reporting rates for each of the seven areas were basic information（70.83%±3.03%），background（68.02%±2.98%），evidence 15.00%（10.00%，55.00%），recommendation（36.76%±3.21%），review and quality assurance 0（0，6.25%），funding and declaration and management of interests（25.37%±5.18%），and other information 16.67%（0，37.50%）. Conclusion The overall methodological and reporting quality of clinical guidelines and expert consensus needs to be improved，and it is recommended that guidelines should be written in strict accordance with the requirements of AGREE Ⅱ and RIGHT checklist.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Brain metastases are a major factor in the poor prognosis of patients with non-small cell lung cancer.The incidence of brain metastases is higher in patients with EGFR-mutated non-small cell lung cancer，and tyrosine kinase inhibitors targeting this target have become the first-line treatment for patients with stable brain metastases from EGFR-mutated NSCLC due to their excellent efficacy and safety，especially third-generation EGFR-TKIs. Combination of other treatments such as chemotherapy，angiogenesis inhibitor，and radiotherapy has also obtained preliminary efficacy.This article provides a review of the efficacy，safety，and future challenges of single-agent EGFR-TKIs and combination therapy in patients with brain metastases from EGFR-mutant non-small cell lung cancer.This article suggests that EGFR-TKI in combination with chemotherapy may be a potential alternative treatment option for patients with EGFR-mutated NSCLC brain metastases，especially for Asian patients，whereas for EGFR-TKI in combination with antiangiogenic or radiotherapy，the frontal benefit of the combination therapy was not obvious，and large prospective studies could be conducted to further validate and find individualized treatment options based on stratification factors such as EGFR mutation type，comorbid mutations，and clinicopathological features. As for EGFR-TKI combined with immunotherapy，the safety of the combined treatment still needs to be further explored.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Lipoprotein（a）［Lp（a）］ is significantly related to atherosclerotic cardiovascular disease（ASCVD），but it is unclear whether clinical agents that lower Lp（a） can reduce the risk of ASCVD. Here，we systematically reviewed the structure，function，genetic characteristics and detection status of Lp（a），discussed the relationship of Lp（a） with ASCVD，aortic valve stenosis and other cardiovascular diseases，and summarized new advance of Lp（a）-lowering therapies. The structural composition of Lp（a） indicates that Lp（a） may promote atherosclerosis，inhibit fibrinolytic reaction and promote inflammation. Multiple evidence from genetic studies and epidemiological studies supports that Lp（a） is significantly associated with an increased risk of ASCVD and major adverse cardiovascular events. In addition，Lp（a） is also associated with other cardiovascular diseases such as aortic valve stenosis. At present，several emerging drugs that lower Lp（a） are in clinical trials and may further reduce residual cardiovascular risk. This paper hopes to offer new thought for the study of Lp（a），and provide a basis for the monitoring and management of blood lipids.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background The prevalence and epidemiology of pre-treatment drug resistance and acquired drug resistance among HIV-infected individuals vary considerably in different regions of China. Both types of drug resistance have adverse effects on the antiviral treatment outcomes for patients，potentially exacerbating their poor prognosis. Currently，there is a paucity of research on the prevalence and epidemiology of PDR and ADR among HIV-infected individuals in Southwest China.Objective This study investigated the prevalence and epidemiology of pre-treatment drug resistance and acquired drug resistance among people living with HIV（PLWH） in Southwest China. Methods This was a large cross-sectional study that enrolled PLWH who visited the infectious diseases department of the largest infectious disease hospital in Southwest China between January 1，2021，and June 30，2023，and underwent drug resistance gene testing. HIV-1 genotype and drug resistance were analyzed using HIV-1 pol sequence. The Stanford University HIV Drug Resistance Database was used to analyze major drug resistance mutations in the reverse transcriptase and protease Sanger sequences. Risk factors associated with pre-treatment drug resistance were evaluated using a Logistic regression model. Results A total of 1 613 individuals were included in the study，with 824 ART-naive and 789 ART-experienced. The most common genotype among ART-naive patients was B+C（47%），and the drug resistance rate was 18.7%（154/824） with non-nucleoside reverse transcriptase inhibitors（NNRTIs） accounting for 14.9%（123/824），nucleoside reverse transcriptase inhibitors（NRTIs）accounting for 1.7%（14/824），protease inhibitors（PIs）accounting for 2.7%（22/824），and integrase strand transfer inhibitors（INSTIs） accounting for 1.9%（16/824）. Among the ART-experienced patients，the most common genotype was CRF01-AE（37.4%），with a drug resistance rate of 27.8%（219/789）. The mutation rates for NNRTIs，NRTIs，PIs，and INSTIs were 7.7%（61/789），19.3%（152/789），2.7%（21/789），and 1.1%（9/789），respectively. Furthermore，Logistic regression modeling revealed that transmission route，CD4 + T-cell count，viral load，and the time interval between diagnosis and ART initiation were associated with an increased risk of pre-treatment drug resistance. Conclusion The incidence of pre-treatment drug resistance and acquired drug resistance mutations among PLWH in Southwest China is relatively high，18.7% and 27.8% respectively. Transmission route，CD4 + T-cell count，viral load，and the time interval between diagnosis and ART initiation are associated with an increased risk of pretreatment drug resistance. Therefore，to ensure long-term treatment success，there is an urgent need for routine baseline genotypic resistance testing and adequate intervals for viral load monitoring.
Subjects: Mathematics >> Control and Optimization. submitted time 2024-07-18
Abstract： For a 4th order 3-dimensional symmetric tensor with its entries $1$ or $-1$, we show the analytic sufficient and necessary conditions of its positive definiteness. By applying these conclusions, several strict inequalities is bulit for ternary quartic homogeneous polynomials.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2024-07-18 Cooperative journals: 《中国全科医学》
Abstract： Halitosis is a common clinical disease，which seriously affects the social and mental health of patients. General practitioners play a key role in the diagnosis and treatment of halitosis. Based on the review of the literature，this paper puts forward a set of ideas for the diagnosis and treatment of halitosis from the perspective of general medicine，including medical history inquiry，physical examination，detection methods and treatment strategies. This paper emphasizes the importance of personalized diagnosis and treatment，and points out that general practitioners should pay more attention to and manage patients with halitosis.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-18 Cooperative journals: 《中国全科医学》
YANG Jianuo
WANG Guanli
YANG Jiafu
HE Jiahao
CHEN Shumin
SHEN Yi
LI Juan
REN Ni
LIU Chunli
DENG Fangge
Abstract： As a non-invasive and non-radiative non-contact clinical detection technology，infrared thermography can identify various diseases early by detecting the body surface temperature and reconstructing the temperature distribution image，and achieve early diagnosis and intervention. This article focuses on reviewing the application and related research progress of infrared thermography in the fields of acute respiratory infectious diseases，sleep apnea syndrome，traditional Chinese medicine lung disease research，neonatal intensive care，and early screening of pulmonary embolism，which has important clinical guidance significance. As a Functional imaging technology，the core advantage of infrared imaging is “Early”. Unlike structural changes in the course of a disease，the early stages of a disease are often Hemodynamics，the functional changes of local abnormal temperature distribution caused by local inflammation and so on can be early diagnosed，early intervention and dynamic monitoring by means of infrared thermography technology based on thermal sensitivity.
Subjects: Physics >> Geophysics, Astronomy, and Astrophysics submitted time 2024-07-18
Abstract： This paper presents a new development in revealing the nature of the inertial force, a concept that has long stimulated discussion in the history of physics. On this basis, its implications are systematically introduced for the improvement of physics teaching. Firstly, all the theorems in the framework of classical mechanics can be form-invariant generalized to any translational frame of reference, provided that the physical meaning of the force term of the particle in the original formulation is replaced from the total forces to the forces being relatively accounted for. Secondly, in analytical mechanics, since in general the conservative force corresponding to the potential energy is typically a part of the forces acting on the particle, it is enough to ensure that the reference origin is chosen at a position where the vector sum of the conservative forces corresponding to the potential energy is always zero. However, in the case of a general translational reference frame, a correction term for the potential energy due to the forces acting on the reference object must be included in the expression of the Lagrangian and Hamiltonian quantities. Thirdly, the symmetric new equation is applied to the system of particles. The generalized center-of-mass motion theorem and the generalized fixed-axis rotation theorem in the translational reference frame are developed. Finally, for instance, the multi-body dynamics is discussed. In principle, the detour that is introduced by the center-of-mass reference frame can be directly omitted and crossed. To illustrate this, the planetary perturbation equation is demonstrated to be derived in a single step by applying the symmetric new equation of Newtonian dynamics. Besides, the introduction of the symmetric new equation has led to further improvements and refinements in the planetary perturbation equation.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： Background Systemic lupus erythematosus（SLE）is a chronic multisystem autoimmune disease. At present，three biological agents have been approved for treating SLE，including belimumab，anifrolumab，and telitacicept. However，a direct comparison of their efficacy and safety is lacked. Objective To analyze the clinical efficacy and safety of belimumab，anifrolumab，and telitacicept on the treatment of SLE using network meta-analysis. Methods Randomized controlled trials（RCTs）reporting belimumab，anifrolumab，and telitacicept to treat SLE were searched in the databases of PubMed，Web of Science，Cochrane Library，and Embase from the establishment of the databases until August 2023. After screening the relevant literatures and obtaining data from eligible RCTs based on the inclusion and exclusion criteria，direct or network meta-analysis was performed using the RevMan 5.4.1，R language 4.3.1，and Aggregate Data Drug Information System（ADDIS）1.16.8 software. Results After screening，4 789 SLE patients from 12 RCTs were included，including 2 721 patients in the experimental group and 2 068 patients in the placebo group. The direct meta-analysis results showed that the relief rate of SLE responder index 4（SRI4）in SLE patients treated with belimumab，anifrolumab，and telitacicept was significantly higher in the experimental group compared with that of the placebo group（OR=1.62，95%CI=1.40-1.88，P<0.001；OR=2.39，95%CI=1.70-3.37，P<0.001；OR=6.28，95%CI=3.20-12.33，P<0.001）. Compared with that of the placebo，the proportion of SLE patients with a reduced oral corticosteroid dosage after belimumab and anifrolumab treatment was significantly higher （OR=1.48，95%CI=1.09-2.02，P<0.001；OR=2.45，95% CI=1.69-3.54，P<0.001），and the severe recurrence（SR）rate was significantly lower（OR=0.59，95%CI=0.49-0.71，P<0.001；OR=0.52，95%CI=0.39-0.69，P<0.001）. The incidence of total adverse events（TAEs）of anifrolumab and telitacicept was significantly higher than that of the placebo group（OR=1.80，95%CI=1.25-2.59，P=0.001；OR=2.13，95%CI=1.18-3.83，P=0.01），while the incidence of serious adverse events（SAEs） of anifrolumab was significantly lower（OR=0.67，95%CI=0.46-0.97，P=0.04）.There were no significant differences in the incidence of TAEs（OR=0.89，95%CI=0.72-1.08，P=0.24）and SAEs（OR=0.82，95%CI=0.59-1.12，P=0.25）between the belimumab group and placebo group. The results of network Meta-analysis showed that the highest SRI4 was detected after the treatment of telitacicept，followed by anifrolumab，subcutaneous injection of belimumab and intravenous injection of belimumab. The highest incidence of TAEs was detected after the treatment of telitacicept，followed by anifrolumab，intravenous injection of belimumaband subcutaneous injection of belimumab. Conclusion Aelimumab，anifrolumab，and telitacicept all exhibit good clinical efficacy on the treatment of SLE，especially telitacicept. Although anifrolumab and telitacicept increase the overall incidence of TAEs after treatment，they reduce the incidence of SAEs. Of note，belimumab exhibits the highest safety on treating SLE.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： In children，autism spectrum disorder（ASD）is primarily characterized by social（communication） impairments and repetitive，stereotyped behaviors and restricted interests，affecting children's social interaction，communication abilities，and behavioral patterns. In recent years，with technological advancements，Digital Therapeutics has played a significant role in managing ASD. For instance，multimodal data integration and machine learning algorithms have been used for the early identification of ASD，while virtual reality，augmented reality，and gamified learning platforms have been widely applied to enhance the social skills and cognitive functions of children with ASD. Although digital therapy has shown great potential and benefits in the field of autism，it also faces challenges，including individual differences in treatment response，uncertainty of long-term effectiveness，and data privacy protection. Overall，Digital Therapeutics has opened up a new path for the management of autism，and also points out important directions for future research and applications.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
WEN Yining1，2，3，4，HUANG Huichang1，3，4，5，ZHAO Mingming1，3，4*
WEN Yining1，2，3，4，HUANG Huichang1，3，4，5，ZHAO Mingming1，3，4*
WEN Yining1，2，3，4，HUANG Huichang1，3，4，5，ZHAO Mingming1，3，4*
Abstract： Subjective cognitive decline（SCD）usually predicts the risk of future cognitive decline，and sleep disturbances are very common in patients with SCD and often precede detectable cognitive changes. Although there is a lack of clarity regarding the relationship between sleep and SCD and the underlying mechanisms of sleep-related cognitive deterioration，studies in recent years have shown a strong link between sleep and cognitive decline. Cognitive decline may be triggered by either sleep deprivation or decreased sleep quality. Therefore，the aim of this review is to provide a comprehensive overview of the research progress on sleep and subjective cognitive decline，and to explore in depth the mechanism of their interaction，with a view to providing new ideas and methods for preventing and delaying cognitive decline，and providing useful references for research and practice in related fields.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： The concept landscape of frailty has evolved from a single dimension which emphasising predominantly physical frailty into a multidimensional concept encompassing physical，psychological and social frailty.Conducting researches on multidimensional frailty armong community-dwelling older adults is an important way to address the current fragmentation of community-based elderly care services and enhance the comprehensive health of this population. In this paper，firstly，we review the evolution of the concept of multidimensional frailty;secondly，classify and describe the multidi. mensional frailty assessment tools that can be applied to community-dwelling older adults;thirdly，analysis the influencing factors of multidimensional frailty in community-dwelling older adults as well as the interactions between the dimensions of frailty，finally，assess the predictive value of multidimensional frailty in community-dwelling older adults in relation to health outcomes. Existing evidences suggest that the multidimensional frailty is found to be the result of a combination of physiological，psychological，and social factors，and that assessing multidimensional frailty in community-dwelling older adults can predict a variety of health outcomes such as disability，disease risk，and mortality，and that the different dimensions of frailty are correlated and interact with each others.However，there is no a standardized tool for evaluating multidimensional frailty in the community-dwelling older adults，and the underlying mechanisms of its occurrence and development have not been clarified.So，the follow-up studies could explore the developmental trajectory of multidimensional debility based on large prospective cohort studies，in order to provide a referable basis for the development of intervention strategies to reverse or delay the frail process in community-dwelling older adults.
Subjects: Electronics and Communication Technology >> Electron Technology Subjects: Dynamic and Electric Engineering >> Electrical Engineering submitted time 2024-07-17
Abstract： In the scope of our investigation, we have solved the stability problem of the boost converter. Ouyang Changlian’s doctoral dissertation made me realize the importance of duty cycle in control system.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： Background The dual antiplatelet therapy of aspirin combined with ticagrelor is the preferred antiplatelet therapy for patients with ST segment elevation myocardial infarction （STEMI） who receive primary percutaneous coronary intervention（PPCI）. Compared with clopidogrel，ticagrelor can inhibit platelets faster and more effectively，and improve prognosis. However，there is still a lack of research on the application of reduced dose ticagrelor in STEMI patients receiving PPCI treatment. Objective To compare the different doses of ticagrelor on the efficacy and safety in patients with STEMI basedon propensity score matching（PSM）. Methods The patients with STEMI who underwent PPCI and antiplatelet therapy with ticagrelor at the Fifth Department of Cardiology，Second Hospital of Hebei Medical University from June 2019 to May 2021 were selected consecutively. According to the different maintenance doses of ticagrelor，patients were divided into a reduced dose group（n=60）and a standard group（n=180），using ticagrelor 60 mg/time（2 times/day）and 90 mg/time（2 times/ day），respectively. The PSM method was used to perform a 1:1 match between two groups，with matching variables including gender，age，medical history，Killip grade at admission，and intervention related parameters. Finally，54 patients were included in the each group. Follow-up was conducted on both groups at 1 month，3 months，and 6 months after discharge，and platelet parameters as well as clinical events were recorded and compared between the two groups of patients. Results There was no statistically significant difference in baseline data，intervention treatment parameters，and incidence of major adverse cardiovascular events（MACEs）during hospitalization between the two groups after PSM（P>0.05）. There was no statistically significant difference in the levels of platelet count（PLT），mean platelet volume（MPV），platelet distribution width（PDW）， and platelet aggregation rate（PAR）between baseline and 1 month after discharge（P>0.05）. The level of MPV in the reduced dose group was higher than that of the standard group at discharge，and the level of PDW was lower than that of the standard group（P<0.05）. The levlel of PDW in the reduction group was higher than that of the standard group after 3 months of discharge （P<0.05）. The level of MPV in the reduction group was higher than that of the standard group after 6 months of discharge （P<0.05）. There was no statistically significant difference in the level of PLT between the two groups before and after discharge （P>0.05）. The levels of MPV in the two groups were higher than baseline at discharge，while the levels of PDW and PAR were lower than baseline（P<0.05）. The level of MPV in the reduction group was lower than that at discharge at 1 month，3 months， and 6 months，while the levels of PDW and PAR were higher than those at discharge（P<0.05）. There was no statistically significant difference in the incidence of MACEs and severe bleeding events between the two groups during the follow-up（P>0.05）. Conclusion Reduced dose of ticagrelor treatment is safe and effective for STEMI patients undergoing PPCI.
Subjects: Digital Publishing >> New Media submitted time 2024-07-17 Cooperative journals: 《中国传媒科技》
Abstract：【目的】为探究其社交化阅读中的互动仪式建构及成效，为提升传统广电媒体的受众阅读体验，提升其全媒体传播实效提供镜鉴。【方法】以互动仪式链理论为理论基础，以微信读书APP为研究对象，以参与观察法和案例分析法为主要研究方法【结果】微信读书通过塑造虚拟共在场域、对局外人提前设限、以具体书目为共同焦点、通过个性化的情感与趣缘属性分享，构筑互动情境。【结论】提出塑造陪伴式阅读体验、构筑奖励性阅读情境、提供个性化阅读推荐等建议，面向未来电视与智能媒体时代，正视从情感联结出发维系受众阅读黏性，或许才是传统广电完善其数字化转型，推动其传播实效精准化、个性化的可行路径。
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： Background Sepsis is a systemic inflammatory response caused by an imbalance of the host immune response to infectious factors，potentially leading to life-threatening organ dysfunction. The application of immature platelet fraction（IPF）to assessing the severity and prognosis of sepsis has been previously analyzed. However，the application of IPF combined with other biomarkers to predict sepsis has been rarely reported. Objective To explore the predictive value of IPF combined with other biomarkers in the severity and prognosis of sepsis. Methods A total of 60 sepsis patients admitted to the Department of Critical Care Medicine，Zhongshan Hospital，Fudan University（Xiamen Branch）from November 2020 to November 2022 were retrospectively recruited for analyzing their clinical data. Patients were classified into the severe sepsis group （n=24） and septic shock group （n=36） based on the severity of sepsis. Divided by the Sequential Organ Failure Assessment （SOFA） score，60 sepsis patients were assigned into the low SOFA group（SOFA score<6 points，n=26）and high SOFA group（SOFA score ≥ 6 points，n=34）. According to the outcome，there were 39 cases in the survival group and 21 cases in the death group. IPF and other blood indicators，including neutrophil to albumin ratio（NAR），platelet to lymphocyte ratio （PLR），neutrophil to lymphocyte ratio（NLR），and lactate to albumin ratio（LAR）were compared. The receiver operating characteristic（ROC）curves of IPF combined with other biomarkers for predicting the severity and prognosis of sepsis were plotted，and the area under the curve（AUC）was calculated. Results The proportion of lung diseases（66.7% vs. 35.9%）， baseline Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE II）scores and baseline SOFA scores were significantly higher in the death group compared to those of the survival group（P<0.05）. Similarly，the proportion of lung diseases（61.8% vs. 26.9%），baseline APACHE II scores and mortality（50.0% vs. 15.4%）were significantly higher in the high SOFA group compared to those of the low SOFA group（P<0.05）. IPF at 48 hours of treatment was significantly higher in the septic shock group than that of the severe sepsis group，which was significantly higher in the high SOFA group compared to that of the low SOFA group，and significantly higher in the death group compared to that of the survival group（P<0.05）. Given the significant difference in 48-h IPF between groups，the laboratory indicators at this time point were selected for further research and analysis. The AUC of IPF in predicting septic shock，a high SOFA score and death was 0.70（cut-off value 3.95%，95% CI 0.55 to 0.83） and 0.72（cut-off value 7.70%，95% CI 0.60 to 0.86），0.73（cut-off value 7.70%，95% CI 0.58 to 0.89），respectively. The AUC of IPF + baseline APACHE II score + NLR，and IPF + baseline APACHE II score + LAR in predicting a high SOFA score was 0.91（95% CI 0.84 to 0.98）and 0.93（95% CI 0.84 to 0.99），respectively. The AUC of IPF + NAR + PLR in predicting the death in sepsis patients was 0.90（95% CI 0.81 to 0.98）. Conclusion IPF combined with different blood indicators can improve the ability to assess the severity and prognosis of sepsis in clinical practice. Specifically，48-hour IPF + baseline APACHE II score+48-hour NLR and 48-hour IPF + baseline APACHE II score+48-hour LAR have high efficacy in predicting the severity of sepsis；whereas 48-hour IPF+NAR+PLR shows a superior efficacy in predicting the prognosis of sepsis.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
FAN Haojie
LIU Lewei
XIA Lei
TIAN Yinghan
YANG Cheng
HAO Mingru
ZHAO Xin
SHEN Qingqing
MO Daming
GENG Feng
LIU Huanzhong
Abstract： Background The incidence of major depressive disorder（MDD）in adolescents is annually elevated. Non-suicidal self-injury（NSSI）is a common clinical manifestation of MDD. Evidence suggested that vitamin D and lipid levels are associated with MDD，but whether they are related to NSSI is unclear. Objective To compare the levels of 25（OH）D3 and blood lipids in MDD adolescents with or without NSSI behavior， and to explore their diagnostic value for NSSI. Methods A total of 129 MDD adolescents who received treatment in the Department of Psychiatry，Chaohu Hospital of Anhui Medical University and the Fourth People's Hospital of Hefei from October 2020 to March 2022 were recruited. They were assigned into NSSI group （n=77）and non-NSSI group（n=52）based on the diagnostic criteria of NSSI in the Diagnostic and Statistical Manual of Mental Disorders， Fifth Edition （DSM-5）. The Positive and Negative Suicide Ideation Inventory（PANSI），Insomnia Severity Index（ISI），and Center for Epidemiological Survey Depression Scale（CES-D）were used to evaluate the clinical symptoms. Fasting venous blood samples were collected to measure the levels of 25（OH）D3 and blood lipids， and compared between groups. In addition，multivariate logistic regression analysis was performed to identify influencing factors for NSSI behavior in MDD adolescents. The diagnostic value of 25（OH）D3 and lipid levels in NSSI behaviors was assessed by plotting the receiver operating characteristic（ROC） curves. Results The age of the NSSI group was significantly lower than that of the non-NSSI group，whereas the total scores of PANSI，ISI，and CES-D were significantly higher than those of the non-NSSI group（P<0.05）. The level of 25（OH）D3 in the NSSI group was significantly lower than that in the non-NSSI group，whereas the levels of total cholesterol（TC），high-density lipoprotein cholesterol（HDL-C），and low-density lipoprotein cholesterol（LDL-C） were significantly higher than those in the non-NSSI group（P<0.05）. Multivariate Logistic regression analysis showed that both LDL-C（OR=5.695，95%CI=2.422-13.388，P<0.001）and 25（OH）D3（OR=0.871，95%CI=0.768-0.987，P<0.05） were the influencing factors of MDD adolescents with NSSI. The area under curve（AUC）of LDL-C and 25（OH）D3 levels in assessing the risk of developing NSSI behavior in MDD adolescents was 0.73（95%CI=0.65-0.82，P<0.001）and 0.62 （95%CI=0.52-0.72，P=0.023），respectively. Their optimal cut-off value was 1.89 mmol/L and 19.15 μg/L，respectively. The AUC of 25（OH）D3 combined with LDL-C levels ［ln（p/1-p）=1.364X1-0.143X2-0.161，where X1 and X2 was LDL-C and 25（OH）D3，respectively］ in diagnosing NSSI behavior in MDD adolescents was 0.77（95%CI=0.69-0.85， P<0.001），with 77.92% of sensitivity and 67.31% of specificity. Conclusion 25（OH）D3 and lipid levels are out of normal ranges in MDD adolescents with NSSI. Measurement of LDL-C combined with 25（OH）D3 levels may provide information to predict the occurrence of NSSI behaviors in MDD adolescents. A regular measurement of LDL-C and 25（OH）D3 and a dynamic monitor is valuable to provide symptomatic supports.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： Background With the aging population in China，the incidence of vascular cognitive impairment（VCI） will increase year by year. Non-dementia vascular cognitive impairment（VCIND）is the most common form of VCI. At present， the research shows that glycolipid metabolic diseases will accelerate the process of VCI，and the treatment of VCI focuses on controlling risk factors，but there is a lack of relevant research on VCIND caused by glycolipid metabolic diseases. Objective To analyze the factors influencing the occurrence of vascular cognitive impairment no dementia（VCIND）with glycolipid metabolic disease，construct a regression model，and conduct risk prediction. Methods A cross-sectional study was conducted to select410 patients with glycolipid metabolic diseases who were hospitalized in the encephalopathy center of Guangdong Provincial Hospital of Traditional Chinese Medicine from March to December 2023. Patients were divided into a cognitive normal group （MMSE>26 points）and a VCIND group（MMSE ≤ 26 points）according to the Mini-Mental State Examination Scale （MMSE）. Multi-factor Logistic regression was used to evaluate the influencing factors of VCIND in middle-aged and elderly patients with glycolipid metabolic diseases，and the risk prediction model of VCIND in glycolipid metabolic diseases was constructed. The predictive value of the model was evaluated via the receiver's operating characteristic（ROC）curve，and the area under the ROC curve（AUC）was calculated. Results Among the 410 patients，there were 209 cases in the cognitively normal group and 201 cases in VCIND. The results of multivariate Logistic regression analysis showed that low education level ［below primary school（OR=25.989，95%CI=5.656-119.33），primary school（OR=6.839，95%CI=3.919-11.933）， Fazekas grade（OR=1.700，95%CI=1.124-2.570）were independent risk factors for the occurrence of VCIND in patients with glycolipid metabolism（P<0.05）. Based on the results of multivariate Logistic regression analysis，the prediction model is logit （P）=-1.608+ primary school×1.923+ below primary school×3.285+Fazekas grading×0.531. The AUC of this risk prediction regression model is 0.767（95%CI=0.721-0.813，P<0.001）. Hosmer-Lemeshow goodness-of-fit test showed that the model has a good fitting effect（χ2 =13.404，P=0.099）. Conclusion Low literacy and Fazekas classification are independent risk factors for the development of VCIND in a population of patients with glycolipid metabolism. Establishing a risk prediction regression model based on the above risk factors has a good predictive value and helps to identify the high-risk group of developing VCIND in patients with glycolipid metabolism disease at an early stage.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： Background Insomnia not only decreases the quality of life and working efficiency，but also relates to other deceases. Suitable exercises may be useful to improve sleep quality. However，comparative studies on the effects of different types of exercise on sleep outcomes are currently lacked. Objective To compare the effects of different exercise types on sleep in insomnia patients and to provide insights for developing exercise prescriptions to improve sleep in this population. Methods Randomized controlled trials（RCTs） investigating the effects of different types of exercises on the sleep of people with insomnia were retrieved from the PubMed，Web of Science，EBSCO，Scopus，China National Knowledge Infrastructure（CNKI），and Wanfang Data Knowledge Service Platform from database inception to December 2023. The quality of the literatures was assessed using the Jadad scale. A network meta-analysis was performed using the random-effects model of the frequency framework in Stata 17.0 software，and publication bias was observed using a funnel plot. Results A total of 36 articles representing 2706 participants were included in this study. Exercise interventions were categorized into five types，including the aerobic exercise（AE）， resistance training（RT），mind-body exercise（ME），prolonged time of exercise（PTE），and AE combined with RT（AE+RT）. The results of the network meta-analysis showed that there was a significant difference in the total score of the subjective evaluation tools between AE group and blank control group（SMD=2.20，95%CI=0.35-4.05，P<0.05）. The maximum surface under the cumulative ranking curve（SUCRA） of the total score of the subjective evaluation tools was detected in AE group（82.2%）， followed by ME（71.1%），AE+RT（54.2%），RT（38.9%），controlled trial（CT）（29.2%） and PTE groups（24.4%）. There was a significant difference in sleep latency（SL） between PTE group versus AE+RT group（SMD=-14.66，95%CI=- 28.60--0.72），between AE+RT group versus RT group（SMD=21.32，95% CI 6.24-36.4），and between AE+RT group versus AE group（SMD=11.19，95%CI=1.56-20.81）（all P<0.05）. The maximum SUCRA of SL was detected in AE+RT group（96.7%），followed by CT（77.1%），ME（49.5%），AE（42.6%），PTE（27.9%）and RT groups（6.1%）. There was a significant difference in sleep efficacy（SE）between AE group versus CT group（SMD=4.59，95%CI=1.59-7.58， P<0.05）. The maximum SUCRA of SE was detected in the AE group（83.1%），followed by AE+RT（59.9%），RT（50.7%）， ME（46.9%），PTE（35.5%）and CT groups（23.9%）. There was a significant difference in wake time after sleep onset（WASO） between PTE group versus RT group（SMD=23.39，95%CI=14.67-32.02），between PTE group versus AE group（SMD=14.86， 95%CI=4.64-36.40），between PTE group versus CT group（SMD=12.11，95%CI=7.62-16.59），between RT group versus ME group（SMD=-27.61，95%CI=-40.49--14.73），between RT group versus CT group（SMD=-11.28，95%CI=-20.86- -1.70），between ME group versus AE group（SMD=19.08，95%CI=5.18-32.98），and between ME group versus CT group （SMD=16.33，95%CI=7.26-25.40）（all P<0.05）. The maximum SUCRA of WASO was detected in the RT group（94.7%）， followed by CT（80.2%），AE（41.8%），ME（31.5%） and PTE groups（1.7%）. There was a significant difference in the total sleep time（TST）between RT group versus AE group（SMD=-20.84，95%CI=-38.46--3.23），between AE group versus CT group（SMD=12.02，95%CI=2.96-21.08）（all P<0.05）. The maximum SUCRA of TST was detected in the AE group（87.2%），followed by AE+CT（71.6%），PTE（53.8%），ME（40.6%），CT（35.9%）and RT groups（10.8%）. There was no significant difference in the sleep quality（SQ）among groups（P>0.05）. The maximum SUCRA of SQ was detected in the AE group（84.2%），followed by AE+CT（75.5%），ME（24.9%）and CT groups（15.4%）. Publication bias analysis of the total score of subjective evaluation tools，SL，SE，WASO，TST，and SQ revealed some asymmetry in all six outcome indicators，indicating a certain risk of publication bias. Conclusion Given the favorable effects of AE on multiple sleep parameters，we recommend insomnia patients engage in moderate-intensity AE，such as jogging or brisk walking，three times a week for approximately 30 minutes. Additionally，options include moderate-intensity RT or AE+RT four to five times a week. When engaging in the above exercises，attention should be paid to the choice of time period，and exercise within 3 hours before bedtime should be avoided as much as possible.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： Background Mycoplasma pneumoniae pneumonia（MPP） is a common respiratory disease in children，which can easily develop into refractory Mycoplasma pneumoniae pneumonia（RMPP）. Children with RMPP have complex conditions，are difficult to treat，and are associated with multiple serious complications. A risk prediction model for RMPP in children can help healthcare professionals to identify children at high risk of RMPP and provide timely therapeutic countermeasures. Objective To systematically review the risk prediction models for RMPP in children. Methods CNKI， Wanfang Data，VIP，CBM，PubMed，Embase，Web of Science and Cochrane Library were searched to collect the related studies on risk prediction models for RMPP in Children to February 20th，2024. Two reviewers independently screened the literature，extracted data and evaluated the quality of the included studies. Meta-analysis of the incidence and predictors of RMPP in children was performed using Stata 18.0 software. Results A total of 14 papers were included，containing 17 risk prediction models. Ten studies were internal validated，and only four studies were external validated，all of which had AUC>0.7. PROBAST results showed that 14 included papers were all at high risk of bias. The results of Meta-analysis showed that the incidence of RMPP in children was 28.2%（95%CI=21.2%~35.1%），hyperthermia，lactate dehydrogenase，c-reactive protein，age， neutrophil ratio，procalcitonin and D-Dimer were independent influences on the occurrence of RMPP in children（P<0.05）. Conclusion Risk prediction models for RMPP in children have good predictive performance，but the overall risk of bias was high and external validation was lacking. The future risk prediction model should focus on hyperthermia，lactate dehydrogenase， c-reactive protein，age，neutrophil ratio，procalcitonin and D-Dimer.
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