ABSTRACT
The present analysis was based on the iteration of the 2023 WHO Essential Medicines Model List(23rd list)and Essential Medicines Model List for Children(9th list).In a methodological fashion,the adjustment procedure of the basic drug list and the materials required to submit the application were sorted out.Subsequently,a comprehensive synthesis of predominant features characterizing the 2023 edition of the EML and EMLc are summarized(offered).Notably,this edition boasts the highest count of medicines ever included featuring extensive inclusion of innovative drugs to fill the gap,select medicines for children carefully,and the emphasizing on clinical benefit evidence and public health affordability.It is suggested that China should update the NEML according to the national conditions and the experience of WHO as soon as possible,pay attention to the difference and connection between the list of essential medicines and the list of medical insurance,and play a meticulous role for establishing effective linkages between two lists.Such measures are envisaged to meet the basic drug needs,and ensure the accessibility and affordability of drugs,thereby optimizing the allocation of health resources.
ABSTRACT
Based on FangNet platform,the data of the prescriptions for the effective cases of post-stroke sequelae treated by national renowned Chinese medical practitioner LIU Mao-Cai were collected for the analysis of medication frequency of the prescribed drugs as well as their properties,flavors and meridian tropism.The medication rules of LIU Mao-Cai for treating post-stroke sequelae was summarized by analyzing the weight scale,co-occurrence and mutual exclusivity of the prescribed drugs and by drug-symptom association rule analysis and drug clustering analysis.The results showed that a total of 105 prescriptions involving 95 Chinese medicines were obtained.The drugs in the prescriptions were mainly warm in nature,sweet in flavor and had the meridian tropism of liver meridian.There were 17 driver herbs,and they were Astragali Radix,Gastrodiae Rhizoma,Corni Fructus,Codonopsis Radix,Eucommiae Cortex,Achyranthis Bidentatae Radix,Chuanxiong Rhizoma,Polygalae Radix,Curcumae Longae Rhizoma,Acori Tatarinowii Rhizoma,Ophiopogonis Radix,Atractylodis Macrocephalae Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,Poria,Uncariae Ramulus cum Uncis,Pinelliae Rhizoma Praeparatum,and Ligustri Lucidi Fructus.The results of drug co-occurrence analysis yielded 12 drug pairs such as Achyranthis Bidentatae Radix-Eucommiae Cortex,drug-symptom association rule analysis yielded 9 groups of drug-symptom association combinations such as Gastrodiae Rhizoma-dizziness,and cluster analysis yielded 4 drug combinations.The results indicated that the drugs for post-stroke sequelae treated by LIU Mao-Cai are mild in nature and mainly have the actions of supporting healthy-qi and replenishing the deficient,and Astragali Radix and Codonopsis Radix are often used to replenish the vital energy,and Corni Fructus,Achyranthis Bidentatae Radix and Eucommiae Cortex are usually used to tonify the liver and kidney.Moreover,simultaneous treatment of phlegm and blood stasis,and simultaneous application of purging and nourishing therapeutics are also stressed.
ABSTRACT
Objective:To obtain the regulatory relationship between genes by screening the differentially expressed long non-coding ribonucleic acid(lncRNA), microRNA(miRNA) and messenger RNA(mRNA) in serum of patients with Yin and Yang syndromes of acute ischemic stroke, and to discuss the material basis and biological mechanism of formation of Yin and Yang syndromes of acute ischemic stroke from the transcriptome level. Method:The microarray chips were adopted to detect expression of lncRNA, mRNA and miRNA in serum of ischemic stroke patients with Yin and Yang syndromes and non-stroke subjects(10 cases each). Differential expression profiles related to Yin and Yang syndromes were selected by conjoint analysis. Further, the obtained differential genes were subjected to antisense lncRNA and mRNA co-expression analysis, gene ontology(GO) and Kyoto encyclopedia of genes and genomes(KEGG) functional pathway analysis, and the intergenic regulatory relationship was obtained to predict the target genes of lncRNA. Partial differential genes in 40 patients(10 with Yang syndrome and 30 with Yin syndrome) were verified by real-time fluorescence quantitative polymerase chain reaction(Real-time PCR). Result:The expression of 227 lncRNA, 54 mRNA and 4 miRNA were closely related to Yang syndrome, 394 lncRNA and 206 mRNA were closely related to Yin syndrome. Antisense lncRNA RP11-647P12.1 and RP11-677M14.2 may regulate the expression of neuron-derived neurotrophic factor(NDNF) and neurogranin(NRGN) by up-regulating the expression level in Yang syndrome. The differential expression of mRNA between Yin syndrome and Yang syndrome was mainly related to neurotransmitter receptor activity regulation, endocrine hormone regulation, inflammatory response, renin-angiotensin system and other pathways. Conclusion:There are differences in the expression profiles of lncRNA, miRNA and mRNA between Yin syndrome and Yang syndrome in acute ischemic stroke, which may be regulated by multiple pathways, such as blood pressure regulation, adrenergic receptor regulation, renin-angiotensin system and γ-aminobutyric acid(GABA). The transcriptome characteristics provide scientific basis for studying the biological basis of Yin syndrome and Yang syndrome in acute ischemic stroke.