In this study, the pharmacokinetic characteristics and tissue distribution of cannabidiol(CBD)/γ-polyglutamic acid-g-cholesterol(γ-PGA-g-CHOL) nanomicelles [CBD/(γ-PGA-g-CHOL)NMs] were investigated by pharmacokinetic experiments, and the effect of CBD/(γ-PGA-g-CHOL)NMs on the lipopolysaccharide(LPS)-induced inflammatory damage of cells was evaluated by cell experiments. CBD/(γ-PGA-g-CHOL)NMs were prepared by dialysis. The CBD concentrations in the plasma samples of male SD rats treated with CBD and CBD/(γ-PGA-g-CHOL)NMs were investigated, and the pharmacokinetic parameters were calculated and compared. UPLC-MS/MS was employed to determine the concentration of CBD in tissue samples. The heart, liver, spleen, lung, kidney, and muscle samples were collected at different time points to explore the tissue distribution of CBD and CBD/(γ-PGA-g-CHOL)NMs. The Caco-2 cell model of LPS-induced inflammation was established, and the cell viability, transepithelial electrical resistance(TEER), and secretion levels of inflammatory cytokines were determined to compare the anti-inflammatory activity between the two groups. The results showed that CBD/(γ-PGA-g-CHOL)NMs had the average particle size of(163.1±2.3)nm, drug loading of 8.78%±0.28%, and encapsulation rate of 84.46%±0.35%. Compared with CBD, CBD/(γ-PGA-g-CHOL)NMs showed increased peak concentration(C_(max)) and prolonged peak time(t_(max)) and mean residence time(MRT_(0-t)). Within 24 h, the tissue distribution concentration of CBD/(γ-PGA-g-CHOL)NMs was higher than that of CBD. In addition, both CBD and CBD/(γ-PGA-g-CHOL)NMs significantly enhanced Caco-2 cell viability and TEER, lowered the secretion levels of inflammatory cytokines, and alleviated inflammation. Moreover, CBD/(γ-PGA-g-CHOL)NMs demonstrated stronger anti-inflammatory effect. It can be inferred that γ-PGA-g-CHOL blank nanomicelles are good carriers of CBD, being capable of prolonging the circulation time of CBD in the blood, improving the bioavailability and tissue distribution concentration of CBD, and protecting against LPS-induced inflammatory injury. The findings can provide an experimental basis for the development and clinical application of oral CBD preparations.
Animals ; Cannabidiol/administration & dosage* ; Polyglutamic Acid/analogs & derivatives* ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Anti-Inflammatory Agents/administration & dosage* ; Micelles ; Caco-2 Cells ; Cholesterol/pharmacokinetics* ; Tissue Distribution ; Nanoparticles/chemistry*

Objective: To analyze the demographic characteristics of patients with red blood cell transfusion reactions, the usage of red blood cell preparations, and the differences in the composition ratio of adverse reactions based on multi-center data from the Haemovigilance Network, in order to reveal the clinical characteristics of red blood cell transfusion and its underlying issues. Methods: Clinical data of patients who experienced transfusion reactions after red blood cell transfusion in the Haemovigilance Network from 2018 to 2023 were collected. The demographic characteristics of patients who experienced transfusion reactions with different types of red blood cell preparations, the utilization of these preparations, and the differences of the composition ratios of transfusion reactions were analyzed. Count data were expressed as numbers (n) or percentages (%), and comparisons between groups were performed using the Chi-square test. Results: Red blood cell transfusion reactions were more common in females (53.56%), with the majority of patients aged 50-69 years (35.54%). The Han polulation accounted for the vast majority of patients (92.77%), and patients in the hematology and obstetrics/gynecology departments had a relatively high proportion of transfusion reactions (13.26% and 14.26%, respectively). Leukocyte-reduced red blood cells and suspended red blood cells were the most common types of transfusion reactions reported among red blood cell preparations. Allergic reactions and non-hemolytic febrile reactions were the most common transfusion reactions, and there were significant differences in the composition ratios of allergic reactions (χ =869.89, P<0.05) and non-hemolytic febrile reactions (χ =812.75, P<0.05) across various types of red blood cell preparations. Conclusion: There are differences in the demographic characteristics and composition ratio of transfusion reactions among different red blood cell preparations. The management of red blood cell transfusion reactions should be tailored to patient characteristics and conditions, and the selection and use of blood products should be optimized to reduce or avoid the occurrence of transfusion reactions, such as considering the use of washed red blood cells for patients with a history of transfusion allergies or those prone to allergies.

Objective:To discuss the efficacy of treating allergic rhinoconjunctivitis(ARC)with intranasal acupuncture at Neiyingxiang(EX-HN9)and Biqiu(Extra)points and the effects on inflammatory cells.Methods:A total of 207 ARC patients were recruited and divided into an observation group(104 cases)and a control group(103 cases)using the random number table method.The control group was prescribed desloratadine dispersible tablets and azelastine hydrochloride eye drops for 1 week,and the observation group was given additional acupuncture at bilateral Neiyingxiang(EX-HN9)and Biqiu(Extra)points,once daily consecutively over 1 week.The clinical efficacy was compared between the two groups when the treatment finished.Before and after treatment,both groups were scored using the rhinoconjunctivitis quality of life questionnaire(RQLQ),and the levels of blood eosinophils(EOS)and interleukin(IL)-17 were detected.The cured cases were observed for recurrence rate at the 6-month follow-up.Results:The observation group had more significant clinical efficacy than the control group(P<0.05).After treatment,The RQLQ score declined in both groups(P<0.05)and was lower in the observation group than in the control group(P<0.05).After the intervention,the levels of blood EOS and IL-17 dropped in the two groups and were lower in the observation group than in the control group(P<0.05).At the 6-month follow-up among the cured cases,a lower recurrence rate was found in the observation group compared to the control group(P<0.05).Conclusion:Based on conventional medications,acupuncture at Neiyingxiang(EX-HN9)and Biqiu(Extra)points can notably enhance the clinical efficacy in treating ARC patients,reducing the inflammatory cells and lowering the recurrence rate.

[Objective]To analyze the therapeutic characteristics of Zhuyu pill in the Handbook of Prescriptions for Emergency.[Methods]This article used the methods of in-depth investigation for the origin of diseases,through discussion of prescriptions,analysis of their compositions and clinical practice.It analyzed five aspects of the Zhuyu pill in Handbook of Prescriptions for Emergency including formulation identification,compilation and supplementation of texts,pathogenesis of diseases and syndromes,explanation of ingredients,and the correlation between syndrome identification and treatment strategies,with case studies provided as example.[Results]The Zhuyu pill in the Handbook of Prescriptions for Emergency possesses the functions of warming the kidneys and invigorating the spleen,dissipating cold and relieving pain,descending counter-flow of Qi and resolving phlegm,nourishing blood and promoting digestion.This formula is effective in treating diseases such as chest impediment,heart pain,as well as Taiyin syndrome,and others.Clinically,it is primarily indicated for conditions characterized by symptoms like heart pain,sour taste in mouth,indigestion,yellowish complexion,abdominal distension,and a slow or feeble pulse.The case reported involved diagnoses of chest impediment,heart pain and phlegm-fluid retention,all showing remarkable efficacy with Zhuyu pill and its modifications.[Conclusion]The Zhuyu pill in the Handbook of Prescriptions for Emergency can effect in treating chest impediment,heart pain,Taiyin syndrome,as well as internal and external phlegm retention and obstruction,thus restoring the normal circulation of Qi,blood and fluids.

[Objective]To summarize Professor CHEN Jian's clinical experience in treating pediatric upper airway cough syndrome,which is based on the"Xuanfu"theory,and to learn how to use wind-dispelling herbs.[Methods]Through clinical observation,medical case organization,literature search and integration of clinical practice experience,this paper elaborates Professor CHEN's understanding of the etiology and pathogenesis of upper airway cough syndrome and summarizes the clinical experience of treating this disease from the perspective of"opening Xuanfu with wind-dispelling herbs",in addition with relevant cases for verification.[Results]Professor CHEN considers the lurking wind in the"Xuanfu"and the upward reversal of lung Qi as the basic pathogenesis when diagnosing and treating pediatric upper airway cough syndrome.The deficiency of Zhengqi and the lack of nourishment in the"Xuanfu"are seen as the root causes of the disease.The obstruction of"Xuanfu"with phlegm,dampness and blood stasis are the pathogenic factors.The prescription is based on"Jiuke"Recipe,with wind-dispelling herbs being a continuous thread throughout.The fundamental treatment approach is using wind-dispelling herbs to treat wind disease,and to open and consolidate the"Xuanfu".The application of wind-dispelling herbs aims to expel wind,open"Xuanfu",overcome dampness and facilitate the flow of"Xuanfu",as well as support and nourish"Xuanfu".The treatment makes differentiation between the nasal and pharyngeal areas,with simultaneous treatment of the lung orifices,ensuring the smooth flow of"Xuanfu"and harmony of the viscera.A case was presented at the end of the paper to illustrate the treatment principle of dispelling wind and opening"Xuanfu",combining both attack and supplementation,leading to the unblocking of"Xuanfu",the expulsion of lurking wind,the transformation of phlegm and dampness and the self-elimination of cough,with a definite therapeutic effect.[Conclusion]Professor CHEN's approach to treating pediatric upper airway cough syndrome with"wind-dispelling herbs to open the Xuanfu"is effective,which provides insights and experience for clinical diagnosis and treatment of the disease,which has significant enlightening significance.

Objective:To observe the clinical efficacy of acupuncture combined with cognitive training in treating mild-to-moderate poststroke cognitive impairment and the impact on cognitive function and cerebral blood flow.Methods:Eighty-eight participants with mild-to-moderate cognitive impairment after a stroke were allocated to an observation group and a control group using the random number table method,each consisting of 44 cases.The two groups received the same conventional symptomatic treatment.In addition,the control group was intervened by cognitive training,and the observation group by cognitive training and Tong Du Xing Shen(unblocking the Governor Vessel and awakening the mind)acupuncture.The intervention lasted 4 weeks in both groups.By the end of the intervention,the two groups were observed for clinical efficacy and the improvements in the symptom score of traditional Chinese medicine(TCM),cognitive function[mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)],cerebral blood flow velocities[cerebral vascular resistance index(RI),arterial blood flow mean velocity(Vm),and arterial systolic velocity(Vs)],and serum biomarkers of neurological deficit[neuron-specific enolase(NSE)and S100 β protein(S100β)].Results:During the observation,each group had 2 eliminated cases.After the intervention,the observation group achieved a total effective rate of 90.5%,higher than that in the control group,which was 73.8%(P<0.05);increases were found in the MMSE and MoCA scores in both groups(P<0.05),and the observation group was higher than the control group(P<0.05);in contrast,decreases were found in the levels of RI and serum NSE and S100β(P<0.05),and the observation group was lower than the control group(P<0.05);the Vs and Vm levels increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion:Tong Du Xing Shen acupuncture plus cognitive training is effective in treating mild-to-moderate poststroke cognitive impairment and can enhance the patient's cognitive function;improving cerebral blood circulation and reducing cerebral nerve damage may be involved in the mechanism.

Objective:To observe the clinical efficacy of DING's Tuina(Chinese therapeutic massage)plus Western medication in treating rotator cuff injury(RCI)and its impact on pain,shoulder function,and shoulder muscle strength in the patients.Methods:Sixty-two RCI patients were divided into an observation group and a control group using a simple randomization method,each consisting of 31 cases.Both groups of patients were prescribed oral celecoxib capsules.In addition,DING's Tuina treatment was offered to the observation group.After 6 weeks of treatment,the two groups were observed for changes in the Constant-Murley score(CMS)for shoulder joint function,the short-form McGill pain questionnaire(SF-MPQ)score,and peak torque(PT)and peak torque to body mass ratio(PT/BM)at angular velocities 120 °/s and 90 °/s as well as the peak torque ratio(PTR)of agonist muscles to antagonist muscles[including adductors to abductors(ADD/ABD)and flexors to extensors(F/E)].Results:After treatment,both groups presented decreased SF-MPQ scores and increased CMS,and the intra-group differences were statistically significant(P<0.05);the observation group had a lower SF-MPQ score and a higher CMS than the control group,showing statistical significance(P<0.05).After the intervention,the ADD/ABD decreased in the control group at the angular velocity 120 °/s in abduction,and the intra-group change was statistically significant(P<0.05);in the observation group,the PT and PT/BM increased compared to the baseline at angular velocities 120 °/s and 90 °/s in abduction,adduction,forward flexion,and backward extension,showing statistical significance(P<0.05).After treatment,the PT and PT/BM at angular velocities 120 °/s and 90 °/s and ADD/ABD at 120 °/s were higher in the observation group than in the control group,and the between-group differences were statistically significant(P<0.05).Conclusion:DING's Tuina combined with oral celecoxib capsules can reduce pain,improve the joint's motor function,and enhance the strength of shoulder muscle groups in RCI patients,and this treatment has a positive impact on the stability when performing shoulder joint abduction and adduction.

Objective:To analyze the predictive effects of the Big Five personality traits and emotions on self-management behaviors in patients with type 2 diabetes mellitus (T2DM).Methods:This study was a cross-sectional research. From 2016 to 2020, community interventions for self-management among patients with chronic diseases were conducted in Hangzhou, targeting patients with type 2 diabetes recruited from 69 community health service centers across the city. The data for this study were derived from the baseline information collected during the community intervention. The Chinese Big Five Personality Inventory (CBF-PI-15), the Type 2 Diabetes Self-Management Scale (2-DSCS), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were employed for questionnaire assessments. Biochemical indicators, including postprandial 2-hour blood glucose, glycated hemoglobin (HbA 1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Spearman correlation analysis was used to examine the relationship between personality traits, relevant biochemical indicators, and self-management behaviors. Hierarchical regression analysis was employed to assess the predictive effects of the Big Five personality traits and emotions on self-management behaviors after controlling for demographic characteristics and factors related to health status. Results:A total of 839 patients were included in this study, comprising 518 females (61.75%) and 321 males (38.25%), with an average age of (66.92±8.67) years and an average disease duration of (8.87±6.91) years. There were significant differences in self-management behavior scores among patients with varying disease durations, educational levels, treatment methods, and levels of anxiety and depression ( t/F=6.172, 3.340, 4.699, 16.007, 27.127, all P<0.05). Neuroticism showed a negative correlation with various dimensions of self-management behaviors ( r=-0.130--0.073), while conscientiousness and agreeableness were positively correlated with various dimensions of self-management behaviors ( r=0.072-0.215). Dietary control score was negatively correlated with HbA 1c and LDL-C ( r=-0.106, -0.077), and regular exercise score was negatively correlated with postprandial 2-hour blood glucose, HbA 1c, TG, TC, HDL-C, and LDL-C ( r=-0.115--0.071). The total score of the 2-DSCS was negatively correlated with HbA 1c, TG, and TC ( r=-0.104--0.071). Patients with a disease duration exceeding 15 years and those receiving insulin injections or a combination of oral medication and insulin injections had higher total 2-DSCS score ( β=0.085, 0.146, 0.118, all P<0.05). Conversely, patients with higher HbA 1c and SDS standard scores had lower total 2-DSCS score ( β=-0.151, -0.328, both P<0.05), while those with higher agreeableness scores had higher total 2-DSCS score ( β=0.143, P<0.05). Conclusion:The traits of neuroticism, conscientiousness, and agreeableness within the Big Five Personality Traits, as well as anxiety and depressive emotions, are correlated with self-management behaviors. Specifically, agreeableness has a positive predictive effect on self-management behaviors, whereas depressive emotions have a negative predictive effect.

[Objective]To summarize Professor ZHANG Yonghua's clinical experience in treating emotional-type insomnia based on the"wind movement smoothening the Xuanfu(pores)"theory for clinical reference.[Methods]Through learning,case collection,literature review and combining modern medical mechanisms,the article explains Professor ZHANG's understanding of the pathogenesis of emotional-type insomnia,explores the syndrome differentiation methods and treatment approaches based on the"wind movement smoothening the Xuanfu"theory,and provides a clinical case for verification.[Results]The core pathogenesis of insomnia caused by emotional disorders is the blockage of the"Xuanfu".Professor ZHANG points out that patients with emotional disorders suffer from the blockage of the"Xuanfu"due to the disharmony of Qi movement,internal disturbance of depressed fire,deficiency of Qi and blood,and accumulation of phlegm and blood stasis,which lead to prolonged and difficult-to-treat insomnia.His treatment approach often starts from"unblocking the Xuanfu",advocating the basic therapeutic method of"wind movement smoothening Xuanfu",using wind herbs to relieve depression and regulate Qi,disperse fire and clear heat,tonify deficiency and nourish the spirit,remove phlegm and resolve blood stasis to unblock the Xuanfu,and harmonize Yin and Yang to restore balance.The attached medical case was a patient of insomnia due to dissociative conversion disorder,whose main pathogenesis was the blockage of the Shaoyang pivot and the internal hyperactivity of the heart fire of the Shaoyin,presenting the syndrome of depressed gallbladder and phlegm-heat.The treatment approach was to resolve phlegm and clear heat,subdue the floating Yang,further regulate the exterior and interior,harmonize Yin and Yang,and unblock the Xuanfu to relieve depression,so as to enable the patient to sleep peacefully.[Conclusion]Professor ZHANG's treatment of emotional-type insomnia based on the"wind movement smoothening the Xuanfu"theory is highly effective and offers a new approach to treating insomnia with traditional Chinese medicine,which is worth promoting and applying.