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Objective:To investigate the effect of curriculum on the awareness and attitude on the rural-oriented medical education among medical students.Methods:The grade 2019 and 2020 medical students of rural-oriented program in Hebei Medical University were enrolled. Two different curricula were adopted in the first year, for students of grade 2020 more courses in general medicine, humanities and social sciences were added, and not for those of grade 2019. A questionnaire survey was conducted at the end of their first academic year. The questionnaire contained the basic information of students, opinions and satisfaction with curriculum design, understanding of policies about rural-oriented medical education, and the sense of career identity; each item in the questionnaire was scored by 5-point Likert scale.Results:A total of 173 questionnaires were distributed and 161 valid questionnaires were recovered, with a recovery rate of 93.1%; there were 55 responders (15 males and 40 females) from grade 2019, and 106 from grade 2020 (52 males and 54 females). The main reasons for choosing rural-oriented program were job security (60.0% (33/55) in 2019 and 58.5% (62/106) in 2020), the main way to know the relevant policies of the program was through the internet (54.5% (30/55) in 2019 and 66.0% (70/106) in 2020); 34.5% (19/55) of grade 2019 students were willing to continue working in rural areas after contracted period of service, while the percentage was 47.2% (50/106) for grade 2020. Students in grade 2020 had a higher satisfaction scores on the content and quality of teaching courses, as well as teaching satisfaction compared to those in grade 2019( t=2.34 and 3.00, P<0.05). The awareness of relevant policies before enrollment and policies related to contract violations among grade 2020 students was higher than that of grade 2019( t=2.70 and 5.08, P<0.05); the scores of all questions about general practice answered by students in grade 2020 were higher than those in grade 2019( t=3.96, 3.37, 3.55, 2.85, 3.84, 5.26 and 5.10,all P<0.05). There were no statistically significant differences in the scores of cognitive, emotional, behavioral, and adaptive aspects of career identity between students of two grades( t=0.70, 0.78, 0.74 and 1.37,all P>0.05). Conclusions:The reformed curriculum has positive effect on the satisfaction and awareness of rural-oriented medical education program and relevant policies among medical students in the program; however, it has less effect on the sense of career identity and willingness to continue to work in rural areas after the contracted period of serve.
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The self-health management level of patients with coronary heart disease depends largely on their health literacy level. The theory of health ecology believes that the factors affecting individual health are multi-level. Based on the perspective of health ecology, this paper analyzed the influencing factors of health literacy of patients with coronary heart disease from five aspects: personal characteristics, behavior, interpersonal network, living and working conditions, environmental policies, so as to provide a basis for formulating targeted and systematic strategies for improving the health literacy of patients with coronary heart disease in the future.
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OBJECTIVE To build an “integration of drug storage and dispensing” intelligent drug validity management system in outpatient pharmacy， and to evaluate the effect of this system. METHODS The information technology was used to connect the drug information in the primary storage， the intelligent secondary storage and the rapid dispensing machine； an “integration of drug storage and dispensing” intelligent drug validity management system was constructed. At the same time， the implementation effects of drug validity management system in outpatient pharmacy of our hospital were evaluated one year before and after the construction of the system. RESULTS By using information technology， intelligent closed-loop management of batch number and expiration date information throughout the entire process of drug circulation in outpatient pharmacy of our hospital had been achieved， making it easy to track and trace drug information. After the establishment of the intelligent system， the time spent on managing drug validity every month was reduced from 103 people·h to 8 people·h； the number of near-expired drugs per month had decreased from （30.67±1.10）types to （17.67±1.17）types（P＜0.05）. CONCLUSIONS The intelligent drug validity management system in outpatient pharmacy based on the mode of “integration of drug storage and dispensing” makes the drug validity management in the outpatient pharmacy more scientific， reasonable and efficient.
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OBJECTIVE To prepare progesterone-2-chloro-4-nitroaniline cocrystal （CNA） so as to improve the solubility of progesterone and primarily evaluate the safety of the progesterone cocrystal in vivo. METHODS Using progesterone as the main body and CNA as the ligand， progesterone-CNA cocrystal was prepared with solvent evaporation method. The cocrystal was characterized by X-ray single crystal diffraction， X-ray powder diffraction （XRPD）， differential scanning calorimetry （DSC） and Fourier transform infrared spectroscopy （IR）. The dissolution rate of cocrystal was compared with those of progesterone and physical mixture. Forty-eight female KM mice were randomly divided into normal group （phosphate buffer containing 0.1% dimethyl sulfoxide）， progesterone group （16 mg/kg）， CNA group （9 mg/kg）， progesterone-CNA cocrystal low-dose， medium- dose and high-dose groups （6， 12.5， 25 mg/kg）， with 8 mice in each group. They were given relevant medicine/solvent intramuscularly， once a day， for consecutive 14 d. The safety of cocrystal was evaluated primarily by determining/observing the changes in body weight， organ index， tissue morphology， blood routine indicators， and liver and kidney function indicators. RESULTS The new crystal structure in the X-ray single crystal diffraction results， the new characteristic peak in the XRPD pattern， the change of melting point in the DSC results， and the change of the characteristic peak position in the range of 3 500- 2 750 cm－1 and 1 700-1 250 cm－1 in the infrared spectrum all Δ 基金项目国家重点研发计划项目（No.2022YFC3502100） indicated that progesterone-CNA cocrystal was successfully ＊第一作者 硕士研究生 。研究方向 ：药物制备技术与工艺 。 prepared， and the dissolution rate of cocrystal was more than E-mail：SWB_1221@163.com # 通信作者教授，硕士生导师，博士。研究方向：药物制备技术与 twice that of the progesterone raw material drug. The results of 工艺。E-mail：wuxx-415@126.com in vivo safety experiments showed that the mortality rate of all 中国药房 2023年第34卷第13期 China Pharmacy 2023 Vol. 34 No. 13 · 1567 · groups was zero. Compared with normal group， uterine indexes of mice in progesterone group and progesterone-CNA cocrystal groups were significantly increased （P＞0.05）， and endometrium was also thickened； there was no statistical difference in the changes of body mass， liver and kidney function， liver index， kidney index， the number of leukocyte， lymphocyte and neutrophil in routine blood test among those groups （P＞0.05）， and the morphology of liver and kidney tissue has also no significant difference. However， the number of plasma red blood cells in the progesterone group decreased significantly （P＜0.05）， and there was no statistical significance in the number difference of red blood cells among progesterone-CNA cocrystal groups （P＞0.05）. CONCLUSIONS The progesterone-CNA cocrystal is successfully prepared with good safety in vivo， which significantly improve the solubility of progesterone.
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At present, the extension tube of the ventilator, a long corrugated tube used in clinical practice, needs to be disconnected from the endotracheal tube when performing open sputum suction. Under positive pressure, the condensed water containing pathogenic microorganisms in the ventilator will be splashed. Some will form aerosol suspended in the air, pollute the air, increase the risk of cross-infection and operator pollution, while the ventilator will emit a corresponding alarm sound, resulting in noise pollution. Based on the above factors, a ventilator pipeline extension tube was designed by the medical staff of department of critical care medicine of the Eighth Medical Center of People's Liberation Army General Hospital and department of critical care medicine of Beijing Friendship Hospital of Capital Medical University, and was obtained the National Utility Model Patent of China (ZL 2020 2 1476518.X). The device consists of the main pipe, first pipe sleeve, second pipe sleeve, valve body, joystick, axial sleeve, etc., which can not only effectively avoid air pollution and reduce the risk of cross-infection, but also reduce noise pollution and the negative impact of loud noise on patients and medical staff.
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The miR-34 family plays an important role in gastric cancer, and the inactivation or reduced expression of the miR-34 family is detected in gastric cancer cell lines and gastric cancer tissues compared with normal gastric mucosa tissues, indicating it is associated with the occurrence and development of gastric cancer. Studies have shown that miR-34 plays a key role in inhibiting gastric cancer progression by regulating IGF2BP3, survivin, Bcl-2 and epithelial-mesenchymal transition-related pathway, indicating that miR-34 is an important target for gastric cancer treatment. In terms of clinical treatment, miR-34 has not only been proved to have radiochemotherapy sensitization, but also achieved good curative effect in tumor clinical trials. With the emergence of miR-34 vectors targeting gastric cancer, it is possible to use it for gastric cancer treatment. Deep understanding of the molecular basis and clinical efficacy of miR-34 for gastric cancer treatment can help to evaluate the potential of the miR-34 family as a new therapeutic target for gastric cancer.
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Ventilators are currently the most commonly used auxiliary mechanical ventilation equipment in clinical practice, and play an important role in the treatment of hypoxemia. Ventilator-associated pneumonia (VAP) is a special type of pulmonary parenchymal inflammation of nosocomial infection in patients with mechanical ventilation, which leads the increase of mortality and affects the prognosis of patients. The non-standard management of ventilator pipeline joints and the aerosol formed by bacterial condensate splashed from ventilator pipeline pollute the air, resulting in cross infection, which are the important reasons for VAP. The existing ventilator pipeline joint cap can achieve the effect of preventing pollution, but the clinical application compliance is not high. Based on the above factors, teachers, students and medical staff of the School of Public Health and Management, Guangxi University of Chinese Medicine and other units have designed a device for preventing pollution and air pollution of the ventilator pipeline joint, and obtained the national utility model patent of China (ZL 2020 2 1361981.X). The device is composed of a model lung, a mask body, a suspension part and a beam mouth part, etc. The use method is simple, and can be applied to the pollution avoidance of invasive ventilator and non-invasive ventilator pipeline joints, to reduce the occurrence of VAP in patients and the occupational exposure of medical staff.
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Objective:To identify the risk factors of cognitive dysfunction in patients with atrial fibrillation and to establish a risk prediction model.Methods:The convenience sampling method was used to evaluate 260 patients with atrial fibrillation who were hospitalized in the Department of Cardiology of the Affiliated Hospital of Jining Medical College from January to December 2020. The cognitive function of the patients was evaluated with the Montreal Cognitive Function Assessment Scale (MoCA). Univariate analysis was used to screen the independent variables that had influence on the occurrence of cognitive dysfunction, and the statistically significant variables were included in the multivariate Logistic regression model. According to the regression coefficients of statistically significant variables, a line map was drawn to construct the risk prediction model of cognitive dysfunction in patients with atrial fibrillation.Results:There were 209 cases with cognitive impairment and 51 cases without cognitive impairment. Univariate analysis showed that sex, age, smoking history, drinking history, education level, free thyroxine, hemoglobin, D-dimer and BMI ( χ2 values were 4.08-18.83, t values were -6.04-2.94, Z=-2.76) were significantly different between the patients with or without cognitive dysfunction. The results of multivariate Logistic regression analysis showed that age ( OR values were 1.13), education level ( OR=0.01-0.05), quit smoking history ( OR=0.36), drinking history ( OR=0.35) and free thyroxine( OR=1.14) had significantly statistical significance ( P<0.05). The area under ROC curve (AUC) = 0.878 and AUC>0.8, this model had good clinical prediction ability. Conclusions:The construction of cognitive dysfunction risk prediction model for patients with atrial fibrillation can prevent or intervene high risk factors in advance, facilitate clinical use, and provide data support for the improvement of cognitive function in patients with atrial fibrillation.
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Objective:To evaluate the effect of aromatherapy on fatigue in maintenance hemodialysis patients.Methods:Searching related domestic and foreign databases from the establishment of the database to September 1st, 2020, included 6 randomized controlled trials of maintenance hemodialysis patients using aromatherapy to relieve fatigue, a total of 435 patients, including 213 in the experimental group and 222 in the control group example. StataMP 16.0 software was used for Meta-analysis.Results:The result of Meta-analysis was SMD=-0.94, 95% CI -1.71, -0.18, and the combined effect size of the two groups was compared, and the difference was statistically significant ( Z value was 2.42, P<0.05). Subgroup analysis using essential oil varieties as indicators showed that the lavender and citrus essential oil mixed group SMD=-1.89, 95% CI -3.22, -0.57, the combined effect size was statistically significant ( Z value was 2.80, P<0.05); The results of subgroup analysis using essential oil measurement as an indicator showed that the 2-drop group SMD=-1.65, 95% CI -2.65, -0.65, and the combined effect size was statistically significant ( Z value was 3.23, P<0.05); The results of subgroup analysis using intervention time as an indicator showed that the 8-week group SMD=-1.23, 95% CI -1.77, -0.70, and the combined effect size was statistically significant ( Z value was 4.51, P<0.05). Conclusions:Aromatherapy can effectively reduce the fatigue level of maintenance hemodialysis patients, and the positive effect of aromatherapy on fatigue is closely related to the type, dosage and intervention time of essential oils.
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Objective:To understand the effect of a new tracheal tube fixation device in the "double fixation" of oral tracheal intubation for critically ill patients in adult emergency department.Methods:A retrospective analysis of patients with oral tracheal intubation admitted to our EICU from January 2016 to June 2017 was performed using traditional tape and inch band fixation as a control group; the experience of treatment from July 2017 to December 2018 for patients with oral tracheal intubation, the new double-fixation method of tracheal tube fixation device was used as the observation group. The degree of displacement, oral cleanliness, facial skin allergies and injuries, and comfort of the two groups of patients was compared.Results:The rate of tracheal displacement in the experimental group was mildly 11.2% (11/98), moderately 5.1% (5/98), and the control group was mildly 24.2% (15/62), moderately 14.5% (9/62) and severe 6.5% (4/62). The incidence of facial skin allergy and skin damage was 6.1% (6/98), 0, and the control group was 24.2% (15/62), 11.3% (7/62), the difference was statistically significant ( Z value was -4.021, χ2 value was 24.48, P<0.05). The comfort score of the test group was (1.05±1.01) points, which was significantly higher than (2.10±1.71) points of the control group ( t value was 4.920, P<0.01). Conclusions:The new type of tracheal tube fixation device "dual fixation" for critically ill patients with mechanical ventilation through oral endotracheal intubation is visually beautiful, and has good firmness and comfort. It can effectively reduce the occurrence of adverse events and has good application value.
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Objective:To investigate the effects of programmed death-ligand 1 (PD-L1) expression on the biological behaviors of gastric cancer cell line MKN45.Methods:The PD-L1 gene of gastric cancer cell line MKN45 was silenced by RNA interference technique. MKN45 cells were divided into blank control group, si-NC group (transfected with siRNA-NC) and si-PD-L1 group (transfected with siRNA-PD-L1). Quantitative real-time PCR was used to detect the mRNA expressions of PD-L1 and epithelial-mesenchymal transformation (EMT)-related proteins E-cadherin, Vimentin and Snail in MKN45 cells, and Western blotting was used to detect the expression levels of PD-L1 protein in MKN45 cells of each group. Transwell migration test, Transwell invasion test and MTT test were used to detect the migration, invasion and adhesion abilities of MKN45 cells.Results:The relative expression levels of PD-L1 mRNA in the blank control group, si-NC group and si-PD-L1 group were 1.002±0.092, 1.005±0.121 and 0.237±0.017, respectively, with a statistically significant difference ( F=75.61, P<0.001). The protein expression levels of PD-L1 in the three groups were 0.944±0.028, 1.008±0.088 and 0.269±0.015, respectively, with a statistically significant difference ( F=172.99, P<0.001). The mRNA and protein expression levels of PD-L1 in the si-PD-L1 group were lower than those in the other two groups (all P<0.001), but there were no statistically significant differences between the blank control group and si-NC group (all P>0.05). The cell migration rates of the blank control group, si-NC group and si-PD-L1 group were (1.000±0.020)%, (1.012±0.084)% and (0.488±0.050)%, respectively, with a statistically significant difference ( F=80.73, P<0.001). The cell invasion rates of the three groups were (0.929±0.087)%, (0.924±0.208)% and (0.300±0.100)%, respectively, with a statistically significant difference ( F=19.37, P<0.001), and the cell adhesion rates of the three groups were (100.000±5.407)%, (99.280±4.845)% and (59.723±2.674)%, respectively, with a statistically significant difference ( F=79.87, P<0.001). Compared with the blank control group and si-NC group, the migration, invasion and adhesion abilities of MKN45 cells in the si-PD-L1 group decreased significantly (all P<0.001). The expression levels of E-cadherin mRNA of the three groups were 1.000±0.023, 0.981±0.051, 3.618±0.201, the expression levels of Vimentin mRNA were 1.000±0.043, 1.108±0.150, 0.328±0.011, the expression levels of Snail mRNA were 1.061±0.103, 1.090±0.110, 0.304±0.043, respectively, with statistically significant differences ( F=477.17, P<0.001; F=65.97, P<0.001; F=72.70, P<0.001). Compared with the blank control group and si-NC group, the mRNA expression levels of Vimentin and Snail of MKN45 cells in the si-PD-L1 group decreased, while the expression level of E-cadherin mRNA increased, with statistically significant differences (all P<0.001). Conclusion:Silencing the expression of PD-L1 can reduce the migration, invasion and adhesion abilities of MKN45 cells, and the mechanism may be related to the effect of PD-L1 on the EMT pathway of gastric cancer.
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Objective:To understand the research status and research hotspots of syndrome differentiation nursing of pectoral stuffiness pain(coronary disease), analyze its existing problems, and provide reference for the development of related research in the future.Methods:The China National Knowledge Infrastructure(CNKI) database was used as a data source to search for relevant literatures. We analyzed the authors, institutions and keywords with CiteSpace 5.3.R8 software, and drew the distribution map of the number of literature published by the related authors and institutions with GraphPad Prism 6.07 software.Results:A total of 356 articles were included in the study. The research power in the field of syndrome differentiation nursing of pectoral stuffiness pain(coronary disease) was mainly concentrated in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. The researchers were mainly Lin Xiaoli and Yang Yuzhu. After clustering 58 keywords, 6 research hotspots of syndrome differentiation nursing for pectoral stuffiness pain(coronary disease) were discovered: importance of emotional nursing; exploration of different nursing forms; study of prognostic significance; embodiment of clinical application value; syndrome differentiation nursing of integrating Chinese and Western medicine; application of characteristic nursing technology of Traditional Chinese Medicine.Conclusions:Among the six research hotspots, the emotional nursing, syndrome differentiation nursing of integrating Chinese and Western medicine and application of characteristic nursing technology of Traditional Chinese Medicine are the research hotspots in recent years(2011-2018). In addition, in order to promote the progress and development of this field, it is necessary to strengthen cooperation and exchanges between authors and institutions, and conduct more in-depth research on the basis of existing research, constantly explore new research directions, and further improve the system of syndrome differentiation nursing.
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Objective:Through the analysis of the ancient books for pectoral stuffiness pain, to explore the relevant Chinese herbal medicine prescriptions, the main syndrome factors corresponding to the prescriptions and the content of medication nursing.Methods:We used the database of Chinese Medical Code (5th Edition) as the data source, and established a database, extracted relevant contents. In the end we carried out statistical analysis and discussion.Results:Four main syndrome factors were extracted from the 102 kinds of prescriptions, which were cold coagulation, qi stagnation, blood stasis and turbid phlegm. The corresponding medication nursing measures mainly contained five aspects, including the temperature, time, frequency, solution of taking medicine and medication taboo. Among them, the temperature of taking medicine was mainly warm and hot; the time of taking medicine was mainly before eating, after eating, empty stomach, before breakfast, at noon, Before sleep and regardless of the time; the frequency of taking medicine was mainly two times a day, three times a day, three times a day and once a night; the solution of taking medicine was mainly wine, porridge, ginger decoction, orange peel decoction, Chen-pi decoction, vinegar decoction and so on; the medication taboo was mainly onions, pork, cold, cabbage, mutton and so on.Conclusion:The study of medication nursing for pectoral stuffiness pain based on the theory of syndrome factors is beneficial to promote the theoretical and clinical research for the disease. It can promote the standardization of medication nursing, improve the nursing staff's ability of syndrome differentiation nursing, and provide a reference for clinical medication nursing of Traditional Chinese Medicine.
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Objective:To explore the diagnostic value of chest CT imaging in differential diagnosis between common-type COVID-19 and mycoplasma pneumonia (MP).Methods:From the January to February 2020, the clinical and imaging data of COVID-19 patients (diagnosed in the Affiliated Hospital of Jining Medical University, the Fourth People's Hospital of Jining and the Second People's Hospital of Jining) and MP patients (diagnosed in the Affiliated Hospital of Jining Medical University) were retrospectively collected and analyzed. Forty-three patients with common-type COVID-19 (28 males, 15 females, 43±14 years old) and 50 patients with MP (19 males, 31 females, 37±14 years old) were enrolled as COVID-19 group and MP group, respectively. The clinical manifestations, laboratory results and chest CT findings of these two groups were analyzed and compared.Results:(1) Clinical manifestations: there were more patients with muscle ache and asthenia in COVID-19 group than in MP group (χ 2=5.110, 4.834, P<0.05). No significant difference was found in fever and cough between two groups (χ 2=0.378, 0.097, P>0.05). (2) Laboratory examination: the procalcitonin level of cases in COVID-19 group was significantly lower than that in MP group (χ 2=12.263, P=0.001). No significant difference was found in leukocyte count, lymphocyte count, C-reactive protein level and erythrocyte sedimentation rate ( Z=-1.117, χ 2=2.410, 0.787, 0.800, all P>0.05) between two groups. (3) Chest CT findings bilateral lung involvement was found more in COVID-19 group than in MP group (χ 2=30.012, P<0.001); while the one lobe of ipilateral lung involvement was less in COVID-19 group than in MP group (χ 2=19.927, P<0.001); there was no significant difference in multiple lobes of ipilateral lung involvment between the two groups (χ 2=1.366, P>0.05). Ground glass, paving stone sign and air bronchus sign were found significantly more in COVID-19 group than in MP group (χ 2=30.171, 19.119, 9.790, all P<0.05); while the pulmonary consolidation, central lobular nodule and centripetal thickening of bronchus wall were found significantly less in COVID-19 group than in MP group (χ 2=25.450, 33.532, 48.553, all P<0.001). Conclusions:The clinical manifestations and laboratory examination have limited value in the differential diagnosis of common-type COVID-19 and MP, while chest CT imaging might be more valuable in the early differential diagnosis of these two diseases.
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Objective To survey on training for general practice backbone mentors in tertiary hospitals of Hebei province.Methods A questionnaire survey on training status was conducted among general practice backbone mentors in tertiary hospitals of Hebei Province.The survey items included the basic information,knowledge of general practice and its training,suggestions for mentors training and general practice discipline construction in tertiary hospitals.Results Total 208 questionnaires were distributed and 208 were retrieved with a recovery rate of 100％.Among 208 participants,all of them were over the age of 30;202 (97.1％) had bachelor degree or above;202 (97.1％) were attending doctors or above;165 (79.3％) had worked for more than 10 years;169 (81.3％) had no or little knowledge of general practice;159 (76.4％)had not received general practice training before;124 (59.6％) thought that general practitioners were not qualified as "gatekeeper" at present;and 192 (92.3％) worked in the hospitals providing standardized residency training.The training contents in general section were prioritized as clinical skills,community health service development and policy,rules for general practice standardized training,theoretical training,the present situation and countermeasure of general teaching,the doctor-patient relationship and medical ethics.The contents in training method section were prioritized as lecture series of clinical medicine,case discussion,seminar,distance education with classroom teaching.The suggestions for mentors training included:the exploration of standardized training model,perfecting continuing education system for general practice mentors,more attention to the training at community health service centers and the consummation of general practice system.The suggestions for general practice discipline construction were that more attentions should be paid by the government and the hospitals leaders,the general practice departments in tertiary hospitals should closely cooperate with community health service centers in training ofqualified general practitioners.Conclusions The specialists in tertiary hospitals of Hebei province do not have enough knowledge about general practice and do not quite understand the necessity of establishment of general practice department,so the training for general practice mentors should be strengthened and improved.Properly policy and more social resources from the government and the hospitals leaders will be helpful for construction of general practice discipline in general hospital.
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Objective To assess the characteristics and satisfaction of outpatients in walk-in clinic of a grade A tertiary hospital.Methods A total of 1 100 outpatients visiting walk-in clinic of the Second Hospital of Hebei Medical University during March 2016 and June 2016 were randomly selected for the questionnaire survey.The self-designed questionnaire included the general information of patients,the satisfaction degree to the walk-in clinic,to special clinics of the hospital or to community clinics and related reasons,and suggestions for further improvement.Results Total 947 valid questionnaires were received with a retrieval rate of 86.09％.Most of participants had one chronic disease (594,62.72％).The satisfaction degree of walk-in clinic (1.78) was higher than that of hospital special clinics (1.93) (P =0.010),in turn the latter(2.33)was higher than that of conmmnity clinics (P ＜ 0.001).The reasons for patient to choose the walk-in clinic were wide range of medications (389,41.08％),reliable quality (285,27.98％),short waiting time (249,26.29％) and so on.Suggestions for improvement of the walk-in clinic were further reducing the waiting time (428,45.20％),need specialists for chronic disease management (210,22.18％),raising reimbursement rate (172,18.16％) and so on.The reasons for patients to choose special clinic were need readjusting prescription (587,61.99％),special disease or drug (427,45.09％).The reasons of dissatisfaction with special clinic were long waiting time (476,50.26％),frequent transfer to multiple departments (221,23.34％),high registration fee (221,23.34％).The reasons for patients to choose community clinic were short distance (350,36.96％),better environment (350,36.96％),short waiting time (184,19.43％).The reason of dissatisfaction with community clinic were low qualification of medical staff (405,42.77％),insufficient medications (392,42.39％);distrusting the quality of drugs (263,27.77％).Suggestions for improvement of the community clinics were upgrading the qualification of medical staff (317,33.47％),enlarging drug variety (298,31.47％),improving medical environment (94,9.93％) and so on.Conclusion Most outpatients visiting walk-in clinic of grade A tertiary hospital are highly satisfied the clinic.To meet the patients' needs the primary medical unit should further improve their overall service.
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Cryptotanshinone (CPT) is a natural compound isolated from traditional Chinese medicine Salvia miltiorrhiza Bunge. In the present study, the regulatory effect and potential mechanisms of CPT on tumor necrosis factor alpha (TNF-α) induced lectin-like receptor for oxidized low density lipoprotein (LOX-1) were investigated. Human umbilical vein endothelial cells (HUVECs) were cultured and the effect of TNF-α on LOX-1 expression at mRNA and protein levels was determined by Real-time PCR and Western blotting respectively. The formation of intracellular ROS was determined with fluorescence probe CM-DCFH2-DA. The endothelial ox-LDL uptake was evaluated with DiI-ox-LDL. The effect of CPT on LOX-1 expression was also evaluated with SD rats. TNF-α induced LOX-1 expression in a dose- and time-dependent manner in endothelial cells. TNF-α induced ROS formation, phosphorylation of NF-κB p65 and ERK, and LOX-1 expression, which were suppressed by rotenone, DPI, NAC, and CPT. NF-κB inhibitor BAY11-7082 and ERK inhibitor PD98059 inhibited TNF-α-induced LOX-1 expression. CPT and NAC suppressed TNF-α-induced LOX-1 expression and phosphorylation of NF-κB p65 and ERK in rat aorta. These data suggested that TNF-α induced LOX-1 expression via ROS activated NF-κB/ERK pathway, which could be inhibited by CPT. This study provides new insights for the anti-atherosclerotic effect of CPT.
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Animales , Ratas , Aorta , Western Blotting , Células Endoteliales , Fluorescencia , Células Endoteliales de la Vena Umbilical Humana , Lipoproteínas , Medicina Tradicional China , Fosforilación , Especies Reactivas de Oxígeno , Reacción en Cadena en Tiempo Real de la Polimerasa , ARN Mensajero , Rotenona , Salvia miltiorrhiza , Factor de Necrosis Tumoral alfaRESUMEN
PURPOSE: Isocryptotanshinone (ICTS) is a natural bioactive product that is isolated from the roots of the widely used medical herb Salvia miltiorrhiza. However, few reports exist on the mechanisms underlying the therapeutic effects of ICTS. Here, we report that ICTS has anticancer activity and describe the mechanism underlying this effect. METHODS: The antiproliferative effect of ICTS was determined using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) and clonogenic assays. The effect of ICTS on the cell cycle was measured using flow cytometry. Apoptosis was determined by Hoechst 33342 staining, DNA fragmentation assays, and Western blotting for apoptotic proteins. Finally, the effect of ICTS on mitogen-activated protein kinases (MAPKs) was determined by Western blotting. RESULTS: ICTS significantly inhibited proliferation of MCF-7 and MDA-MB-231 human breast cancer cells, HepG2 human liver cancer cells, and A549 human lung cancer cells in vitro. Among the tested cell lines, MCF-7 cells showed the highest sensitivity to ICTS. ICTS significantly inhibited colony formation by MCF-7 cells. Furthermore, exposure of MCF-7 cells to ICTS induced cell cycle arrest at the G1 phase and decreased mitochondrial membrane potential. Hoechst 33342 staining and Western blot analysis for apoptotic proteins suggested that ICTS induced apoptosis in MCF-7 cells. In addition, ICTS activated MAPK signaling in MCF-7 cells by inducing time- and concentration-dependent phosphorylation of JNK, ERK, and p38 MAPK. CONCLUSION: Our results suggest that ICTS inhibited MCF-7 cell proliferation by inducing apoptosis and activating MAPK signaling pathways.
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Humanos , Apoptosis , Western Blotting , Neoplasias de la Mama , Ciclo Celular , Puntos de Control del Ciclo Celular , Línea Celular , Fragmentación del ADN , Citometría de Flujo , Fase G1 , Células Hep G2 , Neoplasias Hepáticas , Neoplasias Pulmonares , Células MCF-7 , Potencial de la Membrana Mitocondrial , Proteínas Quinasas Activadas por Mitógenos , Proteínas Quinasas p38 Activadas por Mitógenos , Fosforilación , Salvia miltiorrhizaRESUMEN
Neocryptotanshinone (NCTS) is a natural product isolated from traditional Chinese herb Salvia miltiorrhiza Bunge. In this study, we investigated its anti-inflammatory effects in lipopolysaccharide (LPS)-stimulated mouse macrophage (RAW264.7) cells. MTT results showed that NCTS partly reversed LPS-induced cytotoxicity. Real-time PCR results showed that NCTS suppressed LPS-induced mRNA expression of inflammatory cytokines, including tumor necrosis factor α (TNFα), interleukin-6 (IL-6) and interleukin-1β (IL-1β). Moreover, NCTS could decrease LPS-induced nitric oxide (NO) production. Western blotting results showed that NCTS could down-regulate LPS-induced expression of inducible nitric oxide synthase (iNOS), p-IκBα, p-IKKβ and p-NF-κB p65 without affecting cyclooxygenase-2 (COX-2). In addition, NCTS inhibited LPS-induced p-NF-κB p65 nuclear translocation. In conclusion, these data demonstrated that NCTS showed anti-inflammatory effect by suppression of NF-κB and iNOS signaling pathways.
RESUMEN
Tanshinones are a large class of hydrophobic natural products isolated from traditional Chinese herb Salvia miltiorrhiza Bunge and related plants. Tanshinones include tanshinone ⅡA, cryptotanshinone, tanshinone I, dihydrotanshinone, and so on. Both the tanshinones and the salvianolic acids have been identi-fied as the characteristic and main active ingredients of Salvia miltiorrhiza Bunge with cardiovascular protective activities. Ac-cumulated data in recent years have revealed that tanshinones possess remarkable anti-cancer activities both in vivo and in vitro. In this review, we summarize the latest progress of the an-ti-cancer effect and the underlying mechanisms of tanshinones, particularly with emphasis on tanshinone ⅡA, which might pro-vide reference for the further research and development of these compounds.