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Efficacy of Chinese Medicine Treatment Based on Syndrome Differentiation for Primary Insomnia:A Randomized Placebo Controlled Triple-Blinded Trial

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Chinese Journal of Integrative Medicine 2024年第10期30卷 867-876页

作者： XIONG Zhi-yi LU Ying HE Li-yun ZHANG Run-shun ZHOU Xue-zhong LI Peng LIU yan-jiao ZHU Jian-gui yan shi-yan LIU Bao-yan International Acupuncture and Moxibustion Innovation Institute School of Acupuncture-Moxibustion and TuinaBeijing University of Chinese MedicineBeijing100029China Department of Biomedical Data Science Stanford University School of MedicineStanfordCA94305USA Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesBeijing100700China Guang’anmen Hospital China Academy of Chinese Medical SciencesBeijing100053China School of Computer and Information Technology Beijing Jiaotong UniversityBeijing100044China Beijing Xicheng District Community Healthcare Center Beijing100120China China Academy of Chinese Medical Sciences Beijing100700China

Objective:To assess efficacy of Chinese medicine(CM)on insomnia considering characteristics of treatment based on syndrome ***:A total of 116 participants aged 18 to 65 years with moderate and severe primary insomnia were randomized to the placebo(n=20)or the CM group(n=96)for a 4-week treatment and a 4-week *** CM clinicians independently prescribed treatments for each patient based on syndromes *** primary outcome was change in total sleep time(TST)from *** endpoints included sleep onset latency(SOL),wake time after sleep onset(WASO),sleep efficiency,Pittsburgh Sleep Quality Index(PSQI)and CM ***:The CM group had an average 0.6 h more(95%confidence interval(CI):0.3–0.9,P<0.001)TST and 34.1%(10.3%–58.0%,P=0.005)more patients beyond 0.5 h TST increment than that of the placebo *** was changed–3.3(–3.8 to–2.7)in the CM group,a–2.0(–3.2 to–0.8,P<0.001)difference from the placebo *** CM symptom score in the CM group decreased–2.0(–3.3 to–0.7,P=0.003)more than the placebo *** and WASO changes were not significantly different between *** analysis of prescriptions by these clinicians revealed blood deficiency and Liver stagnation as the most common *** for these clinicians displayed relative stability,while the herbs *** adverse events were mild and were not related to study ***:CM treatment based on syndrome differentiation can increase TST and improve sleep quality of primary *** is effective and safe for primary *** future studies,the long-term efficacy validation and the exploratory of eutherapeutic clinicians'fixed herb formulas should be addressed.(Registration ***01613183).

关键词： primary insomnia Chinese medicine syndrome differentiation randomized controlled trial

Microvascular structural changes in esophageal squamous cell carcinoma pathology according to intrapapillary capillary loop types under magnifying endoscopy

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World Journal of Gastrointestinal Oncology 2024年第8期16卷 3471-3480页

作者： Wei-yang Shu yan-yan shi Jiu-Tian Huang Ling-Mei Meng He-Jun Zhang Rong-Li Cui Yuan Li shi-Gang Ding Department of Gastroenterology Peking University Third HospitalBeijing 100191China Research Center of Clinical Epidemiology Peking University Third HospitalBeijing 10019China Department of Gastroenterology Pathology Laboratory Peking University Third HospitalBeijing 100191China Department of Gastroenterology Peking University International HospitalBeijing 102206China

BACKGROUND The intrapapillary capillary loop(IPCL)characteristics,visualized using magnifying endoscopy,are commonly assessed for preoperative evaluation of the infiltration depth of esophageal squamous cell carcinoma(ESCC).Japan Esophageal Society(JES)classification is the most widely used *** structural changes are evaluated by magnifying endoscopy for the presence or absence of each morphological factor:tortuosity,dilatation,irregular caliber,and different ***,the pathological characteristics of IPCLs have not been thoroughly investigated,especially the microvascular structures corresponding to the deepest parts of the lesions'*** To investigate differences in pathological microvascular structures of ESCC,which correspond to the deepest parts of the lesions'*** Patients with ESCC and precancerous lesions diagnosed at Peking University Third Hospital were enrolled between January 2019 and April *** first underwent magnified endoscopic examination,followed by endoscopic submucosal dissection or surgical *** images were scanned using a threedimensional slice scanner,and the pathological structural differences in different types,according to the JES classification,were analyzed using nonparametric tests and *** The 35 lesions were divided into four groups according to the JES classification:A,B1,B2,and *** analyses revealed significant differences(aP0.05).However,significant differences in the short calibers,long calibers,and area of IPCL were observed between types B1 and B3(aP0.05).CONCLUSION Pathological structures of IPCLs in the deepest infiltrating regions differ among va

关键词： Esophageal squamous cell carcinoma Intrapapillary capillary loop The Japan Esophageal Society classification Magnifying endoscopy Pathological characteristics

Effects and mechanisms of Helicobacter pylori infection on the occurrence of extra-gastric tumors

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World Journal of Gastroenterology 2024年第37期30卷 4090-4103页

作者： shi-Qing Zhao Hui-Ling Zheng Xiao-Tian Zhong Zi-Ye Wang Yi Su yan-yan shi Research Center of Clinical Epidemiology Peking University Third HospitalBeijing 100191China Health Science Center Peking UniversityBeijing 100191China Department of Gastroenterology Peking University Third HospitalBeijing 100191China

Helicobacter pylori(***)colonizes the human stomach and many studies have discussed the mechanisms of *** infection leading to gastric diseases,including gastric ***,increasing data have shown that the infection of *** may contribute to the development of extra-gastric diseases and ***,systemic immune responses,microbiome disorders,and hypergastrinemia caused by *** infection are associated with many extra-gastric *** review highlights recent discoveries;discusses the relationship between *** and various extra-gastric tumors,such as colorectal cancer,lung cancer,cholangiocarcinoma,and gallbladder carcinoma;and explores the mechanisms of extra-gastric carcinogenesis by ***,these findings refine our understanding of the pathogenic processes of ***,provide guidance for the clinical treatment and management of ***-related extra-gastric tumors,and help improve prognosis.

关键词： Helicobacter pylori Extra-gastric tumors Immune system response Mucosal barrier Gut microbiome

Effect of Chinese Medicine in Patients with COVID-19: A Multi-center Retrospective Cohort Study

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Chinese Journal of Integrative Medicine 2024年第11期30卷 974-983页

作者： ZHAO Guo-zhen yan shi-yan LI Bo GUO Yu-hong SONG Shuang HU Ya-hui GUO shi-qi HU Jing DU Yuan LU Hai-tian YE Hao-ran REN Zhi-ying ZHU Ling-fei XU Xiao-long SU Rui LIU Qing-quan Beijing Hospital of Traditional Chinese Medicine Capital Medical University Beijing Institute of Traditional Chinese Medicine School of Clinical Medicine Beijing University of Chinese Medicine School of Acupuncture-Moxibustion and Tuina Beijing University of Chinese Medicine College of Integrated Chinese Medicine Tianjin University of Traditional Chinese Medicine

Objective: To evaluate the effectiveness and safety of Chinese medicine(CM) in the treatment of coronavirus disease 2019(COVID-19) in China. Methods: A multi-center retrospective cohort study was carried out, with cumulative CM treatment period of 3 days during hospitalization as exposure. Data came from consecutive inpatients from December 19, 2019 to May 16, 2020 in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting(IPTW), and the Cox proportional hazards regression model was used for statistical analysis. Results:A total of 2,272 COVID-19 patients were included. There were 1,684 patients in the CM group and 588 patients in the control group. Compared with the control group, the hazard ratio(HR) for the deterioration rate in the CM group was 0.52 [95% confidence interval(CI): 0.41 to 0.64, P<0.001]. The results were consistent across patients of varying severity at admission, and the robustness of the results were confirmed by 3 sensitivity analyses. In addition, the HR for all-cause mortality in the CM group was 0.29(95% CI: 0.19 to 0.44, P<0.001).Regarding of safety, the proportion of patients with abnormal liver function or renal function in the CM group was smaller. Conclusion: This real-world study indicates that the combination of a full-course CM therapy on the basic conventional treatment, may safely reduce the deterioration rate and all-cause mortality of COVID-19patients. This result can provide the new evidence to support the current treatment of COVID-19. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific CM interventions.(Registration No. ChiCTR2200062917)

关键词： Chinese medicine all-cause mortality cohort study coronavirus disease 2019 deterioration rate

Systematic treatment in gastric cancer patients with overt bleeding:A propensity score matching analysis

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World Journal of Clinical Oncology 2024年第9期15卷 1177-1187页

作者： yan-Hong Yao Hua Zhang Yu Xiao Zhen-Tao Liu yan-yan shi Jin-Yu Yu Qian Li Bao-Shan Cao Department of Medical Oncology and Radiation Sickness Peking University Third HospitalBeijing 100191China Department of Cancer Center Peking University Third HospitalBeijing 100191China Research Center of Clinical Epidemiology Peking University Third HospitalBeijing 100191China

BACKGROUND Hemorrhage,which is not a rare complication in patients with gastric cancer(GC)/gastroesophageal junction cancer(GEJC),can lead to a poor ***,no study has examined the effectiveness and safety of chemotherapy as an initial therapy for GC/GEJC patients with overt bleeding(OB).AIM To investigate the impact of OB on the survival and treatment-related adverse events(TRAEs)of GC/GEJC *** Patients with advanced or metastatic GC/GEJC who received systematic treatment at Peking University Third Hospital were enrolled in this *** score matching(PSM)analysis was *** After 1:2 PSM analysis,93 patients were assessed,including 32 patients with OB before treatment(OBBT)and 61 patients without *** disease control rate was 90.6%in the group with OBBT and 88.5%in the group without OBBT,and this difference was not statistically *** was no difference in the incidence of TRAEs between the group with OBBT and the group without *** median overall survival(mOS)was 15.2 months for patients with OBBT and 23.7 months for those without OBBT[hazard ratio(HR)=1.101,95%confidence interval(CI):0.672-1.804,log rank P=0.701].The mOS was worse for patients with OB after treatment(OBAT)than for those without OBAT(11.4 months vs 23.7 months,HR=1.787,95%CI:1.006-3.175,log rank P=0.044).CONCLUSION The mOS for GC/GEJC patients with OBBT was similar to that for those without OBBT,but the mOS for patients with OBAT was worse than that for those without OBAT.

关键词： Gastric cancer/gastroesophageal junction cancer Overt bleeding Risk factors Systematic treatment Overall survival

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对STRICTA清单几个关键问题的梳理

针刺研究 2024年第6期49卷 661-666页

作者：谢依璇刘晓玉马培宏刘保延刘存志闫世艳北京中医药大学针灸推拿学院北京100029 北京中医药大学国际针灸创新研究院北京100029 天津中医药大学针灸推拿学院天津301617 中国中医科学院北京100700

STRICTA清单是针对针刺临床试验中干预措施报告的指南。作为CONSORT清单的扩展版,STRICTA清单促进了针刺临床研究干预措施报告质量的提升。随着时代的发展,临床研究范式不断更新,现有的STRICTA清单能否继续指导当下及未来的临床研究的报... 详细信息

STRICTA清单是针对针刺临床试验中干预措施报告的指南。作为CONSORT清单的扩展版,STRICTA清单促进了针刺临床研究干预措施报告质量的提升。随着时代的发展,临床研究范式不断更新,现有的STRICTA清单能否继续指导当下及未来的临床研究的报告,是亟需考虑的问题。本文系统梳理了STRICTA清单的发展与更新过程,对STRICTA清单的效用特点及有待改进之处进行了分析,并就当前遇到的困境与挑战提出了几点改进建议,以促进STRICTA清单的进一步更新与完善。

关键词： STRICTA清单针灸临床研究报告规范指南

Pattern Classification of Enterovirus 71-Associated Hand, Foot, and Mouth Disease in Chinese Medicine: A Retrospective Study in 433 Cases

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Chinese Journal of Integrative Medicine 2018年第2期24卷 87-93页

作者： LIU yan HE Li-yun WEN Tian-cai yan shi-yan BAI Wen-jing LIU Bao-yan Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical Sciences

Objective： To determine whether patterns of enterovirus 71（EV71）-associated hand, foot, and mouth disease（HFMD） were classified based on symptoms and signs, and explore whether individual characteristics were correlated with membership in particular pattern. Methods： Symptom-based latent class analysis（LCA） was used to determine whether patterns of EV71-HFMD existed in a sample of 433 cases from a clinical data warehouse system. Logistic regression was then performed to explore whether demographic, and laboratory data were associated with pattern membership. Results： LCA demonstrated a two-subgroup solution with an optimal fit, deduced according to the Bayesian Information Criterion minima. Hot pattern（59.1% of all patients） was characterized by a very high fever and high endorsement rates for classical HFMD symptoms（i.e., rash on the extremities, blisters, and oral mucosa lesions）. Non-hot pattern（40.9% of all patients） was characterized by classical HFMD symptoms. The multiple logistic regression results suggest that white blood cell counts and aspartate transaminase were positively correlated with the hot pattern（adjust odds ratio=1.07, 95% confidence interval： 1.006–1.115; adjust odds ratio=1.051, 95% confidence interval： 1.019–1.084; respectively）. Conclusions： LCA on reported symptoms and signs in a retrospective study allowed different subgroups with meaningful clinical correlates to be defined. These findings provide evidence for targeted prevention and treatment interventions.

关键词： hand foot and mouth disease pattern classification enterovirus A human Chinese medicine

Effect of gastric microbiota on quadruple Helicobacter pylori eradication therapy containing bismuth

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World Journal of Gastroenterology 2021年第25期27卷 3913-3924页

作者： Zhan-Yue Niu Si-Zhu Li yan-yan shi yan Xue Department of Gastroenterology Peking University Third HospitalBeijing 100191China Research Center of Clinical Epidemiology Peking University Third HospitalBeijing 100191China

BACKGROUND Helicobacter pylori(***)is an important pathogen that can cause a variety of ***,full eradication of *** remains a significant challenge in clinical *** and other microbial communities have complex interactions in the unique gastric microecological ***,it is not clear whether the interactions have any effect on the therapeutic effect of *** The aim was to investigate the characteristics of the gastric microbiota with *** infection and the influence on the *** eradication *** Patients with *** infection underwent gastroscopy and received treatment for *** prescription included esomeprazole 20 mg bid,Livzon Dele 220 mg bid,amoxicillin 1000 mg bid,and clarithromycin 500 mg bid for 14 *** who did not respond to treatment and failed eradication were compared with those who achieved eradication by 1:2 propensity *** sequencing of the gastric mucosal microbiota was performed,and the results were evaluated by alpha diversity analysis,beta diversity analysis,species correlation analysis,and metabolic pathway correlation *** The eradication rate of all the patients was 95.5%(171/179).Twenty-four patients were enrolled in the study after propensity-matched *** were eight cases in the failure group(patients who did not respond well to therapy)and 16 cases in the success *** majority phyla in the two groups were the same,and included Proteobacteria,Bacteroides,Firmicutes,Actinomycetes,and *** microbial diversity in the failure group had a decreasing trend(P=0.092)and the species abundance was significantly lower(P=0.031)compared with the success *** high rate of *** eradication was associated with Rhodococcus,Lactobacillus,and Sphingomonas,as they were significantly enriched in the successful group(P<0.05).Veronococcus and Cilium were enriched in the mucosa of chronic atrophic gastritis patie

关键词： Helicobacter pylori Eradication Quadruple therapy Influence factors propensity matching Gastric microbiota

Comparative proteome analysis of Helicobacter pylori clinical strains by two-dimensional gel electrophoresis

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2011年第10期12卷 820-827页

作者： Ya-nan ZHANG shi-gang DING Liu-huan HUANG Jing ZHANG yan-yan shi Li-jun ZHONG Department of Laboratory Beijing Tiantan Hospital Affiliated to Capital Medical University Beijing 100050 China Department of Gastroenterology Peking University Third Hospital Beijing 100191 China Department of Thoracic and Cardiovascular Surgery Beijing Shi .ling Shan Hospital Beifing 100043 China peking University Health Science Center Beij＇ing 100091 China

Objective： To investigate the pathogenic properties of Helicobacterpylori by comparing the proteome map of H. pylori clinical strains. Methods： Two wild-type H. pylori strains, YN8 （isolated from biopsy tissue of a gastric cancer patient） and YN14 （isolated from biopsy tissue of a gastritis and duodenal ulcer patient）, were used. Proteomic analysis, using a pH range of 3-10 and 5-8, was performed. The individual proteins were identified by quadrupole time-of-flight （Q-TOF） mass spectrometer and protein database search. Results： Variation in spot patterns directed towards differential protein expression levels was observed between the strains. The gel revealed prominent proteins with several protein ＂families＂. The comparison of protein expressions of the two strains reveals a high variability. Differentially present or absent spots were observed. Nine differentially expressed protein spots identified by Q-TOF included adenosine triphosphate （ATP）-binding protein, disulfide oxidoreductase B （DsbB）-Iike protein, N utilization substance A （NusA）, ATP-dependent protease binding subunit/heat shock protein, hydantoin utilization protein A, seryl-tRNA synthetase, molybdenum ABC transporter ModD, and hypothetical proteins. Conclusions： This study suggests that H. pylori strains express/repress protein variation, not only in terms of the virulence proteins, but also in terms of physiological proteins, when they infect a human host. The difference of protein expression levels between H. pylori strains isolated from gastric cancer and gastritis may be the initiator of inflammation, and result in the different clinical presentation. In this preliminary study, we report seven differential proteins between strains, with molecule weights from approximately 10 kDa to approximately 40 kDa. Further studies are needed to investigate those proteins and their function associated with H. pylori colonization and adaptation to host environment stress.

关键词： Heficobacter pylori Proteome Gastric cancer Gastritis Two-dimensional gel electrophoresis