Objective To understand the frailty status and main influencing factors of elderly Parkinson’s disease (PD) patients. Methods The elderly PD patients who attended the Department of Neurology of Changshu Hospital of Traditional Chinese Medicine between November 2023 and March 2024 were selected. The patients’ frailty conditions were investigated using general information questionnaire, Chinese version of Tilburg Frailty Indicator, Hoehn-Yahr Rating Scale, Mini-Nutritional Assessment Short Form, Movement Disorder Society-Unified PD Rating Scale Part Ⅲ, PD Sleep Scale-2, and Mini-Mental State Examination. Multiple linear regression analysis was used to further determine the influencing factors of the frailty status in elderly PD patients. Results A total of 170 PD patients were included. Among them, 117 cases (68.82%) had frailty, while 53 cases (31.18%) had not frailty. The average score for frailty was (6.48±3.34) points, the average score for nutritional status was (11.89±1.65) points, the average score for motor function was (27.40±13.73) points, the average score for sleep quality was (16.05±7.76) points, and the average score for cognitive status is (26.25±4.51) points. The Pearson correlation analysis results showed that PD patient frailty was positively correlated with motor function and sleep quality (P<0.01), and negatively correlated with nutritional status and cognitive status (P<0.01). The results of multiple linear regression analysis showed that age, education, place of residence, course of disease, Hoehn-Yahr Rating, nutritional status, motor function, cognitive status and sleep quality were the influencing factors of frailty in PD patients (P<0.05). Conclusions Elderly PD patients are prone to frailty. Healthcare professionals should pay attention to early screening for frailty in this population and provide timely and effective interventions to prevent or delay the onset of frailty in patients.
ObjectiveTo provide a scoping review of the clinical studies of acupuncture on Alzheimer' s disease (AD). MethodsThe CNKI, WanFang Data, VIP, CBM, Web of Science, PubMed, EMbase, Cochrane Library databases, and ClinicalTrials.gov, ChiCTR clinical trial registration systems were searched to collect clinical studies on acupuncture treatment of AD from inception to May 14, 2022. Scope review method was used to summarize and analyze the publication year trend, type, degree of disease, traditional Chinese medicine (TCM) syndrome differentiation, sample size, treatment plan, intervention time, and outcome. ResultsA total of 226 clinical original research were included. This field emerged in 1995 and has been increasing. The main type of clinical research was randomized controlled trials. 56 studies paid attention to the severity of AD. Only 54 studies classified AD according to different criteria of TCM syndrome differentiation. There were only 4 studies with large sample size (>200 cases). Conventional acupuncture was the main intervention method in clinical research, with a total of 129 articles. Electroacupuncture was the main special acupuncture method, a total of 31 articles. More than 70 % of the studies had a course of intervention between 84 and 168 days. Among the 12 types of outcome indicators, cognitive function, clinical efficiency, activity function evaluation, cerebrospinal fluid and blood biomarkers, and adverse reactions were the most concerned outcomes. However, less attention was paid to neuropsychiatric symptoms and quality of life in AD patients. Acupuncture could improve the cognitive function of AD patients, but the current clinical related mechanism research was shallow, and the acupuncture point selection was also more diverse. ConclusionThe clinical research of acupuncture in AD has formed a scale, but the current research type is single. The clinical research design schemes are various but not yet unified, and there is a lack of relevant authoritative TCM standards.
Objective To investigate the protective effect of aprotinin on liver injury in septic rats and its mechanism. Methods Thirty male SPF rats were randomly divided into sham operation group, cecum ligation and puncture (CLP) group and aprotinin intervention group (10 rats in each group). The sham operation group was treated with cecal exploration, CLP group and aprotinin group were treated with CLP method to establish sepsis rat model. The rats in each group were sacrificed 24 hours after operation, and the morphological changes of liver tissue in rats were observed, the serum liver function indicators and inflammatory cytokines levels were detected, and the protein expression of Toll-like receptor (TLR4)/nuclear factor κB (NF-κB) signaling pathway in liver tissue was detected. ResultsIn the CLP group, septic rats exhibited significant inflammatory cell infiltration in hepatic tissue and disordered hepatocyte morphology. Compared with the CLP group, the aprotinin group exhibited nearly normal hepatocyte morphology with significant improvement in vacuolar degeneration. Compared with the sham operation group, the serum aspartate aminotransferase, alanine aminotransferase, tumor necrosis factor-α, interleukin-6 were increased, and the expression of TLR4 and p-NF-κB protein in liver tissue was up-regulated in the CLP group (P<0.05). Compared with the CLP group, serum aspartate aminotransferase, alanine aminotransferase, tumor necrosis factor-α, interleukin-6 were decreased, and the expression of TLR4 and p-NF-κB protein in liver tissue was decreased in the aprotinin group (P<0.05). ConclusionAprotinin may play a protective role against sepsis related liver injury by inhibiting TLR4 / NF-κB signaling axis, reducing the production of inflammatory factors and alleviating inflammatory reactions.
ObjectiveTo summarize and evaluate the quality of methodology, report and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture and moxibustion interventions for Parkinson's disease. MethodsEight databases including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Cochrane Library and Web of Science were searched from inception to May 1, 2023. The quality of methodology, report and evidence involved in these studies were evaluated by AMSTAR 2, PRISMA and GRADE tool. ResultsA total of 28 SRs/MAs were included, and the findings of included studies showed that acupuncture and moxibustion had a clinical advantage for Parkinson's disease. The methodological quality of all studies was extremely low. Thirteen reports were relatively complete, 14 reports had certain flaws, and 1 report had relatively serious flaws. And of the 126 reports for seven outcomes, 1 was graded as high, 12 as moderate, 57 as low, and 56 as critically low. ConclusionThe current evidence shows that acupuncture and moxibustion have a certain clinical effect for Parkinson's disease, but the methodological quality and evidence quality of related SRs/MAs are low, and the standardization still needs to be improved. The efficacy of acupuncture and moxibustion in Parkinson's disease still needs to be verified by high-quality clinical studies in the future.
The cultivation of scientific research ability of undergraduate medical students is an important direction of medical education reform. At present, there are many problems in medical undergraduate scientific research education, such as heavy curriculum burden, weak scientific research foundation, and one-sided evaluation of training effect. The teaching faculty of Department of Thoracic Surgery of West China Hospital of Sichuan University tried to advance the systematic scientific research training to the early stage of undergraduate course, put forward the “advanced systematic research” teaching model, and explored the practical path to solve the bottleneck problems such as high threshold and poor coherence of scientific research training through hierarchical curriculum design, dynamic management and comprehensive evaluation system. This article will systematically review the exploration process of the advanced scientific research mode of undergraduate medical students at home and abroad, summarize its limitations, and share the practical experience of the above “advanced systematic research” teaching model, so as to provide references and ideas for optimizing the scientific research education of medical undergraduate.