Addressing the enduring challenge of evaluating traditional Chinese medicines (TCMs), the integrated evidence chain-based effectiveness evaluation of TCMs (Eff-iEC) has emerged. This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines (CPMs), including Biejiajian Pill (BP), Dahuang Zhechong Pill (DZP), Biejia Ruangan Compound (BRC), Fuzheng Huayu Capsule (FHC), Anluo Huaxian Pill (AHP), and Heluo Shugan Capsule (HSC), using both Eff-iEC and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents. Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system, while the assessments for others varied. Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs, exhibiting superior evaluative capabilities. By breaking through the conventional pattern of TCMs effectiveness evaluation, Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs, providing a coherent methodology for clinical decision-making, new drug evaluations, and health policy formulation.

Objective:To investigate the protective effect and mechanisms of umbilical cord tissue transplantation on radiation-induced learning and memory impairment in rats.Methods:Sixty SD rats were randomly divided into three groups with 20 in each group: control group, model group (whole brain X-ray irradiation, dose 20 Gy) and treatment group (whole brain X-ray irradiation, dose 20 Gy + umbilical cord tissue transplantation). The changes of body mass were observed, and the learning and memory of rats were observed by water maze test on the 14th and 28th day after irradiation, the neuron state of hippocampus was observed by HE staining, and the expressions of NF-κB pathway related proteins and IL-6 in hippocampus were detected by Western blot.Descriptive analysis and hypothesis testing were processed by SPSS 17.0.Results:(1) On the 28th day, the escaping latency in the water maze experiment of the treatment group was significantly higher than that of the control group and lower than that of the model group (control group: (11.77±3.02) s, model group: (23.75±3.27)s, treatment group: (18.49±2.32)s; t=3.940, -2.943, both P<0.05); the number of crossing platform in the treatment group was significantly lower than that in the control group and higher than that in the model group (control group: (7.20±0.84), model group (3.60±1.14 ), treatment group (5.00±1.00); t=-3.773, 2.064, both P<0.05). (2)HE staining showed that the neurons in the control group were arranged orderly and the cytoplasm was transparent.The neurons in the model group were arranged disorderly and the contraction of the cell body was triangular or irregular.The number of neurons in the treatment group was less than that in the model group. (3) On the 14th day, the relative expression of TLR4 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (0.69±0.03), model group: (1.06±0.11), treatment group: (0.90±0.04); t=7.275, -2.368, both P<0.05). The relative expression of NF-κB p65 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (1.67±0.12), model group: (2.08 ±0.06), treatment group: (1.93±0.08); t=3.236, -2.684, both P<0.05). The relative expression of IL-6 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (0.77±0.08), model group: (1.12±0.07), treatment group: (0.95±0.06); t=3.274, -3.495, both P<0.05). The relative expression of Bcl-2 / Bax in the treatment group was significantly lower than that in the control group and higher than that in the model group (control group: (1.40±0.52), model group: (0.48±0.06), treatment group: (0.72±0.0 3); t=-2.263, 6.350, both P<0.05). The expression trend of IL-6 and Bcl-2 / Bax protein on the 28th day was the same as that on the 14th day. Conclusion:Cord tissue transplantation can improve the learning and memory impairment caused by radiotherapy, which may be related with the inhibition of inflammation caused by radiotherapy.

Objective:To compare the early outcome of proximal femoral nail antirotation (PFNA) and bipolar hemiarthroplasty in treatment of intertrochanteric fractures in elderly patients aged 90 years or more.Methods:A retrospective case-control study was conducted to analyze the clinical data of 43 elderly patients aged 90 years or more with intertrochanteric fractures admitted to Henan Provincial People's Hospital from January 2017 to June 2018. There were 12 males and 31 females, aged 90-102 years [(92.3±2.5)years]. A total of 31 patients were treated by PFNA (PFNA group) and 12 patients by bipolar hemiarthroplasty (hemiarthroplasty group). Comparisons were made between the two groups in terms of operation time, intraoperative blood loss, time of weight bearing after operation, rate of blood transfusion, incidence of complications 2 weeks and 3 months after operation, Harris score 12 months after operation and mortality 12 months after operation.Results:All patients were followed up for 1-30 months [(19.1±9.8)months] in PFNA group and for 0.5-29 months [(18.6±10.6)months] in hemiarthroplasty group. Operative time was (95.8±31.0)minutes in PFNA group, shorter than (128.8±40.5)minutes in hemiarthroplasty group ( P<0.05). Intraoperative blood loss was (71.3±25.7)ml in PFNA group and (212.5±113.1)ml in hemiarthroplasty group ( P<0.05). Time of weight bearing after operation was (43.9±31.9)days in PFNA group, longer than (5.9±2.8)days in hemiarthroplasty group ( P<0.05). The perioperative blood transfusion rate in PFNA group (29%) was less than hemiarthroplasty group (75%) ( P<0.05). Incidence of complications 2 weeks after operation was similar between PFNA group (23%) and hemiarthroplasty group (42%) ( P>0.05). Incidence of complications 3 months after operation in PFNA group was 26%, similar with 42% in hemiarthroplasty group ( P>0.05). Harris score 12 months after operation in PFNA group was (56.3±32.3)points, comparable to (59.3±36.7)points in hemiarthroplasty group ( P>0.05). Mortality rate 12 months after operation was 19% in PFNA group and 25% in hemiarthroplasty group ( P>0.05). Conclusion:For intertrochanteric fractures in elderly patients aged 90 years or more, PFNA and bipolar hemiarthroplasty are both effective treatments, but PFNA may be a better choice with shorter operation time and less intraoperative blood loss.

Objective To observe the MRI imaging manifestations of the ligaments and soft tissues around the atlanto-axial joint in children with atlanto-axial rotation instability.Methods Assigned into observation group were 50 children with atlantoaxial rotatory displacement who had been treated in our hospital from January 2013 to March 2014.Another 50 healthy children were chosen as a control group who underwent health check-ups during the same period in our hospital.Both groups received MRI examinations of the ligaments and soft tissues around the atlantoaxial joint using the same equipment and methods.MRI manifestations and characteristics of the ligaments and soft tissues around the atlantoaxial joint were analyzed and compared between the 2 groups.Results In the observation group,odontoid gap asymmetry appeared on both sides,with left shift in 32 cases and right shift in 18 cases.The MRI imaging PDWI sequence showed a significant better diagnostic sensitivity than the other sequences (T1WI,T2WI and SPAIR) (P ＜ 0.05).The MRI examinations on all the children with different sequences found 50 cases of degree Ⅰ lesion in the observation group and 4 cases of degree Ⅰ lesion in the control group,and 12 cases of degree Ⅱ lesion in the observation group and none degree Ⅱ lesion in the control group,showing a significant difference between the 2 groups regarding the diagnostic sensitivity of lesions of degrees Ⅰ and Ⅱ (P ＜ 0.05).Conclusions MRI can clearly show the rotation displacement of atlanto-axial joint associated with transverse ligament,alar ligament and lesions of the surrounding soft tissues.MRI has a dcfinite diagnostic value for atlanto-axial rotation displacements in children,especially those caused by transverse ligament tear after trauma.

Objective To assess quantitative and subjective image quality in computed tomography pulmonary angiography (CT-PA)with dual-energy subtraction methods,and to select the best dual-energy subtraction method.Methods 30 consecutive patients underwent CTPA using a single tube,fast voltage switching technique.One set of routine poly-chromatic images (RPI),two sets of monochromatic images with different optimal contrast-to-noise ratios (OCNR)and three sets of dual-energy subtraction images (DE-SI)were obtained by a dedicated workstation with dual-energy software (AW4.5 Advantage WS;GE Healthcare).For all the six sets of images,CNR and the score of global subjective image quality were calculated.Results DESI 3 got the highest CNR,and DESI 1 got the next high CNR.In global subjective image quality,DESI 1 got the highest score.However,when compared with DESI 2,no significant difference was found.Conclusion CTPA with dual-energy subtraction technique is feasible.DESI 1 affords the best bal-ance between quantitative analysis and subjective evaluation compared with other sets of images.

ObjectiveTo investigate the clinical significance of the serum levels of hs-CRP and IL-6 in patients with acute cerebral infarction(ACI). Methods90 patients with ACI were selected and divided into different groups according to the size of infarction and clinical neurologic impairment degree score. The serum hs-CRP level was detected by immunoturbidimetry, IL-6 concentration was detected by enzyme-linked immunosorbent assay (ELISA).ResultsThe serum hs-CRP and IL-6 levels in the patients with ACI were significantly higher than that in the healthy subjects ( P ＜ 0.05). Comparing groups with the different infarction size: the serum levels of hs-CRP and IL-6 were increased steply with the volume of infarction,the differences between the groups were significant( all P ＜0.05). Comparing the three groups : the serum levels of hs-CRP and IL-6 were increased steply with the clinical neurologic impairment degree score ,the differences between the groups were significant( all P ＜ 0.05 ). ConclusionThe serum levels of hs-CRP and IL-6 were significantly elevated in the patients with ACI. The serum levels of hs-CRP and IL-6 were increased closely with the volume of infarction and the clinical neurologic impairment degree score, which suggests that hs-CRP and IL-6 should play an important role in the pathogencsis of ACI, and probably be a prognostic factor of ACI.

OBJECTIVETo study the influence of selenium and fluoride on apoptosis and lipid peroxidation in human hepatocytes in vitro.

METHODSThe apoptosis, cell cycle, GSH content and lipid peroxides (LPO) level in human hepatocytes, LPO level and LDH, AST and ALT activity in cell culture supernatants were investigated after hepatocytes were incubated with selenium and/or fluoride for around 12 hours periods in vitro.

RESULTSThe percentage of hepatocyte apoptosis bodies (15.557 +/- 2.056)%, the number of cells in S phase (4.823 +/- 0.454)% and LPO level in liver tissue and supernatant [(2.884 +/- 0.589) and (3.547 +/- 0.561) nmol/L MDA/mg.prot, respectively], AST and LDH activity in supernatants (91.1 +/- 36.4 and 140.4 +/- 7.6 U/L, respectively) in the fluoride treated group was higher than the control group [(10.313 +/- 1.023)%, (3.253 +/- 0.743)%, (1.473 +/- 0.401) nmol/L MDA/mg.prot, (1.694 +/- 0.443) nmol/L MDA/mg.prot, (54.5 +/- 3.2) U/L and (126.4 +/- 2.6) U/L, respectively], The GSH content in live tissue [(4.225 +/- 0.781) microgram/mg.prot] is lower than control group [(7.595 +/- 1.042) microgram/mg.prot]. Selenium treatment reduced these kinds of toxicity of fluoride through raising GSH content, reducing LPO level, LDH and AST activity and percentage of apoptosis bodies.

CONCLUSIONSSelenium can antagonist apoptosis and lipid peroxidation of hepatocytes induced by fluoride.

Alanine Transaminase ; drug effects ; metabolism ; Apoptosis ; drug effects ; Aspartate Aminotransferases ; drug effects ; metabolism ; Cell Cycle ; drug effects ; Cells, Cultured ; Fluorides ; pharmacology ; Glutathione ; drug effects ; metabolism ; Hepatocytes ; cytology ; drug effects ; metabolism ; Humans ; L-Lactate Dehydrogenase ; drug effects ; metabolism ; Lipid Peroxidation ; drug effects ; Lipid Peroxides ; metabolism ; Selenium ; pharmacology ; Time Factors