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Chen J.,Shanghai Institute of Planned Parenthood Research | Zhong C.,Guizhou Family Planning Research Institute | Liang H.,Shanghai Institute of Planned Parenthood Research | Yang Y.,Guizhou Family Planning Research Institute | And 7 more authors.
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2015

Objective To explore the relationship between age at menarche and infertility. Study design The cross-sectional study investigated 6906 couples from the communities in Sandu Shui Autonomous County of Guizhou Province, China. Face to face interviews were conducted to collect information on age at menarche and time to first pregnancy, as well as demographic characteristics and lifestyle factors. Infertility was defined as being unable to become pregnant after attempting for ≥12 months. Poisson regression was used to assess the relationship between age at menarche and infertility of first attempt. Results The prevalence rate of infertility for the first pregnancy attempt of the study population was 11.87%. There is an obvious monotonic, almost linear, trend of prevalence rate of infertility with increasing age at menarche (P for trend: <0.001). Compared with wives with age at menarche of 13 years, the prevalence ratios of infertility were 0.71 (95%CI: 0.42, 1.20), 1.33 (95%CI: 1.05, 1.68), 1.47 (95%CI: 1.17, 1.85), 1.57 (95%CI: 1.20, 2.04), 1.41 (95%CI: 1.00, 1.99) and 1.73 (95%CI: 1.18, 2.52) for wives with age at menarche of ≤12, 14, 15, 16, 17 and ≥18 years, respectively, after adjusting for wife's year at birth, age at marriage, ethnic group, education and occupation, and husband's smoking and drinking habits before marriage. Conclusions The present community-based study indicated that increasing age at menarche was associated with an increased risk of infertility in the study population. © 2015 Elsevier Ireland Ltd. All rights reserved. Source

Zhao X.,Southern Medical University | Hua Y.,Southern Medical University | Chen H.,Southern Medical University | Yang H.,Jiangmen Wuyi Traditional Chinese Medicine Hospital | And 7 more authors.
Therapeutics and Clinical Risk Management | Year: 2015

Background: Aldehyde dehydrogenase-2 (ALDH2) has a protective effect on ischemic heart disease. Here, we examined the protective effects of ALDH2 on cardiac fibrosis through modulation of the Wnt/β-catenin signaling pathway in a rat model of myocardial infarction (MI). Methods: Wistar rats were divided into the sham (control), MI (model), and ALDH2 activator (Alda-1) groups. After 10 days of treatment, the left ventricular (LV) remodeling parameters of each animal were evaluated by echocardiography. Myocardial fibrosis was evaluated by Masson’s trichrome staining and Sirius Red staining. Expression levels of collagen types I and III and α-smooth muscle actin (α-SMA) were examined. Finally, the expression and activity of ALDH2 and the levels of several Wnt-related proteins and genes, such as phospho-glycogen synthase kinase (GSK)-3β, GSK-3β, β-catenin, Wnt-1, WNT1-inducible signaling-pathway protein 1, and tumor necrosis factor (TNF)-α, were also analyzed. Results: After MI, the heart weight/body weight ratio, LV dimension at end diastole, and LV dimension at end systole were decreased, while the LV ejection fraction and LV fractional shortening were increased in the Alda-1 group. Myocardial fibrosis was also reduced in the Alda-1 group, accompanied by decreased expression collagen types I and III and α-SMA. β-Catenin, phosphorylated GSK-3β, and Wnt-1 levels were significantly increased in the model group. Interestingly, this alteration was partly reversed by Alda-1 treatment. Immunohistochemical staining showed that numerous WNT1-inducible signaling-pathway protein 1 (WISP-1)-and TNF-α-positive cells were found in the model group. However, few WISP-1-and TNF-α-positive cells were detected in the Alda-1 group. Conclusion: The reduction of cardiac fibrosis and the down-regulation of β-catenin, phosphorylated GSK-3β, Wnt-1, and WISP-1 may be mediated by increased ALDH2 activity, leading to reduction of MI-related cardiac fibrosis. © 2015 Zhao et al. Source

Liu F.-b.,Guangzhou University of Chinese Medicine | Hou Z.-k.,Guangzhou University of Chinese Medicine | Yang Y.-y.,Guangzhou University of Chinese Medicine | Li P.-w.,Guangzhou University of Chinese Medicine | And 4 more authors.
Journal of Chinese Integrative Medicine | Year: 2013

OBJECTIVE: To evaluate the application of health assessment instruments in Chinese medicine. METHODS: According to a pre-defined search strategy, a comprehensive literature search for all articles published in China National Knowledge Infrastructure databases was conducted. The resulting articles that met the defined inclusion and exclusion criteria were used for analysis. RESULTS: A total of 97 instruments for health outcome assessment in Chinese medicine have been used in fundamental and theoretical research, and 14 of these were also used in 29 clinical trials that were randomized controlled trials, or descriptive or cross-sectional studies. In 2 152 Chinese medicine-based studies that used instruments in their methodology, more than 150 questionnaires were identified. Among the identified questionnaires, 51 were used in more than 10 articles (0.5%). Most of these instruments were developed in Western countries and few studies (4%) used the instrument as the primary evidence for their conclusions. CONCLUSION: Usage of instruments for health outcome assessment in Chinese medicine is increasing rapidly; however, current limitations include selection rationale, result interpretation and standardization, which must be addressed accordingly. © 2013 Feng-bin Liu et al. Source

Hu B.,Guangdong Academy of Medical science | Ye H.,Guangdong Academy of Medical science | Sun C.,Guangdong Academy of Medical science | Zhang Y.,Guangdong Academy of Medical science | And 14 more authors.
Critical Care | Year: 2015

Introduction: The use of prokinetic agents on post-pyloric placement of spiral nasojejunal tubes is controversial. The aim of the present study was to examine if metoclopramide or domperidone can increase the success rate of post-pyloric placement of spiral nasojejunal tubes. Methods: A multicenter, open-label, randomized, controlled trial was conducted in seven hospitals in China between April 2012 and February 2014. Patients admitted to the intensive care unit and requiring enteral nutrition for more than three days were randomly assigned to the metoclopramide, domperidone or control groups (1:1:1 ratio). The primary outcome was defined as the success rate of post-pyloric placement of spiral nasojejunal tubes, assessed 24 hours after initial placement. Secondary outcomes included success rate of post-D1, post-D2, post-D3 and proximal jejunum placement and tube migration distance. Safety of the study drugs and the tubes during the entire study period were recorded. Results: In total, 307 patients were allocated to the metoclopramide (n = 103), domperidone (n = 100) or control group (n = 104). The success rate of post-pyloric placement after 24 hours in the metoclopramide, domperidone and control groups was 55.0%, 51.5% and 27.3%, respectively (P = 0.0001). Logistic regression analysis identified the use of prokinetic agents, Acute Physiology and Chronic Health Evaluation (APACHE) II score <20, Sequential Organ Failure Assessment (SOFA) score <12 and without vasopressor as independent factors influencing the success rate of post-pyloric placement. No serious drug-related adverse reaction was observed. Conclusions: Prokinetic agents, such as metoclopramide or domperidone, are effective at improving the success rate of post-pyloric placement of spiral nasojejunal tubes in critically ill patients. Trial registration: Chinese Clinical Trial Registry ChiCTR-TRC-12001956. Registered 21 February 2012. © 2015 Hu et al.; licensee BioMed Central. Source

Zhao M.,Guangdong Provincial Hospital of Chinese Medicine | Zhao M.,Southern Medical University | Yan Y.,Shaanxi University of Chinese Medicine | Yang N.,Hospital of Traditional Chinese Medicine of Zhongshan | And 7 more authors.
European Journal of Integrative Medicine | Year: 2015

Introduction: Stroke is the leading cause of death and disability in Chinese adults and brings huge economic burden to the country. Clinical pathways (CP) have been shown to improve outcomes and reduce hospitalization costs and length of stay (LOS) for stroke patients. The objective of this study was to evaluate whether integrating Chinese medicine and western medicine into a clinical pathway for stroke could affect length of stay, hospitalization costs and clinical efficacy. Method: This multicenter study consisted of a prospective clinical (CP) and a retrospective clinical study (RCP). Participants in the CP group accepted Chinese medicine and western medicine treatments based on a standard CP protocol while the subjects in RCP group had been offered routine treatment based on the doctors' personal experience. The information from participants in RCP group was retrospectively collected from the electronic medical system including the demographic characteristics, medical history, neurological impairment evaluation, LOS, hospitalization cost, and critical evidence-based processes in both western medicine and Chinese Medicine. The prospective study was conducted between 18th January to 30th, August, 2010 and the data collection on RCP participants were carried out at the same time.The primary outcome measure was LOS while hospitalization cost, clinical efficacy, adherence of critical processes and incidence of complications were secondary outcome measures. Results: LOS in CP and RCP group was 17.2 days and 21.4 days (P <. 0.001) while hospitalization cost was 1776 US$ and 2433 US$ in CP and RCP group, respectively. 216 Patients (72.7%) in CP group compared to 401 patients (55.1%) in RCP group had improved clinical outcomes (P <. 0.001). Adherence to all evidence-based critical processes in CP group was better than RCP group (P <. 0.001). The multivariate analysis showed that after adjusting the conventional risk factors, CP application also played an important role in shortening LOS, reducing cost and improving clinical outcomes. Conclusion: A clinical pathway for ischemic stroke based on the integration of Chinese medicine and western medicine was effective in shortening LOS, reducing hospitalization cost, improving clinical outcomes and elevating adherence to evidence-based critical processes. © 2015 Elsevier GmbH. Source

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