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Aim To investigate the effect of Xuefu Zhuyu decoction on transforming growth factor-β1(TGF-β1 ) -induced endothelial-to-mesenchymal transition (EndMT) of pulmonary microvascular endothelial cells ( PMVEC), and further analyze the mechanism related to the TGF-β1/Smad signaling pathway. Method To construct an EndMT cell model, PMVEC was treated with TGF-β1 (5 μg · L
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Objective To explore the clinical application value of combined detection of apolipoprotein A1(ApoA1)and alpha-fetoprotein(AFP)in young and middle-aged patients with pulmonary tuberculosis.Meth-ods A total of 82 young and middle-aged patients with pulmonary tuberculosis admitted to the hospital from December 2020 to December 2021 were selected as the observation group,and 85 healthy people who under-went physical examination in the hospital during the same period were selected as the control group.The clini-cal,lipid,inflammation and iron metabolism related indexes were compared between the two groups.Multiva-riate Logistic regression was used to analyze the influencing factors of pulmonary tuberculosis in young and middle-aged patients.The area under the receiver operating characteristic(ROC)curve(AUC)was used to e-valuate the application value of ApoA1,AFP and their combination in the diagnosis of pulmonary tuberculosis in young and middle-aged patients.Results Compared with the control group,the observation group had sig-nificantly higher levels of direct bilirubin,creatinine,AFP and high-sensitivity C-reactive protein(P<0.05),and significantly lower levels of triglyceride,total cholesterol,high-density lipoprotein cholesterol and ApoA1(P<0.05).Multivariate Logistic regression analysis showed that ApoA1 was an independent protective factor(OR=0.119,95%CI 0.019-0.754,P=0.024)and AFP was an independent risk factor(OR=1.554,95%CI 1.138-2.122,P=0.006)for pulmonary tuberculosis in young and middle-aged patients.ApoA1,AFP and the combined prediction of young and middle-aged tuberculosis AUC were 0.644(P=0.006),0.262(P<0.001),0.678(P=0.001),respectively.Conclusion The low level of ApoA1 is an independent protec-tive factor for pulmonary tuberculosis in young and middle-aged patients,and the high level of AFP is an inde-pendent risk factor for pulmonary tuberculosis in young and middle-aged patients.The combined detection of ApoA1 and AFP has good value in predicting pulmonary tuberculosis in young and middle-aged patients.
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Pulmonary hypertension(PH)is a type of progressive cardiovascular disease or clinical syndrome. Its pathological mechanism is complex. The existing clinical drugs cannot well inhibit the progression of the disease. Traditional Chinese Medicine(TCM)has unique advantages in the treatment of PH due to its synergistic effect of multiple components and multiple targets. Recent studies have found that the TCM of promoting blood circulation and removing blood stasis can play a significant role in the treatment of PH, such as dilating pulmonary blood vessels, improving endothelial function, and relieving right heart failure. This article briefly summarizes and discusses the therapeutic effect and mechanism of TCM that can promote blood circulation and remove blood stasis in treatment of PH.
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High level noise can damage cochlear hair cells, auditory nerve and synaptic connections between cochlear hair cells and auditory nerve, resulting in noise-induced hearing loss (NIHL). Recent studies have shown that animal cochleae have circadian rhythm, which makes them different in sensitivity to noise throughout the day. Cochlear circadian rhythm has a certain relationship with brain-derived neurotrophic factor and glucocorticoids, which affects the degree of hearing loss after exposure to noise. In this review, we summarize the research progress of the regulation of cochlear sensitivity to noise by circadian rhythm and prospect the future research direction.
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Animais , Limiar Auditivo , Ritmo Circadiano , Cóclea , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Células Ciliadas Auditivas , Perda Auditiva Provocada por Ruído , Ruído/efeitos adversosRESUMO
OBJECTIVE To investigate t he attitude of endocrinology physicians to clinical conversion and substitution of insulin drugs ,and to provide basis for improving the centralized procurement program of insulin. METHODS The proportion of convertible and substitutable insulin recognized by endocrinology physicians was investigated by questionnaire from 4 dimensions: intergenerational level ,bargaining group level ,common name level and brand/specification level. The subjects were endocrinology physicians in the third grade class A general hospitals in Nanchang. RESULTS A total of 89 questionnaires were successfully distributed,accounting for 80.2% of the on-the-job endocrinology physicians (111 in total )in the third grade class A general hospitals in Nanchang. Eighty-nine questionnaires were collected ,one of which was invalid ,and the effective rate was 98.9%. At the intergenerational level ,93.2% of endocrinology physicians preferred insulin analogues. At the bargaining group level ,the weighted average of the convertible ratio between group 3 and group 4 approved by physicians was 63.9%. At the levels of common name and brand/specification ,the weighted averages of convertible proportion of each group were more than 70%. CONCLUSIONS The method of insulin grouping in Wuhan is reasonable which can complete clinical conversion and substitution of insulin in the group safely. It is suggested to cancel long-acting human insulin group. The weighted average of the proportion of convertible and substitutable drugs in the group is high. It is suggested to increase the agreed purchase volume of insulin and conduct“volume price linked ”negotiations. When the surveyed physicians choose the initial treatment scheme of insulin ,they pay more attention to the factors such as efficacy and safety ,so the replacement of insulin should be based on the clinical efficacy and drug safety.
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ObjectiveTo explore the anti-testicular inflammation mechanism of Wuzi Yanzongwan through network pharmacological analysis and experimental verification. MethodThe active ingredients of Wuzi Yanzongwan were searched in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and their targets were predicted via SwissTargetPredicition. GeneCards and Online Mendelian Inheritance in Man (OMIM) were used to obtain the known targets for the treatment of testicular inflammation. STRING 11.0 was employed to construct the protein-protein interaction (PPI) network, and Cytoscape 3.7.1 to construct the “herbal medicine-active ingredient-target” network of Wuzi Yanzongwan and “active ingredient-disease target” network. Metascape was used for gene ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment of signaling pathways. ResultA total of 72 active ingredients and 624 potential targets of Wuzi Yanzongwan were screened out, and 196 key targets were identified for the treatment of testicular inflammation by Wuzi Yanzongwan. The results of GO annotation showed that the anti-testicular inflammation targets of Wuzi Yanzongwan were involved in the biological processes such as the response to molecule of bacterial origin, the positive regulation of response to external stimulus, and the response to extracellular stimulus. KEGG pathway enrichment revealed that the major pathways associated with the treatment (P<0.01) included the pathways in cancer, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor resistance, transcriptional misregulation in cancer, calcium signaling pathway, apelin signaling pathway, and NOD-like receptor signaling pathway. Wuzi Yanzongwan may exert the anti-testicular inflammation effect by inhibiting the activation of the NLR family pyrin domain-containing 3 (NLRP3) inflammasome pathway to alleviate the inflammatory response, which verifies the prediction results based on network pharmacology to a certain extent. ConclusionThe inhibitory effect of Wuzi Yanzongwan on testicular inflammation is multi-target, multi-pathway, and multi-mechanism. The findings of this study provide evidence support for the clinical application of Wuzi Yanzongwan.
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The novel coronavirus pandemic incited unprecedented demand for assays that detect viral nucleic acids, viral proteins, and corresponding antibodies. The 320 molecular diagnostics in receipt of FDA emergency use authorization mainly focus on viral detection; however, no currently approved test can be used to infer infectiousness, i.e., the presence of replicable virus. As the number of tests conducted increased, persistent SARS-CoV-2 RNA positivity by RT-PCR in some individuals led to concerns over quarantine guidelines. To this end, we attempted to design an assay that reduces the frequency of positive test results from individuals who do not shed culturable virus. We describe multiplex quantitative RT-PCR (qRT-PCR) assays that detect genomic RNA (gRNA) and subgenomic RNA (sgRNA) species of SARS-CoV-2, including spike (S), nucleocapsid (N), membrane (M), envelope (E), and ORF8. The absolute copy number of each RNA target was determined in longitudinal specimens from a household transmission study. Calculated viral RNA levels over the 14-day follow up period were compared with antigen testing and self-reported symptoms to characterize the clinical and molecular dynamics of infection and infer predictive values of these qRT-PCR assays relative to culture isolation. When detection of sgS RNA was added to the CDC 2019-Novel Coronavirus Real-Time RT-PCR Diagnostic Panel, we found a qRT-PCR positive result was 98% predictive of a positive culture (negative predictive value was 94%). Our findings suggest sgRNA presence correlates with active infection, may help identify individuals shedding culturable virus, and that similar multiplex assays can be adapted to current and future variants.
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IntroductoryThe evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in the emergence of many new variant lineages that have exacerbated the COVID-19 pandemic. Some of those variants were designated as variants of concern/interest (VOC/VOI) by national or international authorities based on many factors including their potential impact on vaccines. To ascertain and rank the risk of VOCs and VOIs, we analyzed their ability to escape from vaccine-induced antibodies. The variants showed differential reductions in neutralization and replication titers by post-vaccination sera. Although the Omicron variant showed the most escape from neutralization, sera collected after a third dose of vaccine (booster sera) retained moderate neutralizing activity against that variant. Therefore, vaccination remains the most effective strategy to combat the COVID-19 pandemic.
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Coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other viruses is inevitable as the COVID-19 pandemic continues. This study aimed to evaluate cell lines commonly used in virus diagnosis and isolation for their susceptibility to SARS-CoV-2. While multiple kidney cell lines from monkeys were susceptible and permissive to SARS-CoV-2, many cell types derived from human, dog, mink, cat, mouse, or chicken were not. Analysis of MDCK cells, which are most commonly used for surveillance and study of influenza viruses, demonstrated that they were insusceptible to SARS-CoV-2 and that the cellular barrier to productive infection was due to low expression level of the angiotensin converting enzyme 2 (ACE2) receptor and lower receptor affinity to SARS-CoV-2 spike, which could be overcome by over-expression of canine ACE2 in trans. Moreover, SARS-CoV-2 cell tropism did not appear to be affected by a D614G mutation in the spike protein.
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During the evolution of SARS-CoV-2 in humans a D614G substitution in the spike (S) protein emerged and became the predominant circulating variant (S-614G) of the COVID-19 pandemic1. However, whether the increasing prevalence of the S-614G variant represents a fitness advantage that improves replication and/or transmission in humans or is merely due to founder effects remains elusive. Here, we generated isogenic SARS-CoV-2 variants and demonstrate that the S-614G variant has (i) enhanced binding to human ACE2, (ii) increased replication in primary human bronchial and nasal airway epithelial cultures as well as in a novel human ACE2 knock-in mouse model, and (iii) markedly increased replication and transmissibility in hamster and ferret models of SARS-CoV-2 infection. Collectively, our data show that while the S-614G substitution results in subtle increases in binding and replication in vitro, it provides a real competitive advantage in vivo, particularly during the transmission bottle neck, providing an explanation for the global predominance of S-614G variant among the SARS-CoV-2 viruses currently circulating.
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Objective: To combine macroscopical characteristic indices and chemical indices of Andrographis Herba to evaluate its quality grade. Methods: Both macroscopical characteristic indices and chemical indices (the content of four active diterpenoids and the content of ethanol-soluble extractives) of different batches of Andrographis Herba were determined. The macroscopical characteristic indices were encoded using the method of numerical taxonomy, and the content of four active diterpenoids were determined by HPLC. To screen out the appropriate indices for classification, the correlational analyses were conducted between encoded macroscopical characteristic indices and chemical indices. The quality grade was made by principal component clustering analysis according these evaluation indices, and then was analyzed through partial least squares discriminant analysis (PLS-DA). Furthermore, a partial least squares (PLS) regression was constructed for the quality grade prediction of Andrographis Herba. Results: It showed that the samples could be divided into three grades according to the principal component clustering analysis, and was reasonable evaluating by PLS-DA. The PLS regression model for quality grade of Andrographis Herba was constructed as follows: grade Y=3.761-0.020×the leaf content-0.388×the content of andrographolide-1.117×the content of neoandrographolide-0.274×the content of deoxyandrographolide-0.287×the content of 14-deoxy-11,12-didehydro-andrographolide-0.302×the content of four active diterpenoids-0.104×the content of ethanol-soluble extractives-0.015×the color of stem-0.008 4×the color of leaf-0.003×the diameter of base part of stem+0.020×the number of branch+0.137×the diameter of the upper stem+0.011×plant height, if Y=0.7-1.3, the predicted quality was grade A, if Y=1.7-2.3, then B grade, and if Y=2.7-3.3, C grade or qualified product. Conclusion: The model of grade evaluation we constructed using principal component clustering analysis combing with PLS regression analysis performed well, which was applicable in evaluating the quality grade of Andrographis Herba and other traditional Chinese medicines. It also provided a new strategy for study on grade standards of traditional Chinese medicines.
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Purpose: This retrospective study aimed to explore the importance of risk assessment and hydrodissection pre-treatment for radiofrequency ablation of thyroid nodules and initially establish the concept of thyroid nodule risk assessment and the corresponding ablation norms. Method: Based on the specific location of thyroid nodules, risk assessment and the corresponding preventive measures for thyroid ablation were established. During the period of 2015.10-2017.5, a total of 382 patients were enrolled to compare the safety and efficacy of the ablation for patients with or without risk assessment and the corresponding preventive measures. Statistical analysis encompassed Independent T test for continuous variables and Fisher's exact test/Chi-square test for categorical variables. Result: Of all 382 patients, 188 patients underwent ablation with risk assessment and the corresponding preventive measures before ablation and 194 without, respectively. The patient characteristics, risk grading, ablation time, thyroid function after ablation and the complete ablation rate showed no statistical differences exsisted between two groups (P>0.05). The complication in very high risk nodules was avoided in the group of patients with risk assessment and preventive measures before ablation. Conclusion: It is a very safe and effective way to carry out radiofrequency ablation after pre-treatment of thyroid nodules by hydrodissection technique according to risk assessment. It will provide clinicians with greater help in the ablation treatment of thyroid nodules, and improve the safety of the thyroid ablation.
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OBJECTIVE:To provide reference for promoting the rational use of essential medicines in primary medical institutions.METHODS:Twenty six rural primary medical institutions (13 township health centers,13 village clinics) were randomly selected from 2 poverty-stricken county (city) in Huanggang city of Hubei province.The utilization of essential medicine was investigated and analyzed statistically through exporting hospital information system data and on-site interviews.RESULTS:The utilization rate of essential medicine in sample township health centers was 76.9%,and the amount of essential medicine accounted for 93.0%;the utilization rate of essential medicine in sample village clinics was 89.7%.The utilization rate of variety from essential medicine list was 53.6% in sample township health centers and 25.0% in sample village clinics;the utilization rate of variety from National Essential Medicine List was higher than that of Provincial Essential Medicine List Supplement.The amount of 5 major categories as antimicrobial agents,cardiovascular agent in sample primary medical institutions accounted for 64.7% of chemical agents.The top ten medicines in the list of amount were all essential medicine,9 of which were national essential medicines.There were 2.8 kinds of medicines in each outpatient prescription averagely in sample township health centers.The proportion of antibiotic prescription was 44.2%.CONCLUSIONS:The utilization rate of essential medicines in township health centers of this area is lower than WHO recommended value,and the ratio of amount meets the policy requirements.The utilization rate of variety from Provincial Essential Medicine List Supplement is in low level in primary medical institutions;the amount of anti-microbial drugs is in high level;the rationality of medicine use in prescriptions needs to be improved.It is suggested to adjust the type of provincial supplement list dynamically according to actual situation and control the price and amount of main categories strictly,the rationality of prescription.
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OBJECTIVE:To provide reference for promoting the rational use of essential drugs in primary medical institutions. METHODS:Twenty-three rural primary medical institutions(8 township health centers,15 village clinics)were randomly selected from 2 poverty-stricken counties in Chongzuo city of Guangxi Zhuang Autonomous Region. The utilization of essential drugs was investigated and analyzed statistically through exporting hospital information system data and on-site interviews. RESULTS:The utilization rate of essential drugs in sample township health centers was 72.4%,and the amount of essential drugs accounted for 78.3%. The utilization rate of variety from National List of Essential Drug was 36.9%,which in the Autonomous Regions Essential Drug List Supplement was 47.2%(utilization rate of chemical drugs was 53.9%,and that of Chinese patent drugs was 39.7%). The utilization rate of essential drugs in sample village clinics was 64.4%;utilization rate of variety from National List of Essential Drug was 18.3%, which in the Autonomous Regions Essential Drug List Supplement was 10.5%. The amount of 5 major categories accounted for 47.9% of total amount of chemical agents,among which that of antimicrobial agents took up the highest proportion,being 35.9%. Among top 10 drugs in the list of amount,there were 8 national essential drugs and 4 antimicrobial agents. There were 2.90 kinds of drugs in each outpatient prescription averagely in sample township health centers;the average proportion of antibiotic prescription was 43.0%;the cost of each prescription was 33.12 yuan in average. CONCLUSIONS:The utilization rate of essential drugs in primary medical institutions is lower than the requirements of policy. There are great difference in utilization rate between chemical agents and Chinese patent drugs of township hospital in Autonomous Regions Essential Drug List Supplement. The cost proportion of antimicrobial agents is high. The rationality of prescription drug use still needs to be improved. It is suggested to guarantee essential drugs supply,adjust Autonomous Regions Essential Drug List Supplement in time,control the price of main categories and strengthen antimicrobial agent use monitoring so as to further promote rational drug use.
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Objective To summarize the clinical nursing experience of a human cytomegalovirus infection combined with infantile polymorphic erythema.Methods Through evidence-based nursing,the family members of the children and their families were evaluated in two ways and carried out the familycentered holistic nursing care.The nursing problems of the children should be evaluated in a timely and effective manner.Results After 15 days of treatment,the patient was discharged from hospital and achieved satisfactory results.Conclusions For human cytomegalovirus infection with baby severity exudative polymorphic lupus patients,the implementation of strict protective isolation,meticulous care of skin mucous membrane,prevent eye and perineal secondary infection,close observation and prevention of severe complications in children with play a crucial role in the course of the disease and rehabilitation.
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OBJECTIVE:To evaluate the affordability of 3 anti-tumor targeted drugs gefitinib,trastuzumab and sunitinib in ur-ban and rural residents of Hubei province,and to provide reference for medical insurance price admission of anti-malignant tumor targeted drugs in China. METHODS:Referring to the incidence of malignant tumor stated in statistical yearbook of Hubei province and income data of urban and rural residents in Hubei province,based on the policy of reducing the price of imported drugs by 50% mentioned in the national drug price negotiations,and assume the drugs are included in the medical insurance reimbursement list,WHO/HAI standard survey method,catastrophic expenditure evaluation method and poverty effect evaluation method were ad-opted to calculate the affordability of 3 drugs. RESULTS:According to WHO/HAI standard survey method,increment of payment for 3 drugs were 64.00%-74.00% before and after 50% discount and reimbursement. According to catastrophic expenditure evalua-tion method,50% discount of gefitinib and reimbursement gefitinib,trastuzumab and sunitinib in urban area would result in cata-strophic expenditures of 20.00%、59.28% and 35.48% patients;in rural area,would result in catastrophic expenditures of 50.63%、74.72% and 75.93% patients. According to poverty effect evaluation method,50% discount of 3 drugs and reimbursement caused less than 31.95% urban and rural patients falling to poverty. CONCLUSIONS:Fifty percentage discount of 3 anti-tumor targeted drugs mentioned in the national drug price negotiations cause the economic burden more serious for rural residents than urban resi-dents. In the formulation of policies,the corresponding reimbursement ratio should be adjusted according to urban and rural areas, drug price and disease types for a balance of patients with different economic burden.
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Objective To evaluate factors influencing pass rates for newborn hearing screening under the same test conditions and using the same test methods.Methods Newborn hearing screening was carried out in 1 045 randomly selected newborns in Shengjing Hospital from January to June 2014.The newborns were screened at 2 days of age using transient evoked otoacoustic emissions (TEOAE).Related factors,including the number of embryos,birth weight,gestational age,gender,and mode of delivery were recorded.Data were analyzed using SPSS 19.0 software.Results Of 1 045 newborns,860 (82.3%) passed the hearing screening test and 185 failed.The number of embryos,ear-side tested,gestational age,and birth weight significantly influenced the pass rate using TEOAE.Term infants had a higher pass rate than premature ones (P < 0.001).Heavier infants were more likely to pass (P =0.003).Right ears had a higher pass rate than left ears (P < 0.001).Single babies had a higher pass rate than twins (P < 0.001).Gender (P =0.361) and delivery mode (P =0.892) did not affect the pass rate.Conclusion The number of embryos,birth weight,gestational age,and ear-side tested affect newborn hearing screening results,but gender and mode of delivery show no significant effects on screening.
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This paper summarizes the kinds of long term care facilities, service delivery organization, service model, service role and experience of long-term service system in the United States. It provides referral implications for China to explore and establish its own long-term care service system. . There is a variety of long-term care services such as short and long-term stay, adult day care, and home care services, with a gradual change from institutional services to home and community ones. Long-term care services are provided by paid both formal and mostly unpaid informal caregivers. Informal family caregivers are most frequently daughters (29. 3%), followed by spouses with (21. 2%). With the increased availability of the family and community-based services, the family caregivers are more likely to share long term care services with the paid formal ones. The United States has a well-structured long-term care service system whose access mechanism is rigorous and systematic, emphasizing the evaluation of service quality and effectiveness. Moreover, the U. S. long term care service system pays more attention on elders' wishes, respecting their preferences and rights of choice on the services. Based on the experience of the United States, China should primarily focuses on establishing a family and community-based long term care service system with a variety of service delivery facilities, give a full play to the community health facilities, social partners, and families. The Chi-nese government should not only give a focus to the service institutions and content diversification, but should as well establish a sound and detailed assessment and evaluation standard system to access the services and assure the effec-tiveness of service quality with a humanized concern.
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The aim of the present study was to explore the effect and mechanism of Bushen Huoxue recipe (BHR) on ovarian reserve in mice with premature ovarian failure (POF). Mice were divided into 3 groups: normal group, model group and BHR group. Intraperitoneal injection of cyclophosphamide was performed to create the POF model. Primordial follicular (PDF) number, ovarian wet weight, ovarian index, and estrous cycle were analyzed to evaluate the effect of BHR on POF. Meanwhile, the mRNA and protein level of Mouse Vasa Homologue (MVH) in the bone marrow, peripheral blood and ovary were detected, to explore the underlying mechanism of the treatment efficacy of BHR on ovarian reserve. By the time of BHR treatment for 28 days, BHR increased the PDF number and shortened the estrous cycle of POF mice. BHR also decreased the mRNA level of MVH in the bone marrow, and increased mRNA and protein level of MVH in the ovary of POF mice. Our results demonstrated a treatment efficacy of BHR on POF mice, and revealed that BHR might repair the dysfunction of germline stem cells in the bone marrow, and thus to improve the ovarian reserve and enhance the ovarian function of POF mice through neo-oogenesis.