ObjectiveTo observe the effect of electroacupuncture （EA） on gastric mucosal injury and necroptosis receptor-interacting protein kinase （RIPK）1/RIPK3/mixed lineage kinase domain-like （MLKL） signaling pathway in rats with precancerous lesions of gastric cancer， so as to explore its possible mechanism underlying improvement of gastric precancerous lesions （GPL）.MethodsA total of 32 male SD rats were randomly divided into blank control， model， EA， and sham EA groups， with 8 rats in each group. The GPL model was established by free drinking of N-methyl-N’-nitro-N-nitrosoguanidine solution combined with intermittent fasting for 20 weeks. Starting from the 13th week of modeling， EA （2 Hz/15 Hz， 0.3—0.5 mA） was applied to bilateral “Zusanli” （ST36） and “Zhongwan” （CV12） for rats of the EA group， and applied to non-acupoints （5 mm away to ST36 and CV12） for rats of the sham EA group. The treatment was conducted for 20 min， once a day， 5 times a week for 8 weeks. During the experiment， the general conditions and body weight changes were recorded. Histopathological changes of the gastric tissues were observed by hematoxylin-eosin （H.E.） staining and alcian blue-periodic acid schiff （AB-PAS） staining， separately. The ELISA was used to detect the contents of tumor necrosis factor alpha （TNF-α）， interleukin 1 beta （IL-1β） and transforming growth factor beta 1 （TGF-β1） in the serum. Immunohistochemistry （IHC） was used to detect the levels of caudal type homeobox transcription factor （CDX） 2 in the gastric tissue. The mRNA expression levels of Ki67， alpha-methylacyl-CoA racemase （AMACR）， sex determining region Y box protein 2 （SOX2）， CDX1， RIPK1， RIPK3， MLKL， Caspase-8， Caspase-3 and Caspase-7 in the gastric tissues were detected by using real-time PCR. The protein expression levels of CDX2， AMACR， phospho-RIPK1 （p-RIPK1）， RIPK1， phospho-RIPK3 （p-RIPK3）， RIPK3， phospho-MLKL （p-MLKL）， MLKL， Caspase-8， and Caspase-3 in the gastric tissues were detected by using Western blot.ResultsIn contrast to the blank control group， the model group had a significant decrease in the body weight gain rate， average daily food intake， expression levels of SOX2 mRNA， and Caspase-3 and Caspase-8 mRNAs and proteins in the gastric tissues （P<0.01， P<0.05）， and a considerable increase in the contents of serum TNF-α， IL-1β， TGF-β1， and positive expression of CDX2， expression levels of Ki67， AMACR， CDX1， RIPK1， RIPK3 and MLKL mRNAs， and p-RIPK1/RIPK1， p-RIPK3/RIPK3 and p-MLKL/MLKL ratios in the gastric tissues （P<0.01， P<0.05）. The gastric mucosal glands were deeper in the opening， and had an apparent atrophy with intestinal metaplasia of the gastric epithelium. Compared with the model group， the rats in the EA group （not the sham EA group） showed improved mental state， and increased body weight gain rate and average daily food intake （P<0.01， P<0.05）. The pathological conditions of gastric mucosal atrophy and intestinal metaplasia were improved. In addition， modeling- induced increases of the contents of serum TNF-α， IL-1β， TGF-β1， and positive expression of CDX2， expression levels of Ki67， AMACR， CDX1， RIPK1， RIPK3 and MLKL mRNAs， and p-RIPK1/RIPK1， p-RIPK3/RIPK3 and p-MLKL/MLKL ratios， and as well as the decreases of the expression levels of SOX2 mRNA， and Caspase-3 and Caspase-8 mRNAs and proteins were all reversed by EA （P<0.05， P<0.01）， not by sham EA. H.E. staining showed that the glandular arrangement in the gastric mucosa of the rats in the sham EA group remained disordered， and the pathological histological recovery was poor.ConclusionEA can improve the degree of gastric mucosal lesions in GPL rats， which may be related to its functions in reducing the inflammatory response of the gastric mucosa and inhibiting the necroptosis RIPK1/RIPK3/MLKL signaling pathway of the gastric mucosa.

BACKGROUND:Low back pain (LBP) is very common in women of child bearing age (WCBA) and is a major burden on individuals and society, but studies about it have not been reported. METHODS:Trend analyses were based on data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021. We investigated global trends in the number of prevalence cases, prevalence and the years lived with disability (YLDs), and the YLDs rate for LBP in the WCBA. We used joint point regression analyses to report average annual changes and identify the most variable years in the global trend. Simultaneously, we further analyzed these trends by stratifying them by the region, nation, and age. RESULTS:Globally, the number of the prevalence and the YLDs for LBP increased substantially from 1990 to 2021(the prevalence: 39.65%) (the YLDs: 39.53%), whereas the prevalence and the YLDs rate of WCBA LBP decreased (the prevalence: AAPC: -0.1355 [95% CI -0.1419 to -0.1288) (the YLDs: AAPC: -0.1365 [95% CI -0.1427 to -0.1302]). Regionally, the prevalence and the YLDs rate of LBP among WCBA in the medium socio-demographic index region showed an increasing trend(the prevalence: AAPC: 0.1291 [95% CI: 0.118 to 0.1396]) (the YLDs: AAPC: 0.1371 [95% CI: 0.1251 to 0.1499]). Nationally, Thailand and Vietnam were the countries with the largest increases in YLD rates(Thailand: AAPC: 0.7742 [95% CI: 0.7589 to 0.7904]) (Vietnam: AAPC: 0.7364 [95% CI: 0.7263 to 0.7468]). In age patterns, the highest prevalence and YLDs rates of LBP were found among women in the 45-49 age group(the prevalence: 14,412.77 per 100,000 in 2021 [95% UI: 10,482.27 to 19,077.3]) (the YLDs: 1,639.56 per 100,000 population (95% UI: 1,035.24 to 2,494.9]). CONCLUSION:Despite declines in the prevalence and YLDs of WCBA LBP, the burden remains high. Age- and region-specific prevention and healthcare strategies should be optimized to meet the needs of WCBA and reduce the burden of disease.

BackgroundRecent epidemiological studies and animal experiments have highlighted the significant role of oxidative stress in the development of osteoporosis (OP). The provision of antioxidants is widely considered a fundamental strategy to combat free radical-induced stress, inhibit oxidative damage, and potentially reverse the adverse effects of oxidative stress on bone health. However, there is no consensus in the scientific literature regarding the practical effectiveness of antioxidants in OP prevention and treatment. Some studies have not shown a clear connection between antioxidant supplementation and decreased OP risk. Therefore, it is essential to clarify the potential causal relationship between antioxidants and the development of OP.MethodsThe study utilized the inverse variance weighted (IVW) approach as the primary analytical method in the Mendelian Randomization (MR) framework to investigate the causal effects of five exogenous and six endogenous antioxidants on the risk of OP. To thoroughly assess potential pleiotropic effects and heterogeneity among the data analyzed, the MR-Egger intercept test was employed, and Cochran’s Q statistic was calculated.ResultsIn the evaluation of exogenous antioxidants, single-directional two-sample MR analyses did not reveal any statistically significant relationship between these agents and the risk of OP. Regarding endogenous antioxidants, bidirectional two-sample MR analyses were conducted, which generally indicated that most genetically regulated endogenous antioxidants had no significant association with the onset risk of OP. A significant causal relationship was found between OP and serum albumin levels (β: −0.0552, 95%CI: −0.0879 to −0.0225, p< 0.0011 after Bonferroni adjustment, power = 100%).ConclusionThe research uncovers OP as a possible determinant contributing to a decrement in serum albumin levels, and further suggests a potentially intimate relationship between the downward trajectory of serum albumin concentrations and the advancement of the OP disease process.

基于文献分析提出健脾防治运动性疲劳的思路,并基于网络药理学方法,以健脾代表方补中益气汤为例探讨健脾法防治运动性疲劳的可能作用机制.有关运动性疲劳的中西医发病机制的文献分析显示,脾虚是运动性疲劳的重要病机,线粒体功能障碍在运动性疲劳的发生发展过程中发挥关键作用.网络药理学研究表明,补中益气汤防治运动性疲劳的主要活性成分为槲皮素、β-谷甾醇和豆甾醇,关键靶点主要为白细胞介素6(IL-6)、肿瘤坏死因子(TNF)和白细胞介素1β(IL-1β),靶点可能涉及甲状腺激素、5-羟色胺能突触、缺氧诱导因子(HIF)等信号通路.结果提示,中医健脾法对防治运动性疲劳具有明显优势,而调节线粒体功能可能成为中医防治运动性疲劳的疗效机制研究的切入点.

BACKGROUND:Circulation dysfunction is a major contributing factor to thrombosis in patients with atrial fibrillation (AF) for which effective interventions are lacking. Growing evidence indicates that regulating the paraventricular nucleus (PVN), an autonomic control center, could offer a novel strategy for treating cardiovascular and circulatory diseases. Concurrently, electroacupuncture (EA) at Xinshu (BL15), a form of peripheral nerve stimulation, has shown efficacy in treating several cardiovascular conditions, although its specific mechanism remains unclear. This study aimed to assess the impact of EA at BL15 on circulatory dysfunction in a rat AF model and investigate the pivotal role of PVN neuronal activity.METHODS:To mimic the onset of AF, male SD rats received tail intravenous injection of ACh-CaCl2 and were then subjected to EA at BL15, sham EA, or EA at Shenshu (BL23). Macro- and micro-circulation function were evaluated using in vivo ultrasound imaging and laser doppler testing, respectively. Vasomotricity was assessed by measuring dimension changes during vascular relaxation and contraction. Vascular endothelial function was measured using myograph, and the activation of the autonomic nerve system was evaluated through nerve activity signals. Additionally, chemogenetic manipulation was used to block PVN neuronal activation to further elucidate the role of PVN activation in the prevention of AF-induced blood circulation dysfunction through EA treatment.RESULTS:Our data demonstrate that EA at BL15, but not BL23 or sham EA, effectively prevented AF-induced macro- and micro-circulation dysfunction. Furthermore, EA at BL15 restored AF-induced vasomotricity impairment. Additionally, EA treatment prevented abnormal activation of the autonomic nerve system induced by AF, although it did not address vascular endothelial dysfunction. Importantly, excessive activation of PVN neurons negated the protective effects of EA treatment on AF-induced circulation dysfunction in rats.CONCLUSION:These results indicate that EA treatment at BL15 modulates PVN neuronal activity and provides protection against AF-induced circulatory dysfunction.

骨骼疾病严重影响患者健康及生活质量.越来越多研究发现肠道菌群与肾虚型骨骼疾病关系密切,肠道菌群-肠-脑轴可能是多种肾虚型骨骼疾病发生发展过程中的关键环节.笔者全面总结了肠道菌群在骨质疏松症、膝骨关节炎、股骨头坏死等多种肾虚型骨骼疾病发病机制中的作用,对肠道菌群-肠-脑轴从短链脂肪酸、血清素、炎症细胞及相关免疫因子等方面调控肾虚型骨骼疾病的作用机制进行了综述,以期为肾虚型骨骼疾病的诊断与治疗提供新思路.

该文通过问卷调查法、文献资料法、数理统计法,对广东高校大学生关于舞狮认知度进行调查研究,结果显示:大学生对舞狮了解度较好,关注度较低,对舞狮文化价值和运动价值认知较薄弱.建议:学校提高学生对舞狮的关注度,开设舞狮特色课程,加强舞狮文化价值和运动价值的宣传,以弘扬中华民族传统体育精神为己任,开创南狮运动发展的新局面.

At present, four operating modes have been explored for physical-medical integration in China: hospital health guidance center, sports club health guidance, community health monitoring center and industry-university-research cooperation on the integration of physical and medical services. However, physical-medical integration is still in its infancy, the cultivation of physical-medical integration talents has been a key to the deep development of "physical-medical integration". The researches show that the current training mode of integrative talents mainly focuses on on-the-job training, which is faced with many problems such as serious shortage of specialized talents, imperfect certification system and single talent training mode. It is suggested that the training system, the curriculum system, the public opinion system and the professional standards should be improved so as to realize the scientific and sustainable development of physical-medical talents.

In an era of digital information, the elderly care service industry is also undergoing tremendous changes.The community home-based elderly care combining medicine and sports has improved the health and life quality of elder people.The Internet integrates the elderly care resources of the government, communities, and society and puts them into effective use.Under such circumstances, it is easier for us to take full advantage of medical resources.Based on the existing research results and related theories, the author of this paper takes the combination of medicine and sports under "Internet Plus" as the research perspective and analyzes the current situation of community home-based elderly care combining medicine and sports under "Internet Plus."The existing problems in this model have been spotted and the development path and directions have been proposed for improving community home-based elderly care combining medicine and sports under "Internet Plus.

目的:利用文献研究及靶点网络方法挖掘经验用穴足三里穴、中脘穴防治应激性溃疡的作用机制,并进行体内实验验证.方法:检索2010年1月至2021年7月间CNKI、万方、维普、PubMed、Web of Science数据库中关于足三里穴、中脘穴治疗疾病的文献,获取穴位治疗疾病的靶点,构建穴位-靶点网络图;利用GeneCards数据库获取应激性溃疡的疾病作用靶点,构建PPI蛋白互作网络并进行KEGG通路富集分析.构建应激性溃疡大鼠模型,观察足三里穴、中脘穴预针刺对应激性溃疡大鼠的影响.结果:最终纳入文献172篇,共涉及317个靶点;PPI蛋白互作获得53个关键蛋白;KEGG通路富集得到54条信号通路,涉及TNF信号通路、HIF-1信号通路、NOD样受体信号通路、Toll样受体信号通路等.大鼠体内实验显示,与模型组比较,针刺组、抑制剂组均可显著改善大鼠胃黏膜溃疡情况,降低TLR4、Myd88、NF-κB、NLRP3、IL-1 β的水平(P＜0.01,P＜0.05).结论:足三里穴、中脘穴防治应激性溃疡的机制可能与NOD样受体信号通路、Toll样受体信号通路TLR4、Myd88、NF-κB、NLRP3、IL-1β等关键靶点有关.

目的:系统评价运动疗法干预原发性骨质疏松症骨密度有效性.方法:在PubMed、Embase、中国知网、万方等数据库检索运动疗法对骨质疏松影响,运用Noteexpress按照纳入排除标准整理文献,对筛查出符合要求的6篇文献进行质量评价及指标分析.结果:运动疗法对骨质疏松患者骨密度的影响显著高于对照组(MD=0.11,95％CI[0.06,0.16],P＜ 0.05),运动疗法在改善骨质疏松患者骨密度方面优于照组.结论:运动疗法对骨质疏松疗效确切,复合运动疗法相比单一运动疗法更有优势,运动疗法实施6个月为疗效最好时期.

目的 探讨半夏生物总碱对运动氧化应激大鼠胃黏膜的保护作用及机制.方法 将32只SD大鼠随机分为空白组、模型组、半夏生物总碱组(20 mg·kg-1)和阳性对照组(奥美拉唑,10mg·kg-1),每组8只.灌胃给药,每日1次,连续7d.第7天灌胃给药1h后,进行一次性负重力竭游泳运动造模.麻醉后处死所有大鼠,计算胃溃疡指数(UI),采用HE染色法观察胃黏膜组织病理形态;采用酶联免疫吸附法(ELISA)检测血清一氧化氮(NO)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)等氧化应激指标水平,以及胃黏膜组织胃泌素(GAS)、胃动素(MTL)含量.结果 与空白组比较,模型组大鼠的UI值与胃黏膜组织GAS、MTL含量,以及血清NO、MDA含量均显著升高(P＜0.01),血清SOD、GSH-Px水平显著降低(P＜0.01).与模型组比较,半夏生物总碱组大鼠的UI值与胃黏膜组织GAS、MTL含量,以及血清NO、MDA含量均显著降低(P＜0.01),血清SOD、GSH-Px水平显著升高(P＜0.01).结论 半夏生物总碱具有抗氧化作用,能纠正运动应激导致的胃黏膜组织GAS、MTL分泌异常状态,逆转运动氧化应激对胃黏膜的损伤,减少胃溃疡的发生.

肺康复应用于慢性阻塞性肺疾病的治疗已得到广泛研究,其疗效也得到肯定,但对其他慢性呼吸系统疾病的疗效尚不明确,由于相关高质量研究较少,缺少适用于不同疾病的肺康复方案及康复疗效评价体系.本文通过阅读近年国内外关于肺康复治疗各种慢性呼吸系统疾病的疗效研究,综述研究成果,报告肺康复治疗慢性呼吸系统疾病的研究现状.

Embedding the concept and application of big data into the community-based eldercare management service system is an important support for the future development of community-based eldercare services. It will completely change the management model while improving the technology content of elderly care services. It is of great epochal significance and practical value to construct the big data service mode of community-based eldercare health management, which mainly includes the collection of health data, the establishment of electronic health records, assessment and classification, health intervention and education, health tracking and effectiveness evaluation, and proposes to improve the operating mechanism of the model. The countermeasures and suggestions in this way will drive and revitalize community-based eldercare health management service resources, provide a reference for solving the real community-based eldercare problems in the era of big data, and assist in solving the increasingly severe aging problem in our country.

目的:关节镜下重建前交叉韧带已经成为当前前交叉韧带损伤的首选治疗方法,但对于是否保留前交叉韧带胫骨残端重建存在较大争议.文章系统评价关节镜下保留残端与不保留残端重建前交叉韧带的临床效果.方法:通过计算机检索PubMed、EMbase、The Cochrane Library、CBM、WanFang Data、CNKI和VIP数据库,搜集所有关于关节镜下保留残端与不保留残端重建前交叉韧带的临床对照研究,检索时限均从建库至2019年9月.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果:①保留残端组的Lysholm评分明显高于不保留残端组[MD=2.20,95％CI(0.82,3.58),P=0.001];②保留残端组的IKDC评分明显高于不保留残端组[MD=2.28,95％CI(1.20,3.37),P<0.001];③保留残端组的KT1000/KT2000评分明显低于不保留残端组[MD=-0.29,95％CI(-0.52,-0.06),P=0.01];④保留残端组与不保留残端组的轴移试验无明显差异;⑤保留残端组与不保留残端组的Lachman试验无明显差异;⑤保留残端组与不保留残端组的本体感觉差异明显[MD=0.41,95％CI(0.13,0.69),P=0.004];⑥保留残端组与不保留残端组的胫骨隧道直径无明显差异.结论:现有证据表明保留残端重建前交叉韧带可以提高膝关节术后功能评分、本体感觉和客观稳定性,但无证据表明其对主观稳定性和胫骨骨隧道保护有益.

Against the backdrop of the reality of the transformation of scientific and technological achievements in domestic colleges and universities, this paper summarized the common modes and major paths of the transformation of scientific and technological achievements in colleges and universities in Guangdong-Hong Kong-Macao Greater Bay Area (GBA).On the strength of the analysis of the issues and hindrances during the transformation, this paper explored the improvement of the modes and paths of the transformation of scientific and technological achievements.Besides, the specific countermeasures and suggestions were also proposed in this paper for the purpose of providing useful reference for promoting the effective transformation of scientific and technological achievements in the colleges and universities in the GBA.

幽门螺旋杆菌感染是一种慢性感染引起的相关疾病是各种免疫细胞和化学物质长期作用的结果,加之幽门螺旋杆菌自身酶的作用和基因多样性,导致其可在体内持续定植存活,逃避宿主免疫系统.中医理论中的伏邪"结"病机指邪气伏于内,并与机体胶着难解的病理状态,是邪气伏留、病情迁延的重要原因,这与幽门螺旋杆菌持续定植引起感染甚或致癌的免疫逃逸机制有一定相关性.文章基于伏邪"结"病机理论,从基本概念、病机特点、治疗思路着手,结合幽门螺旋杆菌免疫逃逸机制的现代研究进展,分析两者之间的关联,以期为中医药防治幽门螺旋杆菌提供新思路.

目的:观察八段锦联合持续气道正压通气(CPAP)治疗老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效.方法:将90例老年OSAHS患者随机分为对照组和试验组,两组均给予健康教育、饮食及生活干预,对照组予CPAP治疗,治疗组在此基础上进行八段锦功法练习,两组均连续治疗12周.比较两组OSAHS老年患者Epworth嗜睡量表(ESS)评分、睡眠呼吸暂停呼吸暂停低通气指数(AHI)、最长呼吸暂停持续时间、最低血氧饱和度(LSaO2),以及肿瘤坏死因子-α(TNF-α)、白细胞介素-18 (IL-18)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平.结果:与本组治疗前比较,治疗后两组ESS评分、AHI、最长呼吸暂停时间、MDA、TNF-α和IL-18均显著下降(P＜0.05),LSaO2和SOD显著上升(P＜0.05);治疗后与对照组同期比较,试验组ESS评分、AHI、最长呼吸暂停时间、MDA、TNF-α和IL-18均显著下降(P＜0.05),LSaO2和SOD显著上升(P＜0.05).结论:八段锦联合CPAP治疗老年OSAHS临床疗效更显著.

背景:假体周围感染是膝/髋关节置换最常见最严重的并发症之一,占全膝关节置换失败原因的25％,全髋关节置换失败的16％.因此,及时准确地诊断关节假体周围感染具有重要临床意义.目的:评估α防御素和C-反应蛋白对假体周围感染的诊断效应.方法:选取2014年9月到2016年9月初次关节置换或关节翻修手术后疼痛的患者,并检测所选患者滑膜液中α防御素和C-反应蛋白的表达情况,并与肌肉骨骼感染协会(MSIS)标准对比,分别计算检测的阳性预测值和阴性预测值.试验于2020-08-07经广州中医药大学伦理审查委员会批准,审批号K[2020]064.结果与结论:α防御素测试与滑膜液C-反应蛋白阳性联合测试的敏感性为81.1％(95％CI:64.8％-92.0％),特异性为95.9％(95％CI:91.3％-98.5％);滑膜液α防御素和C-反应蛋白联合测试的敏感性为73.0％(95％CI:55.9％-86.2％),特异性为99.3％(95％CI:96.2％-99.9％).提示滑膜液中α防御素和C-反应蛋白可用于关节周围感染的辅助诊断.

目的 探究半夏泻心汤对大鼠运动应激性胃黏膜损伤的预防保护机制.方法 选用32只健康的雄性SD大鼠,随机分为空白对照组、模型组、实验组和阳性对照组,每组8只,空白组正常喂养,试验组予半夏泻心汤灌胃,阳性对照组予奥美拉唑溶液灌胃,模型组予蒸馏水灌胃,连续干预7天后,采用一次性游泳力竭方法建立运动应激性胃溃疡模型,计算胃溃疡指数(UI),电镜下观察胃粘膜组织形态,采用ELISA方法测定胃粘膜的TNF-α、IL-1β、IL-6.结果 空白组大鼠胃黏膜的UI显著低于模型组,差异有统计学意义(P<0.01);模型组UI显著高于中药组和西药组(P<0.01),中药组和西药组对比UI无明显差异(P>0.05).空白组大鼠胃黏膜的IL-1β、IL-6、TNF-α的表达量均明显低于模型组,差异有统计学意义(P<0.01).中药组和西药组的炎症因子IL-1β、IL-6、TNF-α表达量也明显低于模型组的表达量,差异有统计学意义(P<0.01);中药组的IL-1β、IL-6、TNF-α表达量与西药组的相比无明显差异(P>0.05).通过造模前给予半夏泻心汤或奥美拉唑灌胃,胃粘膜病理学形态改善明显.模型组TNF-α、IL-1β、IL-6的表达明显多于其余3组,其中实验组与阳性对照组的表达量无明显差异.结论 半夏泻心汤可提高机体免疫力,降低胃黏膜中TNF-α、IL-1β、IL-6的表达,抑制炎症反应,减少运动应激性胃溃疡的发生.