Does High-Speed Rail Opening Affect the Health Care Environment?-Evidence From China.

Using the panel data of 280 prefecture-level cities in China from 2004 to 2014, this paper examines the effects of high-speed rail opening on health care environment based on Difference-in-Differences method (DID). Through an empirical analysis, the results proved that high-speed rail opening can significantly promote the health care environment and this effect is different in regions with different levels of economic development. Finally, we tested the mechanisms of how the high-speed rail opening affects the healthcare environment. High-speed rail opening improves the healthcare environment by increasing road accessibility and promoting economic development. Our results support the view that high-speed rail opening has an important contribution to the improvement of health care conditions.

MiR-223 promotes pyroptosis of enteritis cells through activating NF-κB signalling pathway by targeting SNIP1 in inflammatory bowel disease.

Inflammatory bowel disease (IBD) is a common inflammation-related intestinal disease. Studies have shown that excessive pyroptosis of intestinal cells is involved in the development of IBD. However, the regulatory mechanism of pyroptosis in IBD remains unclear. Here, our study purposed to clarify the underlying regulatory mechanism of miR-223 to promote pyroptosis in IBD.MiR-223 and Smad Nuclear Interacting Protein 1 (SNIP1) expression in colon tissues collected from IBD patients and healthy volunteers were evaluated using qRT-PCR. Cell viability and pyroptosis were evaluated by CCK8 and flow cytometry assay, respectively. Pyroptosis-related proteins and nuclear factor κB (NF-κB) signals were determined by WB. Dual-luciferase reporter gene assay was employed to investigate the binding relationship between miR-223 and SNIP1.MiR-223 was significantly upregulated in IBD colon tissues and cell models, while SNIP1 was significantly decreased. Silence of miR-223 markedly enhanced cell viability and inhibited pyroptosis in the IBD cell model. MiR-223 could bind to 3'-UTR of SNIP1 and SNIP1 could activate NF-κB signalling pathway. Further rescued experiment found that knockdown of SNIP1 dramatically abolished the bio-effects mediated by miR-223 silence on the cell viability and pyroptosis of the IBD cell model. Likewise, the inactivation of NF-κB signalling markedly weakened the regulatory roles of SNIP1 downregulation in the IBD cell model. Besides, inhibition of NF-κB signalling attenuated the pyroptosis-promoting effect of overexpressing miR-223.Our data suggested that miR-223 activated the NF-κB pathway via targeting SNIP1, thus promoting the process of cell pyroptosis, and ultimately participating in the pathogenesis of IBD.

[Intervention mechanism of electroacupuncture in rats with ulcerative colitis: an analysis based on the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-kappa B signaling pathway].

OBJECTIVE: To investigate the protective effect of electroacupuncture(EA) on rats with ulcerative colitis (UC) and its effect on the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-kappa B (NF-κB) signaling pathway. METHODS: Sprague-Dawley rats were randomly divided into blank group, model group, salicylazosulfapyridine (SASP) group, low-intensity EA group, and high-intensity EA group, with 8 rats in each group. Enema with 2，4，6-trinitrobenzenesulfonic acid was performed to establish a model of UC. The rats in the two EA groups were given EA at"Tianshu" (ST25), "Guanyuan" (CV4), and "Zusanli"(ST36) for 15 min each time, once a day, with a current intensity of 1 mA for the low-intensity EA group and 5 mA for the high-intensity EA group(among them, "Tianshu" "Zusanli" bilateral alternate acupoints); the rats in the SASP group were given SASP suspension 3 mL every day by gavage. The course of treatment was 15 days for all groups. HE staining was used to observe the pathology of the colon and determine tissue damage index(TDI); ELISA was used to measure the serum levels of interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-17 (IL-17), and prostaglandin E2 (PGE2); immunohistochemical staining and real-time PCR were used to measure the protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue. RESULTS: Compared with the blank group, the model group had significant reductions in body weight, serum IL-4, and IL-10 (P<0.05) and significant increases in colonic mucosa TID, the serum levels of IL-17 and PGE2 and the protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05). Compared with the model group, the SASP group and the EA groups had significantly higher body weight and serum levels of IL-4 and IL-10 (P<0.05), as well as significantly lower colonic TDI, serum levels of IL-17 and PGE2, and integrated optical density and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05). Compared with the SASP group, the low-intensity EA group had significantly higher colonic TDI and protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05), and compared with the SASP group, the high-intensity EA group had a significantly higher body weight (P<0.05) and lower colonic TDI and protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05). Compared with the low-intensity EA group, the high-intensity EA group had significantly higher body weight (P<0.05), and lower colonic TDI and protein and mRNA expression of TLR4, MyD88, and NF-kB in colonic tissue (P<0.05). CONCLUSION: Electroacupuncture exerts a protective effect on the colonic mucosa in rats with UC possibly by inhibiting the TLR4/MyD88/NF-κB signaling pathway and reducing the release of inflammatory cytokines, and high-intensity EA may have a better effect than low-intensity EA.

Quality assessment of clinical research on liver cancer treated by intra-arterial infusion of Chinese medicine.

OBJECTIVE: To assess the methodological quality of clinical research on Chinese medicine (CM) applied by intra-arterial infusion in treating primary liver cancer (PLC). METHODS: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and three Chinese databases, including Chinese BioMedical Database (CBM), China National Knowledge Infrastructure (CNKI) and China Academic Journal (VIP) were searched. Chinese articles were also searched manually in 16 journals. Two reviewers independently selected studies, the quality of literatures were assessed according to the Cochrane Collaboration method of quality assessment. RESULTS: A total of 14 articles met the inclusion criteria for this review. Only three of these articles described the randomization method used. None of the studies was blinded. All of the articles didn't report the calculation of the sample size. Only six studies mentioned adverse reactions. All of the studies were of grade C according to the Cochrane Collaboration method. Six studies reported results of survival, and only two of these reported better efficacy in the treatment groups. CONCLUSIONS: The quality of studies concerned intra-arterial infusion of CM in treating with PLC was poor and the exact effect of these medicines still need evaluation. Well designed RCTs with large sample sizes, adequate follow-up data and reliable methods of assessment are needed to better appraise the real effect of CMs in the treatment of PLC patients.

[A comparative study of inflammatory factor expression of phlegm-heat syndrome and phlegm-dampness syndrome model with acute exacerbation of chronic obstructive pulmonary disease].

OBJECTIVE: To reveal characteristic of phlegm-heat syndrome and phlegm-dampness syndrome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) from expression of inflammatory factor. METHODS: Forty-eight Wistar rats were randomly divided into four groups (each n=12): normal control group, AECOPD group, phlegm-heat syndrome of AECOPD group (PHs group) and phlegm-dampness syndrome of AECOPD group (PDs group). The expressions of interleukins (IL-1ß, IL-6, IL-10), tumor necrosis factor-α (TNF-α) proteins in lung tissue were detected by immunohistochemical staining method. IL-1ß mRNA and IL-10 mRNA expressions were measured by reverse transcription- polymerase chain reaction (RT-PCR). RESULTS: The mRNA and protein expressions of inflammatory factors in lung tissue in AECOPD group, PHs group and PDs group were remarkably enhanced compared with those in normal control group. Compared with AECOPD group, the protein expressions of IL-1ß, TNF-α and IL-6 and the mRNA expression of IL-1ß in lung tissue in PHs group and PDs group were markedly enhanced (IL-1ß protein: 6.26 ± 2.43, 8.20 ± 2.61 vs. 4.30 ± 2.38, TNF-α protein: 10.28 ± 2.64, 10.67 ± 2.68 vs. 7.47 ± 2.90, IL-6 protein: 8.13 ± 3.03, 10.45 ± 3.37 vs. 5.66 ± 3.18, IL-1ß mRNA: 0.41 ± 0.03, 0.48 ± 0.05 vs. 0.35 ± 0.04, all P<0.01), and the expressions of IL-10 protein and IL-10 mRNA were obviously weakened (IL-10 protein: 7.00 ± 1.89, 4.70 ± 2.31 vs. 9.33 ± 2.58, IL-10 mRNA: 0.43 ± 0.05, 0.35 ± 0.03 vs. 0.52 ± 0.06, P<0.05 or P<0.01). The protein expressions of IL-1ß and IL-6 proteins and the mRNA expression of IL-1ß in PDs group were significantly higher than those in PHs group, while the expressions of IL-10 protein and IL-10 mRNA were evidently lowered (all P<0.05). CONCLUSIONS: There were more strong expressions of IL-1ß and IL-6 and more weaken expressions of IL-10 in phlegm-dampness syndrome than in phlegm-heat syndrome, which may be one of the main reason of serious damage in lung tissue and delayed recovery of the patient with phlegm-dampness syndrome of AECOPD. All the above findings need further investigation.

Health-related quality of life evaluated by tumor node metastasis staging system in patients with hepatocellular carcinoma.

AIM: To investigate and evaluate the change in health-related quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM Stage I to Stage II, Stage IIIA, Stage IIIB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage I to Stage IIIB (P = 0.002 vs Stage I; P = 0.032 vs Stage II; P = 0.033 vs Stage IIIA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage II; P = 0.032 vs Stage IIIA). For the social and family well-being subscale, only Stage IIIB scores were significantly lower as compared with Stage I scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were significant differences for Stages IIΙ, IIIA and IIIB (P = 0.002 vs Stage I). CONCLUSION: HRQoL of patients with HCC worsens gradually with progression of TNM stages. The most impaired subscales of HRQoL, as measured by FACT-Hep, were physical and emotional well-being.

[A comparative study of biological indicators of phlegm-heat syndrome and phlegm-dampness syndrome model with acute exacerbation of chronic obstructive pulmonary disease].

OBJECTIVE: To compare phlegm-heat syndrome with phlegm-dampness syndrome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in regard to inflammatory response, hormone level, lung pathological examination and lung function. METHODS: Fifty-six Wistar rats were randomly divided into four groups, including normal control group, AECOPD group, phlegm-heat syndrome of AECOPD group (PHs group), phlegm-dampness syndrome of AECOPD group (PDs group). The level of white blood cell (WBC) count, neutrophil ratio, free triiodothyronine (FT(3)), free thyroxine (FT(4)), epinephrine (E), norepinephrine (NE), cortisol (COR), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-8 (IL-8) in blood, and TNF-alpha, IL-8, intercellular adhesion molecule-1 (ICAM-1) in broncho-alveolar lavage fluid (BALF) were determined with radioimmunology. Lung function was tested by whole-body plethysmography. RESULTS: (1)The count of WBC and neutrophil ratio in PDs group were higher than in PHs group, AECOPD group and normal group, there was significant difference in multiple comparison. The levels of inflammatory mediators in serum and BALF in three model groups were evidently higher than in normal group, and IL-8 [(4.13+/-1.28) microg/L] and CRP [(3.07+/-0.69) microg/L ] in serum in PDs group were higher than those in PHs group [(1.75+/-0.53) microg/L, (1.98+/-0.42) microg/L, both P<0.01]. (2)FT(3) level in blood in both AECOPD group and PHs group [(9.44+/-3.17) pmol/L , (9.95+/-3.68) pmol/L] was significantly higher than that in normal control group [(4.53+/-2.80) pmol/L], FT(3) in PDs group [(2.13+/-1.31) pmol/L] was evidently lower than that in normal group (P<0.05 or P<0.01). The level of FT(4) [(2.23+/-0.71) pmol/L], E [(87.27+/-29.32) nmol/L] and NE [(71.69+/-21.24) nmol/L] in PDs group were all obviously lower than those in normal group [FT(4): (4.64+/-1.49) pmol/L, E: (143.94+/-32.90) nmol/L, NE: (100.32+/-27.73) nmol/L, P<0.05 or P<0.01]. There was no significant difference in the above three parameters between AECOPD group and normal group. Each parameter in PHs group was markedly higher than that in AECOPD group. The content of COR in PDs group was higher than in PHs group, in which COR was higher than in AECOPD group, which was equal to that in normal group. (3)The pathological changes in lung included inflammatory cell infiltration , exfoliation of cilia, dilatation of alveolar spaces of lung tissue in AECOPD group, which were more significant in PHs group and PD group. Inflammatory cells infiltration around the bronchi, thickening of interalveolar spaces, and vasodilatation were more pronounced in PHs group and PDs group than in AECOPD group. Inflammatory cell infiltration around the bronchi were about the same between PHs and PDs groups. (4)The levels of peak expiratory velocity (PEV), tidal volume (V(T)), minute ventilation (MV) were significantly lower in AECOPD group, PHs group and PDs group than in normal control group, but the levels of frequency (f) and inspiratory resistance (Rin) were evidently higher. Compared with AECOPD group, the levels of PEV, V(T), MV were significantly decreased, the level of respiratory f and Rin evidently increased in PDs group. Compared with PHs group, the levels of PEV, V(T), MV significantly decreased in PDs group, while the level of f and Rin evidently increased. There was no significant difference in the above five parameters between AECOPD group and PHs group. CONCLUSION: The changes in local and systemic inflammatory response, lung histopathological injury in PHs group and PDs group were more evident than changes in AECOPD group. The changes in systemic inflammatory response, decrease in functional indicators of thyroid and adrenal medulla, and decline in lung function were more marked in PDs group than in PHs group.