AIM:To determine the effects of glutamine ( Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury in the rats.METHODS: Thirty male Wistar rats were randomly divided into 3 groups (n=10): sham group, I/R group and Gln pretreatment group .The rats in Gln pretreatment group were pretreated with 1 g· kg -1 · d-1 Gln by orogastric route for 7 d, the rats in the other 2 groups were pretreated with normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion .After the operation , the plasma endo-toxin, serum D-lactic acid, superoxide dismutase ( SOD) and malondialdehyde ( MDA) levels were measured .The intesti-nal mucosal injury was observed with HE staining and evaluated using Chiu 's scoring.RESULTS: Serum D-lactic acid, endotoxin level , MDA level and Chiu's score in I/R group were significantly higher than those in sham group and Gln group (all P<0.05).Serum SOD activity was significantly lower than that in sham group and Gln group (P<0.05).CON-CLUSION:Glutamine has a protective effect on the intestines during ischemia-reperfusion injury .The mechanism may be related to oxidative stress response .

According to foreign and domestic standards of clinical quality and the author team’ experience summary of long-term clinical study, it has been found that quality control in clinical acupuncture operators is closely related to operator’s ability, good communication between doctors and patients, signature for informed consent, implementation of inclusion and exclusion criteria, practice of blind method and random concealment, patient’s compliance, standardized writing and keeping of CRF, management of instruments and consumables, and coordination and association between researchers. The implementation method of quality control in clinical acupuncture operators is explored by the clinical practice of the author team in “973” project, and analysis and discussion of the above key points.

AIM:To determine the effects of glutamine ( Gln) pretreatment on occludin protein in the rats with intestinal ischemia-reperfusion ( I/R ) injury.METHODS: Male Wistar rats ( n =30 ) were randomly divided into 3 groups (n=10):sham group, I/R group and Gln pretreatment group.The rats in Gln pretreatment group were pretreated with Gln at dose of 1 g? kg-1? d-1 by orogastric route for 7 d, and those in the other 2 groups were pretreated with the same volume of normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion.After the operation, the levels of IL-10, IL-2, TNF-α, SOD and MDA were measured.The occludin protein was determined by the methods of immunohistochemistry and Western blotting .RESULTS: The occludin protein level in I/R group was significantly lower than that in sham group and Gln group (P<0.05).The levels of MDA and TNF-αin I/R group were significantly higher than those in sham group and Gln group ( P<0.05 ) .The levels of SOD , IL-10 and IL-2 in I/R group were significantly lower than those in sham group and Gln group ( P<0.05 ) .CONCLUSION:Glutamine has a protective effect on occludin protein in intestinal ischemia-reperfusion injury .The mechanism may be rela-ted to oxidative stress response and inflammatory inhibition .

Objective To assess the local anatomy of the Jing Bi with high-frequency ultrasound, and to evaluate the clinical significance of high-frequency ultrasound in acupuncture. Methods A total of 206 healthy subjects were observed with the high-frequency ultrasound. Two common location points of Jing Bi were selected and acupunctured under guidance of high-frequency ultrasound. The sensation of subjects was observed. Brachial plexus diameter, distance between skin and membrana pleuralis, as well as the brachial plexus and the pleura were measured. Results The filiform needle tip to lung, lung tissue and the brachial plexus were all showed, and the brachial plexus diameter, distance between skin and membrana pleuralis, the distance between the brachial plexus and the pleura were obtained. The patients felt when the needle reached the membrane of brachial plexus. All subjects got feeling within 10 seconds after acupuncture, and no pneumothorax occurred. Conclusion The local anatomy of dangerous acupoints can be accurately observed with high-frequency ultrasound. High-frequency ultrasound has important value and significance for acupuncturing the dangerous acupoints.

Objective To investigate the effects of isoliquiritigenin on the invasive ability of human gastric carcinoma SGC7901 cells, and its molecular mechanisms thereof. Methods The logarithmic phase human gastric carcinoma SGC7901 cells were divided into control group (normal cell culture fluid) and isoliquiritigenin group (isoliquiritigenin solu?ble in cell culture fluid, the concentrations were 10, 25, 50 and 100 μmol/L respectively). Each group had four repeated holes. The proliferation of SGC7901 cells were detected with MTT assay after 24 h, 48 h and 72 h of culture. The experimen?tal drug concentration and action time were researched for the subsequent experiments. The in vitro invasion abilities of SGC7901 cells were assessed with Transwell test. The expression levels of MMP9, Akt and P-Akt were detected by Western blot assay. Results The proliferation of SGC7901 cells were inhibited by 10μmol/L isoliquiritigenin, which can be signifi?cantly inhibited by 25, 50 and 100μmol/L isoliquiritigenin in a concentration-dependent and time-dependent manner. The half inhibitory concentrations (IC50) of 24, 48 and 72 h were 52.48, 44.49 and 32.50μmol/L, respectively. Therefore, the 25, 50 and 100μmol/L isoliquiritigenin were selected as the subsequent experimental drug concentration, and 24 h was used as the action time. Compared with the control group (209.75±9.29), the membrane cell number of 25μmol/L (138.50±10.15), 50μmol/L (89.50 ± 16.56) and 100μmol/L (45.00 ± 8.08) decreased gradually (F=267.948,P<0.05). There was no signifi?cant difference in the expression level of Akt protein between four groups (F=1.492). The expression levels of P-Akt and MMP9 were gradually decreased with the increase of the isoliquirigenin concentration (F=359.219 and 431.324,P<0.05). Conclusion Isoliquiritigenin can obviously inhibit invasion ability of SGC7901 cells, which may be related to the down reg?ulation of the signal transduction pathway protein PI3K/Akt and the down steam protein MMP9.

This study was based on the project prophase of expert consultation and literature consult, and aimed to analyze the medicine establishment from the perspective of traditional Chinese medicine (TCM) doctors, in order to further study the influence of medical insurance on the development of TCM. Detailed suggestions were made in or-der to promote the benign development trend of TCM and medical insurance. Questionnaire survey was used in the investigation on perceptions of TCM related with medical insurance among 253 TCM doctors in appointed medical institution of medical insurance. Data was processed with frequency statistics. The results showed that after becoming the appointed medical institution of medical insurance, the medical insurance patients have become the main service group (73.5%) of hospitals (68.4%) and incomes of TCM doctors (41.9%) have increased, which contribute to TCM hospitals of becoming bigger and stronger (63.6%). The medical insurance patients have chosen TCM treatment main-ly for its curative effect (37.9%) and safety (24.1%). The influence of reimbursement ratio in medical insurance was relatively low (1.2%). The reimbursement range of TCM medical insurance needs to be further expanded, such as Chinese medicine nosocomial preparation (90.5%), decoction preparation fee (78.3%), and etc. It was concluded that under the background of universal health coverage, medical insurance plays a more and more important role in the development of TCM. And TCM should ensure its safety and improve its curative effect through the standardization of TCM and other measures. Meanwhile, the formulation of medical security policy and medical insurance management service standards should also consider the characteristics of TCM, and encourage the service of TCM.

Objective To evaluate the efifcacy of endoscopic Over-The-Scope-Clip system (OTSC) system for the acute iatrogenic digestive tract perforation. Methods To collect 11 cases with digestive tract perforation closed with the OTSC system, including 7cases of gastric perforation, 1 case of duodenal perforation,3 cases of colorectal perforation. Results 11 cases were successfully closed with OTSC system in time, the average time needed for the endoscopic closure is 6~15 min. And the perforation diameter is 0.6~3.7 cm, average diameter is (1.89 ± 0.27) cm. No intraoperative bleeding and delayed hemorrhages, no deaths occurred. Conclusion Endoscopic OTSC system is a successful method for the digestive tract perforation and is worth to popularize.

This study was aimed to explore clinical functions of consensus-based clinical practice guidelines (CB CPGs) in traditional Chinese medicine (TCM). Under the guidance of the State Administration of TCM, 42 TCM hospitals in China had conducted a questionnaire survey for 73 CB CPGs and 2993 questionnaires had been included and analyzed. According to the category of good, general and bad, the proportion of the good in improving safety performance was 69.43%, controlling cost was 58.57%, regulating medical behavior was 55.50%, improving clinical effectiveness was 46.74%. It was concluded that the CB CPGs had played a good role in improving safety performance and controlling cost in TCM clinical practice.

Objective To analyze the risk factors for postoperative pulmonary complications(PPC)in patients undergoing lung cancer surgery to establish a nomogram model to predict the risk of PPC.Methods From January 2014 to October 2017,316 patients undergoing lung cancer surgery at Shandong Provincial Hospital Affiliated to Shandong University were enrolled in this study.Their clinical data were analyzed and univariate analysis was used to determine the risk factors related to PPC.The significant variables were included in the multivariate logistic regression analysis to analyze the independent risk factors for PPC.Then the R software was used to establish a predictive nomogram model.Bootstrap method was used to validate the nomogram model and ROC curve was used to explore the predictive efficacy of the model in predicting the PPC.Results A total of 55 cases out of 316 patients undergoing lung cancer surgery had PPC.The prevalence rate was 17.4%.Age(OR=1.151,95%CI 1.041-1.274),chronic obstructive pulmonary disease(COPD)(OR=3.659,95%CI 1.498-8.939),smoking index(OR=1.171,95%CI 1.055-1.300),pN stage(N1:OR=6.686,95%CI 1.959-22.814;N2:OR=7.714,95%CI 2.390-24.900;N3:OR=15.943,95%CI 4.318-58.869)and the poor compliance of breathing exercise(OR=1.298,95%CI 1.031-1.635)were all independent risk factors for PPC.The nomogram model showed a conformance-index of 0.841,while ROC curve showed that the area under the curve for the nomogram model predicting pressure sores was 0.820(95%CI:0.760-0.881).Conclusions The nomogram built based on age,COPD,smoking index,pN stage,and the poor compliance of breathing exercises has good discrimination and accuracy which could be used for predicting individual PPC risk and screening the patients with high risk,with potentially high clinical application value.

Objective:To preliminarily discuss the mechanism of Salvia miltiorrhiza and Rrhizoma alismatis in the prevention and treatment of lipid metabolism through regulating the imbalance of fibrinolytic system in rats with non-alcoholic fatty liver. Methods:The model of non-alcoholic fatty liver in rats was duplicated by high-fat diet feeding. Totally 60 adult Wistar rats were randomly divided into 6 groups (n=10 per group), namely the control group, the model group, Salvia miltiorrhiza group, Rrhizoma alismatis group, Salvia miltiorrhiza and Rrhizoma alismatis group,and Dongbaogantai group. The control group and the model group were given distilled water,and the other group was given Salvia miltiorrhiza,Rrhizoma alismatis,Salvia miltiorrhiza combined with Rrhizoma alismatis and Dongbaogantai,respectively. Rhizoma Alismatis decoction at high dose and low dose as well as Dongbaogantai was respectively adminis-trated in the designed groups,and the corresponding indices were detected 4 weeks later. Results:In the model control group,the con-tents of TC、TG、FFA in serum and the expression of PAI-1 were significantly elevated(P<0.05 or P<0.01),while the expression of t-PA was significantly reduced(P<0.01).After treatment,the contents of TC、TG、FFA in serum and the expression of PAI-1 in every treatment groups were reduced(P<0.01),while the expression of t-PA was elevated(P<0.01).Conclusion: Increasing the expres-sion of t-PA and reducing the expression of PAI-1 might be viewed as the mechanisms of Salvia miltiorrhiza and Rrhizoma alismatis in the prevention and treatment of non-alcoholic fatty liver disease.