Although geriatric diseases are complicated due to the coexistence of many diseases,they often have a common pathological basis and are closely related to the pathogenesis of deficiency and excess in traditional Chinese medicine.Exploring the characteristics of the pathogenesis of deficiency and excess diseases in the elderly is helpful to keep simplicity and restrain complexity,grasp the law of occurrence and development of diseases in the elderly as a whole,and give full play to the advantages of traditional Chinese medicine in the prevention and treatment of chronic diseases.Based on the fundamental characteristics of deficiency and excess in senile diseases,researcher Hu Jingqing further summarized that"essence deficiency,Yin deficiency,Yang deficiency,qi deficiency,blood deficiency"and"qi stagnation,phlegm dampness,blood stasis,fire and heat,and latent wind"are the most common pathogenesis in the occurrence and development of senile diseases.Among them,deficiency is the basic pathogenesis of senile diseases,especially deficiency of kidney essence.Excess disease is the key pathogenesis of the development and changes of senile diseases.Qi stagnation is often the initial step in the development of senile diseases.Phlegm dampness and blood stasis are the pathological products of"excess due to deficiency"and are also the main secondary pathogenesis of senile diseases.In clinical identification of senile diseases,attention should be paid to grasping the pathogenesis of deficiency and excess and its concurrent changes.

Tongue diagnosis is an indispensable objective basis for TCM diagnosis and treatment of epidemic diseases.To understand its application in an epidemic situation and to support in the diagnosis and treatment of infectious diseases using traditional Chinese medicine,the tongue image APP was implemented in this study to monitor the tongue image features of patients with new coronavirus pneumonia.It has been discovered through practice that the tongue image APP enables medical professionals to objectively,conveniently,quickly,and flexibly collect the patient's tongue image.It has also been discovered through the analysis of the tongue image characteristic data that the tongue image APP can,to a certain extent,objectively reflect the general law of the tongue image characteristics of the new crown pneumonia.According to the tongue image data gathered by the Tongue Image APP,Xinguan pneumonia patients'tongues were typically red,their fur was typically white,yellow,or both white and yellow,and they had a greater amount of thick and greasy fur.Nevertheless,there are still several issues with the Tongue APP application that have been noted:①The consistency of tongue shape and coating was poor;for instance,the inconsistency rate between a thin and fat tongue was as high as 62.96%;②The tongue image analysis index in the APP is still mostly a qualitative index,and the degree of discriminating is insufficient.The results of this study demonstrate that the tongue image information of different ages,sexes,disease classifications,and onset times does not reflect obvious differences and certain rules.③The tongue image characteristic indexes gathered by the tongue image APP are insufficient and do not include information on glossiness of tongue image(such as dark tongue)and tongue state.To promote the adoption of the tongue image APP and better support the prevention and treatment of epidemic diseases by traditional Chinese medicine,we should fully integrate modern advanced science and technology,improve the short videos of tongue coating,quantification of qualitative indicators,comprehensive collection of tongue image characteristic indicators,etc.

Summarize the professor Hu Jingqing's experience in treating pathogenesis of intermingled phlegm and blood stasis by using purgative method.Intermingled phlegm and blood stasis is one of the most important pathogenesis of many difficult diseases in the contemporary era.From the perspective of TCM theory,the purgative method can dissipate phlegm,eliminate blood stasis and resolve masses,which is a suitable method for the treatment in pathogenesis of intermingled phlegm and blood stasis.In clinical practice,the professor Hu Jingqing emphasizes the specific classification of pathogenesis of phlegm and blood stasis in diagnosis,using the purgative methods according to different classifications of"excess heat"and"deficiency cold".And make flexible selections of various purgative drugs in prescription.Last but not least,it is suggested that the purgative method also should not be used as the only treating method.

To investigate the in situ intestinal absorption characteristics and pharmacokinetic behavior of metformin-resveratrol compound water-in-oil nanoemulsion (MRCE) in rats, the in situ intestinal perfusion model was constructed in rats to study the intestinal absorption characteristics of MRCE in different intestinal segments. Male Sprague-Dawley rats were randomly divided into two groups. After intragastric administration of metformin and MRCE, blood was taken at a preset time point. The content of metformin in intestinal perfusion samples and blood samples at various time points was determined by HPLC. Plasma concentration-time profiles of free metformin and MRCE were calculated, and the main pharmacokinetic data were processed and analyzed by DAS 2.1.1 software. The absorption rate constant (Ka), the effective permeability (Peff) and the percentage of absorption (PA) of MRCE in each intestinal segment were significantly higher than those of metformin (P < 0.05). The area under the drug-time curve (AUC0-72 h), the half-life (t1/2) and mean residence time (MRT0-72 h) of MRCE were 1.68, 11.25 and 6.97 times of metformin, respectively (P < 0.01).The relative bioavailability of MRCE was 167.6%. The 90% confidence interval of AUC0-72 h was 156.9%-187.4%, which was not within the standard interval of bioequivalence. The intestinal absorption of MRCE was significantly better than that of free metformin; MRCE improved the oral bioavailability of metformin and was not bioequivalent to metformin.

Objective:To investigate the awareness and knowledge of influenza and vaccine among primary care providers in Shanghai.Methods:An online questionnaires survey was conducted by Shanghai Alliance for Respiratory Diseases in Primary Care from December 2017 to August 2018, healthcare providers in district central hospitals and community health care centers of Shanghai were invited to participate in the survey. The questionnaire contained the following items: the basic information of respondents; knowledge of influenza and its vaccine; current status of influenza vaccination; factors affecting promoting vaccination; the intention, attitude, perception of promoting vaccination and the influencing factors, and suggestions on promoting influenza vaccination.Results:A total of 1 542 valid questionnaires were collected, 88.3% (1 361/1 542) responders correctly recognized main symptoms of influenza; 58.2% (898/1 542) ignored the contact transmission of influenza; 41.6% (641/1 542) didn′t know the frequency of influenza vaccination; 82.7% (1 276/1 542) failed to recognize that pregnant women should also receive influenza vaccination. The survey showed that 31.2% (481/1 542) of responders had been vaccinated against influenza. The vaccination rate in community health care institutions was significantly higher than that in district central hospitals [39.1% (304/778) vs. 23.2% (177/764), χ 2=45.44, P<0.05]. Factors affecting vaccination for healthcare providers were: influenza antigen was variable, and vaccination had no effects [49.5% (404/816)]; the efficacy of the flu vaccine was doubt [48.8% (634/1 298)]; the vaccine wasn′t free [46.5%(604/1 298)]. The respondents believed that the main ways to improve the influenza vaccination were to formulate relevant national vaccination policies [79.7%(1 229/1 542)], to regularly publicize knowledge of influenza and influenza vaccine to residents through communities [65.8% (1 015/1 542)], and to recommend the patients by primary care medical staff [64.4% (993/1 542)]. Conclusion:Many healthcare providers have insufficient knowledge about influenza and vaccine. The vaccination rate of community health institutions is higher than that in district central hospitals in Shanghai. The willingness to promote influenza vaccination can be influenced by some factors. Increasing the willingness of healthcare providers might be helpful to improve the vaccination coverage among residents in the community.

Although progress has been indeed made by nanomedicines, their efficacies for cancer treatment remain low, consequently leading to failures in translation to clinic. To improve the drug delivery efficiency, nanoparticles need to change size so as to fully utilize the enhanced permeability and retention (EPR) effect of solid tumor, which is the golden principle of nanoparticles used for cancer treatment. Herein, we employed cationic small-sized red emission bovine serum albumin (BSA) protected gold nanocluster (AuNC@CBSA, 21.06 nm) to both load indocyanine green (ICG) and act as imaging probe to realize theranostic. Then AuNC@CBSA-ICG was fabricated with negatively charged hyaluronic acid (HA) to form AuNC@CBSA-ICG@HA, which was about 200 nm to easily retain at tumor site and could be degraded by tumor-specific hyaluronidase into small nanoparticles for deep tumor penetration. The HA shell also endowed AuNC@CBSA-ICG@HA with actively targeting ability and hyaluronidase-dependent drug release. Furthermore, the quenching and recovery of fluorescence revealed the interaction between ICG and carrier, which was essential for the investigation of pharmacokinetic profiles. No matter or , AuNC@CBSA-ICG@HA showed markedly anti-tumor effect, and could suppress 95.0% of tumor growth on mice breast cancer model. All results demonstrated AuNC@CBSA-ICG@HA was potential for breast cancer therapy.

Hydronephrosis is a common and frequent clinical disease. With the extensive application of minimally invasive techniques of Western medicine, it can quickly remove the obstruction and eliminate water. However, there may be problems of easy recurrence after surgery, causing more serious irreversible kidney damage. TCM has a unique advantage in the treatment of hydronephrosis, which can radically relieve the pain of patients, prevent recurrence, and protect the kidney function. Professor SHAO Zhao-di thinks that the cause of hydronephros is deficiency of kidney qi, which affects the function of gasification. Therefore, the treatment should be nourishing qi to invigorate spleen and reinforcing kidney for diuresis. In clinical practice, Bixie Fenqing Decoction can be used to treat hydronephrosis, which can obtain good efficacy.

Multiple outcomes measured repeatedly for the same subject are common in longitudinal observation.If we use the approach by analyzing each outcome separately,it may lead to wrong conclusions due to the failure of accounting for joint evolution of different outcomes.To adequately capture the interdependence among multiple outcomes,we proposed a joint modeling for multivariate longitudinal data by constructing a linear mixed-effects model for each outcome and accommodating the relationship among multiple outcomes through correlation in random effects.Maximum likelihood method was adopted to estimate parameters in this model.The application of this method was demonstrated through the analysis of stroke data.

This article mainly introduces the functional clustering methods and demonstrates its performance by the real analysis of Chinese medical Zong Qi data.The functional clustering analysis hypothesizes that the discrete time series observations are dominated by a continuous function of time,which can be expressed by infinite basis functions.Functional clustering methods include raw data method,filtering method and adaptive method.When dealing with the sparse data clustering analysis,raw data method encounters the difficulty of matrix calculation due to the lack of data on some time grids.Filtering method suits for full time data,while when facing missing data,the fitting curve is inaccurate so that the clustering outcome cannot be explainable.Adaptive method can be applied flexibly to both full time and sparsely sampled data.In the real analysis section,the adaptive method is used to cluster the sparsely sampled Chinese medical Zong Qi time series data,where the elderly individuals are divided into three clusters,the ones with high level of Zong Qi,the ones with moderate level and those with low level.The adaptive method performs well on clustering individuals.

OBJECTIVETo study the pharmacokinetics and bioequivalence of asparaginase loaded in hyaluronic acid-graft-poly(ethylene glycol)/ sulfobutylether-β-cyclodextrin nanocapsules (AHSP) in SD rats.

METHODSThe morphology of AHSP was observed under the transmission electron microscope and the particle size and zeta potential were measured. AHSP and free asparaginase were intravenously injected in rats, and the plasma asparaginase activity was measured at different time points after the injections. The pharmacokinetic parameters were calculated using the software DAS 2.1.1 to assess the bioequivalence of AHSP and free asparaginase.

RESULTSAHSP had an average particle size of 413.80∓10.97 nm with a zeta potential of -20.37∓2.38 mV. The AUC(0-48 h) of AHSP and free asparaginase was 137.34∓1.82 U/mL and 46.38 ∓1.98 U/mL, and their AUC(0-∞) was 164.66∓6.88 U/mL and 51.44∓3.01 U/mL with half-lives of 4.62∓0.60 h and 1.86∓0.38 h, respectively. Compared with free AN, AHSP exhibited increased AUC(0-48 h), AUC(0-∞), and half-life by 2.24, 2.55 and 2.32 folds, respectively. The 90% confidential intervals of AUC(0-48 h), AUC(0-∞) and Cmax of the tested formulation were 75.0%-76.5%, 74.3%-76.1%, and 95.1%-96.7%, respectively.

CONCLUSIONAHSP can improve the bioavailability and extend the biological half-life of asparaginase in rats, and AHSP and free asparaginase are not bioequivalent.

Animals ; Area Under Curve ; Asparaginase ; pharmacokinetics ; Biological Availability ; Half-Life ; Injections, Intravenous ; Nanocapsules ; Rats ; Rats, Sprague-Dawley ; Therapeutic Equivalency