OBJECTIVE：To provide reference for r ational use of TCM decoction piece. METHODS ：Electronic questionnaire survey was conducted on the use （dose，ingredient number ）of TCM decoction piece prescriptions in 12 TCM hospitals from 10 provinces（regions，cities）. Through the hospital information system ，416 100 outpatient prescriptions of TCM decoction piece were collected from the First Affiliated Hospital of Henan University of TCM （our hospital ）during May 2016 to Apr. 2019，and were analyzed in terms of prescription dose ，the number of ingredients and use of TCM decoction pieces. At the same time ，the use of TCM decoction piece prescription were analyzed in different departments ，and the clinical application status of TCM decoction pieces prescription were investigated and relevant suggestions were put forward. RESULTS ：The average dose of TCM decoction piece prescriptions in 12 hospitals were 129.60-245.00 g，and the average number of ingredients were 11.90-18.25；the average dose of TCM decoction piece prescriptions in pediatric department was lower than other departments. The average dose of TCM decoction piece prescriptions in our hospital was 242.21 g；55.75％ of the prescription dose were distributed in 201-300 g，and 15.22％ were over 300 g. The average number of ingredients in prescriptions was about 15，and the prescriptions with 11-20 ingredients accounted for 87.75％，those with more than 20 ingredients accounted for 6.64％. Top 20 TCM decoction pieces in TCM prescriptions of our hospital had different degrees of overdose. Three decoction pieces with the highest frequency of overdose were Radix Curcumae processed by vinegar （85.51％），Atractylodes macrocephala stir-fried with bran （82.10％）and A. macrocephala（79.13％）. The number of TCM decoction piece prescriptions in internal medicine department accounted for 40.84％ in our hospital ；there were a lot of TCM prescriptions with dose exceeding 300 g（11.98％ and 18.69％）and the number of ingredients exceeding 18（14.60％ and 9.53％）in internal medicine department and surgery department. The proportion of pediatric TCM decoction piece prescriptions with more than 18 ingredients accounted for 24.09％. CONCLUSIONS ：The overall dosage of TCM decoction piece prescriptions is relatively high ，the number of ingredients is too much ，and the overdose of single-flavored TCM decoction piece is common. Internal medicine department and surgery department should focus on controlling the number of and the dosage of single-flavored decoction pieces of TCM prescriptions to standardize the prescribed dosage. Gynecology department needs to focus on controlling the dosage of single-flavored TCM pieces and pediatrics department should pay special attention to the use of prescription ingredients ，so as to ensure a more scientific and reasonable standard for the clinical application of TCM decoction piece.

OBJECTIVE: To investigate the mechanism by which dripping pills (STDP) improves coronary microcirculation disorder (CMD) and cardiac dysfunction in a porcine model of myocardial ischemia-reperfusion injury. METHODS: Fourteen minipigs were randomly selected for interventional balloon occlusion of the middle left anterior descending branch to induce CMD, and another 7 pigs received sham operation. The pig models of CMD were randomized equally into the model group and STDP-treated group. All the animals were fed with common feed for 8 weeks, and in STDP-treated group, the pigs were given STDP at the daily dose of 3 mg/kg (mixed with feed) for 8 weeks. Before and at the 8th week after the operation, the pigs underwent coronary angiography and echocardiography to determine the vessel lumen diameter and TIMI frame count (CTFC). The pathologies of the myocardium and the microvessels were examined with HE staining at the 8th week. Western blotting was used to detect the expression of silencing information regulator (Sirt1), peroxidase proliferator-activated receptor-γ coactivator-1α (PGC-1α), peroxisome proliferator-activated receptor α (PPARα), extracellular signal-regulated kinase1/2 (ERKI/2), Toll-like receptor 4 (TLR4), and uncoupling protein 2 (UCP2) in myocardial tissue. RESULTS: Before and at the 8th week after the operation, the diameter of the anterior descending vessel in the 3 groups did not differ significantly ( > 0.05). At the 8th week, the number of CTFC frames in the model group increased significantly compared with that in the sham-operated group, but was obviously lowered by treatment with STDP ( < 0.05). Myocardial ischemia-reperfusion injury significantly increased the interventricular septal thickness at end-diastole, left ventricular end-diastole dimension, end-diastole volume, interventricular septal thickness at end-systole and left ventricular mass at 8 weeks after the modeling ( < 0.05), but such changes were significantly alleviated by treatment with STDP (P < 0.05). STDP treatment markedly alleviated myocardial microvascular congestion, thrombosis and peripheral inflammatory cell infiltration induced by myocardial ischemia-reperfusion, but atrophy of the myocardial muscle fiber remained distinct. STDP obviously suppressed the down-regulation of Sirt1, PGC-1α, and PPARα and the up-regulation of ERK1/ 2, TLR4, and UCP2 in the myocardial tissues induced by myocardial ischemia-reperfusion injury. CONCLUSIONS STDP has anti-inflammatory effects and regulates energy metabolism in the myocardium through modulating Sirt1, PGC-1α, PPARα, ERKI/2, TLR4, and UCP2 to improve CMD and cardiac dysfunction after myocardial ischemia-reperfusion.
Animals ; Drugs, Chinese Herbal ; Microcirculation ; Myocardial Reperfusion Injury ; Myocardium ; Rats ; Rats, Sprague-Dawley ; Swine

Objective: To investigate the association between the promoter region-938 polymorphism of B-cell lymphoma/leukemia-2 (Bcl-2) gene and the esophageal cancer (EC) and gastric cardia adenocarcinoma (GCA) in Hebei Province. Methods: From 2007 to 2010, 145 esophageal cancer patients and 169 cardiaccancer patientsfrom the outpatient department of the Fourth Hospital of Hebei Medical Universitywereselected in a case group, and 195 non-tumor patients were selected in a control group during the same period. A questionnaire survey was used to collect information of research subjects. Pathological tissues were collected to extract genomic DNA and detect the genotype of bcl-2 gene -938. A multivariate logistic regression model was used to analyze the association between the bcl-2 gene locus 938 CC genotype and the EC and GCA. The interaction between age, gender, smoking, drinking, upper gastrointestinal family history and the bcl-2 gene locus 938 CC genotype was analyzed by likelihood ratio test. Results: The age of the esophageal and cardiac cancer groups was (56.3±8.3) and (57.1±8.4) years old, and that of the control group was (54.7±7.1) years old. The proportion of the bcl-2 gene locus 938 CC genotype in the esophageal group [48.3% (70/145)] and the cardiac cancer group [48.5% (82/169)] was higher than that in the control group [33.8% (66/195)] (both P values<0.05).Compared with the AA genotype, the risk of esophageal cancer and cardiac cancerin people with the CC genotype was 2.386 (1.20-4.76) and 2.564 (1.27-5.18) respectively. In the population with CC genotype, compared with the positive family history, drinking, and male, the negative family history, non-drinking, and female had a higher risk of esophageal cancer; compared with the non-smoking, negative family history, non-drinking and male, the smoking, positive family history, drinking, and female had a higher risk of cardiac cancer (all the P interaction values were <0.05). Conclusion People with bcl-2 gene locus 938 CC genotype in Hebei Provincewere more likely to suffer from the esophageal and gastric cardia adenocarcinoma.

Objective To investigate the association between the promoter region?938 polymorphism of B?cell lymphoma/leukemia?2 (Bcl?2) gene and the esophageal cancer (EC) and gastric cardia adenocarcinoma (GCA) in Hebei Province. Methods From 2007 to 2010, 145 esophageal cancer patients and 169 cardiaccancer patientsfrom the outpatient department of the Fourth Hospital of Hebei Medical Universitywereselected in a case group, and 195 non?tumor patients were selected in a control group during the same period. A questionnaire survey was used to collect information of research subjects. Pathological tissues were collected to extract genomic DNA and detect the genotype of bcl?2 gene?938. A multivariate logistic regression model was used to analyze the association between the bcl?2 gene locus 938 CC genotype and the EC and GCA. The interaction between age, gender, smoking, drinking, upper gastrointestinal family history and the bcl?2 gene locus 938 CC genotype was analyzed by likelihood ratio test. Results The age of the esophageal and cardiac cancer groups was (56.3±8.3) and (57.1±8.4) years old, and that of the control group was (54.7 ± 7.1) years old. The proportion of the bcl?2 gene locus 938 CC genotype in the esophageal group [48.3% (70/145) ] and the cardiac cancer group [48.5% (82/169) ] was higher than that in the control group [33.8% (66/195) ] (both P values<0.05).Compared with the AA genotype, the risk of esophageal cancer and cardiac cancerin people with the CC genotype was 2.386 (1.20-4.76) and 2.564 (1.27-5.18) respectively. In the population with CC genotype, compared with the positive family history, drinking, and male, the negative family history, non?drinking, and female had a higher risk of esophageal cancer; compared with the non?smoking, negative family history, non?drinking and male, the smoking, positive family history, drinking, and female had a higher risk of cardiac cancer (all the P interaction values were <0.05). Conclusion People with bcl?2 gene locus 938 CC genotype in Hebei Provincewere more likely to suffer from the esophageal and gastric cardia adenocarcinoma.

Objective To investigate the association between the promoter region?938 polymorphism of B?cell lymphoma/leukemia?2 (Bcl?2) gene and the esophageal cancer (EC) and gastric cardia adenocarcinoma (GCA) in Hebei Province. Methods From 2007 to 2010, 145 esophageal cancer patients and 169 cardiaccancer patientsfrom the outpatient department of the Fourth Hospital of Hebei Medical Universitywereselected in a case group, and 195 non?tumor patients were selected in a control group during the same period. A questionnaire survey was used to collect information of research subjects. Pathological tissues were collected to extract genomic DNA and detect the genotype of bcl?2 gene?938. A multivariate logistic regression model was used to analyze the association between the bcl?2 gene locus 938 CC genotype and the EC and GCA. The interaction between age, gender, smoking, drinking, upper gastrointestinal family history and the bcl?2 gene locus 938 CC genotype was analyzed by likelihood ratio test. Results The age of the esophageal and cardiac cancer groups was (56.3±8.3) and (57.1±8.4) years old, and that of the control group was (54.7 ± 7.1) years old. The proportion of the bcl?2 gene locus 938 CC genotype in the esophageal group [48.3% (70/145) ] and the cardiac cancer group [48.5% (82/169) ] was higher than that in the control group [33.8% (66/195) ] (both P values<0.05).Compared with the AA genotype, the risk of esophageal cancer and cardiac cancerin people with the CC genotype was 2.386 (1.20-4.76) and 2.564 (1.27-5.18) respectively. In the population with CC genotype, compared with the positive family history, drinking, and male, the negative family history, non?drinking, and female had a higher risk of esophageal cancer; compared with the non?smoking, negative family history, non?drinking and male, the smoking, positive family history, drinking, and female had a higher risk of cardiac cancer (all the P interaction values were <0.05). Conclusion People with bcl?2 gene locus 938 CC genotype in Hebei Provincewere more likely to suffer from the esophageal and gastric cardia adenocarcinoma.

Objective To investigate the effect of notch signaling pathway on drug resistance and invasiveness of bladder cancer .Methods We observed the changes of growth and morphology of bladder cancer T 24 , 5637 and J82 cells which treated for 48 hours using γ-secretase inhibitor by inverted microscope .The mRNA and protein lev-els of the EMT molecular markers , including E-cadherin , N-cadherin , vimentin and Alpha-smooth muscle actin were examined by RT-PCR and Western blot in bladder cancer cells;Detected the changes of drug resistance and invasion respectively by MTT and Transwell in bladder cancer cells .Results After completely blocking the Notch signaling pathway , the inverted microscope showed that bladder cancer cells became smaller and more disperse ;RT-PCR and Western blot showed the mRNA and protein levels of E-cadherin were up-regulated ( P<0.05 ) , contrast , N-cadherin , vimentin and Alpha-smooth muscle actin were down-regulated ( P<0.05 ); The prolifera-tion of bladder cancer cells were significantly inhibited by MTT test;The number of through microporous membrane cells significantly decreased ( P<0.05 ) shown by Transwell test .Conclusions The Notch signaling pathway is completely blocked that nhibites proliferation and EMT of bladder cancer cells , reduces drug resistance and inva-sion in bladder cancer cells .It suggests that drug resistance and invasiveness of bladder cancer can be changed through EMT which is regulated through notch signaling pathway .

Objective To observe the efficacy of inhaled tiotropium bromide combined with budesonide/formoterol on reducing the frequency of acute episodes of symptom exacerbation and improving lung function,health status in chronic obstructive pulmonary disease (COPD). Methods Eighty-six patients with COPD were divided into 3 groups, combination group[29 cases, inhaled budesonide/formoterol (160 μg/4.5 μg, twice one day ) and tiotropium bromide ( 18 μg, once one day)], budesonide/formoterol group( 29 cases, 160 μg/4.5 μg, twice one day) and tiotropium bromide group(28 cases, 18 μg, once one day). The treatment continued for 3 months. Results Lung function, symptoms and health status improved obviously in three groups. The forced expiratory volume in one second (FEV1) of combination group after treatment was (1.24±0.18) L , which was improved by 11.7% compared with before treatment. It was significantly higher than that in budesenide/formoterol group and fiotropium bromide group (P < 0.01 ). The rescue medication consumptions and the times of acute episode of combination group were significantly decreased compared with those in the other groups,and there was significant difference (P <0.01). The SGRQ score of combination group was (35.6±13.9) points which was significantly lower than that of budesonide/formoterol group and tiotropium bromide group,and there was significant difference (P < 0.01 ).There was no statistical difference in the adverse events occurred in three groups (P > 0.05 ). Conclusions Combination treatment produces better control of symptoms and lung function and has no greater risk of sideeffects, compared with the treatment of budesonide/formoterol alone and tiotropium bromide alone. The combination treatment should be considered for patients with COPD.

Objective To analyze injury characteristics and treatment of hospitalized patients wounded in Wenehuan earthquake so as to provide references for medical rescue in disasters. Methods The study involved data of seismic patients from Trauma Database System Version 3.0 that collected clini-cal data of seismic patients admitted into West China Hospital of Sichuan University, Chengdu, and First and Second Hospitals of Deyang City. Trauma Database System Version 3.0 was developed by Research Institute for Traffic Medicine of PLA, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing. A comparative analysis was done on patient distribution, injury severity and medical treatment. Results There were 826 qualified patients including 410 males and 416 females ( at age range of 1-102 years, mean 45.8 years). Of all, the patients at age of 31-60 years accounted for 50. 2%. The patients were mainly peasants (43.8%, 208/477), workers (15.7%, 75/477) and students (14.1%, 67/477). Blunt injury (53.2%), crush/bury injury (22.5%) and slip/fall injury were three main causes for injury. The patients for 92.1% were admitted into two hospitals of the City of Deyang within four days after earthquake, while 81.7% of patients were admitted into West China Hospital in Chengdu at days 3-9 after earthquake. Patients with bone injuries accounted for 75.3%. The patients had abbreviated injury score (AIS) for mainly 1-3 points, with incidence rate of se-vere multiple trauma ( ISS > 16 points) of 8.2%. Internal fixation was done in 120 patients ( 34. 1% ), debridement and suturing in 103 (29.3%), external fixation in 55 ( 15.6% ), extremity amputation in 22 (6.3%) and intracerebral surgery in 2 (0.6%). Conclusions The injuries are mainly induced by collapse of buildings during earthquake. Bone injuries are predominant injury type, with AIS of mainly 1-3 points and few severe multiple trauma. The results show that the patients receive late special treat-ment and slow evacuation, indieating necessity of strengthening capacity of early medical treatment and ef-fective evacuation during destructive natural disasters.

Objective To investigate the influence of uremic serum on the monocyte chemoattractant protein 1 (MCP-1) expression of human umbilical vascular endothelial cells (HUVECs) in vitro and the effect of up-regulation of berne oxygenase 1 (HO-1) on the synthesis of MCP-1 of HUVECs in uremic milieu. Methods HUVECs were incubated to confluence and then preineubated with heroin and/or protoporphyrin zinc IX (ZnPP)for 6 hours.The cultures were subsequently incubated with M199 cell medium containing 10% serum of healthy people or with medium containing 10% serum of maintenance hemodialysis (MHD) patients.HO-1 protein and mRNA expression was detected by immunohistochemistry and semi-quantitative RT-PCR.MCP-1 mRNA expression was measured by semi-quantitative RT-PCR,and MCP-1 protein was quantified by ELISA. Results Up-regulated expression of MCP-1 mRNA and protein was detected in HUVECs incubated with medium containing 10% serum of MHD patients.The protein synthesis was 2.95 folds of the control.Heroin induced expression of HO-1 mRNA and protein,and concurrently inhibited the up-regulated MCP-1 expression induced by uremic serum.Such effects of heroin could be blocked by ZnPP. Conclusions Uremic serum induces the expression of MCP-1 in HUVECs.Up-regulated expresson of endothelial HO-1 induced by heroin inhibits the enhancement of MCP-1 synthesis.HO-1 may be beneficial to the alleviation of endothelial cell injury in uremic milieu.

Objective To investigate the correlation between the mierosatellite polymorphism of heme oxygenase-1(HOX-1)gene promoter and susceptibility to chronic obstructive pulmonary disease(COPD)in Han nationality of Southwest China and CT imaging.Method The alleles frequencies with varying number of(GT)n repeatings in the Hox-1 gene in 180 smokers with COPD and in 150 healthy smokers were analyzed.Results Polymorphisms of the(GT)n repeats were grouped into three classes:S(≤25 repeats),M(26-31 repeats),L(≥32repeats).The proportion of genotypic frequencies in the group with class L alleles(L/S,L/M,I/L)was significantly higher in the smokers with COPD than in healthy smokers(29.4%vs18.7%,P=0.023,OR=1.8,95%CI 1.1-3.1).However,there was no relationship between the polymorphism of HOX-1 gene and subtypes of COPD by CT imaging in COPD patients(P＞0.05).Conclusion Genetic polymorphism in Hox-1 is associated with development of COPD in Han nationality of Southwest China.But the polymorphism of HOX-1 gene is not associated with subtypes of COPD by CT imaging.