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With the deepening of China′s healthcare reform, cost control of medical consumables has become an important means to alleviate the problem of " high medical cost" . Through analysis of the difficulties of medical consumables cost control and mechanism loopholes in such control, the authors proposed a whole-process control practice, in terms of assessment, procurement, use, supervision, assessment and evaluation, and recommend on formulating whole-process cost control measures at both government and hospital levels.
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Objective To evaluate the effect of Tandospirone citrate in the treatment of Alzheimer's disease with depression and anxiety disorder. Methods A total of 122 patients with Alzheimer's disease with depression and anxiety were enrolled at the Second Hospital of Jinhua City from January 2015 to December 2016.They were randomly divided into the Lorazepam group(n=61) and the Tandospirone citrate(ADHA)(n= 61).The behavioral pathology in Alzheimer's disease (BEHAVE-AD),self-care ability scale(ADL),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were evaluated in the two groups after three weeks of treatment.The BEHAVE-AD,ADL,HAMA,and HAMD scores and the incidence of adverse reactions were compared between the two groups before and after treatment. Results Baseline scores of BEHAVE-AD, ADL,HAMA and HAMD were not significantly different between the two groups(all P> 0.05). However,post-treatment scores of BEHAVE-AD,ADL,HAMA and HAMD were significantly lower than pre-treatment scores(all P< 0.05),and were more significantly decreased in the Tandospirone citrate group(all P<0.05).Furthermore,the incidence of adverse reactions was significantly lower in the Tandospirone citrate group than that in the Lorazepam group(6.5% vs.19.7%,P< 0.05). Conclusions Compared with Lorazepam,Tandospirone citrate is clinically more effective for Alzheimer's disease complicated with anxiety and depressive disorder.
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Objective:To analyze the different expressions of miRNAs in peripheral blood of rheumatoid arthritis (RA) patients and the osteoclasts in rats,and to verify the key miRNAs in RA.Methods: The miRNAs expressions in monocyte and the co-cultured osteoclasts,peripheral blood of rheumatoid arthritis (RA) patients and normal were detected by miRCURYTM LNA Array.Real time PCR was applied to verify the reliability of miRNA array.The bioinformatics software and database were applied to predict and analyze target genes.Results: miRNA array results showed that 189 miRNAs changed in RA patients compared with the normal;211 miRNAs were changed in osteoclasts group compared with monocytes group.The expressions of ten miRNAs were all abnormal in RA patients and osteoclasts in rats.The results of Real time PCR were consistent with the array.Results of bioinformatics analysis showed that the target gene of miRNA significantly enriched in signaling pathways such as VEGF,MAPK signaling pathways.Conclusion: Some miRNAs had similar abnormal expressions in different species,and these miRNAs may influence the differentiation of the osteoclasts through regulating the related signal passways.
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Objective:To study the mechanism of Qingluo Tongbi Compound (QLT) treating rheumatoid arthritis(RA)by observing miRNA Network of QLT on collagen-induced arthritis ( CIA) mice.Methods:The model of RA was induced by collagenⅡin DBA/1 mice and randomly divided into control group , CIA group, QLT group.Differently expressed miRNAs were detected by miRCURYTM LNA Array.Real-time PCR was applied to verify the reliability of miRNA array.Results:The bioinformatics software and database were applied to predict and analyze target genes.MiRNA array results showed that 221 miRNAs changed in CIA group compared with the control group ,and 169 miRNAs changed in QLT group compared with CIA group.And the results of real-time PCR were consistent with the array.Compared with the control group ,miR-143 was significantly reduced in CIA group ,intervention of QLT obviously upregulated the expression of miR-143.The target genes of miR-143 were significantly stored in VEGF , T cell receptor, MAPK,signaling pathway.Conclusion: Multiple abnormal expression of miRNAs involved in the pathological process of CIA.QLT affected the expression of various miRNAs ,which might be related to immunity ,inflammation,pain pathological process of RA and miR-143 could be a potential target in the treatment.
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Objective To investigate the effect of Pill of Cyperus and Amomum with Six Noble Ingredients in the treatment of gastrointestinal symptoms after chemotherapy in gynecologic cancer patients in serum IgM, IgA and IgG.Methods 72 cases with gastrointestinal symptoms after chemotherapy in gynecologic cancer were selected and all patients were under the IP scheme,and patients were randomly divided into 2 groups,36 cases each.Control group received conventional therapy,study group received more with Pill of Cyperus and Amomum with Six Noble Ingredients,immune functions and peripheral blood, symptom score and KPS score and clinical effect were compared after the treatment.Results Compared with before treatment,2 groups of WBC,NEU,HGB level decreased(P<0.01),CD3 +,NK level,KPS score increased(P<0.05).Compared with the control group, levels of WBC,NEU,HGB in the study group were higher(P<0.01),CD3 +,CD4 +,NK,serum IgG,IgM,IgA levels were higher(P<0.05).Nausea, vomiting,acid regurgitation,appetite symptoms score were lower(P<0.05),KPS scores was higher(P<0.05),the effective rate of the the study group was higher ( P <0.01 ) .Conclusion Pill of Cyperus and Amomum with Six Noble Ingredients in the treatment of gastrointestinal symptoms after chemotherapy in gynecologic cancer patients was curative effect,and it can improve immune function and quality of life and elevated levels of serum IgG, IgM and IgA.
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s:Aim To study the effects of total gluco-sides of paeony ( TGP) on the differentiation of co-cul-tured osteoclasts and the mechanisms of how TGP influ-ences the osteoclasts. Methods The synovial fibro-blasts and monocytes of peripheral blood in adjuvant-induced arthritic rats were separated and co-cultured to induce osteoclasts. The cells were treated with different TGP dosages (5, 50, 500, 5 000 mg·L-1 , and 50 g ·L-1 ) for 48 h. The proliferation, the TRAP activi-ty, and the bone resorption of osteoclasts were ob-served. The levels of IL-1,TNF-α,M-CSF and RANKL in the supernatants of osteoclasts were detected using ELISA. Meanwhile, the expression of ERK, JNK and p38 was detected by real time PCR. Results The ex-periments revealed that 50, 500, 5 000 mg·L-1 TGP inhibited the osteoclast growth, the TRAP activity, and the resorption pit area in a dose-dependent manner. TGP also inhibited the levels of IL-1 , TNF-α, M-CSF and RANKL in the supernatants and the expression of ERK, JNK and p38 in osteoclasts. The appropriate concentrations were 50 mg·L-1 to 5 000 mg·L-1 and had dose-dependent effects within this range. Conclu-sions TGP regulates the differentiation and activity of co-cultured osteoclasts. The effects of TGP are related to its inhibiting the cytokines secretion of synovial fi-broblasts and the activity of MAPK pathways.
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Intrahepatic cholangiocarcinoma is the second most common intrahepatic primary liver tumor after hepatocellular carcinoma (HCC).Epidemiological study suggests a strong correlation between HBV infection and ICC development.This review focused on the potential mechanisms of HBV-induced ICC and gives a primary summary of suggested hypothesis,which included:(1) HBV infection of liver stem/progenitor cells will indirectly lead to HBV infection of intrahepatic biliary epithelial cells and lead to the development of ICC; (2) the changed microenvironment of intrahepatic biliary epithelial cells by HBV infection eventually results in carcinogenesis ; (3) the HBV infection of hepatic sten/progenitor cell can transform into tumor-like stem cells and ultimately differentiate into ICC-like tumor cells.
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[Objective]To explore new directions for traditional Chinese medicine(TCM) scientific research. [Method]Reviewing RWS overseas in recent years, with a randomized control ed trial(RCT) contrast, this study summarized the RWS features and discussed the limitations and advantages of RCT and RWS when carrying out the TCM scientific research.[Result] RWS is different from RCT in research purpose, brings into exclusion criteria, sample size, intervention and evaluation index, evaluation time, data col ection, management and statistical analysis method, etc. [Conclusion] Compared with RCT, RWS more fits the basic characteristics of TCM cal ed holistic concept and syndrome differentiation, is advantageous to the preservation of TCM, indicat-ing the new direction for TCM scientific research.
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Objective To investigate the efficacy of regional lymphadenectomy for patients with T2 gallbladder cancer. Methods From January 1990 to December 2009, 48 patients with T2 gallbladder cancer received regional lymphadenectomy following radical surgery at the Xinhua Hospital of Shanghai Jiaotong University, and their clinical data were retrospectively analyzed. Patients were divided into two groups according to the range of lymphadenectomy. Standard group (23 patients): lymph nodes in the regions of bile duct, common bile duct and hepatoduodenal ligament were dissected; extended group (25 patients): lymph nodes in the regions of hepatoduodenal ligament, head of pancreas, duodenum, portal vein, common hepatic artery and celiac axis were dissected).The condition of patients in the two groups were compared after the treatment. The morbidity and survival rate were analyzed by using Fisher exact test and Kaplan-Meier method, respectively, and the survival rates between the two groups were compared by using Log-rank test. Results No perioperative death was found in the two groups. The morbidities was 17% (4/23) in the standard group and 24% (6/25) in the extended group, with no significant difference between the two groups ( P ＞ 0.05 ). The 5-year cumulative survival rate and median survival time were 40% and 29.8 months in the standard group, and 66% and 53.2 months in the extended group, with significant differences between the two groups ( x2 = 4. 687, P ＜ 0.05 ). Conclusion Extended regional lymphadenectomy should be performed on patients with T2 gallbladder cancer if the primary lesions can be dissected radically.
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Objective To discuss the value of different staging systems for gallbladder cancer.Methods The clinical data of 132 patients with gallbladder cancer who had been admitted to Xinhua Hospital from October 1992 to December 2006 were retrospectively analyzed.The clinical stage and postoperative survival of patients in each stage were analyzed by Nevin staging system,staging systems of AJCC 5th and 6th edition.The survivals of patients were analyzed by Kaplan-Meier method and the comparison between groups was analyzed by Log-rank test.Results According to the Nevin staging system,the accumulative survivals of patients with stages Ⅰ,Ⅱ,Ⅲ,Ⅳ or Ⅴ were 80.3%,75.6%,43.2%,16.2% and 6.5%,respectively.The accumulative survivals of patients with stages Ⅰ,Ⅱ or Ⅲ were significantly higherthan those with stages Ⅳ or Ⅴ(χ~2=7.239,6.152,3.992,12.354,13.171,15.084,P＜0.05).According to the AJCC 5th edition staging system,the accumulative survivals of patients with stagesⅠ,Ⅱ,Ⅲ or Ⅳ were 71.4%,40.9%,10.2% and 5.8%,respectively.The accumulative survivals of patients with stages Ⅰ or Ⅱ were significantly higher than those with stages Ⅲ or Ⅳ (χ~2=18.286,23.729,5.541,13.607,P＜0.05),and the survivals of patients with stage Ⅲ were significantly higher than those with stage Ⅳ (χ~2=7.758,P＜0.05).According to the AJCC 6th edition staging system,the accumulative survivals of patients with stages Ⅰ,Ⅱ,Ⅲ or Ⅳ were 51.1%,11.7%,8.2% and 6.5%,respectively.Patients with stages Ⅰ or Ⅱ had a comparatively low survival,while the survivals of patients with stage Ⅰ were significantly higher than those with stages Ⅱ,Ⅲ or Ⅳ(χ~2=15.300,21.956,31.397,P＜0.05).Patients with stage Ⅱ had a higher survival than those with stage Ⅳ(χ~2=8.789,P＜0.05).There was no significant difference in survival between patients with stage Ⅱ and Ⅲ,and between patients with stage Ⅲ and Ⅳ.Conclusions The AJCC 5th edition staging system is still the perfect staging system of gallbladder cancer.The Nevin staging system is not integrating enough,while AJCC 6th edition staging system is too strict.
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Objective To investigate whether emodin(1,3,8-trihydroxy-6-methylanthraquinone) can attenuate inflammatory response in rats' lungs with acute necrotic pancreatitis (ANP). Method Acute necrotic pancreatitis model was induced by injection of 3% sodium taurocholic acid into the subcapsular of pancreas and emodin was administered by intestine perfusion. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis was measured together with the detection of IL-1β, IL-6 and IL-10 mRNA expressions in rats' lungs by semi-quantitative RT-PCR. Immunohistochemistry was detected the expression of IL-1β converting enzyme (ICE) in the rats' lungs. Result Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis groups are obviously high as compared with normal group(P＜0.05). Plasma amylase was (1 611.20±218.72)IU/L in normal group. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis groups were (1 981.40±56.81)IU/L, (3 287.40±612.37)IU/L and (4 914.60±746.82)IU/L. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis after treatment with emodin groups were obviously low as compared with acute necrotic pancreatitis groups. The plasma amylase was(1 617.20±136.80)IU/L,(2 323.40±318.19) IU/L and (2 670.20±390.03)IU/L respectively. The study showed that the mRNA expression of pro-inflammatory cytokin IL-1β and the expression of IL-6, as well as the expression of IL-1β converting enzyme(ICE) were decreased and IL-10 was increased. Conclusion The study demonstrates that emodin plays an important role in reducing plasma amylase level. Emodin exerts anti-inflammatory effects in acute necrotic pancreatitis rats' lungs by downregulating the mRNA expression of IL-1β and IL-6 and upregulating the mRNA expression of IL-10.
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‘Stasis-heat’is a pathological factor that arises from exogenous and endogenous injuries in the development and progression of diseases.It can also be the pathogenesis at a certain stage of disease.It manifests clinically as the syndrome of‘Stasis-heat Interactivity.’Through long-term clinical practice‘Stasis-heat’has been found to spread in a variety of diseases’processes and has general clinical significance.Using‘Stasis-heat’theory in prescribing an herbal formula can significantly improve clinical efficacy,displaying the advantages of using traditional Chinese medicine to prevent and treat acute and severe diseases.According to more than 30 years of research and clinical practice,based on ongoing discussion and revision by experts,we have developed the‘Guide to TCM Syndrome Differentiation and Treatment of Stasis-heat Interactivity Syndrome,’a work that is an essential reference for both Chinese medicine and integrated Chinese and Western medicine clinicians.This article lays the groundwork in the hope that other experts will provide further input that will improve the guidelines laid out in this piece of work.
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Objective To observe the effect of serum containing Qingluo Tongbi Granula (QTG) on proliferation of fibroblast-like synoviocytes(FLS) and receptor activator of nuclear factor-?B ligand (RANKL) expression in FLS from patients with rheumatoid arthritis.Methods Synovial specimens obtained from the joint of patients were minced into small pieces for the culture of FLS.The morphological features of FLS subcultrued for 3～5 generations were observed under inverted microscope and electron microscope.The effect of QTG-containing serum on the proliferation of FLS was examined by MTT assay.The expression of RANKL in FLS was assessed by RT-PCR.Results After cocultured by serum containing large-dose QTG for 72 hours,proliferation of FLS and expression of RANKL were inhibited.Conclusion QTG can inhibit FLS proliferation,and reduce the expression of RANKL,which may be one of the therapeutic mechanisms of QTG for rheumatoid arthritis.
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Objective:To observe the effects of Qingluotongbi granule(QLT) on the changes of cytokines in adjuvant induced arthritis(AIA) model of rats.Methods:The AIA model of rats were induced by complete Freunds adjuvant. Various doses of QLT were given by gavage once daily for 21 days.Results:QLT〔7.2,14.4 g/(kg?d).ig〕markedly decreased the levels of IL-1 and TNF-? in AIA rats.Conclusion:QLT has modulating effects on the alternations of cytokines of AIA model.
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Objective:To investigate the effects of Qingluotongbi granule(QLT) on RANKL(receptor activator of nuclear factor-?B ligand) expression in peripheral blood T lymphocytes of RA patients.Methods:RANKL expression of peripheral blood T lymphocyts was examined using flow cytometry.Six cases of RA patients were enrolled with six healthy volunteers as the control.Meanwhile examination for the level of RANKL expression in T cells after incubation in presense of QLT-contained serum was observed.Results:RANKL expression of peripheral blood T lymphocytes was much higher in active state RA patients than in healthy people(P
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AIM: To select optimum purification of Qingluotongbi decoction (Caulis Sinomenii etc.). METHODS: Qingluotongbi decoction was refined respectively by ceramic membrane microfiltration, ultrafiltration, alcohol sedimentation, high speed centrifugalization, flocculation and macroporous resin absorption. Their refining effect was compared according to indexes of color, clarity, loss rate of sinomenine, removal ratio of impurity. RESULTS: All kinds of purification made decoction light and clear. Removal ratio of impurity by macroporous resin absorption was the highest and reached 80% or more. Removal ratio of impurity by ceramic membrane microfiltration was 21.17% , less than that by alcohol sedimentation or ultrafiltration, but more than that by flocculation and centrifugalization. Loss rate of sinomenine by AB 8 type macroporous resin absorption was the lowest and reached 6.39% , and that by ceramic membrane microfiltration was 15.31% , less than that by ultrafiltration, alcohol sedimentation, centrifugalization and flocculation. The chromatogram of decoction disposed by macroporous resin was different from that of decoction unsettled, but that disposed by ceramic membrane was similar to that of decoction unsettled. CONCLUSION: The technique of ceramic membrane microfiltration is optimum purification of Qingluotongbi decoction with the virtues of moderate removal ratio of impurity, small amount lose rate of sinomenine and simple process.
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AIM: To observe the effect of Qingluo Tongbi Granule(QLTBG)——containing serum on the proliferation of osteoblasts(OB) and osteoclasts(OC),the activity of AKP of OB. METHODS: (1) OB were separated from the skull of SD rats aged 1 d and OC from the thighbone and shinbone of SD rats aged 5 d.(2) The proliferation of OB and OC was detected by MTT method,and the activity of AKP of OB was examined by diazol method. RESULTS: The proliferation capability of OB was strengthened markedly by the rat sera containing 7.2,14.4 g/kg QLTBG,which could reinforce the activity of AKP obviously as well,while the proliferation of OB was inhibited remarkably by the rat sera containing 3.6,7.2,14.4 g/kg QLT. CONCLUSION: The sera containing QLTBG could enhance the proliferation of OB and the activity of AKP,restrain the proliferation of OC simultaneously.