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Rui Zhang1 *, Lanhua Zhou2 *, Meiyu Lv,1 Na Yue,1 Wenting Fei,3 Linyuan Wang,3 Zhaolan Liu,1 Jianjun Zhang1 1School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China; 2Department of Dermatology, Beijing Jingcheng Skin Hospital, Beijing, 100192, People’s Republic of China; 3School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianjun Zhang, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Liangxiang Town, Fangshan District, Beijing, 102488, People’s Republic of China, Email zhangjianjun@bucm.edu.cnBackground: The tests of sex hormones play pivotal roles in the clinical diagnosis and treatment of acne vulgaris, but the majority of patients with acne vulgaris present regular sex hormone levels within the normal reference range.Objective: To determine the correlation among levels of sex hormones, ratio of androgen to estrogen and acne grades in patients with acne vulgaris.Methods: A cross-sectional study was applied to collect 693 patients with acne vulgaris. All samples were screened by cluster sampling among those who underwent tests of sex hormones at Beijing Jingcheng Skin Hospital from July 2021 to June 2022. A gender stratified analysis was performed to classify acne grades I–IV. Spearman correlation analysis was used to analyze the relationship between age, sex hormones, ratio of androgen to estrogen and acne grades, with multinomial logistic regression to analyze the association of sex hormones with acne grades in patients with acne.Results: (1) The testosterone levels were mostly within normal reference values for both males and females with varying degrees of acne. For females, the serum follicle-stimulating hormone, estradiol, progesterone, testosterone, and ratio of androgen to estrogen were significantly different between acne grades. For males, there were significant differences in serum estradiol, testosterone, and ratio of androgen to estrogen across acne grades. (2) The acne grade was negatively correlated with estradiol and positively correlated with the ratio of androgen to estrogen; the female acne grade was also negatively correlated with age and progesterone, but positively correlated with follicle-stimulating hormone. (3) Multivariate logistic regression analysis indicated that the ratio of androgen to estrogen was independently correlated with the grade of acne and that acne grade worsened as the ratio increased.Conclusion: The increase in the ratio of androgen to estrogen may aggravate the acne grade in patients with acne vulgaris.Keywords: acne vulgaris, sex hormones, testosterone, estradiol, ratio of androgen to estrogen

Purpose: This study aimed to explore the risk factors and clinical characteristics of granulomatous mastitis (GM) through a case-control study and establish and validate a clinical prediction model (Nomogram). Method: This retrospective study was conducted at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Xiyuan Hospital of China Academy of Chinese Medical Sciences and Guang’ anmen Hospital, China Academy of Chinese Medical Sciences from June 2017 to December 2021. In the design of the case-control study, a total of 1634 GM patients and 186 healthy women during the same time period were included and randomly divided into the modeling group and validation group with a 7:3 ratio. To identify the independent risk factors of GM, univariate and multivariate logistic analyses were conducted and used to develop a Nomogram . The prediction model was internally and externally validated using the Bootstrap technique and validation cohort. The receiver operating characteristic (ROC) curve and the calibration curve were used to evaluate the discrimination and calibration of the prediction model. Decision curve analysis (DCA) and clinical impact curve (CIC) were utilized to evaluate the clinical significance of the model. Result: The average age of GM patients was 33.14 (mainly 20 to 40). The incidence was high within five years after delivery. It mainly occurs in the unilateral breast. Majority of the patients exhibited local skin alterations, while some also presented with systemic symptoms. Univariate analysis showed GM was relevant to gestation history, menopause, nipple discharge and invagination, high prolactin level, sex hormone intake, thyroid function, SDS score, breast trauma and diet preference (P < 0.05). Multivariate logistic analysis showed ages (20-40 years old), high prolactin level, sex hormone intake, breast trauma, nipple discharge or invagination and high SDS score were independent risk factors for GM. The mean area under the curve (AUC) in the modeling group was 0.899, and the AUC in the validation group was 0.889. The internal and external validation demonstrated the model's predictive ability and clinical value. Conclusion: The lactation-related factors are the main risk factors of GM, which could lead to milk siltation or ductal secretion increasing. Meanwhile, hormone disorders could affect the secretion and the expansion of mammary ducts. They all can obstruct or injure the duct, inducing inflammatory reactions and immune responses. Blunt trauma, depressed mood and diet preference can accelerate the process. The Nomogram can effectively predict the risk of GM's occurrence.

In this meta-analysis the authors evaluated the effectiveness of acupuncture in improving functional communication and language function in post-stroke aphasia (PSA) patients. Data sources: MEDLINE, EMBASE, CENTRAL, AMED, SinoMed, CNKI, VIP, and Wanfang databases, ICTRP, ISRCTN, EUCTR, ClinicalTrials.gov, and Stroke Trials Registries. A search was carried out for randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or placebo acupuncture on post-stroke aphasia (PSA). The searched records were independently screened by two authors, who extracted the data, and assessed risk of bias of the included RCTs. Data aggregation and risk of bias evaluation were conducted on Review Manager Version 5.3. The protocol was registered in the PROSPERO database (CRD42016037543). A total of 28 RCTs involving 1747 patients (883 patients in the treatment group and 864 patients in the control group) were included in the quantitative synthesis. The results demonstrated significant effects of acupuncture in improving PSA functional communication (P

Huifen Wang,1,* Yanli Zhang,1,* Zhaolan Liu,2 Yin Zhang,3 Hongchuan Zhao,1 Shiyu Du1 1Department of Gastroenterology, China-Japan Friendship Hospital, 2Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, 3Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China *These authors contributed equally tothis work Background: Interleukin-17 (IL-17) is a family of emerged pro-inflammatory cytokines. The IL-17A and IL-17F are two important members of IL-17 family. Previous studies have shown that the functional IL-17A G-197A and IL-17F 7488T/C polymorphisms may contribute to susceptibility to cancer but the results were inconclusive. This meta-analysis was performed to determine the exact association between IL-17 polymorphisms and cancer risk.Methods: Online databases were searched to identify eligible case–control studies. Pooled odds ratios (ORs) and confidence intervals (CIs) were calculated by fixed-effect models or random-effect models. Publication bias was detected by Egger’s test and Begg’s test.Results: Nine eligible case–control studies of IL-17A G-197A and seven studies of IL-17F 7488T/C, including 3,181 cases and 4,005 controls, were identified. Pooled analysis suggested the variant IL-17A-197A allele was associated with increased risk cancer (GA/AA vs GG, OR =1.27, 95% CI: 1.15, 1.41, Pheterogeneity =0.374; and A vs G, OR =1.30, 95% CI: 1.17, 1.45, Pheterogeneity =0.021). For IL-17F 7488T/C, the homozygote 7488CC genotype significantly increased risk of cancer (CC vs TC/TT, OR =1.36, 95% CI: 0.97, 1.91, Pheterogeneity =0.875; and CC vs TT, OR =1.39, 95% CI: 1.03, 1.88, Pheterogeneity =0.979), especially for gastric cancer.Conclusion: The variant IL-17A-197A allele and IL-17F 7488CC genotype were associated with increased risk of cancer, especially for gastric cancer. Keywords: interleukin-17, gene polymorphism, gastric cancer, risk, meta-analysis&nbsp

The purpose of this study was to evaluate the direct medical costs of type 2 diabetes mellitus with or without complications, and to determine the economic impact of complications on type 2 diabetic patients.We performed a cross-sectional study of prevalent type 2 diabetes carried out in four major cities of China. The study populations were 1530 outpatients and 524 inpatients from clinics or wards of a total of 20 hospitals, using a two-phase subject enrollment process, by face-to-face interview with a unique questionnaire.The annual direct medical cost per patient was estimated to be 4800 Chinese Yuan (CNY) in median or 10,164 CNY in mean. There is a difference between annual direct medical costs for patients with or without complications (6056 vs. 3583 CNY; P0.001). It is also significantly different for the pay-out-of-pocket proportions (P = 0.015) between the patients with (44.6%) and without complications (40.4%). The direct medical cost varied significantly among the four cities (P0.001). Patients who simultaneously suffered microvascular and macrovascular diseases had higher direct medical cost (7600) than those with macrovascular (6000) (P = 0.012) and microvascular disease (5364) (P0.001), and those without both (3600) (P0.001). The correlation was statistically significant between the number of complications and direct medical costs (P0.001).The high economic burden raised by diabetes and its complications challenges the Chinese health-care system. It implicates an urgent need of intervention to prevent the development of long-term complications among the diabetic population, especially on the development of complications in high-cost body system.

Introduction Both T-786C mutation in endothelial nitric oxide synthase (eNOS) gene and alcohol dehydrogenase (ADH) gene polymorphism such as ADH3 γ1/γ2 have been reportedly associated with coronary artery disease (CAD). Since ADH2 Arg47His polymorphism is common in Asian population, the aim of this present study was to assess the interaction between eNOS gene T-786C and ADH2 Arg47His polymorphisms on premature CAD risk. Materials and methods Hospital-based case–control study was conducted with 167 premature CAD and 235 late-onset CAD patients. Polymerase chain reaction restriction fragment length polymorphism was used to detect the polymorphisms. Multivariate logistic regression model was performed to adjust the potential confounders and estimate odds ratios (ORs) with 95% confidence intervals (CIs). Synergy index (S) was the measure to assess the interaction as departure from additivity. Results After the adjustment for the potential confounders, and compared with the carriers of TT and Arg/Arg as the reference, the ORs with 95% CIs in parentheses of premature CAD were that 1.13 (0.19–6.59) for CT or CC and Arg/Arg carriers; 2.24 (0.77–6.49) for TT and Arg/His or His/His carriers; 4.18 (1.32–13.22) for CT or CC and Arg/His or His/His carriers, respectively. Based on those ORs, S was 2.32 (95% CI: 0.37–14.72). Conclusions The mutant genotypes of eNOS gene T-786C mutation and the fast form of ADH2 Arg47His polymorphism had an additive interaction on the risk of premature CAD in Chinese population. Further investigations with big sample size are necessary for confirming this additive interaction.

Post-traumatic stress disorder (PTSD) is manifested as a persistent mental and emotional condition after potentially life-threatening events. Different animal models of PTSD have been developed for neuro-pathophysiology and pharmacological evaluations. A single prolonged stress (SPS) induced animal model has demonstrated to result in specific neuro-endocrinological dysregulation, and behavior abnormalities observed in PTSD. However, animal studies of PTSD have mostly been performed at one time point after SPS exposure. To better understand the development of PTSD-like behaviors in the SPS animal model, and to identify an optimal period of study, we examined depressive behavior, anxiety-like behavior, physical activity and body weight in SPS model rats for two weeks. Our results confirmed the SPS-induced PTSD-like behavior and physical activity observed in previous studies, and indicated that the most pronounced symptomatic behavior changes were observed on day 1 and 7 after SPS exposure, which may involve stress-induced acute hormone changes and unclear secondary neurobiological changes, respectively. These results provide a solid basis for further investigation into the neuro-pathophysiology of or neuropharmacology for PTSD using the SPS rat model. However, for chronic (pharmacological) studies longer than 7 days, a prolonged PTSD animal model should be developed, perhaps using enhanced stimulation.

This systematic review aims to evaluate current evidence for the benefit and side effect of oralPanax notoginsengpreparation for coronary heart disease (CHD). We included 17 randomized clinical trials (17 papers and 1747 participants). Comparing with no intervention on the basis of conventional therapy, oralPanax notoginsengdid not show significant effect on reducing cardiovascular events, but it could alleviate angina pectoris (including improving the symptoms of angina pectoris [RR 1.20; 95% CI 1.12 to 1.28; 7 trials,n=791], improving electrocardiogram [RR 1.35; 95% CI 1.19 to 1.53; 8 trials,n=727], decreasing the recurrence of angina pectoris [RR 0.38; 95% CI 0.16 to 0.94; 1 trials,n=60], duration of angina pectoris [RR −1.88; 95% CI −2.08 to −1.69; 2 trials,n=292], and dosage of nitroglycerin [MD −1.13; 95% CI −1.70 to −0.56; 2 trials,n=212]); oralPanax notoginsenghad no significant difference compared with isosorbide dinitrate on immediate effect for angina pectoris [RR 0.96; 95% CI 0.81 to 1.15; 1 trial,n=80]. In conclusion, oralPanax notoginsengpreparation could relieve angina pectoris related symptoms. However, the small sample size and potential bias of most trials influence the convincingness of this conclusion. More rigorous trials with high quality are needed to give high level of evidence, especially for the potential benefit of cardiovascular events.

Ethnopharmacological relevance While there is an increasing number of toxicity report cases and toxicological studies on Chinese herbal medicines, the guidelines for toxicity evaluation and scheduling of Chinese herbal medicines are lacking. Aim The aim of this study was to review the current literature on potentially toxic Chinese herbal medicines, and to develop a scheduling platform which will inform an evidence-based regulatory framework for these medicines in the community. Materials and methods The Australian and Chinese regulations were used as a starting point to compile a list of potentially toxic herbs. Systematic literature searches of botanical and pharmaceutical Latin name, English and Chinese names and suspected toxic chemicals were conducted on Medline, PubMed and Chinese CNKI databases. Results Seventy-four Chinese herbal medicines were identified and five of them were selected for detailed study. Preclinical and clinical data were summarised at six levels. Based on the evaluation criteria, which included risk–benefit analysis, severity of toxic effects and clinical and preclinical data, four regulatory classes were proposed: Prohibited for medicinal usage, which are those with high toxicity and can lead to injury or death, e.g., aristolochia; Restricted for medicinal usage, e.g., aconite, asarum, and ephedra; Required warning label, e.g., coltsfoot; and Over-the-counter herbs for those herbs with a safe toxicity profile. Conclusion Chinese herbal medicines should be scheduled based on a set of evaluation criteria, to ensure their safe use and to satisfy the need for access to the herbs. The current Chinese and Australian regulation of Chinese herbal medicines should be updated to restrict the access of some potentially toxic herbs to Chinese medicine practitioners who are qualified through registration.

Objective. This systematic review aims to evaluate the benefit and side effect of Xuezhikang for coronary heart disease (CHD) complicated by dyslipidemia.Methods. All randomized clinical trials (RCTs) with Xuezhikang as a treatment for CHD combined with dyslipidemia were considered for inclusion. Data extraction and analyses and quality assessment were conducted according to the Cochrane standards.Results. We included 22 randomized trials. Xuezhikang showed significant benefit on the incidence of all-cause deaths, CHD deaths, myocardial infarction, and revascularization as compared with placebo based on conventional treatment for CHD. It remarkably lowered total cholesterol (TC), triglyceride (TG), and low-density lipoprotein-cholesterol (LDL-C) as compared with the placebo or inositol nicotinate group, which was similar to statins group. Xuezhikang also raised high-density lipoprotein cholesterol (HDL-C) compared to placebo or no intervention, which was similar to Inositol nicotinate and slightly inferior to statins. The incidence of adverse events did not differ between the Xuezhikang and control group.Conclusions. Xuezhikang showed a comprehensive lipid-regulating effect and was safe and effective in reducing cardiovascular events in CHD patients complicated by dyslipidemia. However, more rigorous trials with high quality are needed to give high level of evidence.

Background: Multiplex ligation-dependent probe amplification (MLPA) has been used to detect deletions and mutations of the α-globin gene for diagnosis of α-thalassemia. MLPA reaction products are usually separated and analyzed by high-voltage capillary gel electrophoresis (CGE). The goal of this study was to find and use a cost-effective method to separate and analyze MLPA products. Methods: Blood samples were collected from China. DNA was extracted and amplified by PCR using fluorescently labeled primers. In this study, denaturing high-performance liquid chromatography (DHPLC) was used to separate and analyze the reaction products. And the optimal separation conditions were determined using nondenaturing columntemperature. Results: The DHPLC conditions were optimized and have been applied to separate MLPA products and 27 of the MLPA products from 50 to 320 bp were well separated. DHPLC was able to separate up to 37 reaction products that differed by 4–12 base pairs and detected target gene deletions by differences in peak size. Compared with CGE, both the specificity and sensitivity of DHPLC for the 107 DNA samples were 100%. Conclusions: DHPLC could be used to test routinely for α-globin gene mutations and deletions. Combined with MLPA, DHPLC is a low-cost, simple to use, accurate technique with practical value. J. Clin. Lab. Anal. 25:426–431, 2011. © 2011 Wiley Periodicals, Inc.

Background Chronic complications are the major outcome of type 2 diabetes mellitus progress, which reduce the quality of life of patients, incur heavy burdens to the health care system, and increase diabetic mortality. The aims of this study were to describe the prevalence of chronic complications among urban Chinese type 2 diabetic outpatients; and to analyze the associations between chronic complications and patients' demographics, diabetic related clinical characteristics. Methods This cross-sectional hospital-based study was carried out in 4 major Chinese cities: - Shanghai, Chengdu, Beijing and Guangzhou. The survey was conducted from March to July in 2007 among 1,524 type 2 diabetic outpatients. The subjects were interviewed face-to-face by trained interviewers using a questionnaire to capture information on demographics, disease presentations and complications. All the subjects were invited to have a HbA1c test free of charge by the standardized method with Bio-Rad Variant II. Results Of the 1,524 study subjects, 637 (41.8%) were male, and the mean age was 63.3 ± 10.2 years. At least one chronic complication was diagnosed in 792 individuals (52.0%) of the study subjects; 509 (33.4%) presented with macrovascular complications and 528 (34.7%) with microvascular complications. The prevalence of cardiovascular and cerebrovascular conditions, neuropathy, nephropathy, ocular lesions and foot disease were 30.1%, 6.8%, 17.8%, 10.7%, 14.8% and 0.8%, respectively. The prevalence of chronic complications varied between cities, and significantly increased with age and duration of diagnosed diabetes. The mean of HbA1c in diabetic patients with chronic complications was 8.2% ± 1.6% and 63.0% of the subjects with type 2 diabetes related complications had a poor glycemic control with the HbA1c > 7.5%. Conclusions Chronic complications are highly prevalent among type 2 diabetic outpatients, the glycemic control of diabetic patients with chronic complications was poor, and future efforts should be directed at intensive blood glucose control, strengthening early diagnosis and improving case management to prevent and minimize the occurrence of complications.

To explore the influences of patients' self-management to glycaemic control among type 2 diabetic mellitus (T2DM) outpatients in urban China.A cross-sectional study was carried out in 1524 T2DM outpatients from 15 hospitals in 4 major cities of China. Questionnaire interview was used by trained surveyors to collect data on general characters and self-management. HbA1c test was applied to measure blood glucose in the centralized hospital in each city. Logistic regression was used to examine the association between self-management components including diet control, knowledge,blood monitoring and regular exercises and level of HbA1c.1524 outpatients were enrolled in the study. Multivariate analysis showed that patients who were under diet control (OR = 0.49, 95% CI: 0.34 - 0.72), knowledgeable on DM (OR = 0.60, 95% CI: 0.46 - 0.80), compliance behavior (OR = 0.63, 95% CI: 0.40-0.98), having regular monitoring on blood glucose (or = 4 times/month: OR = 0.66, 95% CI: 0.50 - 0.87;4 times/month: OR = 0.51, 95% CI: 0.36 - 0.73) and examining HbA1c (or = 3 times per year: OR = 0.33, 95% CI: 0.23 - 0.48; 0-3 times per year: OR = 0.57, 95% CI: 0.43 - 0.74) were more likely to have a better glycaemic control measured by HbA1c.Diet control, knowing diabetes, compliance behavior and regular monitoring on blood glucose and examining HbA1c can improve the glycaemic control among T2DM outpatients in urban China.

Background Several papers have shown that the T1128C polymorphism of the neuropeptide Y (NPY) gene was related to certain diseases and disorders. However, the allele frequency of the 1128C showed significant differences among some populations with different genetic backgrounds, being absent in Japanese and Korean populations. Therefore, this present study was aimed to explore whether the T1128C polymorphism of the NPY gene exists in a Chinese population. Methods A total of 304 newly diagnosed inpatients with coronary heart disease (CHD) were selected as the subjects in the present study. Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis was performed to detect the T1128C polymorphism. Results Of the 304 CHD patients, only one patient showed the T1128/C1128 genotype in the NPY gene, the others were all the T1128/T1128 genotype. Conclusions The T1128C polymorphism of the NPY gene is population specific and extremely low in a Chinese population.

Most investigations of injuries among Chinese populations are focused on urban or better developed areas, fewer on rural or poor areas.From September 21 to 27, 2002, an epidemiological investigation of eight kinds of injury-related events was carried out among 1,944 students in 39 classes randomly sampled from middle schools in Lijin County, a rural area. The eight kinds of events were: (a) traffic accidents, (b) poisoning, (c) fall, (d) burn or scald, (e) blunt or sharp tools contact, (f) electrical contact, (g) animal or insect bites, and (h) non-fatal drowning.The total incidence rate of eight kinds of injuries in the previous year was 21.1%. The incidence rate among boys was 24.2%, while that among girls was 17.4%, which was significant (chi-square=13.4, P0.05). The incidence rate among junior high school students was 23.1%, while that among senior high school students was 15.5%, which was also significant (chi-square=13.2, P0.05). A case-control study of 410 students with at least one of eight kinds of injury events indicated that students' gender and their mothers' health status were related to their injuries.The injury incidence rate in a rural area was less than other results in urban or developed areas. Students' gender and mothers' health status were important factors associated with the occurrence of injury.In order to improve the surroundings of the growing population of adolescents, some preventive measures should be put forward, especially to the high-risk students of injury.

ObjectiveTo evaluate the curative effect of external application of the Chinese drug, Sanjierupi Gao, on mastalgia caused by mammary gland hyperplasia.MethodsThis randomized, double-blinded, and placebo controlled study enrolled 260 patients with mammary gland hyperplasia from five hospitals. Patients were randomly and equally divided into a Sanjierupi Gao treatment group and a placebo control group. An adhesive plaster was applied to the most painful area on either breast for 7 h a day. Treatment lasted for two menstrual cycles without application during menstruation. Mastalgia was used as the main index of curative effect. The change before and after treatment in days of mastalgia, the time to alleviate pain, pain extent, and severe pain scores were observed.ResultsCompared to the control group, the treatment group had significantly fewer days of mastalgia (P