Prospects of a comprehensive evaluation system for traditional Chinese medicine services / 中西医结合学报

Traditional Chinese medicine (TCM) is a unique health resource in China and one of the main representative traditional medicines globally. TCM has formed a new way of looking at medical practices, health care, scientific research, education, industry and culture. It focuses on promoting and safeguarding the health of people, with an increasing contribution to economic and social development. Establishing a comprehensive evaluation system in accordance with the characteristics of TCM services could promote the scientific merit and the standardization of services management. This would improve health service quality and the social and economic benefits of TCM. It would broaden the field of TCM services research. It would also provide the basis for the formulation of relevant government policies. This study estimates the prospect of establishing a comprehensive evaluation system of TCM services.

Study on interference effect of Sijunzi decoction on brain-gut CaM/CaMK II of spleen Qi deficiency syndrome rats / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the dynamic time-phase expressions of key genes of brain-gut CaM signal pathway of spleen Qi deficiency rats and the intervention effect of Sijunzi decoction.</p><p><b>METHOD</b>Male Wistar rats were randomly divided into the normal control group, model 14 d, 21 d, 28 d groups, and Sijunzi decoction 14 d, 21 d, 28 d groups. Except for the normal control group, the remaining groups were included into the spleen Qi deficiency model with the bitter cold breaking Qi method (ig 7.5 g · kg⁻¹ · d⁻¹ of Rheum officinale, Fructus aurantii immaturus, Magnolia officinalis preparation) and the exhaustive swimming method. On the 7th day after the modeling, the Sijunzi decoction groups were orally administered with Sijunzi decoction 20 g · kg⁻¹ · d⁻¹. The expressions of key genes CaM/CaMK II of CaM signaling pathway in hippocampus and intestine at different time points by immunohistochemical method and Western blot. At the same time, the intervention effect of Sijunzi decoction on spleen Qi deficiency rats and its mechanism were analyzed.</p><p><b>RESULT</b>Spleen Qi deficiency rats showed higher intestinal CaM/CaMK II expression and lower hippocampus CaM/CaMK II expression than normal rats (P < 0.05, P < 0.01). After the treatment of Sijunzi decoction, spleen Qi deficiency rats showed reduction in intestinal CaM/CaMK II expression and increase in hippocampus CaM/CaMK II expression (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>The formation of spleen Qi deficiency syndrome may be related to the high expression of CaM/CaMK II in small intestine tissues and its low expression in hippocampus tissues. Sijunzi decoction may achieve the therapeutic effect in spleen Qi deficiency syndrome by reducing the CaM/CaMK II expression in intestinal tissues and increasing it in hippocampus tissues.</p>

Allergens-induced sensitization alters airway epithelial adhesion molecules expression in mice / 生理学报

To explore the relationship between the epithelial adhesion molecules and immune responses of airway epithelium, we observed the expression of integrin β4 and intercellular adhesion molecule-1 (ICAM-1) in the mice airway epithelium after sensitization with allergens. BALB/c mice were sensitized with intraperitoneal injection of ovalbumin (OVA) or house dust mite (HDM) and then developed airway hyper-responsiveness as determined by barometric whole-body plethysmography. Both OVA and HDM sensitization led to increases of the number of peripheral leukocytes as well as inflammatory cells infiltration in lungs. OVA sensitized mice showed more severe inflammatory cells infiltration than HDM sensitized mice. Immunohistochemistry analysis of mice lung tissues revealed that sensitization with both allergens also led to a decrease of integrin β4 expression and an increase of ICAM-1 expression in airway epithelia. OVA sensitized mice showed a more significant increase of ICAM-1 expression compared with HDM sensitized mice. siRNA mediated silencing of integrin β4 gene in 16HBE cells resulted in an up-regulation of ICAM-1 expression. Our results indicate a possible role of airway epithelial adhesion molecules in allergen-induced airway immune responses.

Evaluation of the value of shear wave elastography in differential diagnosis of benign and malignant breast lesions by logistic regression / 中华医学超声杂志（电子版）

Objective To obtain the elasticity value of solid breast lesions with supersonic shear wave elastrography (SWE) and apply the binary Logistic regression in order to evaluate the value of SWE in differential diagnosis of benign and malignant breast lesions. Methods SWE quantitative elastography was preformed in 91 breast lesions of 91 patients in Zhenghai Longsai Hospital to obtain the maximum and mean elasticity value (Emax, Emean). And receiver operating characteristic (ROC) curves were used to assess the diagnostic performance. A Logistic regression for the gray scale ultrasound and the elastic modulus was conducted with multiple variables including Emax, Emean, border, echo, form, calcification. Results Pathological examination showed 73 benign lesions and 18 malignant lesions. Emax and Emean of malignant lesions were obviously higher than those of benign lesions [(99.73±41.15) kPa vs (38.59±14.28) kPa, (61.45±24.88) kPa vs (23.46±11.44) kPa, t=-15.05,-14.12, both P=0.000]. The area under the ROC curve of Emax and Emean were 0.932 and 0.915. Taking 63.70 kPa as the threshold of Emax, the sensitivity was 77.8%and the speciifcity was 97.3%. Then taking 44.22 kPa as the threshold of Emean, the sensitivity was 83.3%and the speciifcity was 94.5%. The results of Logistic regression analysis showed:the 3 most effective variables were Emax, border of the lesions and Emean. Conclusions The multivariate analysis model of binary Logistic regression can select the valuable indexes of differential diagnosis of benign and malignant breast lesions. SWE plays an important role in differentiating benign and malignant lesions and it is valuable in clinical practice.

The expression and possible role of SENP1 in the pulmonary vascular wall of rat during the development of hypoxic pulmonary hypertension / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the dynamic expression and role of SENP1 (SUMO-specific proteases-1) in the pulmonary vascular wall of rat during the development of hypoxic pulmonary hypertension (HPH).</p><p><b>METHODS</b>Forty adult male Wistar rats were randomly divided into 5 groups (n = 8), and exposed to normoxia (Control group) or exposed to hypoxia for 3, 7, 14 or 21 d, respectively. The HPH models were established by normobaric intermittent hypoxia. Mean pulmonary arterial pressure (mPAP), right ventricle hypertrophy index (RVHI), and vessel morphometry were measured. Reverse transcriptase-polymerase chain reaction(RT-PCR) and in situ hybridization were used to determine the mRNA expression of SENP1. Immunohistochemistry and Western blot were used to determine the protein expression of SENP1.</p><p><b>RESULTS</b>The hypoxic rats developed pulmonary vascular remodeling in pulmonary arterioles after 7 d of hypoxia exposure. Pulmonary vascular remodeling in pulmonary arterioles significantly increased after 14 d of hypoxia. The level of mPAP in hypoxic rats increased significantly after 7 d of hypoxia, reached its peak after 14 d of hypoxic exposure. RVHI was markedly increased after 14 d of hypoxia. In situ hybridization and immunohistochemical analysis showed that SENP1 mRNA and protein were positively stained in control. SENP1 mRNA expression had little changes after exposure to hypoxia compared with the control, however, SENP1 protein expression was declined gradually after 7 d of hypoxia. The results of RT-PCR and Western blot showed that the same dynamic expression of SENP1 mRNA and protein in lung tissues of rats. Linear correlation analysis showed that SENP1 protein were negatively correlated with mPAP, pulmonary vascular remodeling index and RVHI.</p><p><b>CONCLUSION</b>Under chronic hypoxia, SENP1 protein can be degradated. The dynamic expression of SENP1 protein may play a role in implicating in the development of HPH.</p>

The effect of transcription factor KLF2 in expression of gamma-GCS depend on regulation by Nrf2 in lung of rats with chronic obstructive pulmonary disease / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To study the expression of lung Krüppel-like transcription factor (KLF2/LKLF) in lung tissues of rats with chronic obstructive pulmonary disease (COPD) and the relationship between KLF2 and NF-E2-related factor 2 (Nrf2), and make further explore the effects of KLF2 on the expression of gamma-glutamylcysteine synthetase (gamma-GCS).</p><p><b>METHODS</b>Twenty-two male SD rats were randomly divided into a COPD group (n = 10) and a normal control group (n = 11). The rat model of COPD established by cigarette smoking and intratracheal instillation of lipopolysaccharide (LPS), and lung tissues were obtained. The expressions of KLF2, Nrf2, gamma-GCS mRNA and protein in lung tissues were measured by immunohistochemistry (IHC), Western blot, in situ hybridization (ISH) and reverse transcription-polymerase chain reaction (RT-PCR). To explore the relationship between KLF2 and Nrf2 protein,we utilize the method of co-immunoprecipitation (CO-IP).</p><p><b>RESULTS</b>IHC and Western blot showed that protein expressions of KLF2, Nrf2, gamma-GCS were higher in the lung tissues from rats with COPD than those in the control groups (all P < 0.05). The levels of KLF2, gamma-GCS mRNA were markedly increased in the COPD group (all P < 0.01) while Nrf2 mRNA expression in COPD group had no significant difference with that in control group ( P > 0.05). CO-IP result showed that KLF2 were obviously present in immunoprecipitates of Nrf2 (P < 0.01) . Linear correlation analysis showed that the level of KLF2 protein was positively correlated with the level of Nrf2 protein (P < 0.05), and KLF2, Nrf2 proteins were positively correlated with gamma-GCS mRNA and protein (all P < 0.05).</p><p><b>CONCLUSION</b>The expression of KLF2 is significantly up-regulated in COPD, which maybe up-regulate gamma-GCS mRNA expression by increasing Nrf2 expression and nuclear translocation against oxidative stress.</p>

The roles of PPAR-gamma/PGC-1alpha to Nrf2/gamma-GCS-h in lung of guinea pigs with bronchial asthma / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h in lung of guinea pigs with bronchial asthma, and to explore the roles of them.</p><p><b>METHODS</b>Forty adult male guinea pigs were randomly divided into 4 groups: the control group (group A), asthmatic group ( group B), dexamethasone group (group C) and rogridone group (group D), 10 guinea pigs in each group. The asthmatic model was established by the ovalbumin challenge method. Expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h mRNA in lung tissue were assayed by in situ hybridization. Expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h protein were detected by immunohischemistry and by Western blot.</p><p><b>RESULTS</b>In situ hybridization showed that the expressions of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h mRNA in lung tissue were the lowest in group B and the comparison among groups showed statistical significant (all P < 0.01). Immunohistochemistry and Western blot indicated that the value of PPAR-gamma/PGC-1alpha and Nrf2/gamma-GCS-h protein in lung tissue were the lowest in group B, and expressed primarily in nucleus, the differences being statistically significant (all P < 0.01). There was positive correlation between PPAR-gamma and PGC-1. gamma-GCS-h mRNA also positively correlated between PPAR-gamma/PGC-1alpha and Nrf2 in nucleus, and the expression of Nrf2 was also positively correlated with PPAR-gamma/ PGC-1alpha.</p><p><b>CONCLUSION</b>In acute asthmatic models induced by ovalbumin, the expressions of PPAR-alpha/PGC-1alpha and Nrf2/gamma-GCS-h were decreased, and PPARgamma/PGC-1alpha could up-regulate the expressions of Nrf2/gamma-GCS-h to increase the antioxidant defense of tissues, thus being implicated that PPARgamma/PGC-1alpha might play important roles in the pathogenesis and prevention of asthma.</p>

Thinking on hospital construction of integrated traditional Chinese and Western medicine / 中国中西医结合杂志

Through supervising the construction of some key hospitals of integrated Chinese and Western medicine (ICWM), the characteristic indexes and problems concerning hospital construction were analyzed. It was pointed out that in order to improve the level of construction and administration of ICWM hospitals, the overall effect of construction should be paid attention to, the cultivation of ICWM professionals should be strengthened and the ICWM standard based assessment on clinical efficacy should be stressed. Besides, the strategies on administration pattern of ICWM hospitals were discussed.

Phase I study of docetaxel combined with carboplatin in patients with non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To determine the maximum tolerated dose (MTU) and dose-limiting toxicity (DLT) of Docetaxel and Carboplatin in patients with non-small cell lung cancer.</p><p><b>METHODS</b>Docetaxel was given at escalating doses until MTD was determined from the initial dose of 65 mg/m2 to 75 mg/m2, 85 mg/ m2 on dl. Carboplatin was targeted to an area under the plasma concentration curve of 5 using Calver's equation on dl. The treatment cycle was repeated every 3 weeks.</p><p><b>RESULTS</b>16 patients received TXT and CBP for total of 54 courses (median four courses). Neutropenia was the dose-limiting toxicity. The MTD of TXT is 85 mg/m2.</p><p><b>CONCLUSION</b>We recommend TXT 75 mg/m2 on d1 and CBP with a target AUC of 5 on d1, 3weeks repeated for chemotherapy in naïve patients with NSCLC.</p>

Nodular regenerative hyperplasia of the liver:a clinical study of 12 cases / 中华消化杂志

Objective To review the clinical,histological and diagnostic aspects of 12 documented cases of nodular regenerative hyperplasia of the liver(NRHL),to make this condition be understood and dealt with better. Method Twelve NRHL cases were diagnosed based on liver biopsy from 300 portal hypertension patients who had been underwent splenectomy.Imaging studies were performed as part of the diagnostic evaluation.Clinical manifestation and biochemical tests were recorded at the time of diagnosis.Management and prognosis were also reviewed.Results Most patients were complicated with autoimmune disease,6 cases were diagnosed systemic lupus erythematosus and 1 was Crohn's disease and 1 suspected ulcerative colitis.Six cases were treated by prednisone and 3 cases by immunosuppressant.Eleven cases had suffered from portal hypertension.All cases had no history of viral hepatitis.Biochemical tests showed mild increase of liver enzyme and relative normal synthetic liver function.The histological finding was nodular in the hepatic parenehyma,with mild periportal fibrosis,intraportal lymphocytic infiltration,narrow and obstruction of branch of portal vein,and lack of hepatocyte necrosis.All cases were diagnosed liver cirrhosis and portal hypertension before operation.Management was directed to portal hypertension and varices bleeding with satisfactory results.Most of them keep a stable condition during the follow-up. Conclusion The NRHL was uncommon and its cause and pathogenesis was unclear,may be related with immune and hepatic blood circulation disorder.It should be considered in patients with unexplained portal hypertension and distinguished it from liver cirrhosis.Liver biopsy confirms the diagnosis.Management directed to portal hypertension may improve clinical condition.