Objective To investigate the effects ofYangyin Yiqi Mixture on pulmonary fibrosis caused by bleomycin in rats;To discuss its possible mechanism.Methods SD rats were randomly divided into normal control group, model group, dexamethasone acetate group, low-dose, middle-dose and high-doseYangyin Yiqi Mixture groups. Bleomycin was used to establish pulmonary fibrosis rat models through endotracheal instillation. One day after molding, each medication group received gavage with relevant medicine. Lung tissues were taken on the 7th, 14th and 28th day. Masson staining was used to observe pathological change;alkalinehydrolysis was used to detect HYP content;Western blot was used to detect the protein expressions of MMP-2 and TIMP-1.Results Compared with the normal control group, on 7th day, collagen in lung tissue of rats in model group markedly increased;the content of HYP in lung tissue significantly increased (P<0.01). On 28th day, collagen was deposited diffusely and the alveolar was destroyed;content of HYP in lung tissue increased significantly (P<0.01). Compared with model group, deposited collagen in lung tissue was alleviated, and the content of HYP were remarkable reduced in middle and high doseYangyin Yiqi Mixture groups and displayed dose-dependent. Western blot results showed that the protein expressions of MMP-2 and TIMP-1 increased quickly compared with the low expression of normal lung tissue in the 7th day of molding (P<0.05), and reached high expression in the 28th day. Compared with the model group, the level of MMP-9 in high-dose Yangyin Yiqi Mixture group decreased significantly in the 14th day;the expression of TIMP-1 decreased significantly in the 7th, 14th and 28th day (P<0.05).ConclusionYangyin Yiqi Mixture can effectively resist pulmonary fibrosis, which may be realized by inhibiting the expressions of TIMP-1 and MMP-9, regulating and promoting collagenic hydrolysis and restraining deposition of collagen.

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States (U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, OkCopay.com. We examined descriptive statistics (range, median and 20% intervals) for the cost of acupuncture "first-time visits" and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15-400; the highest median was $150 in Charleston, South Carolina, while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were: Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits, the cost range was $15-300; the highest median was $108 in Charleston, South Carolina, and the lowest $40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.