Alternative therapies in health and medicine最新文献

Objective: Coumarins are known to have antidiabetic properties. They are also known to have direct effects on the cardiovascular system. However, their insulin and amylin-releasing effects have not been thoroughly studied. This study investigated the effect of 5,7-dimethoxycoumarin (Citropten) fractions in grapefruit peel on insulin and amylin secretions in normal male Wistar rats.

Methods: Methanol extract from grapefruit peels was fractionated using vacuum-assisted liquid chromatography with n-hexane, ethyl acetate, and methanol. Gas Chromatography Mass Spectrometry analysis reported ethyl acetate fraction with the highest concentration (85.66%) of 5,7-dimethoxycoumarin. Intraperitoneal Glucose Tolerance Test was performed on 5 sets of 5 rats receiving intraperitoneally: 1) negative control, 1 ml of sterile water 2) positive control, 0.2 mg/kg glimepiride, 3) ethyl acetate fraction containing 20 mg/kg 5,7-dimethoxycoumarin, 4) methanol fraction containing 20 mg/kg 5,7-dimethoxycoumarin, 5a) 1 ml 0.6% hydrogen peroxide and 20 mg/kg 5,7-dimethoxycoumarin; 5b) 1 ml 6% hydrogen peroxide and 20 mg/kg 5,7-dimethoxycoumarin; and 5c) 1000 mg/kg Vitamin C and 20 mg/kg 5,7-dimethoxycoumarin.

Results: Results showed that ethyl acetate fraction containing 20 mg/kg 5,7-dimethoxycoumarin had comparable plasma glucose control as obtained with glimepiride, with indirect insulin secretion effect unlike direct-acting glimepiride; the methanol fraction was less effective. An oral Glucose Tolerance Test confirmed the antidiabetic efficacy of 5,7-dimethoxycoumarin. Both ethyl acetate and methanol fractions of 5,7-dimethoxycoumarin induced extrapancreatic amylin synthesis and secretion.

Conclusion: 5,7-dimethoxycoumarin will find special applications in the management of obesity and for people with diabetes having chronic complications. Since the overall plasma glucose regulation is achieved through amylin and insulin synergy, attention should be shifted from insulin-based to amylin-based therapy. There is a need to focus on natural compounds that stimulate extrapancreatic amylin release, especially in patients with type 1 diabetes who are insulin dependent.

Objective: This study aims to evaluate the efficacy of integrating nursing early warning systems with doula-assisted childbirth nursing on natural childbirth rates and associated outcomes.

Methods: A total of 150 women who underwent childbirth in the obstetrics and gynecology department of our hospital between September 2021 and March 2023 were enrolled as participants. They were randomly allocated into either the observation group or the control group, each comprising 75 individuals. The control group received standard nursing care, while the observation group received nursing early warning systems combined with doula-assisted childbirth nursing. Comparison between the two groups included modes of childbirth, the intensity of childbirth pain, neonatal Apgar scores, the incidence of postpartum hemorrhage, duration of the first and second stages of labor, and maternal satisfaction with nursing care.

Results: Our findings indicated a higher natural childbirth rate in the observation group compared to the control group (P < .05). Furthermore, the SAS score of the observation group post-nursing was significantly lower than that of the control group. Additionally, neonates in the observation group exhibited higher Apgar scores compared to those in the control group. Moreover, mothers who underwent natural childbirth in the observation group experienced lower childbirth pain scores and reduced postpartum hemorrhage incidence (P < .05). The duration of both the first and second stages of childbirth was shorter in the observation group than in the control group. Furthermore, overall satisfaction with care was significantly higher in the observation group than in the control group, with a statistically significant difference (P < .05).

Conclusions: This study underscores the effectiveness of implementing nursing early warning systems combined with doula-assisted nursing in enhancing maternal satisfaction, reducing postpartum hemorrhage, and improving maternal well-being and neonatal outcomes. The findings advocate for the widespread adoption of this intervention in clinical practice.

The hypersensitivity of the nasal mucosa to pathogens, allergens, or nasal drugs, accompanied by a dysfunctional immune response, is the cause of various types of rhinitis. Regardless of the commercial drugs used in treatment, rhinitis is a chronic disease of the modern population. Hence the dilemma: can commercially-available drugs cure rhinitis or only temporarily suppress the disease symptoms. This article aims to contribute to clarifying the dilemma and highlight some possible solutions to the problem of rhinitis. Screening of the scientific literature, both in the field of pharmacotherapy and traditional herbal medicine, on the mechanisms of rhinitis treatment and the possibility of restoring the atrophied nasal mucosa led us to an acceptable idea. Namely, the evidence-based review indicates that herbal medicines may be considered a new class of immune adjuvants. Traditional Chinese, Japanese, and Indian herbal medicine dominate studies that indicate the importance and efficacy of herbal extracts of various medicinal plants in this indication area. However, most phytotherapy-related studies focus mainly on alcoholic plant extracts. Due to possible incidences of irritation, herbal oily macerates may bea better option for direct application to an already livid or atrophied nasal mucosa. We indicate that oily macerates are enriched in liposoluble phytocomponents that can prevent the inflammatory reaction and exert their immunoregulatory effect as efficiently as those in the alcoholic extract. We hypothesize that the selected herbal oils could not only alleviate existing rhinitis symptoms but also restore atrophied nasal mucosa. The oily macerates are characterized by better stability than ethanolic extracts, higher concentration of medicinal substances, synergistic effect in polyherbal formulation, prolonged release and improved penetration of bioactive compounds, epithelizing properties, antiviral and anti-inflammatory activity, and only a small amount is needed to achieve the desired therapeutic effect in the nasal cavity.

Background: Fall is a public health problem that cannot be ignored by elderly stroke patients, and rehabilitation care plays an important role in the rehabilitation process of elderly stroke patients.

Objective: To investigate the prevention effect of fall risk in elderly stroke patients under the intelligent model of rehabilitation care.

Methods: The general data of elderly patients who were diagnosed as stroke and admitted to our hospital between June 2021 and June 2022 were retrospectively analyzed, with exclusion like unclear clinical data or combined with other severe organ insufficiency. A total of 150 of them were selected for the study, and the patients were divided into a fall group and a non-fall group according to whether they had a fall or not. The factors associated with falls in stroke patients were analyzed univariately, and the rehabilitation care intelligence model of the predictive model of falls in stroke patients was established using multiple covariance ridge regression analysis to observe the predictive value of patients' risk of falling in the rehabilitation care intelligence model.

Results: Results of multiple covariance ridge regression analysis to build the model showed age (P < .001), low MNA-SF score (P < .001), hypertension (P = .035), anaemia(P = .048), gout (P < .001), assistive devices (P = .002), visual impairment (P = .033), elevated ALB (P < .001), and elevated HGB (P < .001) as risk factors for falls in stroke patients. The diagnostic threshold for screening elderly stroke patients for falls based on risk factors was 0.272, with a sensitivity of 90.7%, specificity of 98.1% and an area under the ROC curve of 0.976 (P < .05), which was superior to other single indicators in terms of diagnostic value. The calibration of the prediction model, based on the Hosmer and Lemeshow test of goodness of fit, showed P = 1.14, indicating a high calibration of the prediction model.

Conclusion: There are many risk factors for falls in stroke elderly patients, such as low MNA-SF score, gout, elevated ALB, and elevated HGB. Building a rehabilitation nursing intelligent model based on the above inducement factors can reduce the risk of patients falling to a certain extent, and the prediction model has a high degree of calibration. Therefore, a simple and standardized intelligent rehabilitation nursing model for stroke patients in the early stage can effectively prevent the occurrence of falls.

Background: In China, traditional Chinese medicine (TCM) is an important part of the comprehensive treatment of hepatocellular carcinoma (HCC), and Chinese herb formulas with the effect of "yiqi jianpi jiedu huayu" (replenishing qi, strengthening spleen, and removing toxicity and blood stasis) are the common and efficient treatments for HCC. However, the mechanism of these formulas in treating HCC remain unclear.

Objective: In this paper, our goal is to explore the potential mechanism of Phyllanthus urinaria L anti-neoplastic decoction (PAD), the representative formula of "yiqi jianpi jiedu huayu", in treating HCC.

Design: The research team performed the network pharmacology and in vitro experiment (preparation of PAD aqueous extract, cell cultures and MTT assay, cell apoptosis assay, wound healing assay, transwell assays, western blot).

Setting: The study took place in the Department of Hepatology, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), China.

Outcome measures: The active components and targets of PAD and HCC targets were screened by five Chinese herbs and two disease databases respectively. The network pharmacology was utilized to construct the relationship network between PAD and HCC, and the mechanism was predicted by pathway enrichment analysis. The experiment was performed to verify the intervention effect of PAD on HCC and phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway.

Results: The relationship network between PAD and HCC suggested that PAD mainly regulated the potential therapeutic targets of HCC by key active components such as quercetin, luteolin, calycosin, wogonin, and pinocembrin. Pathway analysis demonstrated PAD could play an anti-HCC effect via multiple pathways (e.g., PI3K/Akt). Results of the experiment showed that PAD could effectively inhibit the proliferation and migration of HCC cells, and promote HCC cells apoptosis in a concentration-dependent behavior. Additionally, PAD could decrease the protein expression of phosphorylated PI3K/Akt.

Conclusion: PAD mainly exerts an anti-HCC effect through multiple active components represented by quercetin and multiple pathways represented by the PI3K/Akt pathway. This study provided an experimental basis for the clinical application of PAD.

Objective: This study aims to compare the therapeutic efficacy of laparoscopic right-lower quadrant and midline approaches for the treatment of right-sided colon cancer and evaluate the analgesic effect of parecoxib sodium.

Methods: Sixty patients with right-sided colon cancer admitted to Hospital of Lin 'an District between January 2019 and November 2022 were selected. They were divided into the study group A (n=30) with a right-lower quadrant approach and the study group B (n=30) with a midline approach. All patients received parecoxib sodium. Surgical time, blood loss, postoperative complications, and other relevant indicators were recorded and compared between the two groups. Additionally, a control group of 60 right-sided colon cancer patients who underwent conventional non-exclusive analgesic laparoscopic surgery during the same period was included to compare the analgesic effects between the study and control groups.

Results: The surgical time (RR = 0.608, 95%CI 0.51, 1.53, P = .042), blood loss (RR = 0.798, 95%CI 0.52, 1.02, P < .001), time for bowel function recovery (RR = 0.808, 95%CI 0.50, 1.77, P = .007), and length of hospital stay (RR = 0.766, 95%CI 0.56, 1.72, P =.052) were significantly lower in group A than in group B, while the number of lymph node dissections was higher in group A (RR = 0.803, 95%CI 0.62, 1.52, P = .047). The postoperative levels of tumor-specific growth factor (TSGF) (RR = 0.710, 95%CI 0.50, 1.55, P < .001) and carcinoembryonic antigen (CEA) (RR = 0.803, 95%CI 0.62, 1.52, P < .001) were significantly decreased in both groups A and B, with no significant difference between the groups (P > .05). The incidence of complications in group A was significantly lower than in group B (RR = 0.167, 95%CI 0.17, 0.63, P = .044). The VAS scores of the study group at 2/4/6/8 hours postoperatively were significantly lower than those of the control group (RR = 0.702, 95%CI 0.52, 1.62, P < .001). The SF-36 scores of the study group were significantly higher than those of the control group (RR = 0.753, 95%CI 0.56, 1.82, P < .001).

Conclusions: The Laparoscopic right-lower quadrant approach for the treatment of right-sided colon cancer offers advantages such as shorter surgical time and less blood loss. It demonstrates significant clinical efficacy and reduces the incidence of postoperative complications. Parecoxib sodium enhances postoperative analgesic effect, effectively alleviating patient pain, promoting recovery, and improving quality of life. It is worth promoting in clinical practice.

Background: Diabetic foot ulcers are a serious complication accounting for about 4.54% of ulcers in people with diabetes. Matrix Rhythm Therapy (MRT) is an emerging modality focused on restoring cellular rhythm. This study explores its effect on diabetic foot ulcers (DFUs), a major complication of diabetes. By enhancing microcirculation and tissue regeneration, MRT offers a promising, non-invasive approach to wound healing and improving patient outcomes.

Primary study objective: This study aimed to determine the effect of MRT on DFUs on wound characteristics, ulcer tissue healing, and ulcer grading score.

Methods/design: It was a pilot study with a sample size of 9 participants.

Setting: Recruitment of participants was monocentric, conducted at the General Surgery Department of Dr. Prabhakar Kore Hospital & Medical Research Centre.

Participants: 23 patients were screened and 14 were excluded since they did not meet the inclusion criteria. A total of 9 participants aged between 45 - 75 years with HbA1c < 7.5% and diagnosed DFU were recruited.

Intervention: Each patient received 2 sessions of MRT for 45 minutes, with 3 days interval in between both sessions.

Primary outcome measures: Participants were evaluated in terms of wound characteristics (imitoMeasure- Measure Wound App), ulcer tissue healing score (Bates-Jensen Wound Assessment Tool), and ulcer grade (Wagner Ulcer Grade Classification System).

Results: The experimental group participants showed differences in pretest and posttest outcome scores of wound characteristics [(Area P = .0022) (Length P = .0032) (Width P = .0010), and (Circumference P = .0020)], ulcer tissue healing score P = .0001, and ulcer grading score P = .0431.

Conclusion: The MaRhyThe© treatment, a recent 21st-century innovation, has demonstrated significant efficacy in treating non-healing DFUs, as evidenced by marked improvements in wound characteristics, ulcer tissue healing scores, and ulcer grading scores.

Objective: To evaluate the implementation and effectiveness of progressive rehabilitation nursing in patients undergoing modified radical mastectomy for breast cancer.

Methods: A total of 70 patients undergoing modified radical mastectomy for breast cancer in our hospital were selected as the research subjects, and they were randomly divided into a control group and an observation group, with 35 patients in each group. The control group received routine rehabilitation nursing intervention after surgery, while the observation group received progressive rehabilitation nursing intervention based on the control group's nursing. The quality of life, self-care ability, mental state, and incidence of complications were compared between the two groups.

Results: Before the intervention, the two groups had no significant difference in the quality of life (P > .05). After the intervention, the quality of life in the observation group was significantly better than that in the control group (P < .05). Before the intervention, the two groups had no significant difference in the self-care ability (P > .05). After the intervention, the self-care ability in the observation group was significantly better than that in the control group (P < .05). Before the intervention, the two groups had no significant difference in the SAS and SDS scores (P > .05). After the intervention, the SAS and SDS scores in the observation group were significantly lower than those in the control group (P < .05). The incidence of complications in the control group was 22.86%, while that in the observation group was 5.71%. The incidence of complications in the observation group was significantly lower than in the control group (P < .05).

Conclusion: Compared with routine nursing intervention, the implementation of progressive rehabilitation nursing intervention can further improve the quality of life, self-care ability, and mental state of patients undergoing modified radical mastectomy for breast cancer and reduce the risk of related complications, which helps promote the recovery process of patients and is worthy of clinical promotion and application.

Context: Bedwetting is a socially disruptive condition that can lower an individual's self-confidence. Bedwetting is quite common in school-going children and a close correlation has been observed between the mind and physical symptoms in many cases. Reassurance and relieving the anxiety in patients can help reduce the complaints. Nocturnal enuresis in a 9-year-old girl was treated with the constitutional approach to homeopathic medicine.

Objective: This case was undertaken to assess the efficacy of individualized homeopathic medicine for managing nocturnal enuresis.

Case summary: A 9-year-old girl came with complaints of bedwetting for the past 1 year. It was noticed that she had lost her sister who was 5 years old. The patient was thirsty and thermally chilly. No change in bowel habits was noted. Sleep was disturbed in the first half of night due to involuntary urination. The patient had a craving for sweets and a strong aversion to milk. After a detailed analysis of the case, the homeopathic medicine Ignatia amara 30C was prescribed for 15 days, and satisfactory results were observed.

Result: This case was successfully treated with the selected homeopathic medicine, preventing further complications.

Conclusion: Further studies can be undertaken to assess the effectiveness of homeopathy in the management of nocturnal enuresis.

Background: Although mild head of bed elevation (HBE) is a proven method to reduce obstructive sleep apnea, there is no study to apply mild HBE in daily life using an adjustable bed.

Objective: We aimed to explore the applicability of mild HBE using an adjustable bed in daily life by investigating adverse events and discomforts induced by mild HBE. This pilot randomized trial additionally investigated the objective effects of mild HBE on sleep using polysomnography (PSG).

Methods: Pilot randomized controlled trial. With a two-tailed alpha of 0.05 and a power of 0.95, the minimum number of participants for each group; control group slept on flat bed and study group slept on bed with mild HBE on follow-up PSG; was calculated to be 12. Considering a 20% follow-up loss, we enrolled a total of 32 participants (16 participants for each group).

Setting: Dongguk University, Ilsan hospital.

Participants: A total of 37 individuals complained of subjective sleep disturbance in the Republic of Korea, 32 of whom met the inclusion criteria between September 2021 to July 2022. 23 participants completed the study and participants were randomly assigned into two groups.

Intervention: A mild HBE of 7.5 degrees using an adjustable bed was implemented. PSG results and questionnaires were evaluated.

Results: There was no difference in the proportion of adverse events between groups after post-intervention which was adjusting mild HBE on study group. Changes in sleep satisfaction from baseline to post-intervention showed no significant difference between groups either. However, changes in respiratory distress index (RDI) (F = 6.088, 95% CI, 17.0% to 26.4%; P = .023) and apnea-hypopnea index (AHI) (F = 5.542, 95% CI, 13.6% to 23.5%; P = .029) were significantly different.

Conclusions: Mild HBE is an implementable method for changing sleep posture without definitely causing discomfort or worsening sleep satisfaction. Since an easily applicable way to implement mild HBE using an adjustable bed in daily life reduces RDI and AHI in both subjects complaining of sleep disturbance and obstructive sleep apnea, it can be an alternative treatment for obstructive sleep apnea.