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Objective: To evaluate the efficacy of endoscopic transnasal surgery for sinonasal and skull base adenoid cystic carcinoma (ACC), and to analyze the prognostic factors. Methods: Data of 82 patients (43 females and 39 males, at a median age of 49 years old) with sinonasal and skull base ACC who were admitted to XuanWu Hospital, Capital Medical University between June 2007 and June 2021 were analyzed retrospectively. The patients were staged according to American Joint Committee on Cancer (AJCC) 8th edition. The disease overall survival(OS) and disease-free survival(DFS) rates were calculated by Kaplan-Meier analysis. Cox regression model was used for multivariate prognostic analysis. Results: There were 4 patients with stage Ⅱ, 14 patients with stage Ⅲ, and 64 patients with stage Ⅳ. The treatment strategies included purely endoscopic surgery (n=42), endoscopic surgery plus radiotherapy (n=32) and endoscopic surgery plus radiochemotherapy (n=8). Followed up for 8 to 177 months, the 5-year OS and DFS rates was 63.0% and 51.6%, respectively. The 10-year OS and DFS rates was 51.2% and 31.8%, respectively. The multivariate Cox regression analysis showed that late T stage and internal carotid artery (ICA) involvement were the independent prognostic factors for survival in sinonasal and skull base ACC (all P<0.05). The OS of patients who received surgery or surgery plus radiotherapy was significantly higher than that of patients who received surgery plus radiochemotherapy (all P<0.05). Conclusions: Endoscopic transonasal surgery or combing with radiotherapy is an effective procedure for the treatment of sinonasal and skull base ACC. Late T stage and ICA involvement indicate poor prognosis.
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Male , Female , Humans , Middle Aged , Carcinoma, Adenoid Cystic/surgery , Retrospective Studies , Skull Base/pathology , Disease-Free Survival , PrognosisABSTRACT
Objective:We aimed to analyze the spectrum of diseases of Experienced Ten Acupoints in clinical studies, in order to provide reference for further clinical trials.Methods:The Chinese academic journals full-text database (CNKI),Chinese science and technology journals full-text database (VIP),Wanfang database and Chinese biomedical database (SinoMed), PubMed, Cochrane Library and Web of Science Database were searched from the incecption to October, 2021. The quantitative analyses were conducted on the characteristics of the clinical studies, including years of publication, journals, affiliations of authors, interventions, diseases, types of studies, evaluation of efficacy, rate of citations.Results:A total of 81 articles were included in 44 journals. The majority types of studies were RCTs, the main intervention was acupuncture as well as acupuncture combined with Traditional Chinese Medicine or medicine. For types of diseases, digestive system diseases account for the major part (66.67%), followed by nervous system diseases (17.28%).Conclusions:The studies associated with Experienced Ten Acupoints were relatively few, the corresponding spectrum of diseases was in limit range, and experimental studies lacks. This study suggested that the clinicians should pay attention to the classical acupoints prescriptions, and the research progress of clinical trials should be more standardized.
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@#In order to investigate the effects of neuroprotective peptide SNP-9 which is derived from silk fibroin hydrolysate on the injury of the blood-brain barrier in Alzheimer′s disease (AD), Aβ25-35 was used to damage brain microvascular endothelial cells bEnd.3 to establish AD injury model and drug intervention was performed.MTT assay was used to detect the effects of SNP-9 and Aβ25-35 on cell viability.RT-qPCR was used to determine the effects of SNP-9 and Aβ25-35 on the mRNA levels of tight junctions (TJs)-related ZO-1, occludin and claudin-5.Western blot was used to detect the effects of SNP-9 and Aβ25-35 on the protein levels of TNF-α, phosphorylated NF-κB, NF-κB, IκBα and RAGE.The results showed that SNP-9 reduced bEnd.3 cell damage induced by Aβ25-35, and improved the abnormal mRNA levels of ZO-1, occludin and claudin-5 in model cells.It alleviated the abnormal protein levels of TNF-α, phosphorylated NF-κB, IκBα and RAGE induced by Aβ25-35. These results suggest that SNP-9 may regulate the levels of TNF-α in model cells by influencing RAGE/NF-κB pathway, and then ameliorate TJs-related abnormalities and alleviate bEnd.3 cell injury induced by Aβ25-35.
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Objective: To investigate the effect of maternal exposure to lipopolysaccharide during pregnancy on allergic asthma in offspring in mice. Methods: Animal experimental research was carried out from June 2019 to June 2021.Pregnant C57BL/6J mice were randomly divided into 2 groups by intraperitoneal injection with 7 μg/kg lipopolysaccharide (LPS) or phosphate buffered saline (PBS) at day 15.5 of gestation. After birth, 6 offspring were randomly chosen from each group at the age of 4 weeks, and stimulated with house dust mites (HDM) or PBS, further divided into 4 groups, such as LPS+PBS group, LPS+HDM group, PBS+PBS group, PBS+HDM group, with 3 mice in each group. The cough and wheezing were observed, the histological changes in lung tissue were examined after HE staining, and the expression of inflammatory factors including interleukin (IL)-4, IL-6, IL-17A, IL-23, interferon (IFN)-α and IFN-β in the lung tissue were detected by high-throughput liquid protein chip detection. T test or rank sum test was used for the comparison among these groups. Results: The asthma-like airway inflammation was more obvious in PBS+HDM group after stimulated by HDM than that in PBS+PBS group, nevertheless, this manifestation in LPS+HDM group was milder than that in PBS+HDM group. HE staining showed that inflammatory cell aggregation in the lung tissue in PBS+HDM group was significantly higher than that in PBS+PBS group (4.0 (3.5, 4.0) vs. 0 (0, 0.5), Z=2.02, P=0.043), while it was much lower in LPS+HDM group compared to PBS+HDM group (1.0 (0.5, 1.5) vs. 4.0 (3.5, 4.0), Z=1.99, P=0.046). High-throughput liquid protein chip detection of lung tissue showed that IL-6, IL-23 and IFN-β levels were significantly higher in PBS+HDM group when compared to those in PBS+PBS group ((114±3) vs. (94±4) ng/L, (210±4) vs. (173±7) ng/L, (113±2) vs. (94±4) ng/L, t=4.37, 4.84, 3.96, all P<0.05), while the levels of IL-6, IL-23, IFN-α, IFN-β in LPS+HDM group were significantly lower than those in PBS+HDM group ((87±5) vs. (114±3) ng/L, (171±7) vs. (210±4) ng/L, (16.1±0.6) vs. (20.9±0.3) ng/L, (95±1) vs. (113±2) ng/L, t=5.07, 5.07, 7.28, 7.47, all P<0.05). Conclusions: Prenatal low dose LPS exposure can reduce offspring's airway inflammatory reactions and prevent the development of allergic disease. Maternal infection during pregnancy may affect the occurrence and development of allergic asthma in offspring.
Subject(s)
Animals , Female , Humans , Mice , Pregnancy , Asthma/etiology , Disease Models, Animal , Inflammation , Interleukin-23 , Interleukin-6 , Lipopolysaccharides , Lung , Maternal Exposure/adverse effects , Mice, Inbred C57BL , PyroglyphidaeABSTRACT
Sophorae Tonkinensis Radix et Rhizoma （STRER） is a commonly used Chinese medicine in clinical practice， which has the effects of clearing heat， removing the toxin， alleviating edema， and relieving sore throat. In recent years， the clinical reports of STRER-induced poisoning have gradually increased， with neurotoxicity and hepatotoxicity as the main characteristics of the acute attack. Timely treatment will lead to the good prognosis， but long-term or high-dose administration will cause irreversible damage. Therefore， the safety of clinical use of STRER should be highlighted. The chemical components in STRER mainly include alkaloids， flavonoids， triterpenoids， triterpenoid saponins， and polysaccharides， as well as small amounts of proteins， organic acids， and trace elements， where alkaloids both serve as the important material basis for the pharmacodynamic action and the main substances causing toxicity. The adverse events induced by STRER and its alkaloids include nerve injury, Hepatic injury, cardiovascular injury, kidney injury and reproductive injury， and gastrointestinal reaction. Quinolizidine alkaloids are the main toxic components， mainly including matrine， oxymatrine， cytisine， sophocarpine， oxysophocarpine， sophoridine， sophoramine， and lehmannine. Many studies have been carried out on the toxicity of different extracts and alkaloids of STRER in China and abroad， but there are no comprehensive and detailed reports on the toxicity mechanism of alkaloids in STRER. As a Chinese medicine， STRER is widely used. It's an urgent problem to clarify the material basis and mechanism of toxicity caused by STRER and reduce the toxicity for good clinical application. The present study reviewed the components of alkaloids， toxicity， and toxic mechanism of extracts and alkaloids in STRER to provide the basis for further development and clinical safe and effective application of STRER.
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BACKGROUND@#Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. @*METHODS@#In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. @*RESULTS@#We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. @*CONCLUSION@#Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.
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Objective To establish an ion chromatography method for the salt form determination of new psychoactive substances （NPS）. Methods The method of conducting qualitative and quantitative analysis of six types of organic acid ions （acetate ion, tartrate ion, maleate ion, oxalate ion, fumarate ion, citrate ion） and five types of inorganic anions （fluoride ion, chloride ion, nitrate ion, sulfate ion, phosphate ion） in NPS sample by ion chromatography was developed. The salt forms of 222 seized NPS samples （103 samples with synthetic cannabinoids, 81 samples with cathinones, 44 samples with phenylethylamines, 12 samples with tryptamines, 7 samples with phencyclidines, 6 samples with piperazines, 2 samples with aminoindenes, 26 samples with fentanyls and 43 samples with other types of NPS） were analyzed by this method. Results Each anion had good linearity in the corresponding linear range, the correlation coefficients （r） were greater than 0.999, the limits of detection were 0.01-0.05 mg/L, and the limits of quantitative were 0.1-0.5 mg/L. Except that 5F-BEPIRAPIM was hydrochloride, the salt forms of the other 102 synthetic cannabinoids were all base. The salt form of 81 cathinone samples, 44 phenylethylamine samples, 7 phencyclidine samples and 2 aminoindene samples were all hydrochloride. The salt forms of tryptamine samples included base, hydrochloride, fumarate and oxalate. The salt forms of piperazine samples included base and hydrochloride. The salt forms of fentanyl samples and samples of other types included base, hydrochloride and citrate. Conclusion Ion chromatography is a simple, accurate and efficient method for determining the salt form of NPS samples, which makes the qualitative and quantitative conclusions of NPS more scientific and rigorous.
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Chromatography, Liquid , Gas Chromatography-Mass Spectrometry , Ions , Psychotropic Drugs/chemistryABSTRACT
Objective To study the qualitative analysis strategy for unknown synthetic cannabinoid in the suspicious herbal product when no reference substance is available. Methods The synthetic cannabinoid in herbal blend was extracted with methanol. The extract was concentrated by rotary evaporator and separated and purified by preparative liquid chromatography, to obtain high purity synthetic cannabinoid sample. Gas chromatography-mass spectrometry （GC-MS）, ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-QTOF-MS） and nuclear magnetic resonance （NMR） were used to determine the structure of the prepared compound. Results High purity unknown sample （10 mg） was obtained by preparative liquid chromatography. The sample was analyzed by GC-MS, UPLC-TOF-MS and NMR, and through spectrum analysis, the unknown synthetic cannabinoid was determined as 5F-EDMB-PICA. Conclusion The method to extract unknown synthetic cannabinoid from low content herbal products by preparative liquid chromatography was established, and the structure of the unknown sample was identified by comprehensive use of GC-MS, UPLC-QTOF-MS and NMR. The information will assist forensic laboratories in identifying this substance or other compounds with similar structures in their casework.
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Cannabinoids , Chromatography, High Pressure Liquid , Chromatography, Liquid , Gas Chromatography-Mass Spectrometry , Mass SpectrometryABSTRACT
@#Liquid preparations are the commonly used oral dosage forms in pediatric clinical practice.This review introduces the pediatric oral liquid dosage forms including extemporaneous preparation of oral liquid formulations, oral liquid sustained and controlled release formulations, nanosuspensions, nanoemulsions, self-nanoemulsions and milk-based liquid formulations.In addition, the efficient flavoring and taste masking technologies, using safe pharmaceutical excipients, high-demanding technical standards and verification strategies, establishing excellent workflow management systems can contribute to the development and application of pediatric oral liquid dosage forms which are safer, more effective and better compliant.This review is helpful in laying the relevant theoretical foundation for further studies on pediatric oral liquid dosage forms.
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BACKGROUND@#Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. @*METHODS@#In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. @*RESULTS@#We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. @*CONCLUSION@#Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.
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Objective To study the influence of halogenated hydroxyl-alkanes inhalation anesthetic on the determination of ethanol content in blood. Methods Halogenated hydroxyl-alkanes were analyzed by headspace gas chromatography with double column confirmatory detection method. The influence of halogenated hydroxyl-alkanes on determination of ethanol content in blood sample by headspace gas chromatography was explored under the different detection conditions of KB-BAC1/ KB-BAC2 and J&W DB-ALC1/DB-ALC2 gas chromatographic column. Results The retention time of sevoflurane and enflurane was similar to that of ethanol and tert butanol respectively when using the J&W DB-ALC1/DB-ALC2 gas chromatographic column, and interfered with the detection of ethanol content in blood; only J&W DB-ALC1 gas chromatographic column can separate the sevoflurane and ethanol components, so as to eliminate their influence on the detection of ethanol content in blood. When using KB-BAC1/KB-BAC2 gas chromatographic column, the retention time of sevoflurane, isoflurane and ethanol is similar, especially that of sevoflurane and ethanol, and sevoflurane obviously interferes with the determination of ethanol content in blood. Conclusion Halogenated hydroxy-alkanes interfere with determination of ethanol content in blood by headspace gas chromatography. The interference can be discriminated effectively by choosing the suitable chromatographic column and double column confirmatory detection.
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Alkanes , Anesthetics, Inhalation , Ethanol , Isoflurane , SevofluraneABSTRACT
The theory on four seas is a kind of view to explain the longitudinal and horizontal distribution relationship of meridians and collaterals by ancient scholars. The authors were attempted to explore it by taking the theory on sea of marrow as example in terms of literature analysis. In (Chapter 33 of ), it is recorded that sea of marrow flows into two locations, but they are not the acupoint sites for treatment. Based on the comprehensive literature investigation, it is known that such two sites to which sea of marrow flows refer to a kind of boundaries so that the range of sea of marrow is determined, the function of it explored, and the controversy on "heart dominating mind" and "brain governing spirit" solved. It is defined that the function of sea of marrow is the macro-conception of (mind, spirit) that is modulated by vital movement information. Additionally, in association with meridian literature analysis, as well as acupoint textual research, it finally focuses on Naohu (GV 17) that is the critical point in the application of the theory on sea of marrow. In clinical application of such theory, the importance should be attached to the governor vessel, Naohu (GV 17) and their spatial system of bone.
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Humans , Acupuncture Points , Acupuncture Therapy , Bone Marrow , MeridiansABSTRACT
@# Objective: To investigate the expressions of programmed death ligand 1（PD-L1）in triple-negative breast cancer (TNBC) and its correlation with angiogenesis. Methods: 120 cases of TNBC patients who underwent surgery in the Fourth Hospital of Hebei Medical University from March 1, 2011 to June 1, 2012 were collected. The tumor tissues of patients were surgically resected and confirmed by pathology. PD-L1 protein expression in TNBC tissues of 120 patients was detected by tissue microarray combined with immunohistochemistry, and its relationship with various clinical indicators was analyzed. Blood vessels and lymphatic vessels were labeled withCD34andD2-40todetectmicrovesseldensity(MVD)andlymphaticvesseldensity(LVD)inTNBC.Results:Thepositiveexpression rate of PD-L1 in the tumor cells and interstitial infiltrating lymphocytes fromTNBC was 56.7% (68/120); No correlation was found between PD-L1 protein expression and the gender, age, histological grade, clinical stage, or tumor size of patients with TNBC (P>0.05), but related to the lymph node metastasis (P<0.05) and vascular thrombus (P<0.05). TNBC with high PD-L1 expression exhibited high incidence of lymph node metastasis and formation of vascular thrombus, and the expression of PD-L1 was positively correlated with MVD (r=0.500, P=0.02) as well as LVD (r=0.662, P=0.01). Log-Rank test showed that the survival time of TNBC patients with positive PD-L1 protein expression was significantly shorter than that of patients with negative expression (P<0.05). Cox multivariate analysis suggested that PD-L1 protein expression could be an independent prognostic factor for TNBC overall survival. Conclusion: PD-L1 plays an important role in TNBC angiogenesis and lymphangiogenesis, and is closely related to TNBC invasion and metastasis; blocking PD1/PD-L1 signal pathway is expected to be an effective new strategy for TNBC treatment.
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Objective@#To explore the dynamic variation trend of bronchial wall thickness (BWT) in severely burned patients combined with inhalation injury, and to determine the value of BWT to prognosis of patients.@*Methods@#Forty-three severely burned patients with inhalation injury hospitalized in Intensive Burn Department of the Affiliated Hospital of Nankai University (Tianjin No.4 Hospital) from July to November 2016, conforming to the study criteria, were divided into survival group (n=27) and death group (n=16) according to the prognosis of patients within 14 days after admission. All patients underwent fiberoptic bronchoscopy and inhalation injury rating based on abbreviated injury scale at admission. High resolution CT examination was performed in patients of two groups at admission and 24 h post admission, 3, 7, and 14 d post admission to measure the BWT of right superior lobar bronchus trunk opening. Receiver operating characteristic curves of rating of inhalation damage at admission and BWT at admission were drawn to evaluate the predictive value for death of 43 patients. Data were processed with chi-square test, independent sample t test, Wilcoxon rank sum test, analysis of variance for repeated measurement and least-significant difference-t test.@*Results@#(1) The numbers of patients rated as 0, 1, 2, 3, and 4 grade for inhalation injury in survival group and death group were 0, 19, 6, 2, and 0, and 0, 2, 7, 7, and 0, respectively. There were statistically significant differences between the two groups (Z=-3.79, P<0.01). (2) BWT of patients in death group at admission and 24 h post admission, 3, 7, and 14 d post admission was respectively (2.72±0.26), (3.18±0.22), (2.98±0.18), (2.29±0.17), and (1.45±0.21) mm, which was significantly larger than (2.24±0.15), (2.49±0.15), (1.51±0.17), (1.04±0.16), and (1.01±0.13) mm in survival group (t=7.55, 12.14, 27.11, 19.99, 7.11, P<0.01). BWT of patients in survival group and death group at 24 h post admission, 3, 7, and 14 d post admission showed statistically significant difference when compared with that at admission within the corresponding group (t=5.97, 16.63, 28.21, 38.57, 5.34, 3.31, 4.39, 6.48, P<0.01). BWT of patients in survival group and death group on 3, 7, and 14 d post admission was significantly smaller than that at 24 h post admission within the corresponding group (t=22.27, 34.02, 45.03, 2.77, 10.53, 10.59, P<0.01). BWT of patients in survival group and death group on 7 and 14 d post admission was significantly smaller than that on 3 d post admission within the corresponding group (t=10.49, 18.26, 9.57, 11.44, P<0.01). BWT of patients in survival group and death group on 14 d post admission was significantly smaller than that on 7 d post admission within the corresponding group (t=6.97, 6.15, P<0.01). (3) The total areas under ROC curves of inhalation injury rating at admission and BWT at admission for predicting death of 43 patients were 0.880 and 0.956, respectively (with 95% confidence intervals 0.768-0.991, 0.882-1.000, P<0.05). Grade 1.5 and 2.75 mm were respectively chosen as the optimal threshold values of inhalation injury rating at admission and BWT at admission, with sensitivity of 87.50%, 83.33% and specificity of 77.78%, 96.00%, respectively.@*Conclusions@#The BWT of survived and dead patients with severe burn and inhalation injury increases significantly post burn, while the BWT of survived patients restores to normal level faster. BWT can be used to assess the severity of inhalation injury and to predict death in severely burned patients combined with inhalation injury.
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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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Strategies and techniques are extremely important to improve the evaluation efficiency and fully guarantee the consistency of dosage forms. For preparations with a structural feature as solid dosage forms and particulate dispersion systems, the structures of dosage forms are the outcome of the specific formulation and production process, which determine the drug delivery behaviors as well as the pharmacokinetics of the dosage forms. Conventional techniques failed to quantitatively determine the structures of dosage forms. Synchrotron radiation micro-computed tomography is a new generation of structural quantitative characterization technology in revealing the internal structure of dosage forms with unprecedented capability for quantitative characterization of the static and dynamic structures of dosage forms, enabling to reversely analyze the production process and identify the structure differences between the generics and brand products. Based on synchrotron radiation micro-computed tomography methodology researches and applications in static structures (powders, particulate systems, tablets, films, membranes, etc.), dynamic structures (hydration) and de-formulation of production process, we have classified the structures of dosage forms into four levels from macro-scope to molecular level as dosage forms, granular intermediates for formulation, dynamic structure and molecular structures, and proposed dosage form structure based new strategy for consistency evaluation. Along with conventional dissolution/ release behavior similarity, the internal structure consistency ensures high consistency between the brand product and the generics.
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Objective:To evaluate the impact and analyze the mechanism of separating drug sales from medical services reform on the total medical expenditure containment of outpatient services in Beijing. Methods:The monitoring data and historical data from 89 third-level,78 second-level public hospitals,and 206 primary health institutions and community health service agencies,which participated in the reform,were analysed to estimate the impacts on outpa-tient service utilization and service price. The analysis was based on the data of the first and second quarters of 2016 outpatient and emergency department fee changes,and analysis of service utilization and service price factors on the im-pact of changes in outpatient and emergency services mechanism. Results:The total outpatients'expenditure in Beijing in the second quarter of 2017 was 17.38 billion yuan,representing a slight decrease of 1.14% than the expenditure in 2016. The growth rate reduced by 2.46%. Expenditure in third-level and second-level hospitals decreased by 2.82% and 3.02%,respectively,with reductions in growth rates of 4.06% and 3.74% respectively. Expenditure in primary institutions increased by 17.09%. The increase rate in the second quarter of 2017 was 26.28%,representing a remark-able increase compared to the rate in 2016(15.84%). The contribution from the medical institution service prices and service utilization to the change of outpatient and emergency medical expenditure containment was 6.98% and -7. 65%,respectively. For third-level hospitals,the contribution was 10.37% and -12.00%,respectively;second-level hospitals were 0.72% and -3.35%,respectively;and the primary health institutions was 6.08% and 9.57%. Con-clusions:Beijing's comprehensive reform of separating drug sales from medical services reform has effectively controlled the rising medical expenditure of outpatient services,mainly by adjusting outpatients service utilization between differ-ent level healthcare institutions.
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Objective:Based on the visualization function for gene network disturbance of Matlab platform,data mining method was used to directly observe transcriptonal changes in aorta vessel at short-time hyperglycemia condition.Methods:The information was down loaded from GEO database of NCBI.Using Matlab system to transfer the data set to a computer-readable structure,using data filter to obtain apparent gene expression disturbance profile after short-time hyperglycemia condition.Applying three clustering algorithms,based on DAVID platform to conduct gene ontology (GO) annotation and enrichment analysis in order to calibrate KEGG pathway and to form gene expression profile analysis.Results:Via data set screening,the pattern of gene expression was divided into 9 clusters by special algorithms.GO analysis indicated that obvious gene enrichments were found in acute inflammation reaction gene,myocardium remodeling gene,stabilizing intracellular calcium gene,cell cycle regulation gene,chemotactic effect gene;especially in mucopolysaccharide gene,glycoprotein structure related gene,fat catabolism gene and myofibril related gene.The above findings were identical to previous study.K-means clustering method presented that in hyperglycemia condition,up-regulated genes didn't return to normal level when blood glucose back to normal which mainly including cell cycle regulation gene,myocardium remodeling gene and stabilizing intracellular calcium gene.Conclusion:Our work provided a new explanation of diabetes metabolic memory;short-term hyperglycemia caused arterial damage was irreversible which incurred inefficient hypoglycemic therapy in coronary artery disease patients.
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AIM To investigate the effects of the compatibility of Ephedrae Herba (Mahuang) and Glycyrrhizae Radix et Rhizoma (Gancao) on pharmacokinetic changes of the plasma levels of glycyrrhizic acid,glycyrrhetinic acid and liquiritin by UPLC-MS/MS.METHODS Twelve SD rats were randomly divided into two groups and orally administered with Glycyrrhizae Radix et Rhizoma and Ephedrae Herba-Glycyrrhizae Radix et Rhizoma (2 ∶ 1) Decoction.Blood samples were collected at different time points,and the main pharmacokinetic parameters were calculated by DAS3.2.2 software.RESULTS Compared with Glycyrrhizae Radix et Rhizoma group,the AUC0-t and Cmax were decreased,the MRT0-t and t1/2z were extended,the Vz/F was increased for glycyrrhizic acid,glycyrrhetinic acid and liquiritin;the CLz/F was increased for glycyrrhizic acid and liquiritin;the Tmax of glycyrrhizic acid was shortened and the Tmax of glycyrrhetinic acid was extended.CONCLUSION After combining Glycyrrhizae Radix et Rhizoma and Ephedrae Herba,the bioavailability of glycyrrhizic acid,glycyrrhetinic acid and liquiritin are reduced,the elimination of them delays,and the distribution volume increases.
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Objective:Based on the visualization function for gene network disturbance of Matlab platform,data mining method was used to directly observe transcriptonal changes in aorta vessel at short-time hyperglycemia condition.Methods:The information was down loaded from GEO database of NCBI.Using Matlab system to transfer the data set to a computer-readable structure,using data filter to obtain apparent gene expression disturbance profile after short-time hyperglycemia condition.Applying three clustering algorithms,based on DAVID platform to conduct gene ontology (GO) annotation and enrichment analysis in order to calibrate KEGG pathway and to form gene expression profile analysis.Results:Via data set screening,the pattern of gene expression was divided into 9 clusters by special algorithms.GO analysis indicated that obvious gene enrichments were found in acute inflammation reaction gene,myocardium remodeling gene,stabilizing intracellular calcium gene,cell cycle regulation gene,chemotactic effect gene;especially in mucopolysaccharide gene,glycoprotein structure related gene,fat catabolism gene and myofibril related gene.The above findings were identical to previous study.K-means clustering method presented that in hyperglycemia condition,up-regulated genes didn't return to normal level when blood glucose back to normal which mainly including cell cycle regulation gene,myocardium remodeling gene and stabilizing intracellular calcium gene.Conclusion:Our work provided a new explanation of diabetes metabolic memory;short-term hyperglycemia caused arterial damage was irreversible which incurred inefficient hypoglycemic therapy in coronary artery disease patients.