Search

Background: Distal symmetric polyneuropathy (DSPN) is the most common chronic complication of type 2 diabetes mellitus (T2DM). DSPN may lead to more serious complications, such as diabetic foot ulcer, amputation, and reduced life expectancy. Observational studies have suggested that vitamin D deficiency may be associated with the development of DSPN in T2DM. However, interventional studies have found that low-dose vitamin D supplementation does not significantly improve neuropathy in DSPN. This study aims to evaluate the efficacy and safety of intramuscular injection of high-dose vitamin D (HDVD) in T2DM with DSPN combined with vitamin D insufficiency. Methods and analysis: We will conduct a multicenter, randomized, double-blinded, and placebo-controlled trial in four large hospitals. All eligible participants will be randomly assigned to either the vitamin D2 supplement or placebo control group and injected intramuscularly monthly for 3 months. Additionally, anthropometric measurements and clinical data will be collected at baseline and 3 months. Adverse events will be collected at 1, 2, and 3 months. The primary outcome measure is the change in the mean Michigan Neuropathy Screening Instrument (MNSI) score at baseline and 3 months postintervention. We will use the gold-standard liquid chromatography-tandem mass spectrometry method to distinguish between 25(OH)D2 and 25(OH)D3 levels. The MNSN score before the intervention will be used as a covariate to compare the changes between both groups before and after the intervention, and the analysis of covariance will be used to analyze the change in the MNSI score after HDVD supplementation. Discussion: Glycemic control alone does not prevent the progression of DSPN in T2DM. Some studies have suggested that vitamin D may improve DSPN; however, the exact dose, method, and duration of vitamin D supplementation are unknown. Additionally, neuropathy repair requires HDVD supplementation to sustain adequate vitamin D levels. This once-a-month intramuscular method avoids daily medication; therefore, compliance is high. This study will be the first randomized controlled trial in China to analyze the efficacy and safety of HDVD supplementation for patients with T2DM and DSPN and will provide new ideas for pharmacological research and clinical treatment of diabetic neuropathy. [ABSTRACT FROM AUTHOR]

Discusses China's efforts to reform child welfare practices to provide safe, permanent families for children instead of institutional care. Considers legal provisions for adoption in China, including the adoption of Chinese children by Western families, and increasing use of this alternative for providing for children's welfare in a culture with a strong sense of family duty toward children. (JPB)

Background: With the aging of the population, the prevalence and incidence of stroke in China are increasing every year. China advocates the establishment of a three-level medical service system for stroke rehabilitation, but it lacks uniform information management among all levels of medical institutions. Objective: To achieve unified management of stroke patient rehabilitation in multilevel hospitals in the region through informatization construction. Methods: The need for informatization of three-level stroke rehabilitation management was analyzed. Then, network connections were established, and a common rehabilitation information management system (RIMS) was developed for all levels of hospitals to enable daily stroke rehabilitation management, interhospitals referral, and remote video consultation. Finally, the impact on the efficiency of daily rehabilitation work, the functioning and satisfaction of stroke patients were investigated after implementing the three-level rehabilitation network. Results: One year after implementation, 338 two-way referrals and 56 remote consultations were completed using RIMS. The stroke RIMS improved the efficiency of doctors' orders, reduced therapists' time to write medical documents, simplified statistical analysis of data and made referrals and remote consultations more convenient compared to the traditional model. The curative effect of stroke patients managed by RIMS is better than that of traditional management. Patient satisfaction with rehabilitation services in the region has increased. Conclusion: The three-level stroke rehabilitation informatization has enabled the unified management of stroke rehabilitation in multilevel hospitals in the region. The developed RIMS improved the efficiency of daily work, improved the clinical outcomes of stroke patients, and increased patient satisfaction. [ABSTRACT FROM AUTHOR]

The value of promotional marketing and word-of-mouth (WOM) is well recognized, but few studies have compared the effects of these two types of information in online settings. This research examines the effect of marketing efforts and online WOM on product sales by measuring the effects of online coupons, sponsored keyword search, and online reviews. It aims to understand the relationship between firms' promotional marketing and WOM in the context of a third party review platform. Using a three-year panel data set from one of the biggest restaurant review websites in China, the study finds that both online promotional marketing and reviews have a significant impact on product sales, which suggests promotional marketing on third party review platforms is still an effective marketing tool. This research further explores the interaction effects between WOM and promotional marketing when these two types of information coexist. The results demonstrate a substitute relationship between the WOM volume and coupon offerings, but a complementary relationship between WOM volume and keyword advertising. [ABSTRACT FROM AUTHOR]

The study develops an integrated model to examine factors, particularly government factors, which influence IT adoption in Chinese firms. By analyzing the survey data from 1540 firms across 14 industries and across various ownerships in Shanghai, the study contributes several insights into firms' IT usage. First of all, this study sheds light on the IT adoption in Chinese firms and validates the general route from IT infrastructure construction to value realization. Second, the findings suggest that government actions influence firms' IT infrastructure development and IT management decision. However, there is no evidence showing the government impact on firms' IT usage. The study also provides valuable IT adoption implications to firms in China, particularly to those in the modern cities like Shanghai. [ABSTRACT FROM AUTHOR]

Several lines of evidence supported the involvement of ECE-1 in the development of atherosclerosis disease. We investigated the C-338A polymorphism of the ECE-1b gene in carotid atherosclerosis. A cohort of 518 Chinese carotid atherosclerosis patients and 518 controls matched by age and sex were examined for the ECE-1b C-338A polymorphism. The ECE-1b-338 A allele was significantly frequent in carotid atherosclerosis patients than in controls (chi(2)=9.167; P=0.002). A alleles had a 26% increased risk of carotid atherosclerosis compared with C alleles (OR=1.26; 95% CI=1.05-1.52). In stratified analyses, the A allele carrying genotypes was significantly associated with an increased risk of carotid atherosclerosis in females (adjusted OR=1.57; 95% CI=1.14-2.23) and a subject with age >or=64 years (adjusted OR=1.72; 95% CI=1.23-1.41). Our results suggested that ECE-1b-338 A allele carrying genotypes might be associated with increased risk of carotid atherosclerosis in the Chinese population.