To study the lead excretion effect of the chelator Zn-DTPA on the lead intoxication mice, inductively coupled plasma mass spectrometry (ICP-MS) was applied to detect the lead content of biological samples. The acute lead intoxication mice model was established by injecting lead acetate intraperitoneally with the dose of 1 mg. Zn-DTPA was administered intraperitoneally to mice once daily for five consecutive days 4 h after intoxication. Control group, model group, combination of Zn-DTPA and Ca-DTPA group were evaluated at the same time. The urine was collected every day. The mice were sacrificed in batches in the 2rd, 4th, 6th day. Biological samples including urine, whole blood, femur and brain were prepared and nitrated. Lead concentration was detected by ICP-MS. The result showed that Zn-DTPA could increase lead content in urine markedly and reduce lead content in blood, femur and brain.

OBJECTIVETo observe the protective effect of Injection of Panax quinquefolium diolsaponins (IPQDS) and its mechanism on acute myocardial infarction in rats.

METHODThe acute myocardial infarct model was prepared by left anterior descending coronary occulusion for 24 hours in open chest anesthetized rats. The myocardial infarct size (MIS) was calculated. The activities of serum creatine hosphokinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and the contents of malondialdehyde (MDA) and nitric oxide (NO) were determined. Blood was collected to observe low shearing specific viscosity, middle shearing specific viscosity and high shearing specific viscosity of whole blood and plasma viscosity. At the same time, the platelet aggregation rate and platelet adherence rate were also determined.

RESULTIn rats treated by IPQDS (in a dosage of 12.5, 25 and 50 mg x kg(-1) d, i.p. 3d ), the MIS was significantly reduced. The activities of serum CK, LDH and AST, and the content of serum MDA were declined. The activities of SOD and GSH-Px, and the content of NO were increased markedly. In addition, low shearing specific viscosity, middle shearing specific viscosity and high shearing specific viscosity of whole blood and plasma viscosity as well as platelet aggregation rate were also declined significantly. But platelet adherence rate had no significant change.

CONCLUSIONIPQDS has a protective effect on acute myocardial ischemia, which may be related to increasing activity of antioxidase in body, scavenging the damage of peroxidation from oxygen free radicals, decreasing the viscosity of blood and plasma and preventting thrombosis etc.

Animals ; Aspartate Aminotransferases ; metabolism ; Creatine Kinase ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; L-Lactate Dehydrogenase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Myocardial Infarction ; drug therapy ; metabolism ; Nitric Oxide ; metabolism ; Rats ; Rats, Wistar ; Saponins ; therapeutic use ; Superoxide Dismutase ; metabolism

OBJECTIVE To provide suggestions and references for promoting the economic efficiency of anti -AIDS drug use in China .METHODS According to the Chinese Guidelines for the Diagnosis and Treatment of AIDS （2021 Edition）and the National Free HIV Antiretroviral Drug Treatment Manual （4th Edition ），non-free anti -HIV drugs and therapeutic regimens were screened；the data on domestic and foreign drug prices were collected ，and the price and affordability of non -free anti -HIV drugs and drug regimens were analyzed with the median price ratio （MPR）method and drug affordability study method by standard survey method . RESULTS A total of 18 non-free anti -HIV drugs （based on drug names ）were screened ，of which 5 drugs were only domestically produced ，11 were only imported ，and 2 were both domestic and imported drugs ；eight types were listed in the Basic Medical Insurance Catalogue （2021 Edition）. The median MPR for 18 drugs was 0.504，and drugs with affordability of less than 1 accounted for 55% of the total number of drugs before medicare reimbursement ，and this figure increased to 75% after medicare reimbursement . The median affordability after reimbursement of 10 single-tablet combinations was 0.625，of which the affordability of the four single -tablet combinations recommended by the guidelines for use alone was less than 1. There was no statistically significant difference in the affordability of two regimens before and after medicare reimbursement and between recommended regimens and alternatives after reimbursement （P＞0.05）. CONCLUSIONS The affordability of single non -free anti - HIV drugs in China is good ，but the affordability of combination drugs is poor . The affordability advantages of single -tablet combination formulations over conventional therapeutic regimens are significant . The government and enterprises should focus on the research and development of innovative drugs and strengthen drug price control ，and establish and improve the non -free drug protection system for HIV/AIDS groups ，so that they can choose more drugs and use drugs more economically .

Objective To investigate the kinesiophobia level in patients after spinal fracture sur-gery and their correlations with rehabilitation self-efficacy and adherence.Methods A total of 150 patients who underwent spinal fracture surgery were enrolled in this study.General information was collected from all patients.The Tampa Scale for Kinesiophobia,Self-Efficacy for Rehabilitation Out-comes Scale,department-developed Rehabilitation Adherence Scale and postoperative activity pain[assessed using the Visual Analogue Scale(VAS)]were analyzed.Pearson correlation analysis was used to examine the relationships of kinesiophobia level with rehabilitation self-efficacy and adher-ence.Multiple linear regression analysis was conducted to identify factors influencing kinesiophobia level.Results The total score of postoperative kinesiophobia level in patients with spinal fracture was(57.14±3.12),which was at a high level.The total score of rehabilitation self-efficacy was(35.19±3.45),which was at a low level.The total score of rehabilitation compliance was(16.46±2.32),which was at a low level.Pearson correlation analysis showed that the total score of kinesio-phobia level was negatively correlated with the total score of rehabilitation self-efficacy and rehabilita-tion compliance(P＜0.05).Univariate analysis revealed statistically significant differences in scores of kinesiophobia level among patients with different educational levels,postoperative activity pain and the presence or absence of postoperative complications(P＜0.05).Multiple linear regression analy-sis identified self-efficacy(B=-0.271,95％CI,-0.439 to-0.103),adherence(B=-0.168,95％CI,-0.331 to-0.004),educational level(B=0.190,95％CI,0.020 to 0.361),postoperative complications(B=0.403,95％CI,0.233 to 0.573)and postoperative ac-tivity pain(B=0.162,95％CI,0.003 to 0.320)were the influencing factors of postoperative ki-nesiophobia level in patients with spinal fracture.Conclusion The patients with spinal fracture have a higher level of kinesiophobia.The influencing factors of level of kinesiophobia are rehabilita-tion self-efficacy,rehabilitation compliance,education level,postoperative complications and post-operative activity pain.

Objective To investigate the kinesiophobia level in patients after spinal fracture sur-gery and their correlations with rehabilitation self-efficacy and adherence.Methods A total of 150 patients who underwent spinal fracture surgery were enrolled in this study.General information was collected from all patients.The Tampa Scale for Kinesiophobia,Self-Efficacy for Rehabilitation Out-comes Scale,department-developed Rehabilitation Adherence Scale and postoperative activity pain[assessed using the Visual Analogue Scale(VAS)]were analyzed.Pearson correlation analysis was used to examine the relationships of kinesiophobia level with rehabilitation self-efficacy and adher-ence.Multiple linear regression analysis was conducted to identify factors influencing kinesiophobia level.Results The total score of postoperative kinesiophobia level in patients with spinal fracture was(57.14±3.12),which was at a high level.The total score of rehabilitation self-efficacy was(35.19±3.45),which was at a low level.The total score of rehabilitation compliance was(16.46±2.32),which was at a low level.Pearson correlation analysis showed that the total score of kinesio-phobia level was negatively correlated with the total score of rehabilitation self-efficacy and rehabilita-tion compliance(P＜0.05).Univariate analysis revealed statistically significant differences in scores of kinesiophobia level among patients with different educational levels,postoperative activity pain and the presence or absence of postoperative complications(P＜0.05).Multiple linear regression analy-sis identified self-efficacy(B=-0.271,95％CI,-0.439 to-0.103),adherence(B=-0.168,95％CI,-0.331 to-0.004),educational level(B=0.190,95％CI,0.020 to 0.361),postoperative complications(B=0.403,95％CI,0.233 to 0.573)and postoperative ac-tivity pain(B=0.162,95％CI,0.003 to 0.320)were the influencing factors of postoperative ki-nesiophobia level in patients with spinal fracture.Conclusion The patients with spinal fracture have a higher level of kinesiophobia.The influencing factors of level of kinesiophobia are rehabilita-tion self-efficacy,rehabilitation compliance,education level,postoperative complications and post-operative activity pain.

OBJECTIVE To evaluate the cost-effectiveness of pembrolizumab combined with chemotherapy versus placebo combined with chemotherapy in the first-line treatment of advanced or unresectable biliary tract carcinoma （BTC） from the perspective of China’s health system. METHODS A partitioned survival model was constructed based on the KEYNOTE-966 study data. The simulation period was 21 days， and the simulation time was the patient’s whole life. Using quality-adjusted life year （QALY） as the output indicator， the cost-utility analysis method was used to evaluate the cost-effectiveness of the two schemes mentioned above. Univariate and probabilistic sensitivity analyses were performed to verify the results of the basic analysis， and to explore the cost-effectiveness under the scenario of drug donation scheme. RESULTS The basic analysis showed that both the cost and effectiveness of the pembrolizumab group were higher than those of the placebo group， and the incremental cost-effectiveness ratio （ICER） was 3 909 359.78 yuan/QALY， which was higher than the willingness-to-pay （WTP） threshold of 3 times 2022 gross domestic product （GDP） per capita （257 094 yuan）， indicating no cost-effectiveness. The results of univariate sensitivity analysis showed that the utility discount rate， the utility value of progression-free survival （PFS） status， the cost discount rate， and the cost of pembrolizumab had a great influence on ICER. Probabilistic sensitivity analysis verified the robustness of the results of basic analysis， and concluded that when the WTP threshold was greater than 1 500 000 yuan/QALY， the pembrolizumab group became cost-effective. The results of the scenario analysis showed that considering the drug donation scheme of pembrolizumab for low-income people， although its treatment cost was significantly reduced， it was still not cost-effective. CONCLUSIONS At the WTP threshold of 3 times China’s GDP per capita in 2022， pembrolizumab combined with chemotherapy is not cost-effective compared with placebo combined with chemotherapy for advanced or unresectable BTC.

Objective:To evaluate the clinical efficacy of Xiaoqinglong Decoction Granules in the treatment of chronic persistent cold syndrome of bronchial asthma; To explore its treatment mechanism.Methods:A randomized double-blind controlled study was performed. Totally 60 patients from the Respiratory Department of Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine from January 2021 to January 2022 were selected as the observation subjects. They were divided into two groups using a random number table method, with 30 cases in each group. The control group was given conventional treatment plus placebo, and the experimental group was given conventional treatment plus Xiaoqinglong Decoction Granules. The treatment for both group lasted for 14d. TCM syndromes and clinical symptoms before and after treatment were scored. Asthma Control Test Questionnaire (ACT) was used to evaluate asthma control status, and the Asthma Quality of Life Questionnaire (Mini AQLQ) was used to evaluate the physiological and psychological effects of asthma on patients; FEV1 was detected using a German Jaeger lung function instrument FEV1/FVC. A exhaled nitric oxide (FeNO) detection instrument was used to observe the changes in FeNO at a flow rate of 50 ml/s, and non-targeted metabolomics analysis was performed using liquid chromatography-mass spectrometry (LC-MS); adverse reactions were observed during treatment and drug safety was evaluated.Results:Eventually 47 cases were included, 24 cases of test group and of 23 cases of control group. Xiaoqinglong Decoction Granules could reduce the TCM syndrome score of patients with chronic duration cold syndrome of asthma ( P<0.05). 2 weeks after treatment, follow up for 4 weeks experimental group clinical symptom score [3.00(1.00,4.00),3.00(0.00,4.00) vs. 3.5(3.00,5.00), Z=8.62], breathing symptom scores [1.00(0.00,1.00),1.00(0.00,1.00) vs. 1.00(0.75,2.00), Z=6.80], cough symptom score [0.50(0.00,1.00),1.00(0.00,1.00) vs. 1.00(0.00,1.25), Z=6.12] were lower than those in the experimental group before treatment in the same group ( P<0.01 or P<0.05). The ACT score of the experimental group at 4 weeks of follow-up was [22.50 (21.00, 24.00) vs. 9.00 (15.00, 21.50), Z=-4.87], Mini AQLQ score (78.5 ± 12.46 vs. 71.27 ± 9.70, t=-2.46) and the control group had an ACT score of [24.00 (19.00, 25.00) vs. 21.5 (8.00, 23.00) Z=-3.18] at 4 weeks of follow-up was higher than before treatment in the same group ( P<0.01 or P<0.05). The experimental group was followed up for 4 weeks with a FEV1 of [2.96 (2.27, 3.49) L vs. 2.60 (2.32, 3.49) L, Z=-3.72], FEV1/FVC [(80.83 ± 6.84)% vs. (77.46 ± 8.15)%, t=-2.32] and FeNO [24.00 (12.50, 31.00) ppb vs. 30.00 (17.00, 91.00) ppb, Z=-3.72] was higher than before treatment in the same group ( P<0.01 or P<0.05). Through LC-MS technique analysis, there were 75 kinds of different metabolites between the experimental group before and after treatment, and 295 kinds of different metabolites between the control group and the experimental group after treatment. Further intersection of differential metabolites showed that they were mainly concentrated in histidine metabolic pathway, phosphonate metabolic pathway and phosphate metabolic pathway. Related metabolites 2-aminoethyl phosphonate and thiomalonic acid were involved. Conclusions:Xiaoqinglong Decoction Granules can effectively improve the TCM syndrome and clinical symptoms of patients with chronic persistent cold syndrome of asthma, especially for wheezing, cough and chest tightness, which can improve the levels of FEV1 and FEV1/FVC in patients and effectively reduce FeNO. Through metabolomics studies, it is speculated that Xiaoqinglong Decoction Granules may play a role in the treatment of asthma by regulating histidine metabolism pathway through thiomalonic acid.

【Objective】 To explore the relationship between plasma adiponectin levels and hypertension based on the Hanzhong adolescent hypertension cohort. 【Methods】 A total of 361 young individuals with normal renal function， aged 32 to 41 years old， were taken as the research subjects. We collected or measured data including general characteristics， blood pressure （BP）， height， weight， pulse rate， and biochemistry indexes such as fasting glucose， blood lipid and plasma hs-CRP. The concentration of plasma adiponectin was determined by ELISA method. Binary logistic regression was performed to analyze the relationship between plasma adiponectin and hypertension. 【Results】 The plasma adiponectin level in patients with hypertension was significantly lower than that in normotensive patients ［3.56 （2.57-5.02）） μg/mL vs. 4.82 （3.19-6.89） μg/mL， P=0.012］. Partial correlation analysis showed a weak correlation of plasma adiponectin level with systolic BP and diastolic BP （r=-0.155， P=0.003 and r=-0.144， P=0.006）. Binary logistic regression analysis showed that after adjusting for confounding factors such as age， BMI， and high-sensitivity C-reactive protein， the risk of hypertension was 2.46 times higher in patients with plasma adiponectin in the lowest gender-specific tertile than those in the highest tertile （OR=2.46， 95% CI: 1.22-4.99）. 【Conclusion】 Hypoaponectinemia is an independent risk factor for hypertension in young individuals with normal renal function.