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Objective:To explore the application effect of dyadic intervention scheme based on dyadic disease management theory and Information, Knowledge, Attitude, and Practice model in the discharge preparation of elderly stroke patients and family caregivers.Methods:The 92 pairs of elderly stroke patients and their caregivers hospitalized in the Department of Neurology in People′s Hospital of Zhengzhou University were conveniently selected. The non synchronous control method quasi experimental research was adopted. Totally 46 pairs of subjects who met the criteria for admission and discharge from May to July 2022 were set as the control group, and routine nursing was carried out; from August to October 2022, 46 pairs of subjects who met the criteria for admission and emission were set as the observation group to implement the dyadic intervention program. The scores of discharge readiness, self-efficacy and unplanned readmission rate of patients between the two groups were compared, and the scores of caregiver readiness, self-efficacy and caregiver stress between the two groups were compared.Results:Finally, 85 pairs of subjects completed the study, with 42 pairs in the control group and 43 pairs in the observation group. On discharge day, the total scores of discharge readiness and caregiver readiness in the observation group were (95.19 ± 4.47), (23.02 ± 2.20) points, respectively, which were higher than those in the control group (85.71 ± 5.31), (19.57 ± 1.65) points, with statistically significant differences ( t=8.91,8.16, both P<0.01); the self-efficacy levels of patients in the observation group at discharge and one month after discharge, as well as those of caregivers at discharge and one month after discharge were (73.86 ± 4.87), (75.91 ± 4.51), (75.67 ± 4.99), (79.21 ± 4.90) points, respectively, higher than those in the control group (71.62 ± 5.19), (73.33 ± 4.91), (73.48 ± 4.24), (75.48 ± 4.24) points, with statistically significant differences ( t values were from 2.05 to 3.75, all P<0.05); the pressure levels of caregivers in the observation group at discharge and one month after discharge were (7.51 ± 2.48), (6.28 ± 1.99) points, respectively, lower than those in the control group (8.76 ± 2.55), (7.45 ± 2.36) points, with statistically significant differences ( t=-2.29, -2.48, both P<0.05); the unplanned readmission rate of patients in the observation group one month after discharge was 7.0% (3/43), lower than the control group′s 23.8% (10/42), with statistically significant difference ( χ2=4.65, P<0.05). Conclusions:The implementation of dyadic intervention on elderly stroke patients and caregivers can make their discharge preparation process more adequate, thus reducing the caregiver′s care pressure, reducing the unplanned readmission rate of patients, and improving their health outcomes.
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Gastric cancer is one of the malignancies with high incidence in the world. Xiangsha Liu Junzitang，a common prescription for the prevention and treatment of gastric cancer，has the effects of moving Qi to relieve pain，drying dampness， and invigorating the spleen. It is especially indicated for gastric cancer of the spleen and stomach qi deficiency syndrome. Based on the databases such as CNKI，Wanfang Data，and PubMed，the clinical efficacy and experimental studies of Xiangsha Liu Junzitang for the prevention and treatment of gastric cancer were summarized and sorted out，and the mechanism of Xiangsha Liu Junzitang for the prevention and treatment of gastric cancer was elaborated in order to provide useful references for the clinical and basic research on Xiangsha Liu Junzitang in the field of gastric cancer in the future. In clinical practice，Xiangsha Liu Junzitang can treat gastric precancerous lesions，increase the body immunity of patients with gastric cancer，improve the symptoms of spleen and stomach weakness after gastric cancer surgery，and reduce the adverse reactions of the digestive tract after chemotherapy for gastric cancer. Its clinical efficacy is superior to that of western medicine alone whether it is combined with western medicine or used alone. In the experimental research，Xiangsha Liu Junzitang has the effects of regulating inflammatory factors，inhibiting the proliferation of gastric cancer cells，promoting the apoptosis of gastric cancer cells，and improving the activity of pepsin. Modern pharmacological research has shown that Xiangsha Liu Junzitang can conduct a comprehensive intervention with multiple components and multiple targets. The main components of a single drug contained include saponins，polysaccharides，lactones，volatile oils，organic acids，and others， with the effects of protecting gastric mucosa，regulating endocrine，and promoting apoptosis of epithelial cells in gastric mucosal dysplasia，reflecting the advantages and values of traditional Chinese medicine in the prevention and treatment of gastric cancer.
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Wulingsan， a classic prescription first recorded in the Treatise on Cold Damage （Shang Han Lun） by ZHANG Zhong-jing for patients with water retention syndrome due to the disturbance of Qi transformation in bladder， has often been modified by ancient and modern doctors for the treatment of renal diseases. It produced satisfactory outcomes without inducing adverse reactions. The databases including China National Knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform， and PubMed were searched for articles concerning the clinical application and pharmacological mechanism of Wulingsan in the treatment of renal diseases published by domestic and foreign scholars in recent years. The summary of the included articles revealed that Wulingsan has been widely employed for the treatment of renal edema， diabetic nephropathy， acute and chronic glomerulonephritis， nephrotic syndrome， renal insufficiency， abnormal urination， etc.， and the resulting outcomes were satisfactory. Wulingsan alone or in combination with western medicine yielded better clinical outcomes than the western medicine alone. In the exploration of its pharmacological mechanism， there existed some individual reports by Korean scholars， while Chinese scholars tended to work as a team. After years of research， each team has found that Wulingsan was superior to Wulingsan decoction in excreting water， which might be related to the absence of massive low-polarity and volatile components in the decoction that were responsible for regulating the expression of aquaporins （AQP） in kidney of saline-loaded rats. Wulingsan regulates the endocrine state of rats with kidney yang deficiency， inhibits the reabsorption of water， increases the activity of Na+-K+-ATPase， and reduces the expression of AQP 1， AQP 2， AQP 3， and AQP 4. Besides， it bi-directionally regulates the human water metabolism， which is achieved via the dual-directional regulation of purinergic P2X3 receptor expression on bladder detrusor. The efficacy of Wulingsan in treating chronic renal failure is attributed to its protection against the damaged renal tissue，structure and fanction. Hence， this paper summarized the research progress of Wulingsan in the treatment of renal diseases in recent years， aiming to provide a reference for the clinical and basic exploration of Wulingsan against renal diseases in the future.
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Dahuang Zhechongwan （DHZCW） is a classic prescription from the Jingui Yaolue（《金匮要略》） by ZHANG Zhong-jing，with the effects of tonifying deficiency， relaxing the middle， promoting regeneration， and resolving stasis. It has been widely used in the clinical treatment of various diseases with definite efficacy achieved. The research on multiple organ fibrosis has shown that DHZCW can slow down the development of organ fibrosis in the heart， liver， kidney， lung， etc.， and good results in both clinical practice and experimental research have been obtained. The present study reviewed the previous investigations on the experimental mechanism of DHZCW in the treatment of multiple organ fibrosis and revealed that the pathogenesis was closely related despite different disease sites. From the perspective of traditional Chinese medicine （TCM），these diseases shared a common pathogenesis，which was manifested by deficiency. Long-term diseases led to the formation of "dried blood". From the perspective of modern medicine， the diseases all showed pathological changes in the deposition of extracellular matrix （ECM）， and their occurrence and development were all based on certain effector cells ［such as hepatic stellate cell （HSC） and pancreatic stellate cell （PSC）］， with same cytokines ［such as tumor necrosis factor-α （TNF-α），interleukin-6 （IL-6），IL-1β，and α-smooth muscle actin （α-SMA）］ and some key pathways ［transforming growth factor-β1 （TGF-β1）/Smad， phosphatidylinositol-3-kinase （PI3K）/protein kinase B （Akt）， and lipopolysaccharide （LPS） paracrine and autocrine mechanisms］ involved. As a classic prescription for "deficiency-induced dry blood"， DHZCW was effective in treating fibrosis， which was presumedly related to the inhibition of ECM deposition by intervening in the above-mentioned mechanisms， thereby delaying the disease progression. This study is expected to provide literature support to clarify the scientific connotation of DHZCW in the treatment of multiple organ fibrosis and lay a foundation for further experimental and clinical research.
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Diabetes is a common chronic metabolic disease characterized by hyperglycemia. Oxidative stress and oxidative damage have been proposed to contribute to the occurrence and development of diabetes and its complications. With the selective antioxidant effects， hydrogen molecule has attracted wide attention， from researchers at home and abroad， regarding its role in diabetes and its complications. Great progress has been made in promoting hydrogen molecular medicine in the field of diabetes. This review mainly focused on two aspects of the research： basic experiments and clinical trials. In the basic experimental research part， the effects of hydrogen molecule on blood glucose regulation and diabetic complications were discussed. The aim of this review was to provide ideas and references for further research of hydrogen molecules on diabetes and its complications.
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Despite the rapid development of organ transplantation technique, the long-term survival and functional maintenance of transplant organs still depend on the massive use of immunosuppressants.At present, the rejection and infection after organ transplantation remain the major problem facing transplant surgeons and recipients. The basic research in the field of organ transplantation is still steadily advancing to further explore the basic biological principle of rejection and immune tolerance, resolve multiple pathophysiological questions in the process of clinical organ transplantation and provide basic theoretical basis and clinical intervention guidance for wider and more effective application of organ transplantation.In 2020, researchers have achieved significant progresses on a wide range of basic researches of organ transplantation, such as the fundamental principle of immune response, overcoming transplantation rejection and inducing transplantation immune tolerance, etc.In this article, novel attempts and progresses upon inducing transplantation immune tolerance in 2020 were reviewed from two perspectives including inhibition of immune cell function and suppression of immune signaling pathway, and the main development direction of immunology of organ transplantation in the future was prospected.
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Itching is an unpleasant sensation that can cause physical and psychological discomfort. It often occurs in a variety of diseases. In addition to the common chemical medicines, the application of traditional Chinese medicines(TCMs) have attracted much attention for itch. As one of the classic antipruritic formula, Xiaofengsan is widely used by the later generations of doctors based on the edition of Orthodox Manual of External Diseases(Wài Kē Zhèng Zōng). It can be used to remove wind, dehumidify, clear heat and nourish blood by taking into account the complicated pathogenesis of skin diseases. In modern clinics, Xiaofengsan is commonly used for the treatment of rubella, eczema, acute and chronic urticaria, contact dermatitis, allergic dermatitis, psoriasis and other types of dermatitis with remarkable antipruritic effect. Its mechanism is related to its anti-allergic reaction, anti-allergy, anti-inflammatory, anti-histamine,immune regulation etc. This article reviews the research literature of Xiaofengsan and its addition and subtraction in modern pharmacological experimental research and clinical treatment in the past 15 years, and analyzes the current research situation of Xiaofengsan in the topic of antipruritic effect. The focus is on the compatibility characteristics of formula and the component study of single herb after being decomposed of Xiaofengsan, and the main material basis of antipruritic effect is summarized. It was found that Schizonepetae Herba, Saposhnikoviae Radix, Arctii Fructus, Cicadae Periostracum and Sophorae Flavescentis Radix were the main medicines for its antipruritic effect,which was helpful to expand the clinical value of Xiaofengsan and deepen its mechanisms of anti-itching.
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Virtual simulation technology is an effective means to construct “real” environment and experimental conditions. We investigate the characteristics and operation strategies of polar special medical virtual simulation experiment based on “data restoration-scene simulation-platform simulation-experiment research” for special medical workers for special injury treatment under polar special environment by analyzing its technical advantages and application characteristics and by applying it to polar special medicine. This may provide new research ideas and technical methods for further exploring medical service under polar special environment.
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Real world study (RWS),a further verification and supplement for explanatory randomized controlled trial to evaluate the effectiveness of intervention measures in real clinical environment,has increasingly become the focus in the field of research on medical and health care services.However,some people mistakenly equate real world study with observational research,and argue that intervention and randomization cannot be carried out in real world study.In fact,both observational and experimental design are the basic designs in real world study,while the latter usually refers to pragmatic randomized controlled trial and registry-based randomized controlled trial.Other nonrandomized controlled and adaptive designs can also be adopted in the RWS.
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Real world study (RWS),a further verification and supplement for explanatory randomized controlled trial to evaluate the effectiveness of intervention measures in real clinical environment,has increasingly become the focus in the field of research on medical and health care services.However,some people mistakenly equate real world study with observational research,and argue that intervention and randomization cannot be carried out in real world study.In fact,both observational and experimental design are the basic designs in real world study,while the latter usually refers to pragmatic randomized controlled trial and registry-based randomized controlled trial.Other nonrandomized controlled and adaptive designs can also be adopted in the RWS.
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Mesenchymal stem cells (MSCs),progenitor cells with the ability of self replication and differentiation,are able to change into many kinds of cells or tissues.The study of acupuncture combined with MSCs transplantation has made some progress and shown potential application prospect.This article summarized experimental research literatures of acupuncture combined with MSCs transplantation over the past ten years.Biological mechanisms of acupuncture combined with MSCs transplantation might be related to the increase of MSCs survival rate and the directional differentiation of MSCs induced by acupuncture.The combination of acupuncture and MSCs transplantation might be used as a potential routine technique in clinical practice.The underlying mechanisms still need to be further elucidated.
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Objective: To research the anti-inflammatory and anti-allergic effects of Qifangbimin particle.Methods: The anti-inflammatory effects were observed by the methods of xylene-induced ear-swelling in mice and cotton-ball induced granuloma in rats.The anti-allergic effects were evaluated by the method of passive skin allergy model in rats and ear-heterogeneous passive skin allergy model in mice.Results: In the treatment groups with Qifangbimin particle, the swelling degree of ear edema induced by dimethylbenzene in mice was significantly suppressed when compared with that in the control groups (P<0.01 or 0.05) , however, the particle had no significantly inhibitory effect on granulation tissue hyperplasia induced by cotton-ball in rats.The Qifangbimin particle groups obviously decreased the absorbance value of locus coeruleus on rats' back (P<0.01 or 0.05), and Qifangbimin particle at high dose significantly reduced the absorbance value of locus coeruleus of auricle in mice (P<0.01 or 0.05).Conclusion: Qifangbimin particle has significant anti-inflammatory and anti-allergic effects.
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In order to accurately understand the location of Shenshu (BL 23) and to improve the efficacy of acupuncture, a discussion is performed in this paper from aspects of acupoint function, anatomical structure, experiment research, clinical application, etc., hoping to provide benefit for future animal experiments and clinical selection of acupoint. The characteristics of rat spine is different from that of human, and the reliability and authenticity of acupoint location would be compromised if the anatomical characteristics of human was inflexibly applied on animals. "Shenshu" (BL 23) belongs to the bladder meridian of foot, and is located 1.5lateral to the lower border of the spinous process of the second lumbar vertebra. It is close to kidney, therefore deep insertion or repeated lifting and thrusting of needle would damage kidney and causes acupuncture accident. Therefore, to locate "Shenshu" (BL 23) in rat, the 6th lumbar vertebra is located firstly based on tuber coxae of rat, and then 11th thoracic vertebra is located by upward 4 vertebral bodies or locate 9th to 11th thoracic vertebra which are tight, and finally 2nd lumbar vertebra is located by downward 4 vertebral bodies, and "Shenshu" (BL 23) is 5 mm lateral to it. During clinical treatment, the technique should be gentle; oblique and outward insertion of needle is not allowed; the maximum depth of needle insertion is 1.6(approximately 4.30 cm); the vertical or oblique insertion with needle 45° towards spine is appropriate; the depth of 0.8 to 1.2(2.00 to 3.10 cm) is suitable. In cases of too thin or fat patients, the depth of needle insertion should be adjusted for safety.
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The experimental research literatures on traditional Chinese medicines in the treatment of systemic lupus erythematosus ( SLE) in recent years were systematically reviewed , which focused on single herb and its effective components , and compound herbs therapy.It is confirmed that Chinese medicines show exact therapeutic activity on SLE with multi-targeting effects.
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<p><b>OBJECTIVE</b>To study the effect of ligustrazine nanoparticles nano spray (LNNS) on transforming growth factor β (TGF-β)/Smad signal protein of rat peritoneal mesothelial cells (RPMC) induced by tumor necrosis factor α (TNF-α), and the anti-adhesion mechanism of LNNS in the abdominal cavity.</p><p><b>METHODS</b>The primary culture and subculture of rat peritoneal mesothelial cells (RPMC) was processed by trypsin digestion method in vitro. The third generation was identifified for experiment and divided into 5 groups: a blank group: RPMC without treatment; a control group: RPMC stimulated with TNF-α; RPMC treated by a low-dosage LNNS group (2.5 mg/L); RPMC treated by a medium-dosage LNNS group (5 mg/L); and RPMC treated by a high-dosage LNNS group (10 mg/L). Reverse transcription-polymerase chain reaction was applied to test the expression of fifibronectin, collagen I (COL-I), TGF-β mRNA, and Western blot method to test the Smad protein 7 expression of RPMC.</p><p><b>RESULTS</b>Compared with the blank group, a signifificant elevation in fifibronectin (FN), COL-I and TGF-β mRNA expression of RPMC were observed in the control group (P<0.05). Compared with the control group, LNNS suppressed the expressions of FN, COL-I and TGF-β mRNA in a concentrationdependent manner (P<0.05). The expression of Smad7 protein of RPMC was down-regulated by TNF-α stimulation, and up-regulated with the increase of LNNS dose (P<0.05).</p><p><b>CONCLUSIONS</b>TNF-α may induce changes in RPMC's viability, leading to peritoneal injury. LNNS could reverse the induction of fifibrosis related cytokine FN, COL-I and TGF-β, up-regulating the expression of Smad7 by TNF-α in RPMC, thus attenuate peritoneal injury by repairing mesothelial cells.</p>
Subject(s)
Animals , Male , Collagen Type I , Genetics , Metabolism , Epithelium , Metabolism , Fibronectins , Metabolism , Nanoparticles , Chemistry , Particle Size , Peritoneal Cavity , Cell Biology , Pyrazines , Pharmacology , RNA, Messenger , Genetics , Metabolism , Rats, Sprague-Dawley , Signal Transduction , Smad Proteins , Metabolism , Transforming Growth Factor beta , Genetics , Metabolism , Tumor Necrosis Factor-alpha , PharmacologyABSTRACT
Objective To use metabonomics method to study the change of the basic materials of month rhythm of wei qi deficiency syndrome; To find the potential markers so as to provides a new way for the essence of the wei qi deficiency syndrome research.Methods Based on the autumnal equinox in lunar calendar month, the beginning of a month (the first day of lunar August), the middle of a month (the 15th day of lunar August), and the end of a month (the 30th day of lunar August) were set as the three days to draw experimental materials. Two weeks before drawing materials, 20 rats were randomly divided into control group and model group, 10 rats in each group. The model rats were modeled by the stimulus of fatigue combined with coldness and hotness. Control group rats received conventional breeding. The rats in the both groups during the three experiments received decollation and the blood was taken at the 12 o’clock at noon. HPLC-MS was used to detect plasma metabolites, and partial least squares were used to make statistical analysis on the data for comparing plasma metabonomics original data of control group and model group. Possible metabolic markers of wei qi deficiency syndrome were explored, and the potential makers of month rhythm change of wei qi deficiency syndrome were deduced.Results Oleamide, phosphatidyl glycerol, cortisol, proline, dimethyl fumarate, and eicosapentaenoic acid may be potential markers of wei qi deficiency syndrome in the beginning of a month. Sphingosine-1-phosphate, malic acid, cortisol, oleamide, carnitine, eicosapentaenoic acid and dimethyl fumarate may be potential markers of wei qi deficiency syndrome in the middle of a month. Cholesteryl acetate, threonine, cortisol, dimethyl fumarate, oleamide, eicosapentaenoic acid and pyroglutamate may be potential markers of wei qi deficiency syndrome in the end of a month.Conclusion Month rhythm change of wei qi deficiency syndrome may be influenced by oleamide, cortisol, eicosapentaenoic acid, dimethyl fumarate, and aconitic acid, and may be closely related to energy metabolism, meanwhile accompanied by regulation of cell, hormone and nerves.
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Although the new methods and new ideas have been introduced into researches on modern syndromes, research levels of syndromes have continued to be broadened and deepened gradually. However, understanding of essential theories and general research methods have not yet achieved a broad consensus in TCM field. The phenomenon is caused by the systematic complex features of syndromes, which are difficult to be explained for a short while, and require progressive understanding and development. It is also related to the reason that current main stream researches on syndromes lack general overview and analysis. All of the above lead to the failure of efficient penetration of all syndrome researches and restrict synergetic development among these researches. This article summarized and analyzed the overview of key field of study on syndromes, and expounded their disadvantages and development suggestions, with purposes to improve future syndrome research field, enrich syndrome research methods, and promote necessary penetration of syndrome researches.
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This study was aimed to observe the effect ofRong-Shuan (RS) capsule on rodent tolerance against cerebral ischemia, hypoxia and cerebral reserve capacity, which was related to promote blood circulation and remove blood stasis. Acute cerebral ischemia and anoxia models were established by permanent left carotid artery ligation on C57 BL/6 mice and hypoxia inhalation (O2?N2 = 8?92) for 15 min. Duodenal administration of RS capsule at different doses (100, 200 or 400 mg·kg-1) or saline were given 10 min after ischemia onset. The local brain blood circulation changes and neurobehavioral function were evaluated 24 h after ischemia onset. SD rats were given RS capsule at different doses (75, 150, 300 mg·kg-1) or saline. The effect of RS capsule on improvement of microcirculation disturbance induced by high molecular dextran was observed. The results showed that compared with the sham operation group, the brain blood circulation in the model group was significantly decreased; the cerebral infarction area increased; and the behavioral score after cerebral hypoxia was significantly increased (P < 0.05, orP < 0.01). Meanwhile, after the injection of high molecular dextran among rats in the model group, the cerebral leptomeninx microcirculation was obviously slowed down at 3 timepoints, which were 10, 20 and 30 min. Compared with the model group, RS capsule (400 mg·kg-1) can significantly increase the local blood circulation in the brain of mice, improve behavioral disturbance, reduce cerebral ischemia area (P< 0.05, orP < 0.01). RS capsule can also improve blood flow velocity and flow pattern in cerebral leptomeninx microcirculation disturbance induced by high molecular dextran at different timepoints (P < 0.05, orP < 0.01). It was concluded that RS capsule can increase the tolerance against cerebral ischemia, hypoxia and cerebral reserve capacity in order to protect the neural tissues to promote neuronal recovery.
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Allicin is the main active ingredient of Allium Sativum.It is a complex of variety of organic sulfur compounds,which has variety of pharmacological effects,such as anti-tumor, anti-bacterial, anti-inflammatory, anti-ulcer, lowering blood glucose and lipid blood pressure. The paper reviews the research advances about the experimental and clinical application of allicin in recent years.