OBJECTIVE: To establish a proper experimental model of bone cancer pain in rat for acupuncture research, and observe the pain-relieving effect of electroacupuncture (EA) and/or Celebrex on bone cancer pain in rats. METHODS: The rat model of bone cancer pain was established by percutaneous direct puncture technique and inoculating the rat mammary gland carcinoma cells Walker 256 into tibial medullary cavity directly, and evaluated by detecting the bone tumor growth and mechanical allodynia. The effects of daily EA treatment and/or Celebrex treatment on the rat mechanical allodynia after intratibial Walker 256 inoculation was observed in this study. RESULTS: Significant mechanical allodynia in ipsilateral hind paw and tumor growth in proximal end of tibial bone of rats in the untreated group were observed after intratibial Walker 256 inoculation. The mechanical allodynia thresholds in rats that received EA or 5 mg/(kg.d) Celebrex treatment showed no significant difference as compared with that of rats in the untreated group. However, the mechanical allodynia thresholds of rats in 10 mg/(kg.d) Celebrex group showed significant increase after 22- and 26-day treatment as compared with that in the methyl cellulose (MC) group. There was significant difference between rats with EA combined with 5 mg/(kg.d) Celebrex treatment and rats in the untreated group after 10-, 18- and 23-day treatment. CONCLUSION: EA and 5 mg/(kg.d) Celebrex have synergistic effect on pain relieving and their combined use may enhance the analgesic effect on bone cancer pain.

Objective:To investigate the maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) during pregnancy at advanced maternal age for their second child at advanced maternal age, and to explore the relationship with neonatal outcomes.Methods:This study involved 1 965 women of advanced maternal age who delivered the second child in the Northwest Women's and Children's Hospital from July 1 to December 31, 2017. Clinical data of these women and their newborns were collected through the electronic medical record information system. According to pre-pregnancy BMI, all subjects were divided into four groups: underweight group (<18.5 kg/m 2, n=139), normal weight group (18.5-23.9 kg/m 2, n=1 342), overweight group (24.0-27.9 kg/m 2, n=404) and obese group (≥28.0 kg/m 2, n=80). According to the GWG standard recommended by the American Institute of Medicine (IOM) in 2009, they were also divided into three groups: inadequate GWG group ( n=478), normal GWG group ( n=884) and excessive GWG group ( n=603). Mann-Whitey U test, Chi-square test or Fisher's exact test were used as statistical methods. Effects of pre-pregnancy BMI and GWG on gestational age and birth weight of the newborns were analyzed by binary and multi-class logistic regression models. Results:The median pre-pregnancy BMI of the 1 965 women was 22.1 (20.3-23.9) kg/m 2 and patients with abnormal pre-pregnancy BMI accounted for 31.7% (623/1 965). Their median GWG was 13.0 (10.0-16.0) kg and 55.0% (1 081/1 965) of them were abnormal. Compared with normal pre-pregnant weight women, overweight and obesity subjects were associated with increased risks of preterm birth ( OR=2.100, 95% CI: 1.398-3.156), low birth weight infants (LBWI) ( OR=3.187, 95% CI: 1.892-5.367) and macrosomia ( OR=1.758, 95% CI: 1.182-2.614); pre-pregnancy underweight reduced the incidence of large for gestational age (LGA) infants ( OR=0.476, 95% CI: 0.236-0.960). Compared with the normal GWG group, the inadequate GWG group had increased risks of preterm birth ( OR=2.316, 95% CI: 1.530-3.505) and LBWI ( OR=1.850, 95% CI: 1.103-3.104), while the excessive GWG group showed increased risks of macrosomia ( OR=1.828, 95% CI: 1.225-2.726) and LGA infants ( OR=1.955, 95% CI: 1.448-2.640), but a reduced risk of LBWI ( OR=0.359, 95% CI: 0.193-0.667) and small for gestational age infants ( OR=0.452, 95% CI: 0.240-0.852). Conclusions:Both abnormal pre-pregnancy BMI (underweight, overweight and obese) and GWG (inadequate and excessive) have adverse effects on neonatal outcomes in women of advanced age in pregnancy for their second baby. Weight management should be addressed during the whole pregnancy, including both adjusting the pre-pregnancy BMI to normal range and maintaining reasonable GWG, so as to reduce potential adverse outcomes in newborns.

Objective To investigate the frequency and location of cerebral microbleeds in cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy (CADASIL) to understand the imaging and clinical features of the disease.Methods Cranial magnetic resonance imaging and susceptibility-weighted imaging were assessed in seven symptomatic CADASIL patients in People's Hospital of Zhengzhou University from 2014 to 2017.Imaging features and clinical significance of these patients were analyzed retrospectively.Results The seven patients were diagnosed by Notch3 gene detection.Mutations were found in exon 11 in four cases,and in exon 4 in three cases.All the seven patients with CADASIL had cerebral microbleeds,the number of which was 108 (4-36).The number of cerebral microbleeds was found to be higher in cortico-subcortical region than in any other regions.One of CADASIL patients with cerebral microbleeds had intracerebral hemorrhage located in external capsule.The patient with intracerebral hemorrhage had hypertension and multiple cerebral microbleeds.Conclusions Cerebral microbleeds are common imaging characteristics in symptomatic CADASIL,most of which locate in cortico-subcortical region.Cerebral hemorrhage is one of the clinical manifestations of CADASIL patients.

OBJECTIVE To investigate the implementation effects of the national centralized drug volume-based procurement policy （abbreviated as “national centralized procurement policy”） in Guangxi Zhuang Autonomous Region prefecture， and to provide a reference for the future centralized drug procurement work of the medical institution. METHODS Drug procurement data before and after policy implementation were included in the study. The six secondary indicators （such as availability， affordability， and drug safety） and eighteen third-level indicators （such as completion rate of agreed purchase volume， affordability level， drug revenue proportion） were introduced， guided by the policy objectives and issues of concern to policy beneficiaries. Descriptive statistics was adopted to analyze the data before and after policy implementation （in 2019 and 2020） in terms of differences and change trends. RESULTS In terms of accessibility， the participation rate of medical institutions in Guangxi Zhuang Autonomous Region was 92.55%， the proportion of diseases involved and median completed procurement rate were 40.16%， and 287.82% respectively， and the total centralized delivery rate was 97.20%. In terms of affordability， the total reduction amplitude in drug price was 74.80% from 2019 to 2022； the charge for medicine per capita in hospitalization， the proportion of medicine used for outpatient service and hospitalization， decreased by 17.61%， 10.22%， and 20.10% in order； the burden levels on medical fares for patients were all below 1 in addition to chronic diseases， and anti-tumor drugs. In terms of the impact on medicine， the ratio of adverse drug reaction event cases in 2022 was 66.00%， an increase of 1.29% compared to the previous； since the implementation of the policy， 12 drugs from local pharmaceutical enterprises from Guangxi Zhuang Autonomous Region had passed the consistency evaluation， and the market concentration rate of the top 8 pharmaceutical companies was less than 20.00%. In terms of the impact on healthcare and medical insurance， the public medical institutions achieved generic substitution for originator drugs mostly until 2022； about 9.12% of drugs that were non- centrally purchased in the same category were used； 63.39% of people under investigation did not show a need for a second dressing change； drug expenditure decreased by 2.459 billion yuan. CONCLUSIONS The national centralized procurement policy achieves a significant effect in Guangxi Zhuang Autonomous Region. On the other hand， attention should be paid to these suggestions as follows: expanding the category of drugs used in clinic， conducting clinically comprehensive evaluation of selected drugs， and improving reasonable allocation strategy， etc.