Effects of traditional Chinese medicine-assisted intervention on improving postpartum lactation: A systematic review and meta-analysis

Importance

Breast milk is the safest food for infants and has many psychological and physical benefits for infants and mothers. However, problems encountered during the breastfeeding process can reduce postpartum women's willingness to breastfeed. Lactation and engorgement may be improved through Traditional Chinese Medicine auxiliary therapy. However, the overall efficacy of various Traditional Chinese Medicine auxiliary therapies and the relevant meridians and acupuncture points for treating breast milk deficiency remain unclear.

Objective

To investigate Traditional Chinese Medicine auxiliary therapy's effectiveness and acupoints for postpartum women who experience problems during the breastfeeding process.

Methods

Data were sourced from Embase, Web of Science, CINAHL, Cochrane, CNKI, PubMed, and the Airiti Library Central Register of Controlled Trials and Clinical Trials from the database inception to October 2022. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Main outcome measures

The primary outcomes were overall efficiency, prolactin level, milk volume, and breast engorgement in postpartum women with lactation deficiency after-assisted therapies and the correlation between meridian points and milk secretion.

Results

A total of 1,516 studies were initially identified, and 357 articles were assessed. In the final analysis, 20 studies were included, covering various Traditional Chinese Medicine therapies (acupuncture, acupressure, scrapping, moxibustion cupping, etc.) to stimulate relative acupoints without any acupoint stimulation. The overall efficiency (odds ratio [OR] = 14.17, 95% confidence interval [CI] = 6.49 to 30.92), prolactin level (standardized mean difference [SMD] = 0.36, 95% CI = 0.074 to 0.64), improvement of milk volume (SMD = 0.94, 95% CI = 0.59 to 1.29), reduction of engorgement level (OR= 18, 95% CI = 8.34 to 38.82) demonstrated that Traditional Chinese Medicine therapies can effectively improve lactation and breast fullness, thereby helping patients with breast milk deficiency. The most common acupuncture points used to treat agalactia were classified as the Stomach Meridian, Small Intestine Meridian, and Conception Vessel, with the common acupoints CV17: Danzhong, ST18: Rugen, SI1: Shaoze, ST36: Zusanli, and ST16: Yingchuang.

Conclusion

Adjuvant Traditional Chinese Medicine therapy can improve lactation and breast engorgement, thereby increasing the willingness to breastfeed. Clinical Finding: 1. The best time for Traditional Chinese Medicine acupoint intervention for breast deficiency treatment is within 24 h 2. The most effective acupuncture points for improving milk deficiency and bloating pain are ST18: Rugen, ST16: Yingchuang, ST36: Zusanli, SI1: Shaoze, CV17: Danzhong. 3. Traditional Chinese Medicine is non-invasive and effective techniques such as scraping, cupping, acupressure and ear peas. 4. Traditional Chinese Medicine can be combined with other different acupuncture points according to the different constitutions of post-partum women. Breast acupressure, ear acupuncture, scrapping, cupping, and moxibustion are noninvasive treatments that can effectively help patients during lactation, and their clinical practice should be considered and widely promoted.

[Epidemic trends and prevention and control of seasonal influenza in China after the COVID-19 pandemic]

During the COVID-19 pandemic, a series of non-pharmaceutical interventions, which were implemented to curb the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), significantly modified the seasonal pattern of influenza. The intensity of influenza activity markedly decreased and B/Yamagata lineage was no longer detected. As the national influenza sentinel surveillance data shown, clear seasonal patterns were observed for influenza between 2012-2019, annually with an average of 14.57% of specimens tested positive for influenza virus. However, the seasonal pattern of influenza was disrupted after the outbreak of COVID-19. In the 2020-2021 season, influenza demonstrated an extremely low activity (yearly positivity rate<1.0%), followed by a resurgence of winter peak in the 2021-2022 season. Following the downgrade of management of COVID-19 to Class B in China in December 26, 2022, social activities gradually resumed, leading to the rebound of influenza activity with an out-of-season ciculation. After COVID-19 pademic, other respiratory infectious diseases caused by SARS-CoV-2, respiratory syncytial virus, and mycoplasma pneumonia were alternatively or concurrently circulated with influenza. The prevention and control of influenza and other respiratory infectious diseases emphasizes a multi-disease prevention strategy, including long-term and continuous monitoring the epidemic trends in influenza virus and SARS-CoV-2, promoting influenza and COVID-19 vaccination among key populations, and strengthening the knowledge and public awareness of prevention and control for respiratory infectious diseases, etc.

Genetic association of COVID-19 severe versus non-severe cases by RNA sequencing in patients hospitalised in Hong Kong

INTRODUCTION

The coronavirus disease 2019 (COVID-19) pandemic has caused extensive disruption of public health worldwide. There were reports of COVID-19 patients having multiple complications. This study investigated COVID-19 from a genetic perspective.

METHODS

We conducted RNA sequencing (RNA-Seq) analysis of respiratory tract samples from 24 patients with COVID-19. Eight patients receiving mechanical ventilation or extracorporeal membrane oxygenation were regarded as severe cases; the remaining 16 patients were regarded as non-severe cases. After quality control, statistical analyses were performed by logistic regression and the Kolmogorov-Smirnov test to identify genes associated with disease severity.

RESULTS

Six genes were associated with COVID-19 severity in both statistical tests, namely RPL15, BACE1-AS, CEPT1, EIF4G1, TMEM91, and TBCK. Among these genes, RPL15 and EIF4G1 played roles in the regulation of mRNA translation. Gene ontology analysis showed that the differentially expressed genes were mainly involved in nervous system diseases.

CONCLUSION

RNA sequencing analysis showed that severe acute respiratory syndrome coronavirus 2 infection is associated with the overexpression of genes involved in nervous system disorders.

[Analysis of APTT Mixing Test Results in Factor Ⅷ Inhibitor-Positive Hemophilia Patients]

OBJECTIVE

To analyze the results of activated partial thromboplastin time (APTT) mixing test in coagulation factor Ⅷ inhibitor-positive hemophilia patients, so as to increase the value of APTT mixing test in the screen of factor Ⅷ inhibitor.

METHODS

Eighty plasmas samples with different titers of coagulation factor Ⅷ inhibitors had been collected and diluted for routine immediate APTT mixing test and at 37 ℃ 2 hours incubation APTT mixing test. Fifteen samples were selected for immediate and normal temperature incubation for 15 min, 30min, 1 hour, 2 hours and 37 ℃ for 30 min, 1 hour, 2 hours APTT mixing test.

RESULTS

The results of APTT mixing test were significantly correlated with the titers of coagulation factor Ⅷ inhibitors. The ROC curve result showed that the best diagnostic cut-off value for 2 hours incubation APTT mixing test at 37 ℃ to determine the presence or absence of coagulation factor Ⅷ inhibitors was 43.8 s (sensitivity and specificity was 85.90% and 100%, respectively), while the best diagnostic cut-off value for distinguishing high-titer and low-titer Ⅷ inhibitors was 52.4 s (sensitivity and specificity was 98.18% and 95.65%, respectively). The critical coagulation factor Ⅷ inhibitor titer that could not be corrected by immediate APTT was 5.14 BU/ml, while that could not be corrected by 37 ℃ 2 hours incubation APTT was 1.31 BU/ml. Paired samples t -test was performed on the APTT mixing test results at different times and temperatures, and the differences were statistically significant (P < 0.05).

CONCLUSIONS

The APTT mixing test can be used as a screening index for coagulation factor Ⅷ inhibitors. APTT mixing test result shows a significant time-temperature dependence with lower titers of coagulation factor Ⅷ inhibitor. Patients with hemophilia who cannot be corrected by immediate APTT mixing test should be alert to the possibility of high titer of coagulation factor Ⅷ.

[Advances in clinical significance and detection methods research of high density lipoprotein subfractions]

High density lipoprotein (HDL) is an important biochemical index of clinical cardiovascular disease. Many new studies have demonstrated abnormalities of plasma HDL subfractions in patients with this disease,and their clinical significance is greater than the overall abnormalities of HDL. Therefore,the HDL subfraction as an important factor in cardiovascular disease has attracted extensive research and attention. This article summarizes current research on HDL subfractions,their measurements and their relationships with atherosclerosis and coronary artery disease.

[Analysis on the implementation of payment policies for four non-national immunization program vaccines in China]

This study systematically retrieved information on the payment policy of vaccination fees for pneumococcal vaccines, human papillomavirus vaccines, haemophilus influenzae type b vaccines and rotavirus vaccines using a Python-based crawler. The proportion of the population covered by policies among the total applicable population was estimated based on the medical insurance coverage ratio and population data in 2020. This study showed that the payment policies included two categories, government-funded free vaccination policies and medical insurance payment policies. Among the four non-national immunization program vaccines, the free vaccination policies only involved pneumococcal vaccines and human papillomavirus vaccines. Among them, the 13-valent pneumococcal conjugate vaccine, the 23-valent pneumococcal polysaccharide vaccine, and the human papillomavirus vaccine were provided free of charge in 1, 10 and 15 provinces, respectively. For these policies, the corresponding covered population and the proportion among the total applicable population were children aged 6 months to 2 years old (2.5%), older people (1.2% to 21.5%) and middle school girls (1.1% to 12.2%). Medical insurance payment policies were implemented in 14 provinces, and nearly covered the four types of vaccines in the policy implementation areas, with the proportion of the covered population about 10.9% to 41.5% among the total applicable population.

Structure and activation mechanism of the rice Salt Overly Sensitive 1 (SOS1) Na+/H+ antiporter

Salinity is one of the most severe abiotic stresses that adversely affect plant growth and agricultural productivity. The plant Na+/H+ antiporter Salt Overly Sensitive 1 (SOS1) located in the plasma membrane extrudes excess Na+ out of cells in response to salt stress and confers salt tolerance. However, the molecular mechanism underlying SOS1 activation remains largely elusive. Here we elucidate two cryo-electron microscopy structures of rice (Oryza sativa) SOS1, a full-length protein in an auto-inhibited state and a truncated version in an active state. The SOS1 forms a dimeric architecture, with an NhaA-folded transmembrane domain portion in the membrane and an elongated cytosolic portion of multiple regulatory domains in the cytoplasm. The structural comparison shows that SOS1 adopts an elevator transport mechanism accompanied by a conformational transition of the highly conserved Pro148 in the unwound transmembrane helix 5 (TM5), switching from an occluded conformation in the auto-inhibited state to a conducting conformation in the active state. These findings allow us to propose an inhibition-release mechanism for SOS1 activation and elucidate how SOS1 controls Na+ homeostasis in response to salt stress.

[Source Analysis of Heavy Metals in Typical Farmland Soils Based on PCA-APCS-MLR and Geostatistics]

Human activities often increase the content of heavy metals in surface soils, thus affecting the precise quantification and evaluation of heavy metals in regional soils. In order to systematically study the spatial distribution characteristics and contribution rate of heavy metal pollution sources in typical farmland soil around stone coal mines in western Zhejiang Province, heavy metals such as Cd, Hg, As, Cu, Zn, and Ni in topsoil samples of arable land and agricultural products were collected and analyzed, with an emphasis on the geochemical characteristics of each element and ecological risk assessment of agricultural products. Correlation analysis, principal component analysis (PCA), and the absolute principal component score-multiple linear regression receptor model (APCS-MLR) were used to discuss the source and source contribution rate of soil heavy metal pollution in this area. Meanwhile, the spatial distribution characteristics of the contribution rate of Cd and As pollution sources of the soil in the study area were also expounded in detail by the geostatistical analysis method. The results showed that the contents of six heavy metal elements including Cd, Hg, As, Cu, Zn, and Ni in the study area all exceeded the risk screening value. Among them, two elements exceeded the risk control value, Cd and As, and the point-exceeding rates were 36.11% and 0.69%, respectively. The Cd in agricultural products was also seriously exceeded. According to the analysis, there were two main sources of heavy metal pollution in the soil in the study area. Source one (Cd, Cu, Zn, and Ni) was coming from mining activities and natural sources, and the contribution rates to Cd, Cu, Zn, and Ni were 78.53%, 84.41%, 87%, and 89.13%. Source two (Hg and As) was mainly an industrial source, and the contribution rates to As and Hg were 82.41% and 83.22%, respectively. Cd was the heavy metal with the greatest pollution risk in the study area, and measures should be taken to reduce the pollution risk. There was an abandoned stone coal mine rich in elements such as Cd, Cu, Zn, and Ni. Located in the northeastern part of the study area under the action of atmospheric deposition, the confluence of mine wastewater into irrigation water and farmland sediment was one of the important factors for forming the source of farmland pollution. The settled fly ash was the main pollution source of As and Hg, which was also closely related to agricultural production. The above research can provide technical support for the precise implementation of ecological and environmental management policies.

Characteristics and therapeutic profile of TBI patients who underwent bilateral decompressive craniectomy: experience with 151 cases

Background

Decompressive craniectomy (DC) and intracranial pressure (ICP) monitoring are common approaches to reduce the death rate of Traumatic brain injury (TBI) patients, but the outcomes of these patients are unfavorable, particularly those who receive bilateral DC. The authors discuss their experience using ICP and other potential methods to improve the outcomes of TBI patients who receive bilateral DC.

Methods

Data from TBI patients receiving bilateral DC from Jan. 2008 to Jan. 2022 were collected via a retrospective chart review. Included patients who received unplanned contralateral DC after initial surgery were identified as unplanned secondary surgery (USS) patients. Patients’ demographics and baseline medical status; pre-, intra-, and postoperative events; and follow-up visit outcome data were analyzed.

Results

A total of 151 TBI patients were included. Patients who underwent USS experienced more severe outcomes as assessed using the 3-month modified Rankin Scale score (P = 0.024). In bilateral DC TBI patients, USS were associated with worsen outcomes, moreover, ICP monitoring was able to lower their death rate and was associated with a lower USS incidence. In USS patients, ICP monitoring was not associated with improved outcomes but was able to lower their mortality rate (2/19, 10.5%, vs. 10/25, 40.0%; P = 0.042).

Conclusion

The avoidance of USS may be associated with improved outcomes of TBI patients who underwent bilateral DC. ICP monitoring was a potential approach to lower USS rate in TBI patients, but its specific benefits were uncertain.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13049-022-01046-w.

Yellow nail syndrome accompanied by minimal-change nephrotic syndrome: A case report

BACKGROUND

In most cases of yellow nail syndrome (YNS), the classic triad of yellow nails, lymphedema and respiratory manifestations rarely manifest simultaneously. Therefore, diagnosis is delayed or frequently missed.

CASE SUMMARY

We report a 62-year-old YNS patient presenting with bilateral pleural, pericardial and peritoneal effusions who, 2 mo later, developed minimal-change nephrotic syndrome. After treatment with vitamin E, clarithromycin and prednisone for 3 mo, effusions in the chest, pericardium and abdominal cavity decreased while urine protein levels returned to within normal ranges.

CONCLUSION

Clinicians should consider the possibility of YNS for patients presenting with multiple serous effusions and nephrotic syndromes.

Exosome-mediated delivery of SCD-1 siRNA promoted the death of anaplastic thyroid carcinoma cells via regulating ROS level

PURPOSE

Anaplastic thyroid carcinoma (ATC) is one of the most aggressive cancers in the world. Stearoyl-CoA desaturase-1 (SCD-1) is one of major enzymes in the de novo synthesis of fatty acids and is related to cancer aggressiveness and poor patient prognosis. The study aimed to construct exosomes loaded SCD-1 interference, investigate its effects and mechanisms on the cell proliferation and apoptosis of ATC cells.

METHODS

The expressions of SCD-1 in normal thyroid cell line and ATC cell lines were determined by qRT-PCR and western blotting, respectively. Exosomes were prepared and purification then loaded with SCD-1 siRNA by electroporation and observed by transmission electron microscopy. Higher SCD-1 mRNA and protein levels were found in ATC cell lines compared than normal thyroid cell line (P < 0.05), and both Hth-7 and FRO cells could uptake PKH67-labeled exosomes. The effects of exosomes loaded SCD-1 siRNA on ATC cells were measured by CCK8 assay and apoptosis detection kit.

RESULTS

When compared with control group, the cell viability significantly decreased in both two ATC cell lines taken up exosomes loaded SCD-1 siRNA (P < 0.001), and apoptotic and necrotic cells obviously increased (P < 0.05). In order to explore the mechanism of exosomes loaded SCD-1 on ATC, the ROS level was detected by fluorescence reagent. It was found that exosomes loaded SCD-1 siRNA significantly increased intracellular ROS level of ATC cells (P < 0.05).

CONCLUSIONS

Exosomes loaded SCD-1 siRNA inhibited ATC cellular proliferation and promoted cellular apoptosis, and the mechanisms involved maybe the regulation of fatty acids metabolism and ROS level. Our study provides a promising therapeutic strategy for ATC.

Zinc oxide nanoparticles reduce the chemoresistance of gastric cancer by inhibiting autophagy

BACKGROUND

Gastric cancer (GC) is a common malignancy that results in a high rate of cancer-related mortality. Cisplatin (DDP)-based chemotherapy is the first-line clinical treatment for GC therapy, but chemotherapy resistance remains a severe clinical challenge. Zinc oxide nanoparticle (ZnO-NP) has been identified as a promising anti-cancer agent, but the function of ZnO-NP in GC development is still unclear.

AIM

To explore the effect of ZnO-NP on chemotherapy resistance during GC progression.

METHODS

ZnO-NP was synthesized, and the effect and underlying mechanisms of ZnO-NP on the malignant progression and chemotherapy resistance of GC cells were analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays, colony formation assays, transwell assays, wound healing assays, flow cytometry, and Western blot analysis in GC cells and DDP-resistant GC cells, and by tumorigenicity analyses in nude mice.

RESULTS

Our data revealed that ZnO-NP was able to inhibit proliferation, migration, and invasion and induce apoptosis of GC cells. Meanwhile, ZnO-NP significantly reduced the half maximal inhibitory concentration (IC50) of DDP for the inhibition of cell proliferation of DDP-resistant SGC7901/DDP cell lines. Autophagy was increased in DDP-resistant GC cells, as demonstrated by elevated light chain 3-like protein 2 (LC3II)/LC3I and Beclin-1 expression and repressed p62 expression in SGC7901/DDP cells compared to SGC7901 cells. Mechanically, ZnO-NP inhibited autophagy in GC cells and treatment with DDP induced autophagy, which was reversed by ZnO-NP. Functionally, ZnO-NP attenuated the tumor growth of DDP-resistant GC cells in vivo.

CONCLUSION

We conclude that ZnO-NP alleviates the chemoresistance of GC cells by inhibiting autophagy. Our findings present novel insights into the mechanism by which ZnO-NP regulates the chemotherapy resistance of GC. ZnO-NP may serve as a potential therapeutic candidate for GC treatment. The potential role of ZnO-NP in the clinical treatment of GC needs clarification in future investigations.

Effects of an Adaptive Education Program on the Learning, Mental Health and Work Intentions of New Graduate Nurses

Health care workers are at a higher risk of psychological distress than ordinary people. Stress affects physical and mental health, and can even produce an intention to leave. The current training for new graduate nurses (NGNs) during this transitional period mostly focuses on the cultivation of professional ability, with less attention to mental health or emotional feelings, and thus there are insufficient structured support strategies. As such, this study explores the effects of intervention through an appropriate education program on the learning, mental health and work intentions of new recruits during the transition period. A pre-test and post-test for a single group was designed for new nursing staff in a large teaching hospital in northern Taiwan. The test period was from May 2017 to December 2018, and a total of 293 cases were accepted. A three-month adaptive education program was provided and evaluated in terms of: care for learning, care for health, improving professional ability, and individualized guidance on satisfaction, mental health disturbance and work intention. The new graduate nurses who received gentle care and counseling showed a downward trend in their BSRS-5 scores and statistical differences over time (p < 0.001). The higher the BSRS-5 score, the easier it is for new graduate nurses in acute and intensive care units. There is a tendency for turnover leave (p = 0.03). After the intervention of the overall plan, the turnover rate of new graduate nurses within three months was 12.6%, and the one-year retention rate was 87.9%. The adaptive education program uses multiple support strategies to improve learning and professional abilities, to reduce psychological emotions, and thereby to increase retention. Today will face new medical challenges; the education programs will become more important across clinical care settings, and it will be important to rigorously validate their performance in helping NGNs.

Twelve-week intradialytic cycling exercise improves physical functional performance with gain in muscle strength and endurance: a randomized controlled trial

Objective:

To evaluate the effect of intradialytic cycling exercise on physical functional performance with gain in muscle strength and endurance in end-stage renal disease patients with haemodialysis.

Design:

Randomized controlled trial, with repeated measurements at baseline and after 4, 8, and 12 weeks of intradialytic cycling exercise.

Setting:

A 50-bed haemodialysis centre in a regional hospital in Taiwan.

Subjects:

Seventy-six regular haemodialysis patients, recruited and equally and randomly assigned to exercise and control groups.

Intervention:

The intradialytic cycling exercise was performed for 12 weeks and comprised warm-up, main, and cool-down exercise phases. A stationary cycling equipment was used, which involved aerobic and resistance modalities. The intensity was maintained at somewhat hard exertion. Each intradialytic cycling exercise was implemented for 30 minutes, starting at the second hour of treatment.

Main measure:

Measured outcomes were 6-minute walk distance, time taken to complete 10 sit-to-stand-to-sit cycles and number of sit-to-stand-to-sit cycles in 60 seconds.

Results:

Average (standard deviation) participant age was 55.47 (13.00) years. Therefore, the 6-minute walk distance was significantly different at weeks 8 ( P = 0.01) and 12 ( P < 0.001) in the exercise group compared with that in the control group at baseline. Notably, sit-to-stand-to-sit outcomes ( P = 0.01) significantly influenced the 6-minute walk distance. Sit-to-stand-to-sit outcomes significantly improved in the exercise group ( P < 0.05).

Conclusion:

Twelve-week intradialytic exercise for patients on haemodialysis can improve physical functional performance with gain muscle strength and endurance. This is a safe and effective method for improving health.

[Exposure to famine in fetus and infant period and risk for hypertension in adulthood]

Objective: To investigate the relationship between exposure to famine in fetus and infant period and the risks for hypertension in adulthood. Methods: A total of 5 960 participants born between 1956 and 1965 were included in the study and were divided into unexposed group (1963-1965), fetal exposed group (1959-1961), early- childhood exposed group (1956-1958) and transitional group (1962). Logistic regression model was used to explore the association between famine exposure in early life and the risk for hypertension in adulthood. Results: Both the fetal exposure and the early-childhood exposure were the risk factors for hypertension in adulthood (OR=1.249, 95%CI: 1.049-1.486 and OR=1.360, 95%CI: 1.102-1.679). Meanwhile, in rural area, compared with unexposed group, the fetal exposure (OR=1.401, 95%CI: 1.091-1.798) and the early-childhood exposure (OR=1.460, 95%CI: 1.145-1.862) were also associated with a greater risk of hypertension in adulthood. In addition, fetal exposure and early-childhood exposure to famine in women were associated with 36.0% and 31.9% increased risks for hypertension (95%CI: 7.8%-71.7% and 95%CI: 4.8%-66.0%) according to the stratified analysis. Conclusion: Fetal exposure to famine might increase the risk for hypertension in adulthood.

Using Traditional Chinese Medicine to Relieve Asthma Symptoms: A Systematic Review and Meta-Analysis

Studies have demonstrated the effect of acupoint-based interventions in relieving the clinical symptoms of asthma. However, the effect of meridian-based interventions in asthma symptom relief is unknown. This systematic review and meta-analysis determined the effect of multiplex meridian interventions in asthma symptom relief. Eight electronic databases were searched for relevant randomized controlled trials (RCTs) that involved patients with asthma, were published before March 2018, used acupoint stimulation interventions targeting acupoints that correspond to meridians, and considered asthma symptom relief as an outcome. In 204 RCTs that were identified and used in a meta-synthesis, meridians were used 521 times, with the bladder meridian being the most frequently used. Furthermore, 23 RCTs were included in the meta-analysis. Egger's and inconsistency tests revealed no significant differences among the studies (P>0.05). However, the interventions differed significantly in terms of asthma symptom relief effect, as demonstrated by pairwise (odds ratio [OR]=0.28, 95% confidence interval=0.21-0.37) and network (OR=0.18, 95% credibility interval=0.08-0.41) meta-analyses. Surface under the cumulative ranking (SUCRA) revealed that the bladder-conception vessel-governor vessel-stomach multiplex meridian intervention was more effective than non-meridian interventions in relieving asthma symptoms. Additionally, either bladder-conception vessel-stomach or bladder-conception vessel-governor vessel-kidney multiplex meridians may be selected in interventions. This study suggests that practitioners target multiplex meridians, especially the meridians of the bladder and conception vessel, to effectively relieve asthma symptoms.

Respiratory training interventions improve health status of heart failure patients: A systematic review and network meta-analysis of randomized controlled trials

BACKGROUND

Prior studies indicate that doing breathing exercises improves physical performance and quality of life (QoL) in heart failure patients. However, these effects remain unclear and contradictory.

AIM

To determine the effects of machine-assisted and non-machine-assisted respiratory training on physical performance and QoL in heart failure patients.

METHODS

This was a systematic review and network meta-analysis study. A literature search of electronic databases was conducted for randomized controlled trials (RCTs) on heart failure. Respiratory training interventions were grouped as seven categories: IMT_Pn (inspiratory muscle training without pressure or < 10% maximal inspiratory pressure, MIP), IMT_Pl (inspiratory muscle training with low pressure, 10%-15% MIP), IMT_Pm (inspiratory muscle training with medium pressure, 30%-40% MIP), IMT_Ph (inspiratory muscle training with high pressure, 60% MIP or MIP plus aerobics), Aerobics (aerobic exercise or weight training), Qi_Ex (tai chi, yoga, and breathing exercise), and none. The four outcomes were heart rate, peak oxygen uptake (VO₂ peak), 6-min walking distance test (6MWT), and Minnesota Living with Heart Failure QoL. The random-effects model, side-splitting model, and the surface under the cumulative ranking curve (SUCRA) were used to test and analyze the data.

RESULTS

A total of 1499 subjects from 31 RCT studies were included. IMT_Ph had the highest effect sizes for VO₂ peak and 6MWT, IMT_Pm highest for QoL, and Qi_Ex highest for heart rate. Aerobics had the second highest for VO₂ peak, Qi_Ex second highest for 6MWT, and IMT_Ph second highest for heart rate and QoL.

CONCLUSION

This study supports that high- and medium-intensity machine-assisted training improves exercise capacity and QoL in hospital-based heart failure patients. After hospital discharge, non-machine-assisted training continuously improves cardiac function.

[Comparative analysis of sleep monitoring between young and middle-aged and elderly OSA patients]

Objective:The aim of this study is to compare the night sleep hypoxia degree and sleep structure of young and middle-aged and elderly patients with OSA, so that PSG has more important application value.Method:A total of 438 patients diagnosed with OSA from February 2017 to January 2019 were selected,including 119 patients in the youth group with an average age of (28.5±5.1）years,and 319 patients in the middle and elderly group with an average age of (45.8±2.7)years.The results recorded by PSG in the two groups were retrospectively analyzed. Result:①The AHI, ODI, OAI, MAI and ASaO₂of OSA patients in the junior group were significantly higher than those in the middle-aged and elderly group, while CAI was not statistically significant between the two groups (P=0.419).②The NREM stage Ⅰ (61.1±4.3)% in the junior group was significantly higher than that in the junior group (53.3±3.4)%.NREM stage Ⅱ (33.2±2.3)% and NREM stage Ⅲ+Ⅳ (4.3±1.3)% in the junior group were higher than those in the middle-aged group (29.2±3.9)% and stage Ⅲ+Ⅳ (2.6±0.9)%, while the percentage of REM stage and microarousal index were not statistically significant between the two groups.③Young OSA patients were associated with hypertension and 47.0% middle-aged and elderly patients were associated with hypertension.There was no statistical difference between the two groups in whether hypertension was associated with hypertension or not.Conclusion:The NREM phase is particularly susceptible to age, and age affects slow wave sleep. The sleep structure of middle-aged and older people demonstrates their sleep characteristics: reduced total sleep time,slow wave sleep,low sleep efficiency,and delayed sleep. The young people's nighttime hypoxia is more serious. AHI,ODI,OAI,MAI,ASaO₂ and other indicators are significantly higher than the middle-aged and elderly people, but the sleep structure 2 groups are similar, indicating that young people have strong sleep physiological compensation and Adjustment ability.

[Vestibular function test in patients sudden sensorineural hearing loss patients with vertigoand its clinical significance]

Objective:The aim of this study is to analyze the results of vestibular function tests and clinical value of patients with sudden sensorineural hearing loss （SSHL） and vertigo. Method:Twelve cases（24 ears） of unilateral SSHL with vertigo were included in the study group. 11 age and sex matched normal subjects（22 ears） were recruited as the normal control group. Both patients and normal subjects underwent carolic tests, ocular vestibular evoked myogenic potential （oVEMP）, and cervical vestibular evoked myogenic potential （cVEMP） in bilateral ears. The results were compared between the subjects and the normal control group. Result: The rate of positive oVEMP was 25.0% in the affected ear and 50.0% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects; while the rate of positive cVEMP was 58.3% in the affected ear and 58.3% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects. There were no significant differences between the affected and contralateral ears （P>0.05）. Compared to normal subjects, oVEMP and cVEMP in both the affected and contralateral ears were significantly reduced （P<0.05）. The parameters of oVEMP and cVEMP （N1 latency, P1 latency, amplitudes） were not significantly different among the groups（P<0.05）. Compared to normal subjects, the threshold difference of oVEMP and cVEMP in both the affected and contralateral ears werehigher than the normal subjects（P<0.05）. Among 12 SSHL patients who underwent caloric test, 9 were found with unilateral semicircular canal weakness（CP>25%）, and the abnormal rate was 75% （9/12）. Conclusion:Patients with vertigo with vertigo have impaired conduction function in the ipsilateral and contralateral vestibular pathways, mainly due to decreased vestibular evoked myogenic potential, increased threshold, and abnormal cold and heat tests. The vestibular function test provides an objective basis for assessing the inner ear injury in patients with vertigo.