Background:As the trend in delayed childbearing continues to rise, the association of the age difference between grandmothers and mothers at delivery, reflecting intergenerational reproductive age dynamics, with maternal pregnancy cardiometabolic disorders (CMDs) remains under-examined.
Objective:To explore whether a larger age difference between grandmothers and mothers at delivery is associated with an increased risk of maternal pregnancy CMDs.
Study design:This retrospective cross-sectional study was conducted based on the “Grandmothers, Mothers, and Their Children’s Health (GMATCH)” study, which collected data from 2242 pairs of three-generation women within family in Huai’an city, China.
Methods:Multivariable logistic regression model was utilized to estimate the association between age difference and pregnancy CMDs. Restricted cubic splines were used to account for potential nonlinear relationships between continuous age differences and pregnancy CMDs.
Results:Based on data from 2235 grandmother-mother pairs, we noted an increase in the median delivery age from 24 years in grandmothers to 28 years in mothers, with age differences ranging from−21 to 21 years (median:−4, interquartile range:−7, 0). A delivery age difference of ≤−9 years was associated with pregnancy CMDs. Dose-response analysis indicated that a larger age difference between grandmaternal and maternal delivery was associated with a higher risk of CMDs, although this association was attenuated when maternal age at delivery was considered.
Conclusions:Our study underscores the potential importance of intergenerational delivery age differences in pregnancy CMD risk. However, further studies with larger sample sizes are required to validate these findings. Healthcare providers should consider both maternal and grandmaternal age when evaluating risk factors for CMDs.
Background:In recent years, the use of noninvasive physical therapy for spinal cord injury (SCI) has attracted widespread attention owing to its minimal side effects, cost-effectiveness, and high patient compliance.
Objective:This study aimed to review the efficacy and safety of various noninvasive physical therapies for the management of SCI.
Study design:Narrative review.
Methods:We conducted a literature review using PubMed, Web of Science, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials for relevant literature published before November 2024. The findings were organized and presented with a focus on noninvasive physical therapy for the treatment of human SCI.
Results:We describe the advances in the clinical application of noninvasive physical therapy for SCI. Several studies have achieved positive results, helping individuals with SCI achieve functional recovery of the upper limbs, lower limbs, and bladder control, relieve neuropathic pain and sensory deficits and improve their quality of life. Comprehensive treatment is often employed after SCI, and the effects of exercise combined with noninvasive physical therapy or a combination of multiple physical therapies have potential.
Conclusions:Noninvasive physical therapies, such as electrical stimulation, magnetic stimulation, sound, light, and vibration, have beneficial therapeutic effects and are safe for the clinical treatment of SCI; however, they may need to be combined with other treatments.
Background:Several studies have reported favorable results in assessing quality of life in living kidney donors using generic scales. There are limited studies using donor-specific tools to assess quality of life in living kidney donors.
Objective:Based on both the generic and specific quality of life scale for living organ donors, the present study aimed to comprehensively report the quality of life of living related kidney donors in mainland China, and to identify factors affecting their quality of life.
Study design:A Cross-Sectional Study.
Methods:A cross-sectional study was conducted from June to December 2019. A sample of 121 living related kidney donors was recruited from a kidney transplantation center in mainland China. Quality of life was assessed using the abbreviated World Health Organization Quality of Life questionnaire and the quality of life scale for living organ donors. Binary logistic regression was adopted to determine the influencing factors of quality of life.
Results:For the generic assessment, kidney donors scored significantly lower than the Chinese norm in the domain of physical functioning (P<0.05), but significantly higher in the domains of social support and environment. The donor specific quality of life assessment revealed the following issues as prominent among our donors: finance, work, medical expenses, fatigue, concerns about health and income, and inadequate health support. Male donors were more likely to have a good physical function-related quality of life (QoL) (adjusted Odds Ratio[OR] = 3.21, 95%CI:1.34-7.69, P = 0.009), while donors with lower education level were more likely to have impaired physical functioning (adjusted OR = 0.10, 95%CI:0.12-0.82, P = 0.032). The good health condition of the donor’s recipient correlated positively with psychological health (adjusted OR = 3.68, 95% CI:1.03-13.07, P = 0.044). Uncomplicated proteinuria may be a protective factor for psychological (adjusted OR = 4.30 2, 95%CI:1.05-17.59, P = 0.043) and social (adjusted OR = 4.38 2, 95%CI: 1.15-16.69, P = 0.030) Quality of life in kidney donors compared to donors presenting with proteinuria.
Conclusions:The impact of kidney donation on the quality of life of living donors is multifaceted. Medical staff should inform donors about these potential issues they may encounter before donation. This includes not only injuries and complications that may result from the surgery but also the impact of kidney donation on their professional life and capacity to work, as well as possible financial issues, such as increased medical expenses and reimbursement difficulties.
Background:Gynecologic cancer couples have reported high depressive symptom levels. Mindfulness and psychological flexibility are negatively associated with depressive symptoms, but their beneficial effects have rarely been studied beyond the individual level. Few studies address their associations with depression in patient-spouse dyads facing gynecological cancer.
Objective:Explore dyadic associations among couples regarding mindfulness, its five facets, and psychological flexibility with depressive symptoms.
Study design:A cross-sectional study.
Methods:One hundred dyads with one person diagnosed with gynecological (cervix uteri, corpus uteri, or ovary) cancer and their spouses responded to surveys examining depressive symptoms, mindfulness (observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience), and psychological flexibility. The Actor-Partner Interdependence Model was used to explore dyadic associations.
Results:Patients’ and spouses’ acting with awareness (actor effect: β = −0.440, P < 0.001; β = −0.207, P = 0.045) and Acceptance and Action Questionnaire-II (AAQ-II) scores (actor effect: β = 0.604, P < 0.001; β = 0.370, P < 0.001) were associated with depressive symptoms. Patients’ acting with awareness and AAQ-II scores were associated with spouses’ depressive symptoms (partner effect: β = −0.252, P = 0.015; β = 0.227, P = 0.016). Couple similarity scores in describing and non-judging scores played a significant role in patients’ and spouses’ depressive symptoms (describing: β = 0.197, P = 0.045; β = 0.313, P < 0.001; non-judging: β = 0.336, P < 0.001; β = 0.212, P = 0.033).
Conclusions:Mindfulness and psychological flexibility can affect couples’ psychological distress. Future research should examine whether couples facing gynecological cancers benefit from programs that foster an awareness of attending to the present moment and psychological flexibility.
Background:Fibrotic diseases, characterized by excessive extracellular matrix deposition and parenchymal cell loss, represent a critical pathological outcome of chronic tissue injury across multiple organs, including the liver, lungs, heart, and kidneys. The global burden of fibrosis has increased following the coronavirus disease 2019(COVID-19) pandemic, with pulmonary fibrosis emerging as a severe sequela in recovered patients. Despite its prevalence, no effective treatments currently exist to halt or reverse fibrosis progression. Traditional Chinese medicine (TCM), with its multi-component, multi-target approach, has shown promise in addressing the complex pathological networks underlying fibrosis, offering a potential alternative to conventional monotherapies.
Objective:This review aims to comprehensively evaluate the clinical efficacy and molecular mechanisms of TCM formulas in treating fibrotic diseases across multiple organ systems by synthesizing recent advancements, identifying research gaps, and guiding future translational studies.
Study design:Narrative review.
Methods:We searched English and Chinese literature on the treatment of fibrotic diseases with Chinese medicine formulas using the PubMed, EMBASE, China National Knowledge Internet (CNKI), and Wanfang databases. We included Chinese medicine formulas with confirmed anti-fibrotic effects and documented mechanisms of action. Search terms included (“traditional Chinese medicine” OR “TCM”) AND (“fibrosis” OR “pulmonary fibrosis” OR “liver fibrosis” OR “cirrhosis” OR “cardiac fibrosis” OR “renal fibrosis”) AND (“randomized” OR “randomized controlled trial” OR “clinical trial”). Studies were selected based on clear outcome measures (e.g., fibrosis regression, inflammatory markers) and mechanistic validation (e.g., in vivo/in vitro models). Data were categorized by organ system, and key pathways (e.g., transforming growth factor-beta (TGF-β)/small mother against decapentaplegic (Smad), phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (AKT), oxidative stress) were analyzed for cross-organ synergies.
Results:The clinical efficacy and potential mechanisms of the following formulas were reviewed Maimendong decoction, Danggui Buxue decoction, Yangyin Yiqi mixture, Qizhu Kangxian granules, Dahuang Zhechong pills, Bufei Huoxue capsules, Compound Kushen injection, Xuefu Zhuyu decoction, Ziyin Runfei formula, and Huisheng Ganlu pills on pulmonaryfibrosis; Fuzheng Huayu capsules/tablets, Compound Biejia Ruangan tablets, Anluo Huaxian pills, Ganshuang granules, Qianggan capsules, Shenge formula, Gandouling tablets, and Gandou decoction on hepatic fibrosis; Sini decoction, Tongguan capsules, Qishen Yiqi dripping pills, Compound Danshen dripping pills, Shengmai Powder, Tongxinluo capsules, Shexiang Tongxin dripping pills, and Tianma Gouteng decoction on cardiac fibrosis; Buyang Huanwu decoction, Shenkang injection, Qianyang Yuyin granules, Shenluotong decoction, Niaoduqing granules, and Qingshen granules on renal fibrosis. Core pathways regulated by TCM included TGF-β/small mother against decapentaplegic 3 (Smad3) inhibition (e.g., Fuzheng Huayu in hepatic stellate cell deactivation), Nod-like receptor family pyrin domain containing 3 (NLRP3) inflammasome suppression (e.g., Bufei Huoxue capsules in silicosis), and redox balance restoration (e.g., Yangyin Yiqi mixture via superoxide dismutase upregulation).
Conclusion:This review summarizes the efficacy and core pathways of common TCM formulas for treating fibrosis, including TGF-β/Smad3 inhibition, NLRP3 inflammasome suppression, and redox balance restoration. The findings highlight the potential of TCM in fibrosis treatment and provide a reference for its clinical application.
Background:Hemiplegic shoulder pain is a common issue after stroke and affects many stroke survivors. Emerging studies have shown the positive effects of functional electrical stimulation in the management of hemiplegic shoulder pain. However, a systematic review evaluating its efficacy is lacking.
Objective:To systematically review the effects of functional electrical stimulation for hemiplegic shoulder pain in patients who experienced stroke.
Study design:A systematic review and meta-analysis.
Methods:A systematic review of Embase, PubMed, Web of Science, Scopus, Cumulative Index to Nursing Information and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), Wan Fang Database, and China Science and Technology Journal Database (VIP) from the establishment of the databases to July 1, 2024, was carried out. Two researchers independently searched, screened, and extracted data from each database according to the search strategy and resolved any disagreements through negotiation.
Results:Of the 560 articles identified, 7 were included in the final synthesis. We analyzed data from 457 stroke survivors, the results showed that the functional electrical stimulation group had a better performance in relieving shoulder pain (standardized mean difference [SMD] = −1.66; 95 % confidence interval [CI]: −2.58 to −0.74; P = 0.0004), but there was no statistical significance in Fugl-Meyer assessment scores (SMD = 0.32; 95 % CI: −1.00 to 1.63; P = 0.64).
Conclusion:Functional electrical stimulation may be an effective management method to relieve pain for hemiplegic shoulder pain patients. However, these results should be interpreted with caution because of the limited number of studies and potential bias. More rigorous, reasonably designed randomized controlled trial with large sample sizes and long-term follow-up are needed in the future.
Background:More than half of the elderly in China have high blood pressure. Dietary management is essential for maintaining ideal blood pressure levels and reducing the risk of hypertension-related complications. However, dietary management of elderly patients with hypertension in China is insufficient, and factors affecting their dietary behaviors are unclear.
Aims:To explore the factors that may affect dietary behavior among Chinese elderly patients with hypertension.
Design:This was a descriptive qualitative study.
Methods:Fifteen older adults were recruited from a hospital and community in Wenzhou, China, from January 2020 to December 2020. Data were collected through semi-structured interviews, and content analysis was used for data analysis.
Results:Three main themes emerged from the data: personal cognition and perception, availability of dietary advice, and social environment. Factors influencing dietary behavior were identified at the individual, information received, and social levels. Personal cognition is the basis for formation of dietary behavior, and applicability of dietary advice and social environment affect the continuity of dietary behavior.
Conclusions:Diverse factors affected dietary behavior among Chinese elderly patients with hypertension. Diet management programs should assess patients’ cognition and perception, availability of dietary advice, and social environment.