To investigate the protective effects and underlying mechanisms of Qin-Zhu-Liang-Xue decoction (QZLX) in atopic dermatitis (AD) and glucocorticoid resistance, we conducted a single-blinded, randomized controlled clinical trial to evaluate the efficacy and safety of this concoction. Network pharmacology analysis was performed and validated through clinical studies. The efficacy, safety, and mechanism of action of QZLX and glucocorticoid receptor (GR) α recombinant protein were assessed in AD mice induced by 2,4-dinitrofluorobenzene (DNFB). Correlation analysis was performed to determine the clinical relevance of GRα. The trial demonstrated that patients who received QZLX showed considerable improvements in their Scoring Atopic Dermatitis (SCORAD) and Dermatology Life Quality Index (DLQI) scores compared with those who received mizolastine at week 4. Network pharmacological analysis identified GRα as a key target for QZLX in AD treatment. QZLX administration increased the serum GRα expression in AD patients, alleviated AD symptoms in mice, decreased inflammatory cytokine expression, and increased GRα expression without affecting liver or kidney function. In addition, GRα recombinant protein improved AD-like skin lesions in DNFB-induced mice. A negative correlation was observed between GRα expression and clinical parameters, including SCORAD, DLQI, and serum IgE levels. QZLX alleviates AD symptoms through the upregulation of GRα and thus presents a novel therapeutic strategy for the prevention of glucocorticoid resistance in AD management.
Dermatitis, Atopic/drug therapy* ; Animals ; Drugs, Chinese Herbal/administration & dosage* ; Humans ; Mice ; Network Pharmacology ; Male ; Female ; Adult ; Receptors, Glucocorticoid/metabolism* ; Disease Models, Animal ; Single-Blind Method ; Middle Aged ; Young Adult

OBJECTIVE To explore the impact of the adjustment of the national reimbursement drug list on rare disease drugs in hospitals， and to provide reference for improving the drug security of patients with rare diseases in China.METHODS The monthly procurement data of rare disease drugs from 789 medical institutions that continuously reported data from January 2016 to December 2018 were extracted from the Chinese Medicine Economic Information. The single-group interrupted time series model was used to compare drug varieties， procurement amount， average defined daily cost （DDDc） and defined daily doses （DDDs） of rare disease drugs before and after the adjustment of national reimbursement drug list. RESULTS In 2017， a total of 9 rare disease drugs were newly included in the national reimbursement drug list， including pirfenidone， carbidopa/levodopa， riluzole， ropinirole， droxidopa， ezetimibe， everolimus， coagulation factor Ⅸ human recombinant and coagulation factor Ⅶa human recombinant. After the adjustment of the national reimbursement drug list， the average DDDc of 9 rare disease drugs was significantly decreased， the upward trend of DDDs and the procurement amount was significantly increased （P＜0.001）. CONCLUSIONS The number of newly included rare disease drugs in national reimbursement drug list keeps increasing， the coverage of medical security keeps expanding， the price of rare disease drugs is significantly decreased， the economic burden of patients is further decreased， and the consumption of rare disease drugs is significantly increased， benefiting more patients with rare diseases； but at the same time， it also increases the procurement amount of rare disease drugs in hospitals. National medical security departments need to fully consider how to balance the affordability of medical insurance funds with the demand for rare disease drug coverage.

Objective To evaluate the quality of blood after marine storage and transportation,to establish a quantitative energy metabolism platform supported by extracellular flux(XF)technique to determine the glycolysis level of red blood cells(RBC), and to introduce the "functional dose", as a valuable supplement, into the quality evaluation of RBCs after marine storage and transportation.Methods The extracellular acidification rate(ECAR)of erythrocyte glycolysis was detected by XF.The levels of glycolysis, ATP contents and free hemoglobin of RBCs were detected before and after marine navigation.RBC suspensions stored at 4℃in a blood bank on land served as control.Results The results showed that the glycolysis level of RBCs was detected by XF.Indicators of blood quality and energy metabolism of RBCs were detected in the twice marine storage and transportation.Blood samples transported around the Gulf of Bohai had no significant change,indicating that the samples were well preserved.The energy indicators of blood samples navigated in the Pacific Ocean decreased significantly,and it was recommended that the samples be discarded.Conclusion XF technique has been applied to the measurement of erythrocyte glycolysis,enabling high-throughput and multi-indicator dynamic detection of viable cells.The energy metabolism of erythrocyte should be recommended as an important indicator for evaluating blood after marine storage and transportation.

OBJECTIVETo assess the response in THP-1 treated with Rv3671c protein in Mycobacterium tuberculosis (M.tuberculosis).

METHODSThe gene encoding Rv3671c protein of M.tuberculosis was cloned into pET-28a vector and then expressed in Escherichia coli. The Rv3671c was purified with Ni-NTA affinity and ion exchange chromatography. The detection of protein concentration was by Lowry method.THP-1 cell was stimulated with Rv3671c protein and cells were analyzed by Hochest staining under fluorescence microscopy to assay cell death (apoptosis and necrosis). TNF-α and IL-1β were detected by ELISA at each stimulating time.

RESULTSThe Rv3671c protein of M.tuberculosis was successfully expressed in Escherichia coli. The purity of recombinant Rv3671c protein was 95%, and the protein concentration was up to 0.4 mg/ml. The nucleus of THP-1 was isolated and necrosis-like under fluorescence when cells were stimulated by Rv3671c protein. The levels of TNF-α and IL-1β in supernatant were 19 000 and 16 500 pg/ml respectively, and were significantly higher than control cells with the levels of 2100 and 3800 pg/ml separately.

CONCLUSIONThe necrosis of THP-1 cells could be stimulated by Rv3671c protein of M.tuberculosis and it was probably associated with high cytokines TNF-α and IL-1β levels.

Bacterial Proteins ; pharmacology ; Cell Death ; Cell Line ; Humans ; Interleukin-1beta ; metabolism ; Macrophages ; cytology ; metabolism ; Mycobacterium tuberculosis ; genetics ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo observe the dose-effect relationship of electroacupuncture of different current intensities combined with Morphine of different dosage on alleviating the rats' tibial cancer pain, and explore the possible mechanism, which could provide the experiment basis for alleviating the tibial cancer pain by electroacupuncture combined with Morphine.

METHODSOne hundred female Wistar rats were randomly divided into a normal group, a model group and eight treatment groups, 10 cases in each group. The rats in the treatment groups were treated by combined therapies of electroacupuncture of different intensities with 2 Hz /100 Hz dense-disperse wave on "Jiaji"(EX-B 2)and different dosage Morphine in 2 factor 3 level conditions, once a day for 6 days. The pain thresholds were observed before the treatment and 0 min, 1 h, 2 h and 5 h after the first treatment as well as after 3 and 6 times of treatments. The glial fibrillary acidic protein (GFAP) expression was determined by immunohistochemical method.

RESULTSThe rats' pain thresholds were significantly increased with electroacupuncture of 2 mA and 1 mA (all P < 0.01) on the 0 min, 1 h and 2 h of the first treatment, between which there were no significant differences (all P > 0.05). The pain threshold was still increased by electroacupuncture of 2 mA on the 5 h of the treatment (P < 0.01), while that of 1 mA failed to take effect (P > 0.05). After 3 and 6 times of treatments, both electroacupuncture of 2 mA and 1 mA had the effect of increasing the pain threshold (all P < 0.01), and the effect of 2 mA was superior to that of 1 mA (P < 0.05), had the synergistic effect with 5 mg/(kg x d) Morphine (P < 0.05). After 6 times of treatments, both electroacupuncture of 2 mA and 1 mA could inhibit the expression of GFAP (both P < 0.01), and there was no significant difference between them (P > 0.05). Both of 5 mg/(kg x d) and 2.5 mg/(kg x d) of Morphine, however, didn't bring about inhibition effect (P > 0.05).

CONCLUSIONThere is a does-effect relationship on electroacupuncture of different current intensity for alleviating the tibial cancer pain in rats. The electroacupuncture with 2 mA, which is better than that with 1 mA, has the synergistic effect with 5 mg/(kg x d) of Morphine. The electroacupuncture can inhibit the expression of GFAP to cooperate with Morphine for the purpose of alleviating the rats' tibial cancer pain.

Animals ; Bone Neoplasms ; complications ; genetics ; metabolism ; Electroacupuncture ; instrumentation ; methods ; Female ; Gene Expression Regulation, Neoplastic ; Glial Fibrillary Acidic Protein ; genetics ; metabolism ; Humans ; Pain ; etiology ; genetics ; metabolism ; Pain Management ; instrumentation ; methods ; Rats ; Rats, Wistar ; Spine ; metabolism ; Tibia ; metabolism

Carcinoma, Papillary ; genetics ; Humans ; Mutation ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroid Neoplasms ; genetics

OBJECTIVETo study the effect of acupuncture on skeletal muscle endurance in rats as a pre-games assistant training.

METHODSThirty male SD rats were randomly divided into 3 groups: control, model and acupuncture group. Acupuncture group was treated at "Dazhui" (GV 14), "Housanli" (ST 36) by twisting mild reinforcing-reducing method for 20 min, no interventions were added on control and model group. Muscle strength was detected in three groups under anaesthetic (after model established in model group, after model established and treated in acupuncture group). Averaged change percentage of mean skeletal muscle endurance (P(m)) and averaged maximum percentage of skeletal muscle endurance (P(max)) were evaluated.

RESULTS(1) 10P(m) in model group decreased more than acupuncture group statistically (P < 0.05); 20P(m), 30P(m) and 40P(m) in model group decreased significantly compared to those in control group and acupuncture group (P < 0.05, P < 0.01). (2) Changes of 10P(max) in acupuncture group was much less than in model group (P < 0.05); changes of 20P(max), 30P(max), 40P(max) and 50P(max) decreased more in model group than in acupuncture group and control group (P < 0.01, P < 0.05).

CONCLUSIONAs an assistant training method, acupuncture can postpone descending point of muscle strength endurance to delay sport fatigue.

Acupuncture Therapy ; Animals ; Humans ; Kinetics ; Male ; Models, Animal ; Muscle, Skeletal ; chemistry ; physiology ; Physical Endurance ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the effect of portal hypertension on prognosis in patients with decompensated liver cirrhosis.

METHODSThe clinical data of decompensated cirrhosis patients in our hospital, between 2003 and 2006, were retrospected and followed up. Model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) classification was calculated using the standard formula. Kaplan-Meier survival analysis was used to compare the mortality in subgroups ranked by the syndromes. Cox proportional hazards regression was used to evaluate the effect of the syndromes on prognosis.

RESULTSA cohort of 322 patients was admitted in this study at the end of the follow-up. The mortality of variceal bleeding, hepatic encephalopathy, a large volume ascites, spontaneous bacterial peritonitis, the type I and type II hepatorenal syndrome was 45.9%, 79.4%, 66.7%, 100%, 100% and 84.6% respectively. On the whole, the occurrence of all the syndromes was correlated with CTP classification and MELD score. Kaplan-Meier survival analysis showed that all of these syndromes, except for low to medium volume of ascites, significantly affected the survival rate (P<0.01). In Cox regression analysis, all the syndromes were the independent predictors of prognosis, the regression coefficient values of hepatic encephalopathy, spontaneous bacterial peritonitis, type I and type II hepatorenal syndrome, variceal bleeding and ascites were 0.973, 0.928, 0.935, 0.866, 0.464 and 0.369 respectively.

CONCLUSIONSThe portal hypertensive syndromes have significant effect on the prognosis of the patients with decompensated cirrhosis, hepatic encephalopathy is the worst one.

Adult ; Aged ; Esophageal and Gastric Varices ; epidemiology ; etiology ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; epidemiology ; etiology ; Hepatic Encephalopathy ; epidemiology ; etiology ; Hepatorenal Syndrome ; epidemiology ; etiology ; Humans ; Hypertension, Portal ; complications ; epidemiology ; Liver Cirrhosis ; complications ; mortality ; pathology ; Male ; Middle Aged ; Models, Statistical ; Predictive Value of Tests ; Prognosis ; Severity of Illness Index ; Survival Analysis

OBJECTIVETo assess the application of analyzing systems and techniques in acupuncture manipulation education that may improve students' acupuncture manipulation skills.

METHODSThe teacher's acupuncture manipulation (TAM) was recorded in wave, data and video information by the Analyzing System. Students practised, adjusted and corrected their manipulation skills according to the TAM. After finishing the training sessions, the system's grading function evaluated every student's performance.

RESULTSAfter training, the stability of the students' acupuncture manipulation skills and their achievement were both significantly improved (P < 0.01, P < 0.001).

CONCLUSIONThe Analyzing System benefits for imitating and learning the manipulations of specilists and can improve the education quality.

Acupuncture ; education ; methods ; Computer-Assisted Instruction ; methods ; Humans ; Medical Informatics ; education ; methods ; Teaching ; methods

OBJECTIVETo observe the therapeutic effect of acupoint electrogymnastics therapy on apoplectic hemiplegia, so as to further popularize this therapy in treatment of apoplectic hemiplegia.

METHODSUsing three-central, randomized, controlled, multi-blind methods, 153 cases were divided into an electrogymnastics group (n = 77) and an electroacupuncture group (n = 76). They were treated with acupoint electrogymnastics (AE) and traditional electroacupuncture (TEA), respectively. Shousanli (LI 10) and Waiguan (TE 5) on upper limbs and Yanglingquan (GB 34) and Zusanli (ST 36) on the lower limbs were selected in the two groups. A JD-2008 hemiplegia treatment apparatus was used in the AE group. Fugl-Meyer method was used for assessment of motor function and sense function of the four limbs, balance function and joint activity, etc. before and after treatment.

RESULTSIn the motor function and sense function of four limbs, balance function and joint activity in the two groups had significant improvement after treatment (both P < 0. 001) with no significant difference between the two groups (P > 0.05).

CONCLUSIONBoth acupoint electrogymnastics (AE) and traditional electroacupuncture (TEA) have a similar therapeutic effect on apoplectic hemiplegia, but AE has the advantages of safety, reliability and convenience in operation, so it is suitable for long-term rehabilitation treatment of the patient and for popularization in hospital of basic level.

Acupuncture Points ; Aged ; Electroacupuncture ; methods ; Female ; Hemiplegia ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Stroke ; therapy