针灸和药物针灸治疗肥胖的疗效回顾

ObjectiveThe purpose of this study is to review the impact on the usage of traditional Chinese medicine in the treatment of obesity, specifically the usage of acupuncture and phytoacupuncture.MethodsPubMed and Google Scholar databases were searched to identify randomized controlled trials, which the methodology focused on the use of acupuncture and phytoacupuncture for the treatment of obesity from the beginning of these databases to February 2018, supplementing with literature retrospective and manual searches.ResultsA total of 8 trials including 566 participants met the selected criteria. In the alterations of the body mass index and waist circumference, acupuncture and phytoacupuncture seems to have a positive effect as opposed to the subjects who received superficial acupuncture or none. However, there were other parameters that showed promising results such as improvements in the levels of (1) serum total cholesterol, low-density lipoprotein and serum fasting triglyceride, (2) serum insulin and leptin, plasma ghrelin and cholecystokinin and (3) serum pro-oxidant antioxidant balance, as well as improvements in (4) skin fat thickness in the upper limbs, trunk and abdomen, (5) abdominal fat and deep subcutaneous fat tissue. The main acupoints employed in the selected studies are found along several meridians such as the stomach, spleen and conception vessel, and the plants used had the main objective of accelerating the metabolism, reducing appetite and resolving the unbalances in the genesis of obesity.ConclusionIt is suggested that acupuncture and phytoacupuncture can be useful tools for weight loss. When combined with a life-style change, they can contribute to achieve better results than just a life-style change by itself. Nevertheless, the need for further studies to clarify mechanisms of action and adequacy of protocols in order to obtain more homogeneous results is also present.     

Herpetol ameliorates allergic contact dermatitis through regulating T-lymphocytes

An immunosuppressant with fewer adverse effects is still urgently needed for increasing numbers of patients suffering from allergic contact dermatitis. In the present study, we aimed to investigate the immunosuppressive activity of herpetol on T-lymphocytes in vitro and in vivo and explore its potential pharmacological mechanism. The results showed that herpetol could effectively inhibit the proliferation of activated T cells and reduce the production of pro-inflammatory cytokines at 5–20 μM. Additionally, the ear swelling and inflammatory responses induced by picryl chloride were significantly ameliorated by herpetol at 20–40 mg/kg. Moreover, herpetol could cause cell cycle arrest of activated T cells in a dose-dependent manner. Furthermore, herpetol reduced the expression and activity of HIF-1α, Glut1 and LDHA, leading to glycolysis inhibition in activated T cells. Taken together, herpetol showed an immunosuppressive activity against T-cell mediated immune responses in vitro and in vivo, and it has potential for the treatment of immune-related skin diseases.     

Health Care Providers' Advice on Lifestyle Modification for Older Adults

ObjectivesTo describe the pattern of health care providers' advice on lifestyle modification to older adults, and identify correlates of receiving such advice.DesignCross-sectional survey.Setting and participantsData from the National Health and Nutrition Examination Survey study from 2007-2016 on adults ≥65 years (n = 3758) were analyzed.MethodsWe estimated the weighted prevalence and correlates of receiving advice on the following lifestyle modifications: (1) increase physical activity, (2) reduce fat/calories, (3) control/lose weight, and (4) a combination of control/lose weight and physical activity. Data were analyzed according to level of comorbidity (number of chronic conditions including high blood pressure, high blood cholesterol, type 2 diabetes mellitus, coronary heart disease, and arthritis) and body mass index (BMI).ResultsPhysical activity was the most widely prescribed lifestyle modification, reported by 15.7% of older adults free of chronic conditions and 28.9%, 35.4%, and 52.6% of older adults with 1, 2, and ≥3 comorbidities. Advice on reducing fat/calories was reported by 9.2%, 18.5%, 26.3%, and 40.9% of older adults with 0, 1, 2, and ≥3 comorbidities, respectively, and advice on weight loss/control was reported by 6.5%, 19.1%, 20.8%, and 37.5%, respectively. The combination of advice on weight loss/control and physical activity was least commonly reported: 5.1%, 13.5%, 16.6%, and 32.0%, respectively. Overall, lifestyle modifications were more frequently advised to older adults who were overweight, obese, or Hispanic.Conclusions and implicationsIn the United States, lifestyle modifications are not routinely recommended to older adults, particularly those free of chronic conditions, presenting a missed opportunity for chronic disease prevention and management. Among those advised to lose or manage weight, concurrent advice to increase physical activity is not consistently provided.     

Systematic review and meta-analysis of immune response of double dose of hepatitis B vaccination in HIV-infected patients

IntroductionThe prevalence of co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is high and increases risk of hepatitis B chronicity and mortality. Despite guidelines for HIV-infected patients to be immunized against HBV, the immunogenicity of the HBV vaccination in HIV-infected patients is lower than that in the HIV-seronegative population.MethodIn this study, we performed a systematic review of the literature and meta-analysis of randomized clinical trials to investigate the response rate to an increased dose of HBV vaccination in HIV-infected patients. A fixed-effects model, with heterogeneity and sensitivity analyses, was used. We identified nine studies involving 970 HIV-positive vaccine recipients.ResultsThe study results were divided into two groups, depending on the time when antibody against hepatitis surface antigen was measured. Results showed a significant increase in response rates among patients who received a double dose of the vaccine versus the standard dose in both subgroups; the pooled odds ratio (OR) was 1.76 (95% confidence interval [CI]: 1.36–2.29) and 2.28 (95% CI: 1.73–3.01) for the rate that was measured 4–6 weeks and >12 months after completion of vaccination, respectively. The total OR was 1.99 (95% CI: 1.64–2.41). No heterogeneity was found.DiscussionOur meta-analysis shows that a double dose of the HBV vaccine may significantly improve the immune response in HIV-infected patients. Higher immunogenicity was observed, when it was measured 4–6 weeks and >12 months after completion of the vaccination.     

Impact of Duration of Diagnostic Workup on Prognosis for Early Lung Cancer

IntroductionGrowth assessment for pulmonary nodules is an important diagnostic tool; however, the impact on prognosis due to time delay for follow-up diagnostic scans needs to be considered.MethodsUsing the data between 2003 and 2019 from the International Early Lung Cancer Action Program, a prospective cohort study, we determined the size-specific, 10-year Kaplan-Meier lung cancer (LC) survival rates as surrogates for cure rates. We estimated the change in LC diameter after delays of 90, 180, and 365 days using three representative LC volume doubling times (VDTs) of 60 (fast), 120 (moderate), and 240 (slow). We then estimated the decrease in the LC cure rate resulting from time between computed tomography scans to assess for growth during the diagnostic workup.ResultsUsing a regression model of the 10-year LC survival rates on LC diameter, the estimated LC cure rate of a 4.0 mm LC with fast (60-d) VDT is 96.0% (95% confidence interval [CI]: 95.2%–96.7%) initially, but it would decrease to 94.3% (95% CI: 93.2%–95.0%), 92.0% (95% CI: 90.5%–93.4%), and 83.6%(95% CI: 80.6%–86.6%) after delays of 90, 180, and 365 days, respectively. A 20.0-mm LC with the same VDTs has a lower LC cure rate of 79.9% (95% CI: 76.2%–83.5%) initially and decreases more rapidly to 71.5% (95% CI: 66.4%–76.7%), 59.8% (95% CI: 52.4%–67.1%), and 17.9% (95% CI: 3.0%–32.8%) after the same delays of 90, 180, and 365 days, respectively.ConclusionsTime between scans required to measure growth of lung nodules affects prognosis with the effect being greater for fast growing and larger cancers. Quantifying the extent of change in prognosis is required to understand efficiencies of different management protocols.