Exploration of "Strengthening Kidney Yin" Method to Alleviate Female Reproductive Damage Caused by Glycosides of Tripterygium wilfordii Polyglycoside / 中国实验方剂学杂志

Tripterygium wilfordii polyglycosides are one of the most commonly used Tripterygium wilfordii preparations， which have anti-inflammatory and immune-regulating effects. Their unique therapeutic effect on some autoimmune diseases and kidney diseases is almost irreplaceable by other similar drugs， but the possible reproductive damage is the bottleneck that hinders their clinical application. In clinical use， female patients often suffer from menstrual cycle disorders， decreased menstrual flow， even amenorrhea， infertility， and other symptoms， and the main toxic mechanism lies in damaging the reproductive and endocrine functions of the ovary and inhibiting the growth and development of follicles. Therefore， it is particularly necessary to understand the toxic and side effects of Tripterygium wilfordii polyglycosides on female reproduction and master the detoxification methods during clinical use. However， there is no clear solution to these problems. According to the theory of traditional Chinese medicine， "kidney governs reproduction"， and the relationship between kidney Yin， kidney essence， and female ovum is close. Therefore， by considering that the damage to the reproductive system caused by Tripterygium wilfordii polyglycosides belongs to the category of kidney deficiency， Yin damage， and essence deficiency， the "strengthening kidney Yin" method is proposed. It points out that the reproductive toxicity damage of Tripterygium wilfordii polyglycosides on the female can be effectively alleviated by tonifying kidney and Yin essence in clinical use. The relevant research on traditional Chinese medicine， classical prescription， test prescription， and acupuncture is summarized to verify the necessity of the "strengthening kidney Yin" method， so as to provide a theoretical basis for the safe and rational clinical use of Tripterygium wilfordii.

The molecular mechanism of spleen-strengthening and moisture-nourishing liver prescription in treatment of acute-on-chronic liver failure based on network pharmacology and experimental verification / 中国药理学通报

To explore the mechanism of spleen- were obtained for the treatment of acute-on-chronic livstrengthening and moisture-nourishing liver prescription er failure, and 244 intersecting target genes and 7 core (JPLSYGF) in the treatment of acute-on-chronic liver target genes were screened. Molecular docking showed failure using network pharmacology and the molecular that the core target genes AKT1, SRC, VEGFA, docking. Methods Relying on TCMSP and Gene- STAT3 , EGFR, MAPK3 , HRAS had good affinity with Cards and other databases, the relevant targets of JPL- quercetin, the main active component in the JPLSYGF in the treatment of acute-on-chronic liver failure SYGF, and had strong binding activity. In addition, in were obtained. String and Cytoscape were used to con- vivo tests verified that the JPLSYGF could reduce the struct PPI networks of targets, core targets were expression of HRAS, EGFR, STAT3 , SRC, and VEGscreened out, and DAVID was used for GO function FA, to delay the progression of acute-on-chronic liver annotation and KEGG pathway enrichment analysis. failure. Conclusions JPLSYGF may act on core tar- The main active ingredients of the traditional Chinese gets such as HRAS, EGFR, STAT3, SRC, VEGFA medicine compound formula for JPLSYGF were select- and so on, to achieve the effect of treating acute-oned with a bioavailability OB value of =Э 30% and a chronic liver failure. drug-like DL

Study on spleen strengthening effects and mechanisms of Atractylodes chinensis and Atractylodes coreana / 中国药理学通报

Aim To analyze the differences in plasma biomarkers and metabolic pathways between Atractylodes chinensis and Atractylodes coreana after intervention in spleen deficiency rats, and discuss the spleen strengthening mechanism of the two from a non targeted metabolomics perspective. Methods A spleen deficiency model was established in SD rats using a composite factor method of improper diet, excessive fatigue, and bitter cold diarrhea. To determine the content of gastrointestinal and immunological indicators, UHPLC-QE-MS technology was used, combined with principal component analysis (PC A) and orthogonal projections to latent structures-discriminant analysis (OPLS-DA) methods to search for biomarkers in plasma of spleen deficiency rats, and metabolic pathways were induced using the Pathway database. Results After administration of Atractylodes chinensis and Atractylodes coreana, various indicators in plasma of spleen deficiency rats showed varying degrees of regression. Metabolomics analysis showed that Atractylodes chinensis and Atractylodes coreana respectively recalled 70 and 82 plasma differential metabolites. Atractylodes chinensis mainly regulated two metabolic pathways : "Glycine, serine, and threonine metabolism, and "Thiamine metabolism". Atractylodes coreana mainly regulated five metabolic pathways, "Glycine, serine, and threonine metabolism", "Thiamine metabolism, "Pyrimidine metabolism", "Butanoate metabolism", and "Riboflavin metabolism". Conclusions Both Atractylodes chinensis and Atractylodes coreana have certain regulatory effects on spleen deficiency rats, and their mechanism of action may be related to regulating metabolic pathways such as "Glycine, serine, and threonine metabolism, and "Thiamine metabolism"in spleen deficiency.

Mechanism of Bushen Yijing Method in Treatment of Oligoasthenozoospermia Based on Intestinal Microbiota / 中国实验方剂学杂志

Oligoasthenozoospermia is the main cause of male infertility， with complex and diverse causes. Currently， there are still some unclear causes of oligoasthenozoospermia in clinical practice， known as idiopathic oligoasthenozoospermia. With the development of high-throughput sequencing technology， it has been found that intestinal microbiota disorder may be an important promoting factor for the onset of oligoasthenozoospermia. Traditional Chinese medicine believes that "deficiency of kidney essence" is the core pathogenesis of oligoasthenozoospermia. In clinical practice， the method of tonifying the kidney and strengthening the essence has a significant therapeutic effect on oligoasthenozoospermia， but its mechanism of action has not been fully elucidated. Based on the basic theories of traditional Chinese medicine and molecular biology research， it has been found that there is a similarity between "kidney essence" and intestinal microbiota. During the onset of oligoasthenozoospermia， the disorder of intestinal microbiota has similarities with the pathogenesis of "deficiency of kidney essence" in traditional Chinese medicine. Moreover， traditional Chinese medicine for tonifying the kidney and strengthening the essence can regulate the disorder of intestinal microbiota， which may be one of the effective mechanisms for the treatment of oligoasthenozoospermia with the Bushen Yijing method. Based on this， this article explored the mechanism of Bushen Yijing method of traditional Chinese medicine in treating oligoasthenozoospermia from the perspective of intestinal microbiota， so as to provide new ideas for the treatment of oligoasthenozoospermia with traditional Chinese medicine.

Effect of load training on physical fitness in running athletes / Efeito do treinamento de corrida com carga sobre a aptidão física em atletas de corrida / Efecto del entrenamiento de carrera con carga sobre la aptitud física en corredores

ABSTRACT Introduction: Cardiopulmonary capacity and sports endurance are very important for running athletes. Objective: Study whether running with load training can improve physical fitness, focusing on running athletes' cardiopulmonary capacity and exercise endurance. Methods: 36 professional athletes were selected. One group was trained with normal running and the other group was trained with running with a weight load. Results: In the weight-bearing training group, FVC went from 5.13 ± 0.20 to 5.68 ± 1.25, FEV1 went from 4.38 ± 0.33 to 4.56 ± 0.35, PEF went from 8.27 ± 0.98 to 8.88 ± 1.02, ERV went from 1.44 ± 0.37 to 1.68 ± 0.34, IVC went from 4.91 ± 0.45 to 5.28 ± 1.46, VT went from 1.10 ± 0.25 to 1.42 ± 1.26, systolic blood pressure varied from 115.16 ± 8.18 to 117.02 ± 5.47, diastolic blood pressure varied from 78.58 ± 8.97 78.16 ± 7.42, BPM varied from 73.42 ± 9.27 to 73.52 ± 9.02, serum lactic acid was from 1.36 ± 0.28 to 1.31 ± 0.27, and serum creatine kinase was from 21.85 ± 59.02 to 208.11 ± 49.20. Conclusion: Load running training positively impacts athletes' physical fitness and may be added to improve athletes' cardiorespiratory capacity and exercise endurance. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A capacidade cardiopulmonar e a resistência esportiva são muito importantes para os atletas de corrida. Objetivo: Estudar se o treinamento de corrida com carga pode melhorar a aptidão física, com enfoque na capacidade cardiopulmonar e a resistência ao exercício dos atletas de corrida. Métodos: Foram selecionados 36 atletas profissionais. Um grupo foi treinado com corrida normal e o outro grupo foi treinado com corrida com carga de peso. Resultados: No grupo de treinamento com rolamentos de peso, FVC passou de 5,13 ± 0.20 para 5,68 ± 1,25, FEV1 passou de 4,38 ± 0,33 para 4,56 ± 0,35, PEF passou de 8,27 ± 0,98 para 8,88 ± 1,02, ERV passou de 1,44 ± 0,37 para 1,68 ± 0,3431, IVC passou de 4,91 ± 0,45 para 5,28 ± 1,46, VT passou de 1,10 ± 0,25 para 1,42 ± 1,26, pressão arterial sistólica variou de 115,16 ± 8,18 para 117,02 ± 5,47, pressão arterial diastólica variou de 78,58 ± 8,97 78,16 ± 7,42, BPM variou de 73,42 ± 9,27 para 73,52 ± 9,02, o valor de ácido lático sanguíneo foi de 1,36 ± 0,28 para 1,31 ± 0,27, e a creatina quinase sérica foi de 219,85 ± 59,02 para 208,11 ± 49,20. Conclusão: O treinamento de corrida com carga impacta positivamente a aptidão física dos atletas, podendo ser acrescido para melhorar a capacidade cardiorrespiratória e a resistência ao exercício dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La capacidad cardiopulmonar y la resistencia al deporte son muy importantes para los atletas que corren. Objetivo: Estudiar si correr con entrenamiento de carga puede mejorar la forma física, centrándose en la capacidad cardiopulmonar y la resistencia al ejercicio en atletas corredores. Métodos: Se seleccionaron 36 atletas profesionales. Un grupo fue entrenado con carrera normal y el otro con carrera con carga de peso. Resultados: En el grupo de entrenamiento con carga de peso, la FVC pasó de 5,13 ± 0,20 a 5,68 ± 1,25, el FEV1 pasó de 4,38 ± 0,33 a 4,56 ± 0,35, el PEF pasó de 8,27 ± 0. 98 a 8,88 ± 1,02, ERV pasó de 1,44 ± 0,37 a 1,68 ± 0,34, IVC pasó de 4,91 ± 0,45 a 5,28 ± 1,46, VT pasó de 1,10 ± 0,25 a 1,42 ± 1. 2645, la presión arterial sistólica varió de 115,16 ± 8,18 a 117,021 ± 5,47, PPM varió de 78,58 ± 8,97 a 78,16 ± 7,42, las pulsaciones por minuto variaron de 73,42 ± 9,27 a 73,52 ± 9,02, el valor de ácido láctico en sangre fue de 1,36 ± 0,28 a 1,31 ± 0,27, y la creatina quinasa sérica fue de 219,85 ± 59,02 a 208,11 ± 49,20. Conclusión: El entrenamiento de carrera con carga influye positivamente en la forma física de los atletas, y puede añadirse para mejorar la capacidad cardiorrespiratoria y la resistencia al ejercicio de los atletas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Brazilian Portuguese version and content validity of the Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH)

Abstract Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a personalized, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis (RA). Patients are provided with two guidance documents, the 'Patient Exercise Booklet' and the 'Personal Exercise Guide', to continue the exercises independently at home. Objective This study aimed to translate and culturally adapt the SARAH protocol into Brazilian Portuguese and validate its content. Methods The guidance documents 'Patient Exercise Booklet' and 'Personal Exercise Guide' of the SARAH program were translated and culturally adapted to Brazilian Portuguese. The content validity was obtained by calculating the content validity index (CVI). Results The Brazilian version of the SARAH protocol reached semantic, idiomatic, conceptual, and cultural equivalences. The CVI was greater than 0.8, corresponding to a satisfactory index. The verbal comprehension was 4.9, showing good verbal comprehension ofthe target population. Conclusion The Brazilian Portuguese version of the SARAH protocol is available to Brazilian people with compromised hands due to RA with satisfactory content validity.

Training for physical conditioning of young bodybuilding athletes / Treinamento para o condicionamento físico de jovens atletas de musculação / Entrenamiento para el acondicionamiento físico de jóvenes atletas de culturismo

ABSTRACT Introduction Biochemical indicators such as blood urea nitrogen and creatine kinase in young athletes are ways to test their fitness. These data provide the basis for assessing young athletes' physical and functional fitness during training. Objective Investigate serum urea nitrogen levels and creatine kinase levels in weightlifters. Methods 12 biomarkers of athletes were tracked and observed in this article. After this study, it was found that changes were observed in their physiological parameters. These changes are usually found every three weeks. The method of mathematical statistics was used to analyze the data obtained. Results The average creatine kinase levels were significantly elevated in the first cycle. These data differ from the basal level (P<0.01). The increased serum urea nitrogen and creatine kinase levels indicate that the athlete has entered a state of fatigue. Conclusion Blood urea nitrogen and creatine kinase levels are essential in determining the degree of fatigue and sports injuries in athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução Indicadores bioquímicos como nitrogênio ureico no sangue e creatina quinase em atletas jovens são formas de testar a aptidão física. Esses dados fornecem a base para avaliar o condicionamento físico e funcional que os jovens atletas precisam durante o treinamento. Objetivo Investigar os níveis de nitrogênio sérico ureico e creatina quinase em halterofilistas. Métodos 12 biomarcadores de atletas foram rastreados e observados neste artigo. Após este estudo, constatou-se que foram observadas mudanças em seus parâmetros fisiológicos. Estas mudanças são geralmente encontradas a cada três semanas. Utilizou-se o método de estatística matemática para analisar os dados obtidos. Resultados Os níveis médios de creatina quinase foram significativamente elevados no primeiro ciclo. Estes dados são bastante diferentes do nível basal (P<0,01). O aumento do nível sérico de nitrogênio ureico e creatina quinase indica que o atleta entrou em um estado de fadiga. Conclusão Os níveis de nitrogênio ureico no sangue e creatina quinase têm um papel essencial na determinação do grau de fadiga e lesões esportivas dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción Los indicadores bioquímicos como el nitrógeno ureico en sangre y la creatina quinasa en jóvenes atletas son formas de comprobar su estado físico. Estos datos proporcionan la base para evaluar la aptitud física y funcional que necesitan los jóvenes atletas durante el entrenamiento. Objetivo Investigar los niveles de nitrógeno ureico sérico y creatina quinasa en levantadores de pesas. Métodos En este artículo se examinaron y observaron 12 biomarcadores de atletas. Tras este estudio, se observaron cambios en sus parámetros fisiológicos. Estos cambios suelen producirse cada tres semanas. Para analizar los datos obtenidos se utilizó el método de la estadística matemática. Resultados Los niveles medios de creatina-cinasa fueron significativamente elevados en el primer ciclo. Estos datos son muy diferentes del nivel basal (P<0,01). El aumento de los niveles de nitrógeno ureico sérico y de creatina-cinasa indica que el atleta ha entrado en un estado de fatiga. Conclusión Los niveles de nitrógeno ureico en sangre y de creatina quinasa tienen un papel esencial en la determinación del grado de fatiga y de las lesiones deportivas en los atletas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Clinical efficacy and mechanism of action of kidney-tonifying, spleen-strengthening, and diuresis-promoting therapy in treatment of chronic hepatitis B / 临床肝胆病杂志

Chronic hepatitis B is a public health issue worldwide. Nucleotide analogues and interferon therapy can effectively inhibit HBV replication, but they still have the shortcomings such as inability to achieve the clearance of HBV cccDNA and low HBsAg clearance rate. The academic viewpoint of "kidney-tonifying therapy for chronic hepatitis B" provides new ideas and methods for the treatment of hepatitis B. During long-term clinical practice, Department of Hepatology in Shuguang Hospital has identified that "deficiency of spleen and kidney with damp heat remaining" is the key pathogenesis of the continuous progression of chronic hepatitis B and has established the treatment regimen for chronic hepatitis B with the basic treatment method of tonifying the kidney, strengthening the spleen, and promoting diuresis. The clinical research of National Science and Technology Major Project from The 11th Five Year Plan to The 13th Five Year Plan has validated the clinical efficacy of this regimen and clarified that regulating the immune function of the body is the main mechanism of the kidney-tonifying, spleen-strengthening, and diuresis-promoting therapy in the treatment of chronic hepatitis B.

Clinical study of modified Shishi Niubangzi Decoction combined with strengthening tendons-waist exercise on lumbar disc herniation / 国际中医中药杂志

Objective:To observe the clinical effect of modified Shishi Niubangzi Decoction combined with strengthening muscle-waist exercise on lumbar disc herniation (LDH).Methods:Randomized controlled trial. A total of 60 patients with LDH admitted to the Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, were enrolled as the research objects between September 2020 and September 2021. According to the random number table, they were randomly divided into the treatment group and control group, 30 in each group. Both groups were given routine basic treatments (strengthening tendons-waist exercise and three-position six-step manipulation). On this basis, the treatment group was treated with modified Shishi Niubangzi Decoction, while the control group was treated with non-steroidal anti-inflammatory drugs (ibuprofen codeine sustained-release tablets). Both groups were treated for 4 weeks. The responsive rates, back pain intensity, leg pain and numbness by Visual Analogue Scale (VAS) and lumbar function by Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) were compared between the two groups.Results:The response rate of treatment group was significantly higher than that of control group (93.3% vs. 73.3%; χ2=4.32, P=0.038). After treatment, scores of JOA (subjective symptoms, signs, activities of daily living) in the treatment group were significantly higher than those in the control group ( t=3.86, 2.71, 2.21, P<0.05). After treatment, scores of back pain (2.12±0.21 vs. 3.02±0.32, t=12.88), leg pain (2.04±0.64 vs. 2.64±0.66, t=3.58), lower limb numbness (1.75±0.24 vs. 2.41±0.70, t=4.89) in the treatment group were significantly lower than those in the control group ( P<0.01). At 1 week and 1 month after treatment, ODI scores in treatment group were significantly lower than those in control group ( t=10.22, 5.59; P<0.05). Conclusion:The modified Shishi Niubangzi Decoction combined with strengthening tendons-waist exercise can improve responsive rates, improve lumbar pain and function in LDH patients.

Experience of Professor WANG Xianbo in Treating Hepatitis B Virus Associated Acute-on-Chronic Liver Failure by Differentiating Syndromes from Dampness， Heat， Toxicity， Stasis and Deficiency / 中医杂志

By summarising Professor WANG Xianbo's clinical experience in treating hepatitis B virus associated acute-on-chronic liver failure （HBV-ACLF）， it is believed that HBV-ACLF is a syndrome of root-cause deficiency and manifestation excess， with spleen deficiency as the root cause and dampness-heat-toxicity-blood stasis as the manifestation， and the therapeutic methods proposed as “detoxification and cooling of the blood to promote circulation of the internal organs， and strengthening spleen and resolving dampness to take care of the middle energizer”. In the treatment of HBV-ACLF， for syndrome of stasis-heat-toxicity mass， it was common to use the Jiedu Liangxue Formula （解毒凉血方） by detoxifying and cooling blood； For syndrome of dampness-heat-toxicity mass， it was common to use in the Jiedu Liangxue Lishi Formula （解毒凉血利湿方） by detoxifying and cooling the blood， strengthening the spleen and resolving dampness； For syndrome of spleen-deficiency and dampness-heat， it was common to use in the Jiedu Liangxue Jianpi Formula （解毒凉血健脾方， also known as Zhonggan No.2 Formula） by strengthening the spleen and reple-nishing qi， clearing heat and resolving dampness.

Relationship Between Metabolic Remodeling of Endothelial Cells and Tumor Angiogenesis Based on "Yin Fire" Theory and Intervention of Chinese Medicine / 中国实验方剂学杂志

Endothelial cells in the inner wall of blood vessels respond to physical and chemical signals of the body by regulating vascular homeostasis， vascular tension， cell adhesion， cell proliferation， coagulation resistance and inflammatory factors， to maintain the stability of blood vessels. Angiogenesis is the key condition for tumor evolution， and the pathological mode of tumor angiogenesis provides nutrients and oxygen for tumor growth and promotes its proliferation. In recent years， endothelial cells have participated in tumor vascular infiltration and driven angiogenesis， which is considered to be the point link in tumor metastasis. By regulating metabolic remodeling， vascular endothelial cells provide the materials and energy needed in the process of tumor angiogenesis， and their abnormal metabolic characteristics facilitate their adaption to the changes of tumor microenvironment， which is often regarded as an important basis for tumor angiogenesis. The ''Yin fire'' theory in traditional Chinese medicine， originating from Huangdi's Internal Classic （Huang Di Nei Jing）， originally meant Yin deficiency generates internal heat， and belonged to the category of fire of internal injury. After the deduction and changes by physicians over the ages， the pathogenesis of ''spleen and stomach Qi deficiency-Yin fire rising-Qi and fire disharmony'' was gradually formed. The pathogenesis of metabolic remodeling of endothelial cells manifests the pathological characterization of Yin fire in an objective way， which is consistent with the disease state of uncontrolled and hyperactive tumor neovascularization. Changes in spleen and stomach Qi deficiency as well as imbalance of Qi movement lead to the failure of water and food in distribution， and thus metabolic disorders occur. Long term retention turns in phlegm and blood stasis， which combat with blood vessels， and result in abnormal local environment （formation of tumor microenvironment）， adverse pulse channel （imbalance of endothelial cell metabolism）， and tumor neovascularization. Under the guidance of ''Yin fire'' syndrome elements and by focusing on the correlation between Qi and fire， prescriptions are made based on the treatment method of ''strengthening the body and regulating Qi'' to regulate the metabolic function of endothelial cells， thus achieving a relatively balanced state of the body and inhibiting tumor angiogenesis. As a result， this study， centering on the metabolic remodeling of endothelial cells and ''Yin fire'' theory， elucidated the academic ideas， with the purpose of providing some theoretical support for the intervention of tumor vascularization by Chinese medicine.

Textual research on ancient and modern literature and analysis on research hot spots of classical prescription Shenling baizhu powder / 中国药房

OBJECTIVE To provide reference for the clinical application and further research and development of Shenling baizhu powder. METHODS Using the methods of textual research and bibliometrics， the key information such as the composition， dose， processing and usage of Shenling baizhu powder in ancient and modern literature were systematically summarized and sorted out， and the number of publications， keywords， and other contents of modern literature were visually analyzed. RESULTS & CONCLUSIONS Shenling baizhu powder was first collected in Taiping Huimin Hejiju Fang （abbreviated “Jufang”）， the composition of core drugs and most widely used dose ratio in previous generations were the same as those in Jufang， basically focusing on powder making and being taken after mixed with liquid； the dosage was concentrated on 2-3 qian； the function and application of it had been expanded to a certain extent compared with Jufang； its clinical application had gradually extended from internal medicine to surgery， gynecology， pediatrics， ophthalmology， dermatology， etc.， covering all aspects of the disease caused by spleen deficiency in general； the composition mechanism revolved around “strengthening the spleen， replenishing qi and removing dampness”； the recommended prescription drugs were all selected from the corresponding varieties in the pharmacopoeia. Modern research mainly focuses on clinical practice， with traditional Chinese medicine or traditional Chinese and Western medicine combined with this formula as the main modified treatment for various intestinal diseases， diarrhea diseases， and lung diseases. The efficacy and application are the frontier hot spots today， and the mechanism of action has begun to be explored. The usage in the literature and the inclusion in the pharmacopoeia are inconsistent， and further research is needed.

Effect of a Quality Improvement Package on Reducing Newborn Mortality from 26 to 14 in a Himalayan North Indian State

Background: In India, newborn mortality remains high due to a number of factors, including poor quality of care at health facilities. The experience of executing complete neonatal care quality improvement (QI) package at selected hospitals in Himachal Pradesh and reduction in newborn mortality rate (NMR) is described in this study. Objective: The short-term objective was the participants’ retention of knowledge and skills, and the achievement of uniform QI objectives following training and after a minimum of 6 months. Overall reduction in NMR was long-term objective. Methods: Newborn care QI package was implemented according to India Newborn Action Plan over a period of 48 months from 2013 to 2016, through infrastructure, trainings, and supportive supervision. Results: Total 13 health facilities were upgraded; 350 staff nurses and medical officers were trained. The mean posttraining knowledge score was 75% compared to 29% in the pretraining test, and 63% 1 year later. The competencies of health workers in the care of high?risk babies and 12 QI targets had improved, resulting in a 46% reduction in neonatal mortality in the state across all gestations and weights based on sample registration survey. Conclusion: Implementation of a bundle of evidence-based practices in low-resource setting for health system strengthening for intrapartum and neonatal care was linked to changed care behaviors among health-care providers, and reduction in NMR.

Fortalecimiento y promoción de la Revista Peruana de Ciencias de la Salud durante la pandemia COVID-19 / Strengthening and promotion of the Revista Peruana de Ciencias de la Salud during the COVID-19 pandemic / Fortalecimento e promoção da Revista Peruana de Ciencias de la Salud durante a pandemia da COVID-19

La Revista Peruana de Ciencias de la Salud (RPCS) es editada y publicada por la Universidad de Huánuco a través de su Oficina Editorial y en colaboración con los miembros -tanto a nivel nacional e internacional- del comité editorial y científico (1). Durante su historia, la revista se ha caracterizado por su constante dedicación en fortalecer y promover su visibilidad en el entorno académico y científico. Esta editorial tiene como objetivo presentar un sumario de las acciones realizadas en este contexto y de los efectos e impactos esperados.

The Revista Peruana de Ciencias de la Salud (RPCS) is edited and published by the Universidad de Huánuco through its Editorial Office and in collaboration with the national and international members of the editorial and scientific committee (1). During its history, the journal has been characterized by its constant dedication to strengthen and promote its visibility in the academic and scientific environment. The purpose of this editorial is to present a summary of the actions carried out in this context and the expected effects and impacts.

A Revista Peruana de Ciencias de la Salud (RPCS) é editada e publicada pela Universidade de Huánuco através de seu Escritório Editorial e em colaboração com os membros nacionais e internacionais do comitê editorial e científico (1). Durante sua história, a revista tem sido caracterizada por sua constante dedicação em fortalecer e promover sua visibilidade no ambiente acadêmico e científico. Este editorial visa apresentar um resumo das ações realizadas neste contexto e os efeitos e impactos esperados.

Nigeria in the COVID era: Health system strengthening for national security and prosperity

The coronavirus disease­19 pandemic has spread to all parts of the world. As of 20 May 2022, over 500 million confirmed cases have occurred with over 6 million deaths. In Nigeria, over 255,000 cases have occurred with more than 3000 deaths. The pandemic has adversely affected virtually all aspects of human endeavour, with a severe impact on the health system. The Nigerian health system was ill prepared for the pandemic, and this further weakened it. The impacts of the pandemic on the health system include disruption of health services, low motivation of the health workforce, unresponsive leadership and poor funding. The national response, though initially weak, was ramped up to expand capacity building, testing, public enlightenment, creation of isolation and treatment centres and research. The funding for the national response was from the government, private sector and multilateral donors. Nigeria must comprehensively strengthen its health system through motivating and building the capacity of its human resources for health, improved service delivery and provision of adequate funding, to be better prepared against future pandemics.

Strengthening equitable health systems in West Africa: The regional project on governance research for equity in health systems

The West African Health Organization (WAHO) supported an innovative regional initiative that contributes to building effective decision making, community and researcher partnerships to strengthen equitable health systems and influence local programmes and policies. Four projects were funded in Nigeria, Sierra Leone, Burkina Faso and Senegal, supported by a Regional Advisory Committee of experts and local Steering Committees. Based on a framework drawn from WAHO objectives, we reviewed documents, conducted 56 project stakeholder interviews and undertook thematic analysis. A diverse range of stakeholders perceived that the projects were in line with national priorities, were well managed and were equitably implemented. The projects generated evidence that could increase access to and improve quality maternal health services. Sustainable partnerships were formed and stakeholder and research team capacity were strengthened. Our study provides insight into project implementation in West Africa, bearing in mind context-specific issues. (Afr J Reprod Health 2022; 26[5]: 81-89).

An assessment of Nigeria's health systems response to COVID-19

Objectives: This study aims to understand and report on selected health system interventions considered nationally and sub-nationally of particular significance both in terms of COVID-19 responses and in strengthening the health system for the future. Design: A review of published and grey literature, including journals, news/ media and official documents, was conducted from 1st December 2019 to 31st December 2020. The reviewers read and extracted relevant data using FACTIVA in a uniform data extraction template. Responses that related to service delivery were captured. Setting: The assessment considered responses at the national and two state levels: Lagos and Enugu, representing the epicentre and a low COVID-19 burden centre. Inclusion criteria: Documents and news that mentioned COVID-19 response, particularly service delivery aspects, were included in this review. Results: The identified interventions were mostly technical support targeted at health workers: including training of about 17,000 health workers, supervising and engaging more health workers, upgrading laboratories and building new ones to improve screening and diagnosis, and motivation of health workforce with incentives. Furthermore, the influx of philanthropic contributions improved the data and information systems supply of medicines, medical products and non-pharmaceutical protective materials through local production. The presence of political will and the government's efforts in health system's response to COVID-19 facilitated these interventions. Conclusions: Interventions of state and non-state actors have strengthened the health systems to some extent. However, more needs to be done to sustain these gains and make the health system resilient to absorb unprecedented shocks.

Research Advance in Mechanism of Cisplatin Toxic Injury and Its Prevention and Treatment by Traditional Chinese Medicine / 中国实验方剂学杂志

Cisplatin， as one of the commonly used broad-spectrum anti-tumor drugs in clinical practice， is used to treat testicular cancer， ovarian cancer， head and neck cancer， bladder cancer， lung cancer， cervical cancer and other solid cancers. It has obvious curative effect but strong toxic and side effect， and is easy to cause great damage to the body. The toxic reaction may involve serious toxic damages to different organs， and induce nephrotoxicity， hepatotoxicity， ototoxicity， cardiotoxicity， neurotoxicity and other toxicity. Animal experiments have shown that the toxic damage induced by cisplatin is the result of many factors in a time-and dose-dependent manner. In the course of clinical use， the therapeutic dose of cisplatin is also greatly limited due to toxic damage， which seriously affects the quality of life in patients. Therefore， it is the main research direction to find a suitable treatment plan or to use drugs in combination with cisplatin to reduce toxicity and increase efficiency. With the increasing clinical participation of traditional Chinese medicine（TCM）， TCM has shown its unique advantages in treating diseases， and can effectively reduce the cisplatin chemotherapy-induced toxic reaction by improving the oxidative stress state of the body， inhibiting normal apoptosis and inflammatory injury， activating autophagy， regulating the abnormal expression of drug transporters， etc. In this paper， the mechanism of cisplatin-induced toxic damage to various organs and the mechanism of TCM in prevention and treatment of cisplatin-induced toxic damage were summarized in detail， including the dose and mechanism of cisplatin-induced toxic damage to different organs， the effective treatment dose， combined medication mode and prevention and treatment mechanism of combined application of TCM and cisplatin， in order to provide a basis for rational application and clinical medication of TCM combined with chemotherapy drugs such as cisplatin.

Inhibitory Effect of Weichang'an Granule on Invasion and Metastasis of MKN45 Cells in Human Gastric Cancer by RUFY3 / 中国实验方剂学杂志

Objective:To explore the molecular mechanism of spleen-strengthening traditional Chinese medicine （TCM） Weichang'an granule in inhibiting the invasion and metastasis of human gastric cancer MKN45 cells. Method:MKN45 cells were cultured <italic>in vitro</italic> and incubated with different concentrations（600， 900， 1 200， 1 500 mg·L^-1）of Weichang'an granule for 24， 48， 72 h. Cell counting kit-8 （CCK-8） assay was used to detect its effect on the cell proliferation. Western blot was used to detect the expression of RUN and FYVE domain containing 3（RUFY3） in normal gastric mucosa cells and different gastric cancer cell lines. The expression of RUFY3 in the gastric cancer cells after Weichang'an granule intervention （600， 900， 1 200 mg·L^-1） was detected by Western blot. Lentivirus transfection technique was used to achieve the stable and silenced expression of RUFY3 in gastric cancer MKN45 cells. Transwell assay was used to evaluate the influence of Weichang'an granule and silenced RUFY3 on the metastasis and invasion ability of MKN45. E-cadherin，N-cadherin，Vimentin，Zinc-finger transcription factor （SNAIL1 and SNAIL2） protein expression levels were detected by Western blot. Result:RUFY3 expression in human gastric cancer cells was significantly higher than that in normal gastric mucosa．The protein expression of RUFY3 in MKN45 cells of silenced RUFY3 group was significantly lower than that in Lentivirus negative group （<italic>P</italic><0.01）． Weichang'an granule inhibited the expression of RUFY3 in human MKN45 gastric cancer cells （<italic>P</italic><0.05， <italic>P</italic><0.01） in a concentration-dependent manner. As compared with the blank group， both Weichang'an granule and silenced RUFY3 inhibited the metastasis and invasion ability of MKN45 （<italic>P</italic><0.01）. After Weichang'an granule and silenced RUFY3 treatment， the protein expression of epithelial marker gene E-cadherin was up-regulated （<italic>P</italic><0.01）， the protein expression of Vimentin and N-cadherin decreased， but with no statistical difference，while SNAIL1 and SNAIL2 were both significantly down-regulated （<italic>P</italic><0.01）. Conclusion:By targeting RUFY3 to regulate epithelial mesenchymal transformation， the spleen-strengthening TCM compound Weichang'an granule can inhibit the invasion and metastasis of gastric cancer.

Effect of Sishenwan on PI3K/Akt/mTOR Signal Pathway in Colonic Tissue of Rats with Ulcerative Colitis Model of Spleen Kidney Yang Deficiency / 中国实验方剂学杂志

Objective:To discuss the effect of Sishenwan on phosphatidylinositol-3 kinase/protein kinase B/mammalian target of rapamycin（PI3K/Akt/mTOR） signaling pathway related genes and proteins in colon tissue and interleukin-1<italic>β</italic>（IL-1<italic>β</italic>） and interleukin-10（IL-10） expression levels in serum of ulcerative colitis （UC） model rats with spleen kidney Yang deficiency. Method:The 120 SPF Wistar rats were randomly divided into normal group and model group after 7 days of adaptive feeding in SPF laboratory. The model group were given dinitrobenzene sulfonate （DNBS）/ethanol solution enema+hydrocortisone subcutaneously injection+senna leaf gavage to establish UC model of spleen kidney yang deficiency. The rats who successfully established the model were randomly divided into five groups：model group， mesalazine （0.36 g·kg^-1） group， and Sishenwan high， medium and low dose （3.2，1.6，0.8 g·kg^-1） groups， the volume of which was 10 mL·kg^-1. The model group and the blank group were given distilled water of the same volume. Once a day for 21 days. Observe the general conditions of the rats daily， and record the weight， fecal traits and occult blood of the mice for disease activity index （DAI） scoring.Take the rat colon tissue to observe the gross morphology and colon injury， and score the colon mucosal injury index （CMDI）. Hematoxylin-eosin （HE） staining was used to observe pathological changes. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）was used to detect the expression level of PI3K， Akt， mTOR mRNA in colon tissue. The levels of IL-1<italic>β</italic> and IL-10 in serum were detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the expression level of PI3K， phosphorylation （p）-PI3K， Akt， p-Akt， mTOR， p-mTOR protein in colon tissue. Result:Compared with blank group， the general survival status of the rats in model group was relatively poor， the DAI score and the CMDI index were significantly increased （<italic>P<</italic>0.01）. The intestinal mucosa partially disappears， the glands disappear， and a large number of inflammatory cells infiltrate and gather in the mucosal layer and the base layer in the pathological sections of the model group. The expression levels of PI3K， Akt， and mTOR mRNA were significantly increased （<italic>P</italic><0.01）. The IL-1<italic>β</italic> content was significantly increased and the IL-10 content was significantly decreased （<italic>P</italic><0.01）. The expression levels of p-PI3K，p-Akt and p-mTOR protein were significantly increased （<italic>P</italic><0.01）. Compared with the model group， the DAI scores of Sishenwan high and medium dose groups and mesalazine group decreased （<italic>P</italic><0.05）. The CMDI index of mesalazine group and the high， middle and low dose groups of Sishenwan was significantly reduced （<italic>P</italic><0.01）. Pathological sections of rats showed that the inflammatory cells in the drug group decreased， and the mucosal layer structure returned to normal to varying degrees. The mesalazine group and the Sishenwan medium-dose group had the best effects， and the mucosal structure was close to the blank control group. The expression levels of PI3K， Akt， mTOR mRNA in the high and medium dose groups of Sishenwan， mesalazine group and Akt mRNA in low dose group of Sishenwan were significantly reduced （<italic>P</italic><0.05，<italic>P</italic><0.01）. The expression levels of PI3K and mTOR mRNA in low-dose group of Sishenwan decreased， but the difference was not statistically significant. The IL-1<italic>β</italic> content was significantly reduced and the IL-10 content was significantly increased in high， medium dose groups of Sishenwan and mesalazine groups （<italic>P</italic><0.05，<italic>P</italic><0.01）. The level of IL-1<italic>β</italic> decreased and the level of IL-10 increased in the low-dose group of Sishenwan， but the difference was not statistically significant. The expression levels of p-PI3K， p-Akt and p-mTOR protein in the high， medium， and low dose groups of Sishenwan and mesalazine group decreased to varying degrees， and the differences were statistically significant（<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:Sishenwan has the effect of improving the general condition and intestinal mucosal damage of ulcerative colitis model rats with spleen and kidney Yang deficiency. The mechanism may be related to the inhibition of PI3K/Akt/mTOR signaling pathway.