Brief analysis on main indications and compatibility rules of Ciliao (BL 32) based on data mining / 中国针灸

Based on the data mining technology, the main indications and compatibility rules of Ciliao (BL 32) were analyzed and summarized. The relevant literature was retrieved from the databases of CNKI, Wanfang, VIP, Cochrane Library, SinoMed, Scopus, Web of Science, EMbase and PubMed, from the date of establishment to September 8, 2021. Using the software of SPSS Modeler 18.0 and Gephi0.9.2, the included literature was analyzed by data mining. A total of 218 articles were included, of them, there were 36 articles using single-acupoint prescriptions and 182 articles using compound prescriptions. Acupuncture was the most frequently used intervention of Ciliao (BL 32), followed by electroacupuncture. Dysmenorrhea and labor analgesia were the dominant indications of single-acupoint prescriptions of Ciliao (BL 32), and 9 diseases i.e. dysmenorrhea, urinary incontinence, urinary retention, chronic pelvic inflammatory disease, chronic prostatitis and lumbar disc herniation were the dominant indications of compound prescriptions. The main indications of Ciliao (BL 32) involved diseases of reproductive system, urinary system and waist. There were 92 acupoints in compatibility with Ciliao (BL 32), which were main belonged to the bladder meridian, the conception vessel and the spleen meridian, the most frequently used acupoints were Sanyinjiao (SP 6), Guanyuan (CV 4), Shenshu (BL 23) and Zhongji (CV 3).

LIU Zhi-shun's experience in treatment of infertility with decreasing ovarian reserve with electroacupuncture / 中国针灸

To summarize LIU Zhi-shun's clinical experience in treatment of infertility with decreasing ovarian reserve (DOR) with electroacupuncture. LIU Zhi-shun believes that the location of infertility with DOR is the uterus, mainly involving the kidney, thoroughfare and conception vessels. He advocates to select acupoints by combining "disease-symptom-position" with prescription, and selects acupoint prescription of Bushen Tiaochong Zhuyun included Guanyuan (CV 4), Zigong (EX-CA 1), Tianshu (ST 25), Sanyinjiao (SP 6), Ciliao (BL 32) and Zhongliao (BL 33) for electroacupuncture treatment. The key points of operation are accurate positioning and deep acupuncture, focusing on regulating mind and getting qi, adopting electroacupuncture treatment and low frequency stimulation and treating slowly for long-term disease.

Network Pharmacology-based Analysis on Mechanism of Aconiti Lateralis Radix Praeparata and Epimedii Folium in Treatment of Chronic Heart Failure / 中国实验方剂学杂志

Objective:To explore the mechanism of the prescription consisting Aconiti Lateralis Radix Praeparata and Epimedii Folium in the treatment of chronic heart failure （CHF） based on network pharmacology，followed by verification in H9c2 myocardial cells with hypoxia-reoxygenation injury <italic>in vitro</italic> and in zebrafish with vascular endothelial growth factor receptor （VEGFR） tyrosine kinase inhibitor Ⅱ （VRI） -induced vascular insufficiency. Method:The active ingredients in Aconiti Lateralis Radix Praeparata and Epimedii Folium were searched from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP），the corresponding target genes from the Universal Protein Resource （UniProt）， and the CHF-related targets from Online Mendelian Inheritance in Man （OMIM） and GeneCards. Both the active ingredient-potential target network and the active ingredient-CHF-related target network were generated using Cytoscape 3.6.1， followed by the protein-protein interaction （PPI） network construction and Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genome （KEGG） enrichment analysis based on MetaScape. H9c2 myocardial cells exposed to hypoxia-reoxygenation were selected for determining the proliferation-promoting effect by methyl thiazolyl tetrazolium （MTT） assay. The protein expression of B-cell lymphoma-2（Bcl-2）， Bcl-2-associated X protein（Bax），cysteinyl aspartate-specific protease-3（Caspase-3）， protein kinase B（PKB/Akt），phosphorylated protein kinase B（p-Akt），phosphorylated extracellular signal-regulated kinases 1/2 （p-ERK1/2），extracellular signal-regulated kinase 1/2 （ERK1/2）， and poly adenosine diphosphate ribose polymerase（PARP）was detected by Western blotting. The efficacy of the prescription in promoting angiogenesis was verified in a zebrafish model of VRI-induced vascular injury. Result:There were 28 active ingredients for the prescription， 209 corresponding targets， 1 296 CHF-related targets， and 94 common gene targets shared by the prescription and CHF. PPI network clustering suggested that Aconiti Lateralis Radix Praeparata and Epimedii Folium alleviated CHF by interfering with cell differentiation and metabolism and angiogenesis. GO analysis revealed that CHF relief was achieved via the intervention in such biological processes as cell migration，vascular development， and angiogenesis. Pharmacodynamic experiments verified that Epimedii Folium （10 mg·L^-1） alone and the prescription （10 mg·L^-1）both enhanced the proliferation of H9c2 myocardial cells under the hypoxia-reoxygenation condition （<italic>P</italic><0.05），while the latter also increased the expression of Bcl-2，Bcl-2/Bax， and PARP （<italic>P</italic><0.05） and reduced the expression of Caspase-3， Akt， and ERK （<italic>P</italic><0.05）. The prescription at the concentrations of 0.3 and 0.1 g·L^-1 promoted angiogenesis （<italic>P</italic><0.05）. Conclusion:Aconiti Lateralis Radix Praeparata and Epimedii Folium exert the therapeutic effect against CHF via multiple ingredients，multiple targets， and multiple channels. Such combination promotes the proliferation of H9c2 myocardial cells under hypoxic condition and protects zebrafish from vascular injury by up-regulating the expression of Bcl-2 and PARP，increasing Bcl-2/Bax ratio，and down-regulating the expression of Caspase-3，Akt， and ERK.

Mechanisms of Classical Prescriptions and Their Active Components in Immunosenescence Regulation： A Review / 中国实验方剂学杂志

As the body ages， the immune system will undergo a series of changes， which are termed "immunosenescence" and are embodied in immune cells. Previous studies have shown that the immune cells involved in the regulation of immunosenescence include intrinsic immune cells and adaptive immune cells. Intrinsic immune cells are neutrophils， monocytes/macrophages， myeloid-derived suppressor cells， dendritic cells， natural killer cells， etc.， and the underlying mechanisms involve the regulation of cell number， phagocytosis， chemotaxis， adhesion， the function of toll-like receptor （TLR）， antigen presentation， macrophage polarization， cytotoxicity， migration， etc. The adaptive immune cells include T-lymphocytes and B-lymphocytes， and the underlying mechanisms involve the regulation of cell development， proliferation， differentiation， cell number， telomerase activity， self-reactive antibodies， etc. Immunosenescence is the manifestation of aging in the human body and is also an important target for delaying aging by Chinese medicine and western medicine. In recent years， scholars have found some classical prescriptions and their active components （such as Dushentang and total saponins in Panax ginseng leaves， and Shengmaiyin and anwulignan and total saponins in P. ginseng stems and leaves） can regulate immunosenescence by targeting the immune cells and interfering with their molecular regulatory mechanisms. In addition， the mechanisms of the classical prescriptions in regulating immunosenescence are closely related to autophagy. The representative prescription embodying the therapeutic principles of resolving blood stasis and promoting regeneration， Dahuang Zhechongwan， can delay D-galactose-induced renal aging in mice， and its underlying mechanisms are related to the regulation of the number and activity of thymic immune cells and improvement of the protein expression of autophagy-related markers and inflammatory cytokines in the kidney. Therefore， exploring the effects of the classical prescriptions and their active components by targeting the mechanisms of immunosenescence will become a new direction for investigating and developing anti-aging drugs.

Daphnane-type diterpenes from genus Daphne and their anti-tumor activity / 中草药·英文版

Daphnane-type diterpenenoids are the major biologically active constituents in the genus Daphne. We find that there are about 101 Daphnane-type diterpenes in this genus, most of those compounds show different degrees of inhibitory effect on various cancer cell. Some of them have been studied in depth and the potent molecular mechanisms might be associated with modulation of different cell-signaling pathways. In addition, some compounds of this type also can inhibit the synthesis of protein and DNA. Absolutely, the anti-tumor activity of Daphnane-type diterpenes is worthy of attention. Unfortunately, most of the current research on the activity of these compounds is focused on simple drug efficacy, and its in-depth mechanism research is far from enough. On the other point of view, there still exists wide growing space on the depth of these compounds.

Rhein inhibits hydrogen peroxide-induced apoptosis of human umbilical vein endothelial cells and its mechanism / 中国中药杂志

This study investigated the effect of rhein(RH) on the apoptosis and autophagy of human umbilical vein endothelial cells(HUVECs) induced by hydrogen peroxide(H_2O_2) and its underlying mechanism. The oxidative damage model in HUVECs was established and the cells were divided into different treatment groups. Cell survival rate was detected by MTT assay, apoptosis by Annexin V-FITC/PI double staining and Hoechst 33258 fluorescence staining, autophagy by Ad-mCherry-GFP-LC3 B adenovirus transfection, and protein expression by Western blot. The results showed that RH could protect cells by increasing the cell survival rate in a dose-dependent manner, decreasing the expression of apoptosis-related proteins(Bax and cleaved caspase-3) and the ratio of Bax/Bcl-2, elevating the expression of Bcl-2, up-regulating the expression of microtubule-associated protein 1 light chain 3(LC3)-Ⅱ, and down-regulating the expression of p62. Adenovirus transfection results showed that RH could increase the green and red spots, as well as the yellow spots. However, after the addition of autophagy inhibitor 3-MA, autophagy was reduced and apoptosis was increased. RH could enhance the expression of silent information regulator 2 related enzyme 1(SIRT1). The addition of SIRT1 inhibitor EX-527 reduced the protective effect of RH and cell viability. The addition of 3-MA had no effect on the expression of SIRT1 protein, but the expression of SIRT1 and LC3-Ⅱ proteins decreased and the expression of p62 increased after the addition of EX-527. After RH treatment, the phosphorylation of adenosine monophosphate-activated protein kinase(AMPK) increased, while that of the mechanistic target of rapamycin(mTOR) decreased in a dose-dependent manner. Moreover, this effect could be weakened by the AMPK inhibitor compound C. RH may enhance autophagy through SIRT1/AMPK/mTOR pathway to reduce H_2O_2-induced apoptosis of HUVECs.

Localization of Melanoma-associated Antigen MAGEA1 and Identification of Its Interacting Proteins / 中国生物化学与分子生物学报

Melanoma associated antigen family A1 (MAGEA1) is expressed in germ cells and tumors of various histological origins, but its mechanism is still unclear. In this study, the eukaryotic recombinant MAGEA1 expression plasmids with Flag or GFP tags were constructed and transfected into HeLa and HEK293T cells. Western blotting, immunocytochemistry, co-immunoprecipitation, nuclear protein and cytoplasmic protein separation, and mitochondrial isolation were used to detect the expression and location of MAGEA1 and its interaction with other proteins in cells. The results of immunocytochemistry (ICC) and Western blotting showed that the overexpressed MAGEA1 was mainly localized in the cytoplasm and partially co-localized with mitochondria. Co-immunoprecipitation experiments verified the interactions between MAGEA1 and TRIM31, SNW1, HDAC1, and found that MAGEA1 may mainly interact with HDAC1 in the cytoplasm. The studies above indicate that MAGEA1 may be involved in different cellular biological processes and co-localize with mitochondria. It interacts with TRIM31, SNW1 and HDAC1, while MAGEA1 may mainly interact with HDAC1 in the cytoplasm. We propose that it may be involved in protein ubiquitination and the Notch signaling pathway. The results of this study laid an experimental foundation for the subsequent in-depth study of the mechanism of MAGEA1.

Effects of compatibility on pharmacokinetics of mangiferin in INS-1 cells and its intracellular distribution / 中国药理学通报

Aim To investigate the effect of compatibility of phellodendron amurense on the pharmacokinetics of mangiferin(MGF) in INS-1 cells, and the distribution of mangiferin in normal and oxidatively damaged INS-1 cells. Methods INS-1 cells were administered in equal doses of mangiferin, anemarrhena and anemarrhena-phellodendron herb pair. LC-MS/MS was used to determine the content of MGF in INS-1 cells. The normal and model groups (INS-1 cells were treated with 140 μmol · L

Roles of autophagy onself-renewal and differentiation of mesenchymal stem cells / 华西口腔医学杂志

Mesenchymal stem cells (MSCs), which have the potential of self-replication and differentiation, are a very valuable cell source for stem cell-based medical therapy. Their application has opened up a new way for disease research. Although MSCs can maintain cell stemness through self-renewal, with the prolongation of cell passage and culture time, the stemness of MSCs gradually decays, and the cell aging and differentiation potential decreases gradually. Autophagy is a highly conserved cytological process that degrades the modified, excess, and deleterious cytoplasmic components in autophagosomes, which are then degraded by fusion with lysosomes. As the main intracellular degradation and recycling pathway, autophagy plays an active role in maintaining cell homeostasis, self-renewal and pluripotency. In this paper, the role of autophagy in self-renewal and maintenance of multidirectional differentiation potential of MSCs was reviewed, which laid a theoretical foundation and practical basis for the research and application of MSCs.

Advances in research on relationship between osteoporosis and intestinal microbe / 上海交通大学学报（医学版）

Osteoporosis, one of the severest diseases in the middle-aged and elderly population, is the result of the disorder of the normal bone turnover process. At present, many studies have shown that bone turnover is closely related to the microbial environment in the human body. The largest microbiota in the human body exists in the intestine and plays an important role in the normal physiological activities of the body, such as nutrition, metabolism, immunity and barrier. Intestinal microbe can regulate endocrine and immune system through a series of processes, thereby affecting the process of bone turnover in the body. This article briefly reviews the current research about the effects of intestinal microbe on the process of bone turnover in the body. It is expected to provide new ideas for the treatment of osteoporosis by exploring the relationship between osteoporosis and intestinal microbe.

The prevalence and risk factors of metabolic syndrome in Chinese population based on the multi center cross-sectional survey / 中华疾病控制杂志

Objective To understand the prevalence and risk factors of metabolic syndrome (MS) among different ethnic groups. Methods A multicenter cross-sectional survey was conducted. Subjects were selected by multistage stratified random sampling. Physical examination and laboratory testing were performed to collect MS related indicators, and the prevalence was standardized by the 6th general survey data. Further multivariate and logarithmic linear model methods were applied to analyze the risk factors and interaction. Results The overall prevalence of MS was 19.58%. The highest prevalence of MS was in Korean, followed by Han, while the lowest was in Kazakh. The rates of MS, overweight and obesity were higher in men than those in women, and increased along with age. Multivariate analysis result showed that the odds ratio (OR) of female to male was 0.556, and aging increased the risk of MS. The OR of central obesity was 2.765, and would reach to 4.259 when the waist-to-body ratio was over 0.52. The logarithmic linear model showed that the overweight/obesity, hyperglycemia, hypertension and dyslipidemia had independent effects on the risk of MS. Also, there were interactions in the four indicators. Conclusions The incidence of MS is high and the positive interaction between the overweight/obesity, hyperglycemia, hypertension and dyslipidemia is observed, making MS a common crisis to clinical and public health. In order to prevent and control MS, and to reduce the risk of cardiovascular and cerebrovascular diseases and diabetes, early screening of MS should be strengthened and lifestyle intervention should be carried out.

Health-related risky behaviors in adolescents with high functioning autism / 中国实用儿科杂志

OBJECTIVE: To investigate the characteristics of health-related risky behaviors in adolescents with High Functioning Autism(HFA). METHODS: Fifty adolescents aged 12-18 years,IQ≥70 and meeting the criteria of autistic disorder in Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ),and 50 age-and gendermatched healthy controls were recruited. The health-related risky behaviors of all subjects were assessed with the Adolescents Health-related Risky Behavior Inventory(AHRBI). The parents of autistic subjects completed the Adolescents Health-related Risky Behavior Inventory for Parent(AHRBI-P). RESULTS: HFA group had higher total scale score and four subscales' scores of AHRBI than controls,including Suicide and Self-Injury(SS),HealthCompromising Behavior(HCB),Aggression and Violence(AV)and Rule Breaking(RB)(all P<0.05). HFA group had higher scores than controls in the items of "Bullying/Threatening/Intimidating partner", "Deliberately pushing and shoving others", "Not drinking milk/soy milk", "Not participating in any form of physical activity", "Skiping class/Playing truant", "Running away from home", "Biting/Scratching/Bumping to hurt oneself"(all P<0.05). Among all the subscales and items,the scores of HCB,SS, "Not drinking milk/soy milk", "Physical discomfort due to dieting", "Fighting and Arms-taking" and "Drinking" of self-assessment in HFA group were higher than those of parents' assessment(all P<0.05]. CONCLUSION: The adolescents with HFA have more health-related risky behaviors than the healthy adolescents except for Smoking and Drinking(SD)and Unprotected sex(US).

Health-related risky behaviors in adolescents with high functioning autism / 中国实用儿科杂志

OBJECTIVE: To investigate the characteristics of health-related risky behaviors in adolescents with High Functioning Autism(HFA). METHODS: Fifty adolescents aged 12-18 years,IQ≥70 and meeting the criteria of autistic disorder in Diagnostic and Statistical Manual of MentalD isorders,Fourth Edition(DSM-Ⅳ)and 50 age-and gender-matched healthy controls were recruited. The health-related risky behaviors of all subjects were assessed with the Adolescents Health-related Risky Behavior Inventory(AHRBI). The parents of autistic subjects completed the Adolescents Health-related Risky Behavior Inventory for Paren(tAHRBI-P). RESULTS: HFA group had higher total scale score and four subscales' scores of AHRBI than controls,including Suicide and Self-Injury(SS),Health-Compromising Behavior(HCB),Aggression and Violence(AV)and Rule Breaking(RB)[e.g. Total Scores,49.5(39,81)vs. 47(38,60),P<0.05;SS scores,7(5,18)vs. 5(5,12),P<0.05]. HFA group had higher scores in the items of "Bully/Threaten/Intimidate partner", "Deliberately pushing and shoving others", "Do not drink milk/soy milk", "Do not participate in any form of physical activity", "Skip Class/Play truant", "Run away from home", "Bite/Scratch/Bump to hurt oneself" than controls[e.g. the scores of the item "Bully/Threaten/Intimidate partner",1(1,5)vs. 1(1,3),P<0.05]. Among all the subscales and items,the scores of HCB,SS, "Do not drink milk/soy milk", "Physical discomfort due to dieting", "Fighting and Arms-taking" and "Drinking" of selfassessment in HFA group were higher than those of parents' assessment[e.g. HCB scores,8(8,18)vs. 7(5,13),P<0.05]. CONCLUSION: The adolescents with HFA have more health-related risky behaviors than the healthy adolescents except for Smoking and Drinking(SD)and Unprotected Sex(US).

Involvement of Spinal CCL2 in Remifentanil-induced Hyperalgesia in Rats / 中山大学学报(医学科学版)

remifentanil；hyperalgesia；CCL2；microglia@#【Objective】To observe C-C motif chemokine ligand 2（CCL2）mediates remifentanil-induced hyperalgesia by activating microglia in rats.【Methods】Thirty-six adult male SD rats were equally and randomly divided into 6 group with 6 rats in each group：normal saline ，remifentanil，saline + intrathecal injection of phosphate buffer saline（PBS）， remifentanil + intrathecal injection of PBS，saline + intrathecal injection of CCL2 neutralizing antibody and remifentanil + CCL2 neutralizing antibody. To establish remifentanil-induced hyperalgesia model，remifentanil［4 μg/ （kg·min）2 h］ was continuously infused into rats via the tail vein. Then ，immunofluorescence and western blot were performed to examine the expression of spinal CCL2 in rats. Thirty minutes before remifentanil infusion，intrathecal injection of CCL2 neutralizing antibody was performed to observe remifentanil-induced hyperalgesia and the effect on the activation of microglial in the spinal cord of rats.【Results】Compared with the normal saline group，the thermal and mechanical pain thresholds in the remifentanil group were significantly reduced（P < 0.05）. The expression of protein（0.66 ± 0.071 vs. 0.18 ± 0.04；P < 0.001）and average immunofluorescence density of spinal CCL2（0.170 ± 0.009 vs. 0.047 ± 0.006；P < 0.001）were significantly increased on the first day after remifentanil infusion. Prior intrathecal injection of CCL2 neu⁃ tralizing antibody not only inhibited remifentanil-induced activation of microglia in the spinal cord（P < 0.001），but also mitigated remifentanil-induced thermal hyperalgesia and mechanical pain sensitivity（P < 0.05）.【Conclusion】CCL2 me⁃ diates the remifentanil-induced hyperalgesia by activating spinal microglia in rats.

Protective Effect of Salvianolic Acid B on Myocardial Injury in Septic Rats / 中国实验方剂学杂志

Objective:To explore the effect of salvianolic acid B (Sal-B) on the myocardial apoptosis in rats with sepsis. Method:The 50 male SD rats were randomly divided into sham operation group, model group (cecal ligation and perforation were performed to replicate the animal model of sepsis)and Sal-B low, medium and high-dose group(6, 12, 24 mg·kg-1).The myocardial necrosis markers troponin T(TnT), cardiac troponin I (cTnI), creatine kinase-MB (CK-MB) and the tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were assayed by enzyme-linked immunosorbent assay(ELISA).The antioxidant enzyme superoxide dismutase (SOD) activities and malonaldialdehyde (MDA) levels in myocardial homogenates were determined by spectrophotometrically. Haematoxylin-eosin (HE) staining was used to evaluate the pathological change in rats. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL) was used to detect apoptosis of myocardial cells in hearts, respectively. Western blot was used to detect the expression levels of apoptosis-related protein cysteine protease-3 (Caspase-3), b-lymphocytoma-2 (Bcl-2), Bcl-2-related X protein (Bax), autophagy microtubule-related light chain 3 (LC3) and Beclin-1 in myocardial tissue. Result:Compared with sham group, the levels of TnT, CK-MB and cTnI in model group were significantly increased (Pα, IL-1β and IL-6 in myocardial tissue were significantly increased (PPPPPPPα, IL-1 and IL-6 in the myocardial tissue were significantly decreased (PPPPPPPPPPConclusion:Sal-B showed a protective effect on the myocardial apoptosis in septic rats maybe by depressing inflammatory infiltration, anti-oxidative effects and improving the exceptional expression of the proteins such as Bax, Bcl-2, Caspases-3 by enhancing the level of autophagy.

Preparation and Characterization of High Carbamazepine-loading Solid Dispersion / 中国药学杂志

OBJECTIVE: To prepare high carbamazepine (CBZ) loading solid dispersion and investigate its solubilization mechanism and stability. METHODS: The effects of different drug-carrier ratios and preparation METHODS on dissolution were investigated by intrinsic dissolution rate. The existing form of CBZ in the solid dispersion was characterized by differential scanning calorimetry(DSC) and powder X-ray diffraction(PXRD). The micromorphology was observed with scanning electron microscopy and the solubilization mechanism was probed by wettability test and particle size measurement. RESULTS: The solid dispersion prepared by hot-melt extrusion with the drug/carrier ratio of 4∶1 demonstrated the highest dissolution, which was 327 fold that of the untreated drug. CBZ in the solid dispersion was small crystalline which had been transformed from polymorph III to . Wettability of the solid dispersion in hydrochloric acid solution was increased significantly, which could be rapidly dispersed into a nanometer-sized suspension. The solid dispersion was very stable without any changes for more than 6 months under accelerated test conditions. CONCLUSION: The CBZ solid dispersion with 80% drug loading prepared by hot melt extrusion with a hydrophilic polymer, Eudragit EPO, as carrier possesses satisfactory properties such as fast drug dissolution and excellent stability.

Identification of Newly Diagnosed Diabetes and Prediabetes Using Fasting Plasma Glucose and Urinary Glucose in a Chinese Population: A Multicenter Cross-Sectional Study / 中华医学杂志(英文版)

<p><b>Background</b>Although fasting plasma glucose (FPG) has been highly recommended as the sole test for diabetes screening, the efficacy of FPG alone for diabetes screening is potentially limited due to its low sensitivity. The aim of this study was to improve the efficacy of FPG for diabetes screening using urinary glucose (UG).</p><p><b>Methods</b>This study was initiated on November 12, 2015, and ended on June 28, 2016. A representative sample of individuals aged between 18 and 65 years, with no history of diabetes, from 6 cities in Jiangsu Province participated in this study. A 75-g oral glucose tolerance test was used to diagnose diabetes. All urine samples were collected within 2 h of oral glucose loading to measure UG. Partial correlation analyses were used to evaluate the associations between UG and other glycemic variables, including FPG, 2-h plasma glucose (2h-PG), and glycated hemoglobin A1c, after adjustment for age. The performance of UG was evaluated using a receiver operating characteristic (ROC) curve analysis.</p><p><b>Results</b>Of the 7485 individuals included, 8% were newly diagnosed with diabetes and 48.7% had prediabetes. The areas under the ROC curves for UG were 0.75 for estimation of 2h-PG ≥7.8 mmol/L and 0.90 for 2h-PG ≥11.1 mmol/L, respectively. The sensitivity and specificity of UG were 52.3% and 87.8%, respectively, for 2h-PG ≥7.8 mmol/L (cutoff point ≥130 mg), and 83.5% and 87.5%, respectively, for 2h-PG ≥11.1 mmol/L (cutoff point ≥178.5 mg). The combination of FPG and UG demonstrated a significantly higher sensitivity than that of FPG alone for the identification of diabetes ([483/597] 80.9% vs. [335/597] 56.1%, χ = 85.0, P < 0.001) and glucose abnormalities ([2643/4242] 62.3% vs. [2365/4242] 55.8%, χ = 37.7, P < 0.001).</p><p><b>Conclusions</b>The combination of UG and FPG substantially improves the efficacy of using FPG alone for diabetes screening; this combination might be a practical screening tool and is worth being recommended in the future.</p>

How does the world's most efficient healthcare system respond to the challenge? Hong Kong's health governance system, healthcare system reform and implications for mainland China / 中国卫生政策研究

Mainland China's healthcare system reform has achieved remarkable results. As the reform progresses ,more efforts could be made in policy-learning from other Chinese societies with more successful experiences. Hong Kong Special Administrative Region has an internationally renowned healthcare system, ranked at the top in the world's most efficient health systems. This paper reviews Hong Kong's health governance system, the challenges it has faced, its reform initiatives in the recent years, and discusses their implications for the mainland China. Heath governance in Hong Kong has fully realized the separation of regulationswith operation, thus overcoming major institutional barriers. The Hospital Authority of Hong Kong has demonstrated very high efficiency and managerial professionalism. However, Hong Kong's healthcare system is also facing various daunting challenges, and the government has introduced a series of reform initiatives, including the Voluntary Health Insurance Scheme, Public-Private Partnership, and Elderly Health Care Voucher. Many reform ideas and policy instruments can be of reference value for healthcare system reforms in the mainland.

Effects of China diabets educator training and its influencing factors / 中华护理杂志

Objective To describe the effects of China diabetes educator training and explore the influencing factors.Methods Totally 314 diabetes educators who graduated from Johnson & Johnson Diabetes Institute(JJDI) from 2007 to 2014 were recruited and investigated via self-designed evaluation form.Results The total score was 76.64±22.24.The top three items with highest scores were performing nurses training (93.36±62.81),form of health education (84.27±23.09) and working responsibility and procedure of diabetes educator (82.07±32.43).The items scored lower than 60 were regular follow-up system(56.16±31.74),publishing health education papers(38.47±47.75) and conducting related researches (26.11±44.00).Multiple linear regression analysis showed that educators who had longer time of working in diabetes department(t=3.515,P=0.001) and whose post were educators(t=3.404,P=0.001) and who were not first line practitioners (t=-2.589,P=0.001) had higher scores.Conclusion The educators' main work in China is focusing on regular health education.Follow-up management and research renovation capacity should be enhanced in the future for educators.

Identification of Mutations in Myocilin and Beta-1,4-galactosyltransferase 3 Genes in a Chinese Family with Primary Open-angle Glaucoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Glaucoma is a major cause of irreversible blindness worldwide. There is evidence showing that a subset of the disease is genetically determined. In this study, we screened for mutations in chromosome 1q-linked open-angle glaucoma (GLC1A) in a Chinese family with primary open-angle glaucoma (POAG).</p><p><b>METHODS</b>A total of 23 members from five generations of a family were enrolled and underwent thorough ophthalmologic examinations. In addition, 200 unrelated healthy Chinese controls were also recruited as normal control. GLC1A gene was amplified by polymerase chain reaction, and DNA sequencing was performed to screen for mutations.</p><p><b>RESULTS</b>Six members were diagnosed as POAG, with severe clinical manifestations, and history of high intraocular pressures. The mean age of disease onset was 26.3 years. However, the others were asymptomatic. In six affected and three asymptomatic members, gene sequencing revealed a mutation c.C1456T in exon 3 of myocilin gene (MYOC). Furthermore, we also identified a novel mutation c.G322A in beta-1,4-galactosyltransferase 3 (B4GALT3) gene in all six affected and three asymptomatic members, which was not reported previously in POAG patients. The two newly identified variants were absent in other family members as well as controls.</p><p><b>CONCLUSION</b>The mutations c.1456C < T (p.L486F) in MYOC and c.322G < A (p.V108I) in B4GALT3 are likely responsible for the pathogenesis of POAG in this family.</p>