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Background Gastrointestinal symptoms as a common clinical evaluation index require a universal evaluation tool, and the Gastrointestinal Symptom Rating Scale (GSRS) has been widely applicated in domestic studies. However, the versions used are not standardized Chinese versions and their measurement performance has not been reported yet. Objective To explore the measurement performance of the Chinese version of the GSRS, in order to provide an objective basis for expanding the application of the scale. Methods From October 2021 to March 2022, patients with irritable bowel syndrome (IBS), chronic enteritis and chronic gastritis who attended outpatient clinics of splenogastroenterology or gastroenterology in 45 hospitals (community health service centers), including Jilin Provincial People's Hospital and Beijing Changping District Urban Community Health Service Center, etc. The Chinese version of GSRS was used to evaluate the gastrointestinal symptoms of the included patients on treatment days 0, 3, 7 and 14. Reliability and validity analyses were conducted on the Chinese version of GSRS, and the paired Wilcoxon signed rank sum test was applied to compare the changes in the scores of patients before and after treatment. Additionally, effect size (ES), standardized response mean (SRM), and score change rate (CR) were used to assess the responsiveness of the scales. Results A total of 554 patients were included and followed up, including 127 patients (22.93%) with IBS, 244 (44.04%) patientswith chronic enteritis and 183 (33.03%) patients with chronic gastritis. The Cronbach's alpha coefficient for the Chinese version of GSRS was 0.896, the Guttman Split-half coefficient was 0.920, the Spearman-Brown coefficient was 0.926, the intraclass correlation coefficient (ICC) for the two retest results was 0.589, and the Spearman correlation coefficient was 0.662. The content validity index for each item ranged from 0.78 to 1.00. The content validity index (CVI) for the scale-level universal agreement was 0.73, and the average CVI was 0.96. Exploratory factor analysis extracted a total of three common factors with eigenvalues>1, and the rate of cumulative variance contribution is 60.721%.The validation factor analysis demonstrated that the data samples did not fit the initial model M0 well, and each fit index of model M1 is within the acceptable range after correction according to the modification indicator hints in the acceptable range: χ2/df0.900. The total Chinese version of GSRS scores of patients after 14 d of treatment are lower than the total Chinese version of GSRS scores before treatment (P

Glucagon-like peptide-1 receptor agonists (GLP-1RAs), as a kind of novel hypoglycemic agent, are widely used in patients with type 2 diabetes. GLP-1RAs are effective in glycemic control with low risk of hypoglycemia, significant weight loss, and cardiovascular benefit and renal protection. The most common adverse effects of GLP-1RAs are mild to moderate gastrointestinal symptoms, which generally resolve over time. The use of GLP-1RAs also increases the risk of gallbladder or biliary diseases, especially when used at higher doses, for longer durations, and for weight loss, but the absolute risk of gallbladder or biliary tract disease is small. Clinicians and patients need to carefully weigh the benefits and risks of GLP-1RAs to make decisions for the rational use of GLP-1RAs.

ObjectiveTo describe the incidence and distribution characteristics of congenital heart disease in newborns， and to analyze the trend of the notification rate from 2009 to 2018 in Chongming District， Shanghai.MethodsBased on the shanghai birth defects surveillance system， newborns delivered in all medical institutions in Chongming District from 2009 to 2018 were examined for congenital heart disease at birth and followed up to 42 days. The notification rate and trends of various congenital heart diseases were described.ResultsThere were 548 cases of neonatal congenital heart disease in Chongming District from 2009 to 2018， and the notification rate was 20.11‰ （95%CI： 18.47‰-21.85‰）， with statistically significant differences between years during the study period （Z=10.616， P

Background: To systematically analyze differences in atherosclerotic cardiovascular disease (ASCVD) burden between young and older adults. Methods: We estimated the prevalence, mortality, and disability-adjusted life years (DALYs) of ASCVD, including ischemic heart disease (IHD), ischemic stroke (IS), and peripheral artery disease (PAD), in individuals aged 20–54 and > 55 years from 1990–2019, utilizing data from the 2019 Global Burden of Disease Study. The annual percentage changes (EAPCs) for age-specific prevalence, mortality, or DALY rates were calculated to quantify the temporal trends of ASCVD burden. We also analyzed population attribution fractions (PAF) of premature ASCVD mortality and DALYs for different risk factors and compared the burden of extremely premature, premature, and non-premature ASCVD cases based on clinical classifications. Results: From 1990–2019, the global prevalence rates of IHD, IS, and PAD in the 20–54 years age group increased by 20.55% (from 694.74 to 837.49 per 100,000 population), 11.50% (from 439.48 to 490.03 per 100,000 population), and 7.38% (from 384.24 to 412.59 per 100,000 population), respectively. Conversely, the ASCVD prevalence in > 55years age group decreased. Adverse outcome burdens, including mortality and DALYs, varied among ASCVD subtypes. The decrease in the mortality/DALY burden of IHD and IS was lower in the 20–54 years group than in the > 55 years group. For PAD, DALYs among those aged 20–54 increased but decreased among those aged > 55 years. When grouped according to socio-demographic index (SDI) values, lower SDI regions exhibited a higher proportion of young ASCVD burden. The prevalence of young IHD, IS, and PAD in low SDI regions reached 20.70%, 40.05%, and 19.31% in 2019, respectively, compared with 12.14%, 16.32%, and 9.54%, respectively, in high SDI regions. Metabolic risks were the primary contributors to the ASCVD burden in both age groups. Increased susceptibility to ambient particulate matter pollution and inadequate control of high body-mass index and high fasting plasma glucose in young individuals may partially explain the differing temporal trends between young and older individuals. Conclusions: The ASCVD burden in young individuals may become a growing global health concern, especially in areas with lower socioeconomic development levels that require more effective primary prevention strategies. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the impact of a dual glucose‐dependent insulinotropic peptide (GIP) and glucagon‐like peptide‐1 (GLP‐1) receptor agonist tirzepatide (TZP), and its potential dose‐response effect, on heart rate. Methods: Articles were searched from PubMed, Web of Science, Embase, Cochrane Library, and clinical trials registries (ClinicalTrials.gov) databases. Randomized controlled trials (RCTs) comparing TZP at doses of 5, 10 and 15 mg in adults with type 2 diabetes were included. Six study arms were summarized from original research (TZP 5, 10 and 15 mg, GLP‐1 receptor agonists [GLP‐1RAs], insulin, placebo). The GLP‐1RA and non‐GLP‐1RA groups were combined to form a control group. Two reviewers independently extracted data and assessed the quality of each study. Mean differences (MDs) were calculated as effect estimates for continuous outcomes. Pairwise meta‐analyses and network meta‐analyses were conducted. The study protocol was prospectively registered (PROSPERO ID: CRD42023418551). Results: Eight articles were included in this systematic review and meta‐analysis. The mean baseline heart rate ranged from 65.2 to 75.7 beats per minute. Pairwise meta‐analysis showed that, compared with combined the control group, there were significantly greater increases in heart rates in the TZP group (MD 1.82, 95% confidence interval [CI] 0.75, 2.89). Similar significant rises were identified when comparing TZP with GLP‐1RAs and non‐GLP‐1RAs (GLP‐1 RAs: MD 2.29, 95% CI 1.00, 3.59; non‐GLP‐1RAs: MD 1.58, 95% CI 0.26, 2.91). TZP 5 mg was associated with smaller increases in heart rates compared to TZP 10 mg and TZP 15 mg (TZP 10 mg: MD −0.97, 95% CI −1.79, −0.14; TZP 15 mg: MD −2.57, 95% CI −3.79, −1.35). TZP 10 mg increased heart rate less than TZP 15 mg (MD −1.5, 95% CI −2.38, −0.82). Network meta‐analysis indicated that TZP 15 mg was associated with significant increases in heart rate compared with TZP 5 mg (MD 2.53, 95% CI 1.43, 3.62), TZP 10 mg (MD 1.44, 95% CI 0.35, 2.53), GLP‐1RAs (MD 3.46, 95% CI 1.67, 5.25), insulin (MD 2.86, 95% CI 1.32, 4.41) and placebo (MD 2.96, 95% CI 1.36, 4.57). Conclusions: Our study showed not only that there was a greater increase in heart rate in the TZP group than in the control, GLP‐1RA and non‐GLP‐1RA groups, but also that the 15‐mg dose of TZP had the strongest impact on increasing heart rates compared with the other five inventions, with a TZP dose‐response impact on heart rate. Further research on the effects of TZP treatment‐related increases in heart rate is required. [ABSTRACT FROM AUTHOR]

The article discusses the development of the SHARE (SHam Acupuncture REporting) guidelines and checklist for reporting sham acupuncture in clinical trials. Sham acupuncture is commonly used as a control in acupuncture research to evaluate the specific effects of acupuncture. However, the reporting quality of sham acupuncture in trials has been low, hindering the accurate understanding of its effects and leading to misunderstandings about the specific effects of acupuncture. The SHARE guidelines aim to improve the reporting quality of sham acupuncture by providing specific details about its implementation, including stimulation location, needle stimulation methods, and insertion technique. The guidelines also address contextual factors such as practitioner experience, practitioner-patient interaction, and patients' expectations of acupuncture. The SHARE checklist includes 19 subitems across 10 categories and can be used in any clinical trial involving sham acupuncture. The article recommends referencing both the SHARE and the STRICTA (STandards for Reporting Interventions in Controlled Trials of Acupuncture) checklist when conducting trials with sham acupuncture control. The development of the SHARE involved a literature review, Delphi surveys, consensus meetings, and pilot testing. The article acknowledges some limitations, such as the small sample size in the pilot test and the impact of COVID-19 on the consensus meetings. Overall, the SHARE guidelines and checklist aim to enhance the transparency, replication, and accuracy of sham acupuncture procedures in clinical trials. [Extracted from the article]

The article reports that the dipeptidyl peptidase 4 inhibitors are used for patients with type 2 diabetes due to their favorable therapeutic profile and low risk of hypoglycemia. Topics include examines Glucagon-like peptide 1 receptor agonists were reported to be associated with increased risk of gallbladder or biliary diseases, which might be attributable to the effects of GLP-1.

Objective: To summarize the evidence from Traditional Chinese Medicine (TCM) practice in the treatment of acute primary headache and provide clinical practice guidance., Methods: The guidelines were developed in accordance with the World Health Organization guideline development manual. After the establishment of steering committee, panel and the registration and protocol formulation, the evidence on TCM for acute primary headache from published guidelines, clinical evidence, and expert experience and consensus were collected. The grading of recommendations assessment, development and evaluation method was used to grade the evidence and make the recommendations., Results: Based on the available evidence, the guidelines recommended three TCM herbal decoctions, six Chinese patent medicines, and two kinds of external application of Chinese herbal medicines. Diagnostic recommendations based on the expert experience and consensus were also included in the guidelines., Conclusion: TCM diagnosis and treatment of decoction, Chinese patent medicine and external application for treating acute primary headache were recommended. We hope these guidelines will be helpful in standardize the TCM acute treatment of primary headache.

Background: Hyperglycemia is a rapidly increasing risk factor for cancer mortality worldwide. However, the dose‒response relationship between glucose levels and all-cause mortality in cancer survivors is still uncertain., Methods: We enrolled 4,491 cancer survivors (weighted population 19,465,739) from the 1999-2019 National Health and Nutrition Examination Survey (NHANES). Cancer survivors were defined based on the question of whether they had ever been diagnosed with cancer by a doctor or a health professional. Hemoglobin A1c (HbA1c) was selected in this study as a stable marker of glucose level. Mortality was ascertained by linkage to National Death Index records until December 31, 2019. Cox proportional hazard, Kaplan‒Meier survival curves and Restricted cubic spline regression models were used to evaluate the associations between HbA1c and all-cause mortality risk in cancer survivors., Results: In NHANES, after adjusting for confounders, HbA1c had an independent nonlinear association with increased all-cause mortality in cancer survivors (nonlinear P value < 0.05). The threshold value for HbA1c was 5.4%, and the HRs (95% CI) below and above the threshold value were 0.917 (0.856,0.983) and 1.026 (1.010,1.043), respectively. Similar associations were found between fasting glucose and all-cause mortality in cancer survivors, and the threshold value was 5.7 mmol/L., Conclusions: HbA1c was nonlinearly associated with all-cause mortality in cancer survivors, and the critical value of HbA1c in decreased mortality was 5.4%, suggesting optimal glucose management in cancer survivors may be a key to preventing premature death in cancer survivors., (© 2024. The Author(s).)

Objective: To systematically evaluate the efficacy and safety of Angong Niuhuang pill (, ANP) in the treatment of acute stroke. This can provide ideas and basis for the treatment of this disease with integrated Traditional Chinese and Western Medicine., Methods: Randomized controlled trials (RCTs) of China National Knowledge Infrastructure Database, Wanfang Database, Chinese BioMedical Literature Database, PubMed, Embase, and the Cochrane Library were searched from the establishment to March 2022. Two researchers screened the literature and extracted the data according to inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software., Results: A total of 28 RCTs were included, including 2745 patients in the acute stage of stroke (1375 in the experimental group and 1370 in the control group). Meta-analysis showed that compared with conventional treatment, combined treatment with ANP could improve the effective rate of acute stroke patients [relative risk () = 1.26, 95% confidence interval () (1.21, 1.31)], Glasgow Coma Scale scores [mean difference () = 2.01, 95% (1.04, 2.98)], Mini-mental State Examination scores [ = 4.79, 95% (2.22, 7.37)], Activities of Daily Living scores [ = 15.70, 95% (14.05, 17.36)] and the Barthel index scores [ = 13.89, 95% (12.12, 15.65)], reduce National Institute of Health stroke scale scores [ = -3.90, 95% (-4.96, -2.84)] and serum brain natriuretic peptide [ = -38.50, 95% (-46.85, -30.15)]. In terms of safety, the incidence of adverse reactions showed no statistical differences between the two groups [ = 0.71, 95% (0.43, 1.15), = 0.16], and no serious adverse reactions/events were observed, indicating a good safety., Conclusions: Existing clinical research evidence shows that ANP has good efficacy and safety in the treatment of acute stroke, which can provide a basis for the treatment of integrated Traditional Chinese and Western Medicine. However, the quality of included research methodology needs to be improved, and the above conclusions need to be verified by more high-quality studies.