There is a need for a simple and practical tool adapted for the diagnosis of chronic constipation (CC) in the Asian population. This study compared the Asian Neurogastroenterology and Motility Association (ANMA) CC tool and Rome III criteria for the diagnosis of CC in Asian subjects.This multicenter, cross-sectional study included subjects presenting at outpatient gastrointestinal clinics across Asia. Subjects with CC alert symptoms completed a combination Diagnosis Questionnaire to obtain a diagnosis based on 4 different diagnostic methods: self-defined, investigator's judgment, ANMA CC tool, and Rome III criteria. The primary endpoint was the level of agreement/disagreement between the ANMA CC diagnostic tool and Rome III criteria for the diagnosis of CC.The primary analysis comprised of 449 subjects, 414 of whom had a positive diagnosis according to the ANMA CC tool. Rome III positive/ANMA positive and Rome III negative/ANMA negative diagnoses were reported in 76.8% and 7.8% of subjects, respectively, resulting in an overall percentage agreement of 84.6% between the 2 diagnostic methods. The overall percentage disagreement between these 2 diagnostic methods was 15.4%. A higher level of agreement was seen between the ANMA CC tool and self-defined (374 subjects [90.3%]) or investigator's judgment criteria (388 subjects [93.7%]) compared with the Rome III criteria.This study demonstrates that the ANMA CC tool can be a useful for Asian patients with CC.
Ulcerative colitis (UC), a chronic nonspecific inflammatory disease of the intestine, has emerged as a globally prevalent disease, and traditional Chinese medicine (TCM) has shown promising results in treating UC. This guideline is based on the principles of multidisciplinary integration and evidence-based medicine according to the WHO Handbook for Guideline Development and the Reporting Items for Practice Guidelines in Healthcare (RIGHT), and provides a summary of the understanding of TCM in the context of the pathogenesis, diagnosis, treatment of UC, as well as evaluation of efficacy of the various TCM-based treatments, with specific recommendations. The guideline assesses modern evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, and ancient Chinese medical evidence using the evidence grading method of ancient TCM books. When no direct evidence was available, or the GRADE and the ancient TCM books evidence grading methods were not applicable, suggestions were made based on expert consensus. The guideline is intended to provide clinicians and caregivers with strategies for treating and managing adult UC patients with TCM, which requires compliance with local laws and contraindications of medication.
Objective To observe the effect of atropine and N-nitro-L-arginine methyl ester (L-NAME) on the pressure of lower esophageal sphincter (LESP) regulated by electro-acupuncturing (EA) at Zusanli acupoint (He-Sea, st 36) of stomach meridian and explore the neural mechanism of EA. Methods Forty-eight rats were divided into six groups:control group, EA group, atropine group, atropine+EA group, L-NAME group and L-NAME+EA group. LESP was observed and recorded by using three-channel perfusion manometric measurement system. Results LESP increased significantly under or after EA at Zusanli acupoint. Cholinergic M receptor blocker partly abolished the influence of EA on LESP, but EA could restore the decreased pressure of cholinergic M receptor blocked rats. Nitric oxide synthase (NOS) inhibitor increased LESP, and EA could make it higher. Conclusions The main efferent pathway of regulating effect of EA at Zusanli acupoint on LESP is via the chlinergic nerve of vagus, and other mechanism possibly exits.
To clarify the relationship between responsible leadership and multiple performances, a meta-analysis was conducted using R software based on 70 studies, 86 effect sizes, and a sample of 26,732 participants.The results showed that responsible leadership is positively correlated with employee task performance and organizational citizenship behavior, while negatively correlated with employee counterproductive performance.Responsible leadership is positively correlated with organizational financial performance, social performance, and environmental performance.Power distance strengthens the relationship between responsible leadership and employee organizational citizenship performance.Data sources positively strengthen the relationship between responsible leadership and employee task performance/organizational citizenship performance.
Artemisinin, a sesquiterpene lactone endoperoxide, is a valuable and powerful antimalarial drug obtained from the aerial parts of a Chinese herb, Artemisia annua (Liu et al., 1979). Artemisinin and its derivatives show few or no side effects with the existing antimalarial drugs, it has consequently been regarded as the next generation of antimalarial drugs (Looaresuwan, 1994). Currently, commercial production of artemisinin mainly based on its extraction and purification from plant material, however, the endogenous production of artemisinin is very low (0.01%-0.8% dry weight) (Wallaart et al., 1999). In view of the limited availability of artemisinin and the increased demand, the synthetic preparation of artemisinin becomes an attractive proposition. However due to its complex structure, the complete chemical synthesis is very difficult (Schmid & Hofheinz, 1983). Artemisia annua as the only valid source, many research groups have directed their investigations toward the enhancement of artemisinin production in A. annua cell cultures or whole plants by biotechnological approaches. However these approaches were still proved to be not successful (Ghingra et al., 2000). Recently, several genes in artemisinin biosynthesis have been cloned, and important advances in artemisinin biosynthesis have been achieved, which makes it possible to regulate artemisinin biosynthesis in a direct way, for example, by metabolic engineering (Abdin et al., 2003).
A dual-loop printed antenna fed by coplanar strip-line (CPS) with high gain is proposed. This antenna not only has the high gain of 10.13 dB, but also has the low cross polarization level less than -30 dB, which can be used in a low power density application. Furthermore, the broad beam width with more than 62 degrees HPBW in the E plane is able to avoid the precise main beam alignment. For measuring, a balun from the CPS to a microstrip line is designed. The simulated results show that this balun has little effect on the antenna.
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