Objective To investigate the effects of early core muscles and manual respiratory function training on stroke patients with dysphagia. Methods From June, 2015 to January, 2016, 60 stroke patients with dysphagia were divided equally into control group and obser-vation group randomly. Both groups accepted routine swallowing function training, electrical stimulation and respiratory function training, while the observation group accepted core muscles training and manual respiratory function training, for four weeks. They were evaluated with Standardized Swallowing Assessment (SSA), forced vital capacity (FVC), maximum ventilatory volume (MVV) and the maximum ex-piratory time before and after treatment. Results All the indices improved in both groups after treatment (P<0.001), and improved more in the observation group than in the control group (P<0.001). Conclusion Core muscles and manual respiratory function training at early stage can obviously improve swallowing and respiratory function of stroke patients with dysphagia.

Objective:To analyze the pay for performance related costs and provide suggestions for further stud-y. Methods:Empirical literatures from inside the country and overseas were collected with a systematic review. Costs were summarized on the basis of three drivers ( performance appraisal, performance improvement and incentive per-formance) . Results:A total of 141 papers, 47 in Chinese and 94 in English were enrolled. Most papers in Chinese were subjected on healthcare facilities while the English ones emphasized on hospitals. Pay for performance may lead to the healthcare service costs, regulation costs and the resources allocation related costs reduction. In addition to these visible costs, a large amount of others hidden from different hospital management levels were also due to pay for performance. Conclusions:(1) Differences in costs could be found from home and overseas experience which per-haps resulted from the pay for performance, the supporting measures and the policy development. (2) More attention should be paid to the quantification researches on the health facilities’ hidden costs. (3) Most available researches fo-cus on pay for performance cost-effectiveness from the society and service purchase but not the providers’ perspective and the hidden costs were also ignored.

Strychons nuxvomica is widely used by clinic and individual owing to its officinal value. Since toxic dose and therapeutic dose are very close, the poisoning cases are reported frequently. In this review, based on the recent available papers published in the PubMed and CNKI about Strychons nuxvomica, a traditional Chinese herbal medicine, we present the major current approaches in the field of composition, toxicology, pharmacokinetics, decreasing toxicity and increasing efficacy, in order to guide the use of S. nuxvomica in the clinic.
Animals ; Drugs, Chinese Herbal ; pharmacokinetics ; toxicity ; Humans ; Mice ; Strychnos nux-vomica ; chemistry

Driver gene mutation is one of the most important cause of non-small cell lung cancer (NSCLC), as well as the drug target of target therapy. Patients with different driver mutations have different sensitivity to target therapy drug. So it is crucial to select target drug according to respective driver mutation. Nowadays more and more driver mutation detection come into clinical use for the guidance of NSCLC target therapy as well as more detection methods and commercial reagents were developed and utilized. Clinical and laboratory staff should be more cautious to select appropriate detection targets and reagents. Therefore, the relative target driver mutation and detection reagents in target therapy of NSCLC were reviewed in this paper, according to the China National Medical Products Administration, in order to provide reference for better selection of adequate methods and reagents as well as provide advice for personalized therapy of NSCLC patients.

Objective:To evaluate the immunogenicity of a quadrivalent subunit vaccine combined with RFH01 adjuvant in a mouse model.Methods:Identification tests were performed on four monovalent influenza virus subunit vaccine stock solutions according to the methods described in Part 3 of the Chinese Pharmacopoeia 2020 Edition. In the study of the quadrivalent subunit vaccine combined with RFH01 adjuvant, 460 female BALB/c mice (6-8 weeks old) were randomly divided into 46 groups including experimental groups, vaccine control group, negative control group and blank group with 10 mice in each group. In the study of the quadrivalent subunit vaccine in old and young mice, 80 female 10-month-old and 80 female 10-week-old BALB/c mice were randomly divided into 16 groups ( n=10) including monovalent influenza virus vaccine group, quadrivalent subunit vaccine group, quadrivalent subunit vaccine+ RFH01 adjuvant group, chicken embryo quadrivalent split vaccine control group and PBS group. All mice were immunized by intramuscular injection. At 21 d after the primary immunization, a booster immunization was conducted using the same strategy. Blood samples were collected at 21 d and 42 d after the primary immunization for serum separation. Haemagglutination inhibition (HI) test was performed to detect the antibody levels in mouse serum samples. Results:After the booster immunization, the positive conversion rates in all vaccine+ RFH01 adjuvant groups reached 100%, and the geometric mean titers (GMTs) of serum antibodies were significantly higher than those of the vaccine groups without RFH01 adjuvant. There were significant differences in serum antibody titers between the monovalent/quadrivalent subunit vaccine groups with and without RFH01 adjuvant. After the booster immunization, the titers of serum antibodies against H1N1, H3N2, B/Victoria and B/Yamagata in the 10-week-old mice were significantly higher than those in the 10-month-old mice.Conclusions:The monovalent and quadrivalent influenza virus vaccines in combination with RFH01 adjuvant could elicit higher antibody titers in young (6-10 weeks old) and old (10 months old) mice, showing good immunogenicity.

OBJECTIVE：To in vestigate the effects of quercetin （Que）on the expressio n of angiotensin Ⅱ（AngⅡ）-induced myocardial contractile proteins of primary rats through angiotensin-converting enzyme 2-angiotensin-（1-7）-Mas （ACE2-Ang- （1-7）-Mas）axis. METHODS ：Cardiac tissue of rats aged 1-2 d were collected ，and primary cardiomyocytes were isolated and cultured. The gene silencing model of cardiomyocytes ACE2 was constructed. Experiments were divided into 12 groups. Among them，AngⅡ group，AngⅡ+ small interference RNA （siRNA）group，and Ang Ⅱ+ A 779 group were the model groups ；AngⅡ+ losartan group was positive control group ；AngⅡ+Que40 group，AngⅡ+Que80 group，AngⅡ+siRNA+Que40 group，AngⅡ+ siRNA+Que80 group，AngⅡ+A779+Que40 group and Ang Ⅱ+A779+Que80 group were the experimental groups ；blank group and siRNA group were set up. Ang Ⅱ concentration was 1×10－6 mol/L；siRNA final concentration was 50 nmol/L；Que concentration was 40 and 80 μmol/L；A779（Mas receptor inhibitor ）concentration was 1 μmol/L；losartan concentration was 1×10－4 mol/L. mRNA and protein expression of ACE 2，Ang-（1-7） and Mas in primary cardiomyocytes were detected ；the expressions of myocardial contractile proteins were also determined ，such as Na +/Ca2+ exchange channel （NCX），calcium pump （SERCA2a）， phosphoprotein （PLB）. RESULTS ：Compared with Ang Ⅱ group，mRNA expression of Mas was increased significantly in Ang Ⅱ + Que 80 group （P＜0.05）；mRNA expression of ACE2 and Mas were increased significantly in Ang Ⅱ + CZ0210-01） losartan group （P＜0.05）. Compared with Ang Ⅱ group，the 851136165@qq.com protein expression of ACE 2 and Ang- （1-7） were increased significantly in Ang Ⅱ+ Que 40 group（P＜0.05）；compared with Ang Ⅱ + siRNA group ，the protein expression of Ang-（1-7）were increased significantly in Ang Ⅱ+ siRNA+Que 40 group（P＜0.05）；compared with Ang Ⅱ+A779 group，the protein expression of Ang- （1-7）were increased significantly in Ang Ⅱ+A779+ Que 40 group（P＜0.05）. Compared with Ang Ⅱ group，the protein expression of NCX was decreased in Ang Ⅱ+Que40 group（P＜0.05），protein expression of NCX was reduced in Ang Ⅱ+ losartan group （P＜0.05）；compared with Ang Ⅱ+A779 group，the protein expression of NCX was decreased in Ang Ⅱ+A779+ Que80 group （P＜0.05）. CONCLUSIONS ：Que improves the expression of Ang Ⅱ -induced ACE 2-Ang-（1-7）-Mas axis in cardiomyocyte model to some extent ，so as to regulate myocardial contractile protein.