Pub Date : 2023-09-01DOI: 10.1016/j.joim.2023.06.008
Bing-jie Guo , Yi Ruan , Ya-jing Wang , Chu-lan Xiao , Zhi-peng Zhong , Bin-bin Cheng , Juan Du , Bai Li , Wei Gu , Zi-fei Yin
Objective
Jiedu Recipe (JR), a Chinese herbal remedy, has been shown to prolong overall survival time and decrease recurrence and metastasis rates in patients with hepatocellular carcinoma (HCC). This work investigated the mechanism of JR in HCC treatment.
Methods
The chemical constituents of JR were detected using liquid chromatography-mass spectrometry. The potential anti-HCC mechanism of JR was screened using network pharmacology and messenger ribonucleic acid (mRNA) microarray chip assay, followed by experimental validation in human HCC cells (SMMC-7721 and Huh7) in vitro and a nude mouse subcutaneous transplantation model of HCC in vivo. HCC cell characteristics of proliferation, migration and invasion under hypoxic setting were investigated using thiazolyl blue tetrazolium bromide, wound healing and Transwell assays, respectively. Image-iT™ Hypoxia Reagent was added to reveal hypoxic conditions. Stem cell sphere formation assay was used to detect the stemness. Epithelial-mesenchymal transition (EMT) markers like E-cadherin, vimentin and α-smooth muscle actin, and pluripotent transcription factors including nanog homeobox, octamer-binding transcription factor 4, and sex-determining region Y box protein 2 were analyzed using Western blotting and real-time polymerase chain reaction. Western blot was performed to ascertain the anti-HCC effect of JR under hypoxia involving the Wnt/β-catenin pathway.
Results
According to network pharmacology and mRNA microarray chip analysis, JR may potentially act on hypoxia and inhibit the Wnt/β-catenin pathway. In vitro and in vivo experiments showed that JR significantly decreased hypoxia, and suppressed HCC cell features of proliferation, migration and invasion; furthermore, the hypoxia-induced increases in EMT and stemness marker expression in HCC cells were inhibited by JR. Results based on the co-administration of JR and an agonist (LiCl) or inhibitor (IWR-1-endo) verified that JR suppressed HCC cancer stem-like properties under hypoxia by blocking the Wnt/β-catenin pathway.
Conclusion
JR exerts potent anti-HCC effects by inhibiting cancer stemness via abating the Wnt/β-catenin pathway under hypoxic conditions.
Please cite this article as: Guo BJ, Ruan Y, Wang YJ, Xiao CL, Zhong ZP, Cheng BB, Du J, Li B, Gu W, Yin ZF. Jiedu Recipe, a compound Chinese herbal medicine, inhibits cancer stemness in hepatocellular carcinoma via Wnt/β-catenin pathway under hypoxia. J Integr Med. 2023; 21(5): 474–486.
{"title":"Jiedu Recipe, a compound Chinese herbal medicine, inhibits cancer stemness in hepatocellular carcinoma via Wnt/β-catenin pathway under hypoxia","authors":"Bing-jie Guo , Yi Ruan , Ya-jing Wang , Chu-lan Xiao , Zhi-peng Zhong , Bin-bin Cheng , Juan Du , Bai Li , Wei Gu , Zi-fei Yin","doi":"10.1016/j.joim.2023.06.008","DOIUrl":"10.1016/j.joim.2023.06.008","url":null,"abstract":"<div><h3>Objective</h3><p><span>Jiedu Recipe (JR), a Chinese herbal remedy, has been shown to prolong overall survival time and decrease recurrence and metastasis rates </span>in patients<span> with hepatocellular carcinoma (HCC). This work investigated the mechanism of JR in HCC treatment.</span></p></div><div><h3>Methods</h3><p><span>The chemical constituents of JR were detected using liquid chromatography-mass spectrometry. The potential anti-HCC mechanism of JR was screened using network pharmacology and messenger ribonucleic acid (mRNA) microarray chip assay, followed by experimental validation in human HCC cells (SMMC-7721 and Huh7) </span><em>in vitro</em> and a nude mouse subcutaneous transplantation model of HCC <em>in vivo</em><span>. HCC cell characteristics of proliferation, migration and invasion under hypoxic setting were investigated using thiazolyl blue tetrazolium<span><span> bromide, wound healing and Transwell assays, respectively. Image-iT™ Hypoxia Reagent was added to reveal hypoxic conditions. Stem cell sphere formation assay was used to detect the stemness. Epithelial-mesenchymal transition (EMT) markers like E-cadherin, </span>vimentin<span><span> and α-smooth muscle actin, and pluripotent transcription factors including nanog homeobox, octamer-binding transcription factor 4, and sex-determining region Y box protein 2 were analyzed using </span>Western blotting and real-time polymerase chain reaction. Western blot was performed to ascertain the anti-HCC effect of JR under hypoxia involving the Wnt/β-catenin pathway.</span></span></span></p></div><div><h3>Results</h3><p>According to network pharmacology and mRNA microarray chip analysis, JR may potentially act on hypoxia and inhibit the Wnt/β-catenin pathway. <em>In vitro</em> and <em>in vivo</em> experiments showed that JR significantly decreased hypoxia, and suppressed HCC cell features of proliferation, migration and invasion; furthermore, the hypoxia-induced increases in EMT and stemness marker expression in HCC cells were inhibited by JR. Results based on the co-administration of JR and an agonist (LiCl) or inhibitor (IWR-1-endo) verified that JR suppressed HCC cancer stem-like properties under hypoxia by blocking the Wnt/β-catenin pathway.</p></div><div><h3>Conclusion</h3><p>JR exerts potent anti-HCC effects by inhibiting cancer stemness via abating the Wnt/β-catenin pathway under hypoxic conditions.</p><p><span>Please cite this article as: Guo BJ, Ruan Y, Wang YJ, Xiao CL, Zhong ZP, Cheng BB, Du J, Li B, Gu W, Yin ZF. Jiedu Recipe, a compound Chinese herbal medicine, inhibits cancer stemness in hepatocellular carcinoma via Wnt/β-catenin pathway under hypoxia. </span><em>J Integr Med</em>. 2023; 21(5): 474–486.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10302739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.joim.2023.08.006
Dorota Olex-Zarychta
Psychomotor performance is the coordination of a sensory or ideational (cognitive) process and a motor activity. All sensorimotor processes involved in planning and execution of voluntary movements need oxygen supply and seem to be significantly disrupted in states of hypoxia. Hyperbaric oxygen therapy has become a widely used treatment in routine medicine and sport medicine due to its beneficial effects on different aspects of human physiology and performance. This paper presents state-of-the-art data on the effects of hyperbaric oxygen therapy on different aspects of human psychomotor function. The therapy’s influence on musculoskeletal properties and motor abilities as well as the effects of hyperbaric oxygenation on cognitive, myocardial and pulmonary functions are presented. In this review the molecular and physiological processes related to human psychomotor performance in response to hyperbaric oxygen are discussed to contribute to this fast-growing field of research in integrative medicine.
Please cite this article as: Olex-Zarychta D. Effects of hyperbaric oxygen therapy on human psychomotor performance: A review. J Integr Med. 2023; 21(5): 430–440.
{"title":"Effects of hyperbaric oxygen therapy on human psychomotor performance: A review","authors":"Dorota Olex-Zarychta","doi":"10.1016/j.joim.2023.08.006","DOIUrl":"10.1016/j.joim.2023.08.006","url":null,"abstract":"<div><p><span>Psychomotor performance<span> is the coordination of a sensory or ideational (cognitive) process and a motor activity. All sensorimotor processes involved in planning and execution of voluntary movements need oxygen supply and seem to be significantly disrupted in states of hypoxia<span>. Hyperbaric oxygen therapy<span> has become a widely used treatment<span> in routine medicine and sport medicine due to its beneficial effects on different aspects of </span></span></span></span></span>human physiology<span> and performance. This paper presents state-of-the-art data on the effects of hyperbaric oxygen therapy on different aspects of human psychomotor function<span><span>. The therapy’s influence on musculoskeletal properties and motor abilities as well as the effects of hyperbaric oxygenation on cognitive, myocardial and pulmonary functions are presented. In this review the molecular and physiological processes related to human psychomotor performance in response to hyperbaric oxygen are discussed to contribute to this fast-growing field of research in </span>integrative medicine.</span></span></p><p>Please cite this article as: Olex-Zarychta D. Effects of hyperbaric oxygen therapy on human psychomotor performance: A review. <em>J Integr Med</em>. 2023; 21(5): 430–440.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10357355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.joim.2023.08.001
Liang-zhen You , Qian-qian Dai , Xiao-ying Zhong , Dong-dong Yu , He-rong Cui , Yi-fan Kong , Meng-zhu Zhao , Xin-yi Zhang , Qian-qian Xu , Zhi-yue Guan , Xu-xu Wei , Xue-cheng Zhang , Song-jie Han , Wen-jing Liu , Zhao Chen , Xiao-yu Zhang , Chen Zhao , Ying-hui Jin , Hong-cai Shang
Background
The coronavirus disease 2019 (COVID-19) continues to spread worldwide. Integrated Chinese and Western medicine have had some successes in treating COVID-19.
Objective
This study aims to evaluate the efficacy and safety of three traditional Chinese medicine drugs and three herbal formulas (3-drugs-3-formulas) in patients with COVID-19.
Search strategy
Relevant studies were identified from 12 electronic databases searched from their establishment to April 7, 2022.
Inclusion criteria
Randomized controlled trials (RCTs), non-RCTs and cohort studies that evaluated the effects of 3-drugs-3-formulas for COVID-19. The treatment group was treated with one of the 3-drugs-3-formulas plus conventional treatment. The control group was treated with conventional treatment.
Data extraction and analysis
Two evaluators screened and selected literature independently, then extracted basic information and assessed risk of bias. The treatment outcome measures were duration of main symptoms, hospitalization time, aggravation rate and mortality. RevMan 5.4 was used to analyze the pooled results reported as mean difference (MD) with 95% confidence interval (CI) for continuous data and risk ratio (RR) with 95% CI for dichotomous data.
Results
Forty-one studies with a total of 13,260 participants were identified. Our analysis suggests that compared with conventional treatment, the combination of 3-drugs-3-formulas might shorten duration of fever (MD = –1.39; 95% CI: –2.19 to –0.59; P < 0.05), cough (MD = –1.57; 95% CI: –2.16 to –0.98; P < 0.05) and fatigue (MD = –1.36; 95% CI: –2.21 to –0.51; P < 0.05), decrease length of hospital stay (MD = –2.62; 95% CI –3.52 to –1.72; P < 0.05), the time for nucleic acid conversion (MD = –2.92; 95% CI: –4.26 to –1.59; P < 0.05), aggravation rate (RR = 0.49; 95% CI: 0.38 to 0.64; P < 0.05) and mortality (RR = 0.34; 95% CI: 0.19 to 0.62; P < 0.05), and increase the recovery rate of chest computerized tomography manifestations (RR = 1.22; 95% CI: 1.14 to 1.3; P < 0.05) and total effectiveness (RR = 1.24; 95% CI: 1.09 to 1.42; P < 0.05).
Conclusion
The 3-drugs-3-formulas can play an active role in treating all stages of COVID-19. No severe adverse events related to 3-drugs-3-formulas were observed. Hence, 3-drugs-3-formulas combined with conventional therapies have effective therapeutic value for COVID-19 patients. Further long-term high-quality studies are essential to demonstrate the clinical benefits of each formula.
Please cite this article as: You LZ, Dai QQ, Zhong XY, Yu DD, Cui HR, Kong YF, Zhao MZ, Zhang XY, Xu QQ, Guan ZY, Wei XX, Zhang XC, Han SJ, Liu WJ, Che
{"title":"Clinical evidence of three traditional Chinese medicine drugs and three herbal formulas for COVID-19: A systematic review and meta-analysis of the Chinese population","authors":"Liang-zhen You , Qian-qian Dai , Xiao-ying Zhong , Dong-dong Yu , He-rong Cui , Yi-fan Kong , Meng-zhu Zhao , Xin-yi Zhang , Qian-qian Xu , Zhi-yue Guan , Xu-xu Wei , Xue-cheng Zhang , Song-jie Han , Wen-jing Liu , Zhao Chen , Xiao-yu Zhang , Chen Zhao , Ying-hui Jin , Hong-cai Shang","doi":"10.1016/j.joim.2023.08.001","DOIUrl":"10.1016/j.joim.2023.08.001","url":null,"abstract":"<div><h3>Background</h3><p>The coronavirus disease 2019 (COVID-19) continues to spread worldwide. Integrated Chinese and Western medicine have had some successes in treating COVID-19.</p></div><div><h3>Objective</h3><p><span>This study aims to evaluate the efficacy and safety of three traditional Chinese medicine </span>drugs<span> and three herbal formulas (3-drugs-3-formulas) in patients with COVID-19.</span></p></div><div><h3>Search strategy</h3><p>Relevant studies were identified from 12 electronic databases searched from their establishment to April 7, 2022.</p></div><div><h3>Inclusion criteria</h3><p>Randomized controlled trials<span> (RCTs), non-RCTs and cohort studies<span> that evaluated the effects of 3-drugs-3-formulas for COVID-19. The treatment group was treated with one of the 3-drugs-3-formulas plus conventional treatment. The control group was treated with conventional treatment.</span></span></p></div><div><h3>Data extraction and analysis</h3><p>Two evaluators screened and selected literature independently, then extracted basic information and assessed risk of bias. The treatment outcome measures were duration of main symptoms, hospitalization time, aggravation rate and mortality. RevMan 5.4 was used to analyze the pooled results reported as mean difference (MD) with 95% confidence interval (CI) for continuous data and risk ratio (RR) with 95% CI for dichotomous data.</p></div><div><h3>Results</h3><p>Forty-one studies with a total of 13,260 participants were identified. Our analysis suggests that compared with conventional treatment, the combination of 3-drugs-3-formulas might shorten duration of fever (MD = –1.39; 95% CI: –2.19 to –0.59; <em>P</em> < 0.05), cough (MD = –1.57; 95% CI: –2.16 to –0.98; <em>P</em> < 0.05) and fatigue (MD = –1.36; 95% CI: –2.21 to –0.51; <em>P</em> < 0.05), decrease length of hospital stay (MD = –2.62; 95% CI –3.52 to –1.72; <em>P</em><span> < 0.05), the time for nucleic acid conversion (MD = –2.92; 95% CI: –4.26 to –1.59; </span><em>P</em> < 0.05), aggravation rate (RR = 0.49; 95% CI: 0.38 to 0.64; <em>P</em> < 0.05) and mortality (RR = 0.34; 95% CI: 0.19 to 0.62; <em>P</em><span> < 0.05), and increase the recovery rate of chest computerized tomography manifestations (RR = 1.22; 95% CI: 1.14 to 1.3; </span><em>P</em> < 0.05) and total effectiveness (RR = 1.24; 95% CI: 1.09 to 1.42; <em>P</em> < 0.05).</p></div><div><h3>Conclusion</h3><p>The 3-drugs-3-formulas can play an active role in treating all stages of COVID-19. No severe adverse events related to 3-drugs-3-formulas were observed. Hence, 3-drugs-3-formulas combined with conventional therapies have effective therapeutic value for COVID-19 patients. Further long-term high-quality studies are essential to demonstrate the clinical benefits of each formula.<br></p><p><span>Please cite this article as: You LZ, Dai QQ, Zhong XY, Yu DD, Cui HR, Kong YF, Zhao MZ, Zhang XY, Xu QQ, Guan ZY, Wei XX, Zhang XC, Han SJ, Liu WJ, Che","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.joim.2023.06.007
Irene G. Ampomah , Bunmi S. Malau-Aduli , Aduli E.O. Malau-Aduli , Theophilus I. Emeto
This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point. Elements of an integrative healthcare delivery model including philosophies/values, structure, process and outcome were used to conduct a quality assessment of the integrated health system in Ghana. Each element clearly showed that Ghana is currently not running a coordinated health practice model, thus making it a tolerant, rather than an inclusive, health system. Therefore, the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana. The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics. As such, governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings. Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings. This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population.
Please cite this article as: Ampomah IG, Malau-Aduli BS, Malau-Aduli AEO, Emeto TI. From talk to action: Developing a model to foster effective integration of traditional medicine into the Ghanaian healthcare system. J Integr Med. 2023; 21(5): 423–429.
{"title":"From talk to action: Developing a model to foster effective integration of traditional medicine into the Ghanaian healthcare system","authors":"Irene G. Ampomah , Bunmi S. Malau-Aduli , Aduli E.O. Malau-Aduli , Theophilus I. Emeto","doi":"10.1016/j.joim.2023.06.007","DOIUrl":"10.1016/j.joim.2023.06.007","url":null,"abstract":"<div><p><span>This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian </span>health system using the Ashanti Region as the focal point. Elements of an integrative healthcare delivery model including philosophies/values, structure, process and outcome were used to conduct a quality assessment of the integrated health system in Ghana. Each element clearly showed that Ghana is currently not running a coordinated health practice model, thus making it a tolerant, rather than an inclusive, health system. Therefore, the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana. The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics. As such, governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings. Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings. This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population.</p><p>Please cite this article as: Ampomah IG, Malau-Aduli BS, Malau-Aduli AEO, Emeto TI. From talk to action: Developing a model to foster effective integration of traditional medicine into the Ghanaian healthcare system. <em>J Integr Med</em>. 2023; 21(5): 423–429.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10649359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.joim.2023.08.002
Yan-qiong Zhang , Chun-xia Shi , Dan-mei Zhang, Lu-yi Zhang, Lu-wen Wang, Zuo-jiong Gong
Objective
Acute liver failure (ALF) is characterized by severe liver dysfunction, rapid progression and high mortality and is difficult to treat. Studies have found that sulforaphane (SFN), a nuclear factor E2-related factor 2 (NRF2) agonist, has anti-inflammatory, antioxidant and anticancer effects, and has certain protective effects on neurodegenerative diseases, cancer and liver fibrosis. This paper aimed to explore the protective effect of SFN in ALF and it possible mechanisms of action.
Methods
Lipopolysaccharide and D-galactosamine were used to induce liver injury in vitro and in vivo. NRF2 agonist SFN and histone deacetylase 6 (HDAC6) inhibitor ACY1215 were used to observe the protective effect and possible mechanisms of SFN in ALF, respectively. Cell viability, lactate dehydrogenase (LDH), Fe2+, glutathione (GSH) and malondialdehyde (MDA) were detected. The expression of HDAC6, NRF2, glutathione peroxidase 4 (GPX4), acyl-CoA synthetase long-chain family member 4 (ACSL4) and solute carrier family 7 member 11 (SLC7A11) were detected by Western blotting and immunofluorescence.
Results
Our results show that NRF2 was activated by SFN. LDH, Fe2+, MDA and ACSL4 were downregulated, while GSH, GPX4 and SLC7A11 were upregulated by SFN in vitro and in vivo, indicating the inhibitory effect of SFN on ferroptosis. Additionally, HDAC6 expression was decreased in the SFN group, indicating that SFN could downregulate the expression of HDAC6 in ALF. After using the HDAC6 inhibitor, ACY1215, SFN further reduced HDAC6 expression and inhibited ferroptosis, indicating that SFN may inhibit ferroptosis by regulating HDAC6 activity.
Conclusion
SFN has a protective effect on ALF, and the mechanism may include reduction of ferroptosis through the regulation of HDAC6.
Please cite this article as: Zhang YQ, Shi CX, Zhang DM, Zhang LY, Wang LW, Gong ZJ. Sulforaphane, an NRF2 agonist, alleviates ferroptosis in acute liver failure by regulating HDAC6 activity. J Integr Med. 2023; 21(5): 464–473.
{"title":"Sulforaphane, an NRF2 agonist, alleviates ferroptosis in acute liver failure by regulating HDAC6 activity","authors":"Yan-qiong Zhang , Chun-xia Shi , Dan-mei Zhang, Lu-yi Zhang, Lu-wen Wang, Zuo-jiong Gong","doi":"10.1016/j.joim.2023.08.002","DOIUrl":"10.1016/j.joim.2023.08.002","url":null,"abstract":"<div><h3>Objective</h3><p><span><span>Acute liver failure (ALF) is characterized by </span>severe liver dysfunction<span>, rapid progression and high mortality and is difficult to treat. Studies have found that sulforaphane (SFN), a nuclear factor E2-related </span></span>factor 2<span> (NRF2) agonist, has anti-inflammatory, antioxidant and anticancer effects, and has certain protective effects on neurodegenerative diseases<span>, cancer and liver fibrosis. This paper aimed to explore the protective effect of SFN in ALF and it possible mechanisms of action.</span></span></p></div><div><h3>Methods</h3><p><span>Lipopolysaccharide and D-galactosamine were used to induce liver injury </span><em>in vitro</em> and <em>in vivo</em><span>. NRF2 agonist SFN and histone deacetylase 6<span> (HDAC6) inhibitor ACY1215<span><span> were used to observe the protective effect and possible mechanisms of SFN in ALF, respectively. Cell viability, </span>lactate dehydrogenase (LDH), Fe</span></span></span><sup>2+</sup><span><span>, glutathione (GSH) and </span>malondialdehyde<span><span> (MDA) were detected. The expression of HDAC6, NRF2, glutathione peroxidase 4<span> (GPX4), acyl-CoA synthetase long-chain family member 4 (ACSL4) and solute carrier family 7 member 11 (SLC7A11) were detected by </span></span>Western blotting<span> and immunofluorescence.</span></span></span></p></div><div><h3>Results</h3><p>Our results show that NRF2 was activated by SFN. LDH, Fe<sup>2+</sup>, MDA and ACSL4 were downregulated, while GSH, GPX4 and SLC7A11 were upregulated by SFN <em>in vitro</em> and <em>in vivo</em><span>, indicating the inhibitory effect of SFN on ferroptosis. Additionally, HDAC6 expression was decreased in the SFN group, indicating that SFN could downregulate the expression of HDAC6 in ALF. After using the HDAC6 inhibitor, ACY1215, SFN further reduced HDAC6 expression and inhibited ferroptosis, indicating that SFN may inhibit ferroptosis by regulating HDAC6 activity.</span></p></div><div><h3>Conclusion</h3><p>SFN has a protective effect on ALF, and the mechanism may include reduction of ferroptosis through the regulation of HDAC6.</p><p>Please cite this article as: Zhang YQ, Shi CX, Zhang DM, Zhang LY, Wang LW, Gong ZJ. Sulforaphane, an NRF2 agonist, alleviates ferroptosis in acute liver failure by regulating HDAC6 activity. <em>J Integr Med</em>. 2023; 21(5): 464–473.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Mai Thi Thanh Thu, Truong Quang Trung, Duong Thi Thu Huyen, Nguyen Thi Thu Huong, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, João Manuel Garcia do Nascimento Graveto, Anabela de Sousa Salgueiro Oliveira, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira
The rapid advancement of technology has transformed the role of nurses and nursing students in patient care, making it an integral component of healthcare delivery. The use of innovative technologies has become commonplace in healthcare settings, creating a high-tech environment that can enhance nursing care quality and patient experience. It is essential for nursing staff and students to be receptive to incorporating such tools into their practice to ensure safe and efficient use of various forms of healthcare technology. Objective: Given the absence of an existing tool in Vietnam to evaluate healthcare students’ technology acceptance, the aim of our research was to culturally adapt, translate, and validate the Usability Evaluation Questionnaire (UtEQ) among nursing students in Vietnam. Method: We conducted a methodological and cross-sectional study in two phases: translation of the UtEQ to Vietnamese (UtEQ-V) following six stages proposed by Beaton and collaborators, and assessment of its psychometric properties in a non-probability sample of 295 Vietnamese nursing students. Results: The UtEQ-V’s reliability was found to be above 0.8 for all factors (.88–.95), while confirmatory factor analysis showed adequate goodness-of-fit indicators. Conclusion: The UtEQ-V is a reliable and valid instrument that can support nursing educators and researchers to assess students’ technology acceptance during their clinical training.
{"title":"HOW DO NURSING STUDENTS PERCEIVE HEALTHCARE TECHNOLOGY? A PSYCHOMETRIC VALIDATION STUDY OF THE USABILITY EVALUATION QUESTIONNAIRE IN VIETNAM","authors":"Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Mai Thi Thanh Thu, Truong Quang Trung, Duong Thi Thu Huyen, Nguyen Thi Thu Huong, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, João Manuel Garcia do Nascimento Graveto, Anabela de Sousa Salgueiro Oliveira, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira","doi":"10.29073/jim.v4i2.766","DOIUrl":"https://doi.org/10.29073/jim.v4i2.766","url":null,"abstract":"The rapid advancement of technology has transformed the role of nurses and nursing students in patient care, making it an integral component of healthcare delivery. The use of innovative technologies has become commonplace in healthcare settings, creating a high-tech environment that can enhance nursing care quality and patient experience. It is essential for nursing staff and students to be receptive to incorporating such tools into their practice to ensure safe and efficient use of various forms of healthcare technology. Objective: Given the absence of an existing tool in Vietnam to evaluate healthcare students’ technology acceptance, the aim of our research was to culturally adapt, translate, and validate the Usability Evaluation Questionnaire (UtEQ) among nursing students in Vietnam. Method: We conducted a methodological and cross-sectional study in two phases: translation of the UtEQ to Vietnamese (UtEQ-V) following six stages proposed by Beaton and collaborators, and assessment of its psychometric properties in a non-probability sample of 295 Vietnamese nursing students. Results: The UtEQ-V’s reliability was found to be above 0.8 for all factors (.88–.95), while confirmatory factor analysis showed adequate goodness-of-fit indicators. Conclusion: The UtEQ-V is a reliable and valid instrument that can support nursing educators and researchers to assess students’ technology acceptance during their clinical training.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75916499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thiago Ramos de Barros, Verônica Salerno, Filipe Brasil e Silva, Thalita Ponce Sobral, M. Vaisman, Miriam Raquel Meira Mainenti
A revisão objetivou descrever os efeitos de treinamentos militares que combinam atividade física intensa e privação de sono em marcadores de estresse oxidativo, lesão celular, desempenho físico e cognitivo. Foi realizada uma revisão sistemática seguindo as recomendações do PRISMA e a pesquisa foi realizada nas bases de dados Pubmed e Google Scholar. A frase de busca foi desenvolvida para identificar estudos experimentais que investigaram momentos pré e pós treinamentos militares, avaliando pelo menos uma das variáveis dependentes: dano oxidativo, capacidade antioxidante, lesão celular, alerta cognitivo e desempenho físico. Vinte e quatro estudos preencheram os critérios de inclusão. As intervenções dos estudos incluídos variaram de 1 a 63 dias, com predominância de atividade física intensa e importante privação de sono. As comparações dos dados pareados convergiram com o aumento dos níveis de lesão celular, queda dos desempenhos físico e cognitivo (p<0,05). Houve escassez das avaliações de estresse oxidativo e distinção entre os protocolos dos estudos encontrados. A revisão concluiu que a combinação de atividade física intensa e privação de sono são capazes de provocar aumento nos níveis de lesão celular e queda de performance física e cognitiva. Sugere também que há uma lacuna de informações sobre estresse oxidativo e treinamentos militares.
{"title":"ESFORÇO FÍSICO E RESTRIÇÃO DE SONO MODIFICAM MARCADORES BIOQUÍMICOS E COGNITIVOS EM MILITARES: UMA REVISÃO SISTEMÁTICA","authors":"Thiago Ramos de Barros, Verônica Salerno, Filipe Brasil e Silva, Thalita Ponce Sobral, M. Vaisman, Miriam Raquel Meira Mainenti","doi":"10.29073/jim.v4i2.702","DOIUrl":"https://doi.org/10.29073/jim.v4i2.702","url":null,"abstract":"A revisão objetivou descrever os efeitos de treinamentos militares que combinam atividade física intensa e privação de sono em marcadores de estresse oxidativo, lesão celular, desempenho físico e cognitivo. Foi realizada uma revisão sistemática seguindo as recomendações do PRISMA e a pesquisa foi realizada nas bases de dados Pubmed e Google Scholar. A frase de busca foi desenvolvida para identificar estudos experimentais que investigaram momentos pré e pós treinamentos militares, avaliando pelo menos uma das variáveis dependentes: dano oxidativo, capacidade antioxidante, lesão celular, alerta cognitivo e desempenho físico. Vinte e quatro estudos preencheram os critérios de inclusão. As intervenções dos estudos incluídos variaram de 1 a 63 dias, com predominância de atividade física intensa e importante privação de sono. As comparações dos dados pareados convergiram com o aumento dos níveis de lesão celular, queda dos desempenhos físico e cognitivo (p<0,05). Houve escassez das avaliações de estresse oxidativo e distinção entre os protocolos dos estudos encontrados. A revisão concluiu que a combinação de atividade física intensa e privação de sono são capazes de provocar aumento nos níveis de lesão celular e queda de performance física e cognitiva. Sugere também que há uma lacuna de informações sobre estresse oxidativo e treinamentos militares.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87478344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Debashish Debnath, Hasan Shahriar Rahman, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Bui Vu Binh, Le Thi Tra My, Le Thi Cuc, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Pham Thi Thuy Chinh, Mai Thi Thanh Thu, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira
The modernization of healthcare delivery is a reality in various international settings. To ensure efficient and safe use of the diverse forms of healthcare technology available, professionals and students must be receptive to incorporating such tools into their practice. Currently, there is no instrument in Bangladesh to assess healthcare students’ technology acceptance. Objective: To translate, culturally adapt, and validate the Usability Evaluation Questionnaire (UtEQ) among Bangladeshi healthcare students. Method: A cross-sectional study with a methodological approach was conducted in two phases. The first phase involved the translation of the UtEQ questionnaire to Bengali, following the six stages proposed by Beaton et al. In the second phase, the psychometric properties of the questionnaire were evaluated using a non-probability sample of 486 undergraduate healthcare students from three higher education institutions in Bangladesh. Confirmatory factor analysis was performed, and the Cronbach’s alpha coefficient was estimated to find out the internal consistency. Results: Internal consistency was found to be excellent for all scale dimensions, ranging from 0.88 to 0.92, while confirmatory factor analysis showed adequate goodness-of-fit indicators. Conclusion: The UtEQ-B provides a reliable and valid method for healthcare educators and researchers to assess technology acceptance among healthcare students during clinical training in Bangladesh.
{"title":"HOW DO MEDICAL AND NURSING STUDENTS VIEW HEALTHCARE TECHNOLOGY? A PSYCHOMETRIC VALIDATION STUDY OF THE USABILITY EVALUATION QUESTIONNAIRE IN BANGLADESH","authors":"Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Debashish Debnath, Hasan Shahriar Rahman, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Bui Vu Binh, Le Thi Tra My, Le Thi Cuc, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Pham Thi Thuy Chinh, Mai Thi Thanh Thu, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira","doi":"10.29073/jim.v4i2.767","DOIUrl":"https://doi.org/10.29073/jim.v4i2.767","url":null,"abstract":"The modernization of healthcare delivery is a reality in various international settings. To ensure efficient and safe use of the diverse forms of healthcare technology available, professionals and students must be receptive to incorporating such tools into their practice. Currently, there is no instrument in Bangladesh to assess healthcare students’ technology acceptance. Objective: To translate, culturally adapt, and validate the Usability Evaluation Questionnaire (UtEQ) among Bangladeshi healthcare students. Method: A cross-sectional study with a methodological approach was conducted in two phases. The first phase involved the translation of the UtEQ questionnaire to Bengali, following the six stages proposed by Beaton et al. In the second phase, the psychometric properties of the questionnaire were evaluated using a non-probability sample of 486 undergraduate healthcare students from three higher education institutions in Bangladesh. Confirmatory factor analysis was performed, and the Cronbach’s alpha coefficient was estimated to find out the internal consistency. Results: Internal consistency was found to be excellent for all scale dimensions, ranging from 0.88 to 0.92, while confirmatory factor analysis showed adequate goodness-of-fit indicators. Conclusion: The UtEQ-B provides a reliable and valid method for healthcare educators and researchers to assess technology acceptance among healthcare students during clinical training in Bangladesh.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88487872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paulo Jorge dos Santos Costa, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Truong Quang Trung, Nguyet Thi Nguyen, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Hoang Thi Minh Thai, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Pedro Miguel dos Santos Dinis Parreira
Coaching has become an important approach to support self-management of patients with non-communicable diseases (NCDs) in healthcare education. Studies conducted in European countries have emphasized the significance of formal coaching training in enhancing the competencies of healthcare students. However, in Southeast Asia, where NCDs pose a serious public health concern, there is a lack of such training opportunities. To address this issue, an exploratory pre and post study was conducted to evaluate the effectiveness of the DigiCare educational intervention in improving clinical coaching skills. Nursing and medical students from six universities in Vietnam and Bangladesh were invited to participate. The intervention included both theoretical and practical classes with interactive methods and home assignments, with a total duration of over 10 contact hours. Pre- and post-intervention assessments were conducted using the Self-Efficacy and Performance in Self-management Support instrument, which was translated and culturally adapted to both countries. Statistical analysis showed a significant improvement in students’ overall competence scores from before (M = 2.6, SD = .67) to after the intervention (M = 3.05, SD = .55), with a medium effect size (p < .001; d = .73). The DigiCare educational intervention appears to be a low-cost and meaningful addition to the curriculum of both nursing and medical universities across countries, with potential benefits in the development of students’ clinical coaching competencies.
{"title":"EFFECTIVENESS OF THE DIGICARE EDUCATIONAL INTERVENTION IN IMPROVING NURSING AND MEDICAL STUDENTS’ CLINICAL COACHING SKILLS IN VIETNAM AND BANGLADESH: AN EXPLORATORY PRE-POST STUDY","authors":"Paulo Jorge dos Santos Costa, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Truong Quang Trung, Nguyet Thi Nguyen, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Hoang Thi Minh Thai, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Pedro Miguel dos Santos Dinis Parreira","doi":"10.29073/jim.v4i2.764","DOIUrl":"https://doi.org/10.29073/jim.v4i2.764","url":null,"abstract":"Coaching has become an important approach to support self-management of patients with non-communicable diseases (NCDs) in healthcare education. Studies conducted in European countries have emphasized the significance of formal coaching training in enhancing the competencies of healthcare students. However, in Southeast Asia, where NCDs pose a serious public health concern, there is a lack of such training opportunities. To address this issue, an exploratory pre and post study was conducted to evaluate the effectiveness of the DigiCare educational intervention in improving clinical coaching skills. Nursing and medical students from six universities in Vietnam and Bangladesh were invited to participate. The intervention included both theoretical and practical classes with interactive methods and home assignments, with a total duration of over 10 contact hours. Pre- and post-intervention assessments were conducted using the Self-Efficacy and Performance in Self-management Support instrument, which was translated and culturally adapted to both countries. Statistical analysis showed a significant improvement in students’ overall competence scores from before (M = 2.6, SD = .67) to after the intervention (M = 3.05, SD = .55), with a medium effect size (p < .001; d = .73). The DigiCare educational intervention appears to be a low-cost and meaningful addition to the curriculum of both nursing and medical universities across countries, with potential benefits in the development of students’ clinical coaching competencies.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81473375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carla Carvalho, Ana Pinto, Soraia Oliveira, Maria Inês Matos, Paulo Santos-Costa
Burnout affects physical and psychological health and is considered a major public health threat. The COVID-19 pandemic brought numerous social and economic challenges to organizations across the different work sectors, enhancing the risk of workers experiencing Burnout. However, the influence of the COVID-19 pandemic on the study of Burnout Syndrome remains unclear. To address this challenge, we analyzed pre-pandemic and post-COVID-19 outbreak research trends in this field. A comparative bibliometric analysis was conducted for the pre-pandemic period (01/2015 to 12/2019) and after the COVID-19 outbreak (01/2020 to 06/2021). Twelve thousand eighty-one publications were analyzed. Exponential growth in annual research activity on this subject was found since the COVID-19 outbreak. After 2020, the keyword “COVID-19” is often associated with “Burnout”, showing a clear international focus on this field. Research output disparities among the most affected countries have been found, with increased publications in countries such as the United States of America, China, Spain and Italy, while others have understudied this subject (e.g., India, Brazil, France). Further bibliometric analyses in this scope are recommended.
{"title":"COVID-19 PANDEMIC’S INFLUENCE ON THE STUDY OF BURNOUT: A BIBLIOMETRIC ANALYSIS","authors":"Carla Carvalho, Ana Pinto, Soraia Oliveira, Maria Inês Matos, Paulo Santos-Costa","doi":"10.29073/jim.v4i2.733","DOIUrl":"https://doi.org/10.29073/jim.v4i2.733","url":null,"abstract":"Burnout affects physical and psychological health and is considered a major public health threat. The COVID-19 pandemic brought numerous social and economic challenges to organizations across the different work sectors, enhancing the risk of workers experiencing Burnout. However, the influence of the COVID-19 pandemic on the study of Burnout Syndrome remains unclear. To address this challenge, we analyzed pre-pandemic and post-COVID-19 outbreak research trends in this field. A comparative bibliometric analysis was conducted for the pre-pandemic period (01/2015 to 12/2019) and after the COVID-19 outbreak (01/2020 to 06/2021). Twelve thousand eighty-one publications were analyzed. Exponential growth in annual research activity on this subject was found since the COVID-19 outbreak. After 2020, the keyword “COVID-19” is often associated with “Burnout”, showing a clear international focus on this field. Research output disparities among the most affected countries have been found, with increased publications in countries such as the United States of America, China, Spain and Italy, while others have understudied this subject (e.g., India, Brazil, France). Further bibliometric analyses in this scope are recommended.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87262266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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