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Objective:To observe the effect of Puerariae Lobatae Radix on type 2 diabetes mellitus (T2DM) rats and related mechanism. Method:Ninety SD rats were divided into normal group, model group, metformin group, Puerariae Lobatae Radix high dose group, Puerariae Lobatae Radix medium dose group and Puerariae Lobatae Radix low dose group, 15 rats in each group. The rats in abnormal group were fed with high-fat and high sugar diet for 4 weeks, and then T2DM model was established by intraperitoneal injection of 40 mg·kg-1 streptozotocin (STZ). Puerariae Lobatae Radix high-dose group was intragastrically administered with 2.1 g·kg-1 of Puerariae Lobatae Radix extract powder, Puerariae Lobatae Radix medium-dose group was intragastrically administered with 1.4 g·kg-1 of Puerariae Lobatae Radix extract powder, Puerariae Lobatae Radix low-dose group was intragastrically administered with 0.7 g·kg-1 of Puerariae Lobatae Radix extract powder, 0.2 g·kg-1 of metformin hydrochloride in metformin group, distilled water once a day in normal group and model group. After 8 weeks, fasting blood glucose (FBG), glycosylated serum protein (GSP), insulin (FINS), triglyceride (TG), cholesterol (TC) were measured, and insulin resistance index （HOMA-IR） was calculated. The expression of tumor necrosis factor -α(TNF-α) was observed by immunohistochemistry. Western blot was used to detect the protein expression of glucose regulatory protein 78 （GRP78）, activated transcription factor 6 （ATF6） in pancreatic tissue. Result:Compared with normal group, the contents of FBG, GSP, TG, TC, FINS, TNF-α in model group were significantly increased (P<0.05), the HOMA-IR was significantly increased (P<0.05), the protein expressions of GRP78 and ATF6 in pancreatic tissue were significantly increased (P<0.05). Compared with model group, the contents of FBG, GSP, TG, TC, FINS and TNF-α in the metformin group and Puerariae Lobatae Radix high, medium and low dose groups were significantly decreased (P<0.05), HOMA-IR decreased significantly (P<0.05), and the expression of GRP78 and ATF6 protein in pancreatic tissue decreased significantly (P<0.05). Conclusion:Puerariae Lobatae Radix can significantly improve insulin resistance in T2DM rats, inhibit the expression of inflammatory factor TNF-α in pancreatic tissue, reduce the protein expression of GRP78 and ATF6 in pancreatic tissue.
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Objective:To investigate the effect of Buyang Huanwu Tang in resisting lipopolysaccharide (LPS)-induced macrophage activation and autophagy through phosphatidylinositol 3-kinase/protein kinase B/mammalian rapamycin target protein (PI3K/Akt/mTOR) signaling pathway. Method:The cell counting kit-8 (CCK-8) method was used to screen out the optimal LPS concentration for inducing the activity of RAW264.7 macrophages. RAW264.7 macrophages were treated separately with PI3K blocker 3-methyladenine(3-MA) (5 mmol·L-1), Akt blocker MK2206 (5 μmol·L-1), mTOR blocker Rapamycin (10 μmol·L-1), Beclin1 blocker Spautin-1 (5 μmol·L-1), different doses of Buyang Huanwu Tang serum (5%, 10%, 20%) and the optimum concentration of LPS for 24 h. The concentrations of inflammatory factors interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in RAW264.7 macrophages were detected by enzyme-lined immunosorbent assay(ELISA). Western blot was used to detect the expression levels of phosphorylated PI3K, phosphorylated Akt, phosphorylated mTOR protein, microtubule light chain protein 3 (LC3), ubiquitin-binding protein 1 (p62) and Beclin-1. The autophagy flow of RAW264.7 cells was detected by transfection with autophagy double-labeled adenovirus. Result:Results of CCK-8 showed the highest cell viability when 10 mg·L-1 LPS was applied. The concentrations of IL-1β, IL-6 and TNF-α in the model group were significantly higher than those in the blank group (PPβ, IL-6 and TNF-α (PPPPPPPPConclusion:Buyang Huanwu Tang can resist LPS-induced macrophages activation and autophagy, inhibit macrophage inflammatory response, regulate PI3K/Akt/mTOR signaling pathway, and inhibit the excessive occurrence of autophagy.
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Objective:To obtain the health production efficiency performance and its changing trend of China's health system in recent years by adopting international comparison,and to provide policy recommendations to improve health production efficiency.Methods:It described the relative efficiency of health system in China by reporting the international ranking of health inputs and outputs indicators.It employed total health expenditure per capita as input indicator and health outcomes as output indicators to construct frontier health production function,China's health production function and marginal health production function based on data envelopment analysis and production function method.Results:In the past decade,compared to efficient countries with similar health development level,the efficiency performance of China's health system was between 65％ and 73％.With the increasing trend of health investment,China's marginal health output had been declined and tended to be gentle.Conclusion:The current health production efficiency in China was relatively high.However,how to improve the efficiency and marginal health output was the focus of future health system reform under the background of rapid growth of total health expenditure.
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OBJECTIVE@#To evaluate the comprehensive technical efficiency of the tertiary public hospitals in Beijing between 2006 and 2015 and explore its influencing factors, so as to propose corresponding policy suggestions.@*METHODS@#The data envelopment analysis was employed to evaluate the comprehensive technical efficiency, pure technical efficiency and scale efficiency of the tertiary public hospitals in Beijing. Malmquist index model was used to analyze the changes of the above three dynamic efficiencies. Finally, randomeffect panel tobit model was utilized to analyze the influencing factors of the comprehensive technical efficiency.@*RESULTS@#The average comprehensive technical efficiency and pure technical efficiency of the tertiary public hospitals in Beijing were relatively high, and they had respectively increased from 0.44 and 0.51 in 2006 to 0.62 and 0.68 in 2015, and the highest proportion of two kinds of efficiency values was between 0.5 and 0.8. Most of the scale efficiency values distributed between 0.8 and 1.0, and the majority of hospitals were in a state of decreasing returns to scale. The total factor productivity of hospitals had been increasing at an average rate of 5.78% per year due to the double progress of technical efficiency and technology at annual rates of 3.77% and 1.94% respectively, further decomposing technological efficiency change, and the pure technical efficiency change increased at the speed of 3.21% per year, and the annual average rate of progress in scale efficiency was only 0.53%. The comprehensive technical efficiency was positively correlated with the turnover rate of beds, annual visits per doctor, the ratio of doctors to nurses, and negatively correlated with the number of beds, the ratio of outpatients to inpatients, the proportion of medical technical personnel, and the proportion of drugs.@*CONCLUSION@#Future health policies should strictly control the scale of tertiary public hospitals, pay attention to the innovation and application of hospital technology, change the hospital internal management level and management model, promote refined management, and achieve sustainable development.