Objective:To construct an evaluation index system of operation quality and effectiveness of compact urban medical groups and provide references for evaluation of compact urban medical groups.Methods:The evaluation index system was constructed by Delphi method,and the weight was determined by analytic hierarchy process.Results:The evaluation index system consisted of 5 primary indexes,12 secondary indexes and 40 tertiary indexes.Providing assessment methods for the construction of medical groups,the evaluation index system is scientific and authoritative.Conclusion:At the initial stage,policy support should be strengthened,innovative governance mechanisms should be explored,and measures such as implementing a community of responsibilities,strengthening information interconnection,and improving profit distribution mechanisms should be taken to gradually promote the construction of close urban medical groups.

Cordycepin (Cpn), a natural active compound derived from the traditional Chinese medicine Cordyceps sinensis, has antifibrotic, antioxidant, and anti-inflammatory effects, but the impact of Cpn on pulmonary fibrosis and the downstream molecular mechanism remain unclear. In this study, A549 cells were induced by transforming growth factor β1 (TGFβ1) in vitro, the viability of A549 cells was evaluated by CCK-8 assay; and migration of A549 cells were detected by wound healing assay, invasion of A549 cells were detected by transwell assay. Molecular docking and molecular dynamics simulations were used to predict the interaction of histone deacetylase 7 (HDAC7) with vimentin and the association of Cpn with HDAC7. The pulmonary fibrosis model of mice was established by bleomycin in vivo to investigate the effect of Cpn on pathological changes of lung tissue. The impact of Cpn and molecular mechanism on pulmonary fibrosis were studied by Western blot assay, cell transfection assay, immunoprecipitation assay, immunofluorescence assay, immunohistochemistry and real-time quantitative PCR (RT-qPCR). All animal experiments were approved by the Shanghai Children's Medical Center Experimental Animal Ethics Committee (grant No. SCMC-LAWEC-2022-017). Results showed that Cpn had no toxic effect on A549 cells even at the concentration of 100 μmol·L^-1. Cpn inhibited migration and invasion of A549 cells and reduced deposition of collagen, the degree of lung inflammation and fibrosis in mice; in vivo and in vitro models, Cpn significantly reversed mRNA and protein expressions of epithelial-mesenchymal transition (EMT) and lung fibrosis markers collagen I, α-smooth muscle actin (α-SMA), N-cadherin, vimentin and E-cadherin and HDAC7. Deficiency of HDAC7 suppressed TGFβ1-induced EMT and expression of collagen I; vimentin interacted with HDAC7; and molecular docking experiment revealed that Cpn was interrelated with HDAC7. In conclusion, Cpn can target HDAC7 to mediate EMT and exert its anti-fibrotic effect, the inhibition of EMT and the improvement of pulmonary fibrosis provide a new idea and choice for the development of anti-pulmonary fibrosis drug.

This study aims to investigate the effect of salvianolic acid B (Sal B), the active ingredient of Salvia miltiorrhiza, on H9C2 cardiomyocytes injured by oxygen and glucose deprivation/reperfusion (OGD/R) through regulating mitochondrial fission and fusion. The process of myocardial ischemia-reperfusion injury was simulated by establishing OGD/R model. The cell proliferation and cytotoxicity detection kit (cell counting kit-8, CCK-8) was used to detect cell viability; the kit method was used to detect intracellular reactive oxygen species (ROS), total glutathione (t-GSH), nitric oxide (NO) content, protein expression levels of mitochondrial fission and fusion, apoptosis-related detection by Western blot. Mitochondrial permeability transition pore (MPTP) detection kit and Hoechst 33342 fluorescence was used to observe the opening level of MPTP, and molecular docking technology was used to determine the molecular target of Sal B. The results showed that relative to control group, OGD/R injury reduced cell viability, increased the content of ROS, decreased the content of t-GSH and NO. Furthermore, OGD/R injury increased the protein expression levels of dynamin-related protein 1 (Drp1), mitofusions 2 (Mfn2), Bcl-2 associated X protein (Bax) and cysteinyl aspartate specific proteinase 3 (caspase 3), and decreased the protein expression levels of Mfn1, increased MPTP opening level. Compared with the OGD/R group, it was observed that Sal B had a protective effect at concentrations ranging from 6.25 to 100 μmol·L^-1. Sal B decreased the content of ROS, increased the content of t-GSH and NO, and Western blot showed that Sal B decreased the protein expression levels of Drp1, Mfn2, Bax and caspase 3, increased the protein expression level of Mfn1, and decreased the opening level of MPTP. In summary, Sal B may inhibit the opening of MPTP, reduce cell apoptosis and reduce OGD/R damage in H9C2 cells by regulating the balance of oxidation and anti-oxidation, mitochondrial fission and fusion, thereby providing a scientific basis for the use of Sal B in the treatment of myocardial ischemia reperfusion injury.

Objective:To summarize the imaging features of severe unilateral transverse sinus and sigmoid sinus thromboses, and evaluate the efficacy and safety of intravascular interventional therapy in them.Methods:Thirty-seven patients with severe unilateral transverse sinus and sigmoid sinus thromboses clinically mainly manifested as intracranial hypertension and accepted endovascular intervention in Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University from June 2012 to September 2022 were chosen; their clinical data were retrospectively analyzed and imaging features were summarized. Short-term efficacy was evaluated according to blood flow restoration degrees and pressure gradient reduction in the occlusive sinus and modified neurological symptoms before and after endovascular intervention. Hospitalized complications were observed; safety and long-term efficacy were evaluated according to postoperative clinical follow-up and imaging results 6-12 months after endovascular intervention.Results:(1) Preoperative brain MRI and (or) CT showed different degrees of swelling of the brain tissues, with the affected side as the target; mixed signals/density shadow could be seen in the blocked transverse sinus and sigmoid sinus; venous cerebral infarction or post-infarction cerebral hemorrhage could be combined in some patients. MRV, CTV and DSA showed poor or completely occluded transverse sinus and sigmoid sinus while normal in the contralateral side; obvious thrombus filling-defect was observed in the occluded venous sinus after mechanical thrombolysis. (2) Occlusive sinus blood flow was restored in all patients after endovascular intervention, and pressure gradient of the occlusive segment decreased from (16.6±3.3) mmHg before to (2.8±0.8) mmHg after endovascular intervention. Before discharge, clinical symptoms of all patients were significantly improved (modified Rankin scale [mRS] scores of 0 in 30 patients, 1 in 5 patients, 2 in 1 patient and 3 in 1 patient), and 2 patients had unilateral limb movement disorder (muscle strength grading III and IV, respectively). All patients received clinical follow-up for (9.6±3.0) months. At the last follow-up, neurological function obviously improved compared with that before endovascular intervention, without new neurosystem-related symptoms (mRS scores of 0 in 30 patients, 1 in 6, and 2 in 1 patient). In 34 patients received MRV or DSA follow-up, 28 had complete recanalization of occlusive sinus and 6 had partial recanalization, without obvious stenosis or recurrent occlusion.Conclusions:Severe unilateral transverse sinus and sigmoid sinus thrombosis can cause local intracranial venous blood stasis, and then cause "increased regional venous sinus pressure", which is manifested as unilateral brain tissue swelling and even venous cerebral infarction or post-infarction cerebral hemorrhage. Early diagnosis and endovascular intervention can obviously improve the prognosis of these patients, enjoying good safety.

Transgenic 5 × FAD mice are APP/PS1 transgenic mice carrying five familial Alzheimer's disease(AD)gene mutations.Beta-amyloid precursor protein(amyloid precursor protein,APP)expression is related to the K670N/M671L(Swedish),1716V(Florida),and V7171(London)mutations,and presenilin 1(PSI)is affected by the M146L and L286V mutations.5 × FAD mice express high levels of β-amyloid in the brain at 1.5 months old,and neuritic plaques began to appear at 2 months old.The pathological phenotypes of 5 × FAD mice include amyloid plaque aggregation,neuronal loss,gliosis,and memory dysfunction,while their biological characteristics include changes in the formation of brain β-amyloid plaques,hyperphosphorylation of Tau protein,synaptic dysfunction,neuroinflammatory response,mitochondrial dysfunction,blood-brain barrier injury,neuronal injury,endoplasmic reticulum stress,and eye lesions.As a classic animal model of AD,5 × FAD transgenic mice can simulate the neuropathological process and behavioral manifestations of late-stage AD in humans,and these mice are thus widely used in research into the pathogenesis of AD and the development of new drugs.In this review,we summarize the model construction,biological background,and biological characteristics of 5 x FAD transgenic mice,and the development and application of drugs for the prevention and treatment of AD,to provide references for the application of 5 x FAD transgenic transgenic mice in AD research.

Objective To explore the differences in curative effect of lanthanum carbonate and calcium carbonate on hyperphosphatemia in patients with end-stage renal disease(ESRD)after maintenance hemodialysis(MHD).Methods Patients with hyperphosphatemia after MHD treatment of ESRD were divided into treatment group and control group.Treatment group was given lanthanum carbonate chewable tablet orally,250 mg each time,tid;the control group was given calcium carbonate chewable tablets orally,500 mg each time,bid.Both groups were treated continuously for 3 months.The clinical efficacy,calcium and phosphorus metabolism,vascular sclerosis indexes[brachial ankle pulse wave conduction velocity(baPWV),ankle brachial index(ABI),homocystine(Hcy)],serum renal function indexes[[32 microglobulin(β2-MG),serum creatinine(SCr),blood urea nitrogen(BUN)],serum inflammation indexes[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],and the safety was evaluated.Results There were 104 cases in the treatment group and 96 cases in the control group.After treatment,the effective rate of the treatment group was 94.23％(98 cases/104 cases)higher than that of the control group 85.42％(82 cases/96 cases),and the difference was statistically significant(P＜0.05).After treatment,the serum phosphorus levels of treatment group and control group were(1.42±0.19)and(1.68±0.20)mmol·L-1,respectively;the serum calcium levels were(2.32±0.30)and(2.49±0.24)mmol·L-1,respectively;the product of calcium and phosphorus were(49.28±6.25)and(52.05±5.60)mg2·dL-2,respectively;the baPWV levels were(1 560.72±114.90)and(1 613.49±109.77)cm·s-1,respectively;ABI levels were 1.20±0.09 and 1.17±0.07,respectively;Hcy levels were(32.02±3.21)and(34.84±2.89)μmol·L-1,respectively.Compared with the control group,there were statistically significant differences in the above indexes in treatment groups(all P＜0.05).After treatment,there was no significant difference in levels of renal function indexes(β2-MG,SCr,BUN)and inflammatory indexes(hs-CRP,TNF-α,IL-6)between the two groups(all P＞0.05).The adverse drug reactions of the treatment group were mainly diarrhea and rash;and the adverse drug reactions of the control group were mainly diarrhea and hypercalcemia.The difference in incidence of adverse drug reactions between control group and treatment group was not statistically significant(2.88％vs 3.13％,P＞0.05).Conclusion Compared with calcium carbonate,improvement effect of lanthanum carbonate is better on phosphorus and calcium-phosphorus metabolism in MHD patients with ESRD and hyperphosphatemia,which can delay the progression of vascular sclerosis.

Objective To observe the clinical efficacy of Sanjiao Tiaoqi Acupuncture in the treatment of post-stroke respiratory dysfunction.Methods Seventy-two patients with post-stroke respiratory dysfunction were randomly divided into observation group and control group,36 cases in each group.The control group was given routine treatment,and the observation group was treated with Sanjiao Tiaoqi Acupuncture on the basis of the control group,both groups were treated for 14 consecutive days.After 2 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of white blood cell count(WBC),C-reactive protein(CRP)and clinical pulmonary infection score(CPIS)were observed before and after treatment.The changes of diaphragmatic activity were compared before and after treatment between the two groups.Results(1)After treatment,the WBC and CRP levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the WBC and CRP levels,with statistically significant differences(P＜0.05).(2)After treatment,the CPIS scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving CPIS scores,with a statistically significant difference(P＜0.05).(3)After treatment,the diaphragm mobility of patients in the two groups was significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving diaphragm mobility,and the difference was statistically significant(P＜0.05).(4)The total effective rate was 91.67％(33/36)in the observation group and 75.00％(27/36)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Sanjiao Tiaoqi Acupuncture for post-stroke respiratory dysfunction can significantly promote the absorption of inflammatory factors in patients and improve diaphragm mobility,with remarkable clinical efficacy.

Objective To evaluate the predictors of recurrent in-stent restenosis(R-ISR)occurrence in drug-eluting stents(DES).Methods A total of 201 patients with ISR who received percutaneous coronary intervention(PCI)surgery in the First Medical Center of the Chinese PLA General Hospital from January 2010 to August 2023 were selected as the study objects,and the patients were divided into R-ISR group and non-R-ISR group according to their post-discharge angiography review.The clinical baseline data and the features of interventional surgery during the first ISR-PCI were retrospectively analyzed.Results Among the 201 patients,168 were males and 33 were females,with an average age of(61.97±10.02)years.The median interval between initial and follow-up angiography was 1.5 years.Patients were divided into two groups based on their radiographic reviews:R-ISR group(98 patients and 104 ISR lesions)and non-R-ISR group(103 patients and 111 ISR lesions).Multivariate Logistic regression analysis showed that the incidence of R-ISR was correlated with Ostial disease(OR 2.987,95％CI 1.343-6.642,P=0.007),plain old balloon angioplasty(POBA)performed for ISR lesions(OR 3.081,95％CI 1.293-7.343,P=0.011)and the maximum diameter stenosis rate of ISR lesions before surgery(OR 1.016,95％CI 1.002-1.030,P=0.022).Conclusions In patients currently receiving interventional therapy for ISR,Ostial disease,POBA treatment for ISR disease,and maximum diameter stenosis rate of ISR disease were associated predictors of R-ISR development.

The annual incidence of neurodegenerative disease has been increasing with the aging of the global population,seriously affecting the quality of life of elderly patients and imposing a heavy burden on society.Glycyrrhetinic acid,which inhibits neuroinflammation and protects neurons,is one of the main active ingredients of the traditional Chinese medicine Glycyrrhiza glabra.Increasing numbers of studies are focusing on the mechanism of action of glycyrrhetinic acid and its derivatives in neurodegenerative disease.This review summarizes studies on the effects and mechanisms of action of glycyrrhetinic acid and its derivatives in Alzheimer's disease,Parkinson's disease,amyotrophic lateral sclerosis,multiple sclerosis,and cerebellar atrophy.Additionally,the future applications of glycyrrhetinic acid and its derivatives in neurodegenerative disorders are discussed.

Objective:To compare the difference between the Evidence Quality Grading System for Public Health Decision-making(PHE-Grading)and the Grading of Recommendations Assessment,Development and Evaluation(GRADE)System in evaluating the quality of evidence for public health decision-making.Methods:Systematic reviews about topic"Public health"were electronically searched in the Cochrane Library database from inception to February 27,2024.EndNote 20 software was used for literature screening,Excel 2021 and SPSS 22.0 software were used for data collation and analysis,and the forest plot was drawn by RevMan 5.4.1 software.Results:A total of 61 systematic reviews were finally included for evidence quality evaluation.The forest plot of GRADE and PHE-Grading evidence grading results showed that high grade[OR:2.39,95%CI(1.21 to 4.75)],moderate grade[OR:0.40,95%CI(0.31 to 0.52)],low grade[OR:0.37,95%CI(0.29 to 0.46)],and extremely low grade[OR:85.11,95%CI(34.80 to 208.11)],and the differences in evidence quality grading results between the two systems were statistically significant.Conclusions:Compared with GRADE,PHE-Grading may be more accurate in grasping the certainty of public health decision-making evidence.Currently,the quality of public health decision-making evidence is still concentrated in low and middle level,and high-quality research still needs to be strengthened to support scientific decision-making.