Chicoric acid alleviates lipopolysaccharide-induced acute lung injury in mice through anti-inflammatory and anti-oxidant activities

Acute lung injury (ALI) is a severe clinical disease with high mortality rates. Chicoric acid (CA), an active component extracted from traditional Chinese medicine, was suggested to have anti-inflammatory and anti-oxidant activities. Inflammation and oxidative damage are implicated in the pathogenesis of ALI. In this study, we explored the protection effect of CA on LPS-induced ALI, and further discussed the possible molecular mechanisms. The results showed that CA could significantly improve the histological changes of LPS-induced acute lung injury. In addition, CA not only decreased LPS-stimulated protein leakage and lung wet/dry ratio but also reduced inflammatory cell infiltration, myeloperoxidase (MPO) activity and the generation of pro-inflammatory cytokines in bronchoalveolar lavage fluid (BALF). Meanwhile, CA lessened the reactive oxygen species (ROS) generation, and malondialdehyde (MDA) formation, and decreased glutathione (GSH) and superoxide dismutase (SOD) depletion, which were caused by LPS challenge. Furthermore, CA dramatically inhibited LPS-stimulated MAPK and NLRP3 activation and increased the expression of NAD (P) H: quinone oxidoreductase (NQO1), and dismutase (SOD), glutamate-cysteine ligase catalytic/modifier (GCLC/GCLM) subunit and heme oxygenase-1 (HO-1), as well as its upstream genes nuclear factor-erythroid 2-related factor 2 (Nrf2), which might be central to the protective effects of CA. In conclusion, these data indicated that the protective effects and mechanisms of CA on LPS-induced ALI and provided new insights for its application.     

安徽省各级医疗机构药品使用现状及目录共同性研究

目的：分析安徽省各级医疗机构药品使用现状及药品目录的共同性。方法：从安徽省医药集中采购平台上随机抽取9家三级医疗机构、10家二级医疗机构、20家一级医疗机构2018年的药品采购数据,采用R软件和Excel软件进行分析。结果：从药理学分类来看,安徽省一级医疗机构药品结构与二、三级医疗机构差异较大,而二、三级医疗机构药品结构相似;国家基本药物品种数和金额占比均随医疗机构级别的升高而降低,国家医保药物与之趋势相同;进口药品的品种和金额占比均随医疗机构级别的升高而增加。2018年采购数据显示,各级医疗机构院均药品数分别为241,405,802种,而同级医疗机构相同药品数仅分别为20,19,186种;39家样本医疗机构共有药品数仅8种。结论：各级医疗机构药品共同性小,不利于分级诊疗中患者转诊用药的上下衔接。     

Reining in Costs of Kidney Dialysis: US Supreme Court Offers Hope to End Predatory Pricing

PurposeTwo for-profit dialysis providers control >70% of the US kidney dialysis market. They use their excessive market power to force private insurers to pay nearly 4 times the Medicare rate, earning exorbitant profits for themselves at the expense of the health care system. Both the legislative and judicial systems have been called on to address this inequity, so far without success.MethodsWe examined the history of this issue as set forth in official Centers for Medicare & Medicaid Services, US Department of Health and Human Services, Federal Trade Commission, and other regulatory documents as well as court filings and opinions. We analyzed the legislative efforts to address the problem and the judicial response.FindingsWe found that most efforts, to date, have failed. However, a 2022 US Supreme Court decision helps illuminate a path forward, in large part by defining the limits of judicial intervention.ImplicationsWe identify a path forward that would separate the monopolistic players using a multipronged effort involving US Department of Justice, Federal Trade Commission, Office of Inspector General, and states attorneys general. We also caution that, based on our research, the providers could challenge further efforts by deciding to withdraw services in certain areas or refuse to do business with certain insurers, resulting in patients having difficulty accessing dialysis.     

蔡永亮从肝论治失眠经验

蔡永亮教授,安徽省首届名老中医,首届江淮名医,从事临床、教学、科研工作四十余载,精于临床,专于科研,学研俱丰,善于总结经验。对失眠颇有研究,主张“从肝论治失眠”,认为临床上大多数失眠可分为五型,并自拟“解郁3号方”治疗失眠,有良好疗效。作者师承于蔡永亮教授,总结蔡教授“从肝论治失眠”经验,以期为失眠的辨证论治提供参考。     

针刺加重复经颅磁刺激治疗脑卒中后失眠的临床观察

目的:评价“通督调神法”针刺加重复经颅磁刺激(rTMS)治疗脑卒中后失眠的临床疗效。方法:将72例脑卒中后失眠患者随机分为2组,每组36例。对照组采用频率1 Hz、运动阈值90%的rTMS治疗,观察组在对照组rTMS治疗基础上加“通督调神法”针刺治疗。穴位取百会、神庭、印堂、风府、四神聪、神门、三阴交、申脉和照海。每日治疗1次,每周治疗5d后休息2d,共治疗4周。现察两组治疗后匹兹堡睡眠质量指数(PSQI)、焦虑自测量表(SAS)和抑部自测量表(SDS)评分改善情况,并进行两组临床疗效比较。结果:治疗4周后,两组PSQK SAS及SDS评分均降低,组内差异均有统计学意义(均P<0.001);观察组治疗后三项评分均低于对照组,组间差异均有统计学意义(P<0.05,P<0.05,P<0.001),现察组和对照组临床疗效差异有统计学意义(P<0.05)。结论:“通督调神法”针刺加rTMS治疗脑卒中后失眠疗效优于单独rTMS治疗,且能更好地改善患者焦虑、抑耶情绪。     

针刺治疗儿童腹型偏头痛案

A girl patient, seven years old, complaining intermittent periumbilical pain accompanied with headache and vomiting for almost one year. Acupuncture was adopted in treatment. Acupoints were Băihuì(百会GV20), Yìntáng (印堂EX-HN3), Zhōngwăn (中脘CV12), Tàiyáng (太阳EX-HN5), Wángŭ (完骨GB12), Hégŭ (合谷LI4), Tiānshū (天枢ST25), Zúsānlĭ (足三里ST36), Sānyīnjiāo (三阴交SP6) and Tàichōng (太冲LR3), electroacupuncture, warming needling moxibustion and infrared irradiation were applied. Acupuncture and moxibustion were given once every two days and 10 treatments were as one course. After one course of treatment, the child patient narrated that the attack frequency of headache and abdominal pain was reduced, the severity alleviated and the persistent duration shortened. After two courses of treatment, abdominal pain never occurred and the child patient was recovered and had a normal life and school activity. The disease was not recurred in one-year follow-up.     

穴位埋线联合耳穴贴压治疗神经性贪食症18例

Prof. Min LI adopted acupoint catgut embedding at Zhōngwǎn (中脘CV12), Tiānshū (天枢ST25), Wèishū(胃俞BL21), Dàchángshū(大肠俞BL25), Zúsānlǐ (足三里ST36), Sányīnjiāo (三阴交SP6), and Tàichōng (太冲LR3), and combined with auricular plaster therapy at Wèi (胃 CO4) , Dà cháng (大肠 CO7) , Gān (肝CO12) ,Jiāogăn (交感 AH6a) ,Nèifēnmì (内分泌CO18) for the treatment of 18 cases of bulimia nervosa(BN). The result was that 9 cases were clinically cured, 6 cases improved, 3 case ineffective, and the total effective rate was 83.33%, no obvious adverse reactions. The therapeutic effect of acupoint catgut embedding combined with auricular plaster therapy for BN is good, without side effects.     

电针联合骨质疏松治疗仪对脊髓损伤患者骨代谢指标的影响

ObjectiveTo observe the effect of electroacupuncture combined with low-frequency pulsed electromagnetic field on bone metabolism in patients with spinal cord injury (SCI).MethodsThe 60 SCI patients who met the inclusion criteria were randomly divided into 2 groups by means of a random number table. In the control group, 30 patients were treated with osteoporosis treatment apparatus. In the observation group, 30 patients were treated with osteoporosis treatment apparatus and electroacupuncture at the foot-shaoyangacupoints [Yánglíngquán (阳陵泉GB 34) and Xuánzhōng (悬钟GB 39) of both sides].The treatment was applied once a day, 5 days a week, for 8 weeks.Before and after treatment, the changes of indexes in the two groups, including the bone mineral density (BMD), bone gla-containing protein (BGP), serum alkaline phosphatase (ALP), procollagen type I C-peptide (PICP), and 25‑hydroxy-vitamin D [25(OH)D], were observed for comparison.ResultsAfter treatment, in the two groups, the BMD and 25(OH)D indexes of the femoral neck, greater trochanter, and Ward's triangle region were not significantly changed in comparing with those before treatment (P>0.05), while the BGP, ALP, and PICP indexes were significantly higher than those before treatment (P<0.05). After treatment, in the observation group, the BGP and ALP indexes were significantly increased in comparing with those of the control group, and the difference was statistically significant (P<0.05), whilst the BMD, PICP, and 25(OH)D indexes of the femoral neck, greater trochanter, and wards triangle region, were not significantly different in comparing with the control group (P>0.05).ConclusionThe osteoporosis treatment apparatus can improve bone metabolism in SCI patients, and the curative effect can be enhanced when combined with electroacupuncture at foot-shaoyangacupoints.     

胃癌组织中PDCD4基因的表达和甲基化水平及其临床意义

目的 观察胃癌组织中抑癌基因PDCD4启动子区甲基化状态及其对PDCD4表达水平的影响并探讨其临床意义。方法 通过免疫组织化学、Western blot法检测胃癌组织中PDCD4蛋白的表达;RT-PCR法检测PDCD4 mRNA的表达;甲基化特异性PCR（MSP）法检测PDCD4启动子区甲基化水平。分析PDCD4表达水平以及启动子甲基化水平与胃癌患者临床病理特征之间的相关性。结果 胃癌组织中PDCD4蛋白及mRNA表达水平均显著降低（P<0.05）,甲基化作用显著增强（P<0.05）。PDCD4蛋白表达缺失与胃癌的分化、临床分期以及淋巴结转移密切相关（P<0.05）;PDCD4高甲基化与胃癌的淋巴结转移、临床分期密切相关（P<0.05）。PDCD4甲基化水平与PDCD4蛋白以及mRNA表达水平均呈负相关（P<0.05）。结论 胃癌组织中PDCD4表达水平显著降低,并与胃癌发展相关,启动子区高甲基化可能是PDCD4表达缺失的原因。