Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Objective:To understand the development status of maternal and child health care institutions in China from 2012 to 2022, identify the challenges they face, and provide references for further promoting the high-quality development of these institutions.Methods:Data from the China Health Statistics Yearbook (2013—2015), China Health and Family Planning Statistics Yearbook (2016—2017), and China Health and Wellness Statistics Yearbook (2018—2023) were used. Descriptive analysis was conducted on the data related to resource allocation and utilization efficiency, service provision, income and expenditure structure, and operational status of maternal and child health care institutions in China from 2012 to 2022, using methods such as fixed-base growth rate, year-on-year growth rate, and average annual growth rate. Results:From 2012 to 2022, the number of maternal and child health care institutions in China decreased from 3 044 to 3 031. In terms of resource allocation, the average annual growth rates of bed numbers and business-use floor area were 5.404% and 10.923%, respectively, while the average annual growth rate of health professionals was 7.183%. Regarding service provision, the average annual growth rates of outpatient visits and inpatient admissions were 3.954% and 1.572%, respectively. In terms of service efficiency, the bed occupancy rate decreased from 76.9% to 53.9%, and the average number of patients seen per physician per day decreased from 8.85 to 7.30. In terms of income and expenditure and operations, the income-expenditure surplus rate decreased from 9.16% to 5.41%, and the debt-to-asset ratio increased from 27.88% to 33.60%. During the same period, the average annual growth rates of bed numbers and business-use floor area in grassroots maternal and child health care institutions were 4.545% and 10.091%, respectively, lower than the national average. The number of outpatient visits increased from 89.03 million to 126.93 million, with an average annual growth rate of 3.610%, while the number of inpatient admissions decreased from 4.19 million to 3.91 million, with an average annual decline of 0.689%. The income-expenditure surplus rate of grassroots institutions decreased from 7.76% to 4.05%, 1.36 percentage points lower than the national level, and the debt-to-asset ratio increased from 27.53% to 36.37%, higher than the overall level.Conclusions:From 2012 to 2022, maternal and child health care institutions in China achieved certain developments in resource allocation and service scale. However, several challenges remain, including unbalanced resource allocation, decreased utilization efficiency, slowed growth in medical service volume, imbalanced income and expenditure structure, increased asset operation risks, and restricted development of grassroots institutions. It is recommended that relevant management departments and maternal and child health care institutions optimize resource allocation, plan for service transformation and upgrading, expand income sources, strengthen internal financial control, and reinforce the construction of high-quality and efficient maternal and child health care systems to promote the high-quality development of maternal and child health care institutions in China.

Objective:To understand the development status of maternal and child health care institutions in China from 2012 to 2022, identify the challenges they face, and provide references for further promoting the high-quality development of these institutions.Methods:Data from the China Health Statistics Yearbook (2013—2015), China Health and Family Planning Statistics Yearbook (2016—2017), and China Health and Wellness Statistics Yearbook (2018—2023) were used. Descriptive analysis was conducted on the data related to resource allocation and utilization efficiency, service provision, income and expenditure structure, and operational status of maternal and child health care institutions in China from 2012 to 2022, using methods such as fixed-base growth rate, year-on-year growth rate, and average annual growth rate. Results:From 2012 to 2022, the number of maternal and child health care institutions in China decreased from 3 044 to 3 031. In terms of resource allocation, the average annual growth rates of bed numbers and business-use floor area were 5.404% and 10.923%, respectively, while the average annual growth rate of health professionals was 7.183%. Regarding service provision, the average annual growth rates of outpatient visits and inpatient admissions were 3.954% and 1.572%, respectively. In terms of service efficiency, the bed occupancy rate decreased from 76.9% to 53.9%, and the average number of patients seen per physician per day decreased from 8.85 to 7.30. In terms of income and expenditure and operations, the income-expenditure surplus rate decreased from 9.16% to 5.41%, and the debt-to-asset ratio increased from 27.88% to 33.60%. During the same period, the average annual growth rates of bed numbers and business-use floor area in grassroots maternal and child health care institutions were 4.545% and 10.091%, respectively, lower than the national average. The number of outpatient visits increased from 89.03 million to 126.93 million, with an average annual growth rate of 3.610%, while the number of inpatient admissions decreased from 4.19 million to 3.91 million, with an average annual decline of 0.689%. The income-expenditure surplus rate of grassroots institutions decreased from 7.76% to 4.05%, 1.36 percentage points lower than the national level, and the debt-to-asset ratio increased from 27.53% to 36.37%, higher than the overall level.Conclusions:From 2012 to 2022, maternal and child health care institutions in China achieved certain developments in resource allocation and service scale. However, several challenges remain, including unbalanced resource allocation, decreased utilization efficiency, slowed growth in medical service volume, imbalanced income and expenditure structure, increased asset operation risks, and restricted development of grassroots institutions. It is recommended that relevant management departments and maternal and child health care institutions optimize resource allocation, plan for service transformation and upgrading, expand income sources, strengthen internal financial control, and reinforce the construction of high-quality and efficient maternal and child health care systems to promote the high-quality development of maternal and child health care institutions in China.

Objective:To analyze the allocation of general practitioners per 10 000 population in China and its influencing factors, so as to provide reference for optimizing the allocation of general practitioners resources in China.Methods:The number of general practitioners per 10 000 population and other relevant data of 31 provinces (except Hong Kong, Macao and Taiwan) in China from 2012 to 2021 were collected from China Statistical Yearbook, China Health Statistics Yearbook, China Health and Family Planning Statistical Yearbook. The geographical area data of 31 provinces (except Hong Kong, Macao and Taiwan) from 2012 to 2021 were retrieved from the website of the Central People ′s Government. The influencing factors of the number of general practitioners per 10 000 population were preset by literature analysis and unstructured interview. Taking the number of general practitioners per 10 000 population as the dependent variable, the correlation between it and the preset influencing factors was analyzed by panel data regression. Results:From 2012 to 2021, the average annual growth rate of the number of general practitioners per 10 000 population in each province of China was greater than 0. The factors affecting the number of general practitioners per 10 000 population included the number of people per square kilometer ( r=3.818, P<0.01), the number of beds in medical and health institutions per capita ( r=2.135, P<0.01), the proportion of the elderly population aged 65 and above ( r=0.180, P<0.01), and the proportion of total expenditure in medical and health institutions to gross domestic product ( r=0.080, P<0.01). Conclusions:The development trend of general practitioners resources allocation in China is good, but the government needs to integrate the population agglomeration and aging trend, the allocation of medical and health resources, the investment support for the development of general practitioners and other influencing factors, optimize the allocation of general practitioners resources according to local conditions, and strengthen policy support for areas and links where the allocation of general practitioners resources is relatively weak.

Objective:To analyze the allocation of general practitioners per 10 000 population in China and its influencing factors, so as to provide reference for optimizing the allocation of general practitioners resources in China.Methods:The number of general practitioners per 10 000 population and other relevant data of 31 provinces (except Hong Kong, Macao and Taiwan) in China from 2012 to 2021 were collected from China Statistical Yearbook, China Health Statistics Yearbook, China Health and Family Planning Statistical Yearbook. The geographical area data of 31 provinces (except Hong Kong, Macao and Taiwan) from 2012 to 2021 were retrieved from the website of the Central People ′s Government. The influencing factors of the number of general practitioners per 10 000 population were preset by literature analysis and unstructured interview. Taking the number of general practitioners per 10 000 population as the dependent variable, the correlation between it and the preset influencing factors was analyzed by panel data regression. Results:From 2012 to 2021, the average annual growth rate of the number of general practitioners per 10 000 population in each province of China was greater than 0. The factors affecting the number of general practitioners per 10 000 population included the number of people per square kilometer ( r=3.818, P<0.01), the number of beds in medical and health institutions per capita ( r=2.135, P<0.01), the proportion of the elderly population aged 65 and above ( r=0.180, P<0.01), and the proportion of total expenditure in medical and health institutions to gross domestic product ( r=0.080, P<0.01). Conclusions:The development trend of general practitioners resources allocation in China is good, but the government needs to integrate the population agglomeration and aging trend, the allocation of medical and health resources, the investment support for the development of general practitioners and other influencing factors, optimize the allocation of general practitioners resources according to local conditions, and strengthen policy support for areas and links where the allocation of general practitioners resources is relatively weak.

Objective:To explore and analyze the value of CT texture combined with baseline data in lymph node metastasis of cN0 papillary thyroid microcarcinoma (PTMC), in order to provide evidence for the evaluation of lymph node metastasis of PTMC.Methods:106 patients with single stage cN0 papillary PTMC confirmed by operation and pathology in Department of Radiology and Hernia Department of Huzhou First People’s Hospital from Aug. 2020 to Aug. 2022 were selected for retrospective analysis. Metastatic lymph nodes and non-metastatic lymph nodes were delineated in CT images, and they were divided into a lymph node metastasis group (22 cases) and a group without lymph node metastasis (84 cases). At the same time, lymph node CT texture feature images were obtained in both groups. Logistic regression was used to analyze the relationship between CT texture and lymph node metastasis, and ROC curve was drawn to evaluate the predictive value of CT texture for lymph node metastasis in cN0 stage PTMC patients. The patients were divided into<1/4 group (51 cases), 1/4-<1/2 group (36 cases), and ≥1/2 group (19 cases) according to the different contact range between tumor and thyroid margin in CT signs. The baseline data and lymph metastasis distribution of each group were analyzed.Results:The results of single factor analysis showed that there were no differences in tumor location, tumor calcification or thyroglobulin in CT texture between LNM group and non-LNM group ( P>0.05). The incidence of tumor contact with thyroid margin, tumor diameter ≥7 mm, age<45 and male ratio of sex in LNM group were higher than those in non-LNM group ( P<0.05). Multivariate Logistic regression analysis showed that tumor was in contact with thyroid margin ( OR=6.080, 95% CI: 1.738-21.273), tumor diameter ≥7 mm ( OR=2.779, 95% CI: 1.135-6.805), age<45 years old ( OR=6.074, 95%CI: 1.980-18.636) and gender male ( OR=12.642, 95% CI: 3.125-51.136) were independent risk factors for lymph node metastasis in cN0 stage PTMC patients ( P<0.05). There were no significant differences in gender, age, tumor diameter, tumor location, tumor calcification or thyroglobulin among<1/4 group, 1/4-1/2 group and ≥1/2 group ( P>0.05). The incidence of LNM in ≥1/2 group was higher than that in<1/4 group and 1/4-1/2 group, and pairwise comparison between groups had statistical significance ( P<0.05) . Conclusions:It is an independent risk factor for lymph node metastasis in cN0 stage PTMC patients with tumor and thyroid boundary contact, tumor diameter ≥7 mm, age<45 years old, male, and the wider the tumor and thyroid boundary contact, the higher the risk of lymph node metastasis. CT texture analysis combined with baseline data has important reference value in predicting lymph node metastasis of cN0 TMPC.

Objective To Summarize perioperative nursing for 20 patients with the hyperreflexia of neurogenic detrusor by injection of botulinum toxin A.Methods Mental states of patients were assessed by Huaxi Emotional Distress Index questionnaire and psychological support was given to these patients,patients were assisted and instructed to record the urine diary correctly,cautions for the use of botulinum toxin A was interpreted,drinking water and activities were guided,and adverse reactions,follow-up results at 6,12 weeks were observed.Life quality by Incontinence Quality of Life Questionnaire was observed,the times of urinary incontinence,maximum pressure volume of bladder,maximum pressure of detrusor and the effect of urinary incontinence were compared.Results The absolute value of evasion and restrictive behavior,psychological effects,social fear disorders were (38.5 ± 19.6),(38.8 ±22.5),(28.1 ±20.3),respectively,on admission,and (41.2 ±27.1),(43.7 ± 26.5),(33.5 ± 28.8),respectively,at 6 weeks after nursing,and were (40.9 ± 27.7),(39.6 ± 24.3),(36.3 ± 28.7),respectively,at 12 weeks after nursing.The evasion and restrictive behavior,social fear disorderswere improved at 6,12 weeks after nursing as compared to nursing before.Conclusion Perioperative care for patients with the hyperreflexia of neurogenic detrusor by injection ofbotulinum toxin A can not only improve therapeuticeffect,improve social status,but also improve patients'self-management ability and quality of life.

Objective To Summarize perioperative nursing for 20 patients with the hyperreflexia of neurogenic detrusor by injection of botulinum toxin A.Methods Mental states of patients were assessed by Huaxi Emotional Distress Index questionnaire and psychological support was given to these patients,patients were assisted and instructed to record the urine diary correctly,cautions for the use of botulinum toxin A was interpreted,drinking water and activities were guided,and adverse reactions,follow-up results at 6,12 weeks were observed.Life quality by Incontinence Quality of Life Questionnaire was observed,the times of urinary incontinence,maximum pressure volume of bladder,maximum pressure of detrusor and the effect of urinary incontinence were compared.Results The absolute value of evasion and restrictive behavior,psychological effects,social fear disorders were (38.5 ± 19.6),(38.8 ±22.5),(28.1 ±20.3),respectively,on admission,and (41.2 ±27.1),(43.7 ± 26.5),(33.5 ± 28.8),respectively,at 6 weeks after nursing,and were (40.9 ± 27.7),(39.6 ± 24.3),(36.3 ± 28.7),respectively,at 12 weeks after nursing.The evasion and restrictive behavior,social fear disorderswere improved at 6,12 weeks after nursing as compared to nursing before.Conclusion Perioperative care for patients with the hyperreflexia of neurogenic detrusor by injection ofbotulinum toxin A can not only improve therapeuticeffect,improve social status,but also improve patients'self-management ability and quality of life.

Purpose To explore the clinical value of ultrasound in charactering brain anomalies in open spina bifida at 11-13+6 weeks of gestation.Materials and Methods Abdominal and transvaginal ultrasound was performed in 125 cases of normal fetus and 4 cases of confirmed open spina bifida at 11-13+6 weeks of gestation to compare the morphology of intracranial translucency (IT), diencephalon and midbrain.Results Fetal IT was readily recognized in all 125 normal cases, with diencephalons and midbrain showing number 8 shape. In 4 cases of open spina bifida, fetal IT cannot be identified, and the expected 8 shape of diencephalon and midbrain was distorted.Conclusion Fetal brain characteristics including intracranial translucency and the shape of diencephalon and midbrain in 11-13+6 weeks gestation are valuable ultrasound screening indicators for open spina bifida.

Objective To observe the seroreversion of serological tests for syphilis in neonates born to mothers with syphilis and to evaluate the influence of antisyphilitic treatment on the time of seroreversion in uninfected neonates.Methods A total of 115 neonates born to mothers with syphilis were recruited in this study,and underwent toluidine red unheated serum test (TRUST),Treponema pallidum particle assay (TPPA)and 19S IgM-TPPA at birth.Follow up was scheduled at 1,3,6,9,12,18 and 24 months of age,and cancelled as soon as both TRUST and TPPA became negative during the 24 months.Both TRUST and TPPA were carried out at each follow-up visit.Kaplan-Meiter survival analysis and Wilcoxon rank-sum test were conducted to assess these data by using SPSS 13.0 software.Results At birth,TPPA was positive in all (100％) of the neonates,TRUST in 97 neonates (84.3％) with the titer ranging from 1 ∶ 1 to 1 ∶ 256,19S IgM-TPPA in 3 neonates who were diagnosed with congenital syphilis (CS).CS was ruled out in the other 112 neonates with negative 19S IgM-TPPA after follow up.Of the 3 neonates with CS,all became negative for TRUST within 12-18 months after birth,2 remained positive for TPPA at 24 months of age,1 remained positive for TPPA at 20 months of age,and all were still followed at the time of this writing.The cumulative seroreversion rate was 82.2％,98.9％ and 100％for TRUST at 0-3,4-6 and 7-9 months of age,respectively in 90 uninfected neonates,3.1％,30.2％,85.4％ and 100％ for TPPA at 0-3,4-6,7-9 and 10-12 months of age,respectively in 96 uninfected neonates.Of 16 neonates who missed some follow-up visits,all turned negative for TRUST and TPPA within 15 months after birth.As far as the TP-seropositive uninfected neonates were concerned,no statistical differences were observed in the seroreversion time of TRUST or TPPA between neonates receiving antisyphilitic treatment and those without antisyphilitic treatment (x2 =0.54,2.41,respectively,both P ＞ 0.05).The seroreversion of TRUST occurred earlier than that of TPPA (Z =10.45,P ＜ 0.01).Conclusions Most uninfected neonates born to syphilitic mothers turn negative for TRUST within 6 months after birth,and for TPPA within 12 months.And the seroreversion of TRUST usually occurs earlier than that of TPPA.Antisyphilitic treatment shows no significant influence on the seroreversion time of TRUST or TPPA in these seropositive uninfected infants.