ObjectiveTo investigate the optimal ratio of goat horn replacing antelope horn in Fufang Lingjiao Jiangya pills and the blood pressure-lowering mechanism of this medicine. MethodsThe blood pressure-lowering efficacy of Fufang Lingjiao Jiangya pills with varying proportions of goat horn replacing antelope horn was evaluated on spontaneous hypertensive rats （SHR）. In this experiment， 50 SHR rats were randomly grouped as follows： model （n=8）， captopril （0.01 g·kg^-1） （n=6）， low-dose blank Fufang Lingjiao Jiangya pills （0.342 g·kg^-1） （n=6）， high-dose blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1） （n=6）， low-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， high-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）， low-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， and high-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）. Additionally， 8 WKY rats were used as the normal group. Drugs were administered by gavage for 4 weeks while an equal volume of distilled water was administered for the normal and model groups. Blood pressure was measured before administration， 3 h post administration， and biweekly thereafter. In the experiment for Fufang Lingjiao Jiangya pills with goat horn replacing antelope horn in different proportions， 48 SHR rats were randomly grouped as follows： model， blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1）， antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1）， 2× goat horn-containing Fufang Lingjiao Jiangya pills （0.824 g·kg^-1）， 4× goat horn Fufang Lingjiao Jiangya pills （0.969 g·kg^-1）， and 6× goat horn Fufang Lingjiao Jiangya pills （1.112 g·kg^-1）. The normal group included 8 WKY rats， and the normal group and model group received an equal volume of distilled water. The treatment lasted for 2 weeks， and blood pressure was recorded at various time points （pre-administration， 3 h post administration， and on days 4， 7， 10， and 14 of administration）. Serum levels of angiotensin-converting enzyme （ACE）， angiotensin Ⅱ（Ang Ⅱ）， renin， and interleukin-6 （IL-6） were measured by enzyme-linked immunosorbent assay. Histopathological changes in the heart， kidney， and thoracic aorta were observed by hematoxylin-eosin staining. The protein levels of ACE2， angiotensin Ⅱ type 1 receptor （AT1R）， and angiotensinogen （AGT） in the kidney tissue were determined by Western blot， while the expression of nuclear factor （NF）-κB p65 and Toll-like receptor 4 （TLR4） in the thoracic aorta tissue was assessed by immunohistochemistry. ResultsCompared with the model group， all treatment groups showed lowered blood pressure （P<0.05， P<0.01）， and the 6× goat horn-containing Fufang Lingjiao Jiangya pills group showed consistent blood pressure-lowering effect with the antelope horn-containing Fufang Lingjiao Jiangya pills group. Compared with the normal group， the model group showed elevated serum levels of ACE， Ang Ⅱ， renin， and IL-6， while the elevations were declined in the Fufang Lingjiao Jiangya pills groups （P<0.05， P<0.01）. Pathological changes in the heart， kidney， and thoracic aorta were alleviated in all the treatment groups， with the 6× goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups exhibited the best effect. Western blot and immunohistochemistry results showed that all the treatment groups exhibited down-regulated protein levels of AT1R， AGT， NF-κB p65， and TLR4 and up-regulated protein levels of ACE2 （P<0.05， P<0.01） compared with model group， with the 6×goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups showcasing the best effect. ConclusionReplacing antelope horn with 6×goat horn in Fufang Lingjiao Jiangya pills can achieve consistent blood pressure-lowering effect with the original prescription. The prescription may exert the effect by inhibiting the renin-angiotensin-aldosterone system （RAAS） and TLR4/NF-κB signaling pathways.

Objective A neuroblastoma(NB)liver transplantation model was established and compared with the adrenal orthotopic transplantation model to explore its characteristics.Methods 5× 105 SK-N-SH cells were implanted along the long axis of the left lobe of mouse livers with a micro-injection needle.The growth,metastasis,expression of related genes,and histopathological changes of tumors were detected after the modeling.Results The tumor formation rate in mice inoculated with tumor cells reached 100％after 21 days,and tumor growth,metastasis,related gene expression changes,and pathological characteristics were apparent.Conclusions In this study,a neuroblastoma liver transplantation model was successfully constructed via a relatively simple surgical method to provide a more suitable choice for future scientific NB experiments.

Objective To explore the effect of lean management on cost control of single disease in patients with acute cerebral infarction (ACI) in stroke center. Methods A retrospective study was conducted. The patients with ACI who underwent intravenous thrombolysis in the stroke center of Taizhou Central Hospital in Zhejiang Province were enrolled. Thirty patients adopted traditional management procedures from July 2016 to September 2017 were enrolled in the control group, and 32 patients received lean management from October 2017 to December 2018 were enrolled in the lean group. The patients in the control group were treated with traditional intravenous thrombolysis, and the patients were sent to the neurology ward for intravenous thrombolysis. The patients in the lean group applied lean management value stream to optimize process management, the lean management team of the stroke center was established, and the green channel for stroke treatment was established to eliminate the waiting time as far as possible. The location of thrombolysis was changed from neurology ward to the neurological intensive care unit (NICU) in emergency department. The patients in the two groups were compared in terms of intravenous thrombolytic door-to-needle time (DNT), admission time to the neurologist's visit time (T1), CT examination time to neurology ward or NICU admission time (T2), neurology ward/NICU visit time to medication time (T3), and the proportion of patients with DNT controlled within 40 minutes, recovery of neurological impairment 7 days after thrombolysis [national institutes of health stroke scale (NIHSS) score], activity of daily living assessment (Barthel index), length of hospital stay, cost of hospital stay and patient satisfaction. At the same time, the main process quality and the implementation rate of easily missed indexes of cerebral infarction single disease were recorded. Results Compared with the control group, DNT, T1 and T2 in the lean group were significantly shortened [DNT (minutes): 39.56±11.12 vs. 63.03±19.63, T1 (minutes): 16.23±6.79 vs. 33.48±12.63, T2 (minutes): 13.45±3.84 vs. 17.47±5.56, all P < 0.01], T3 was slightly shortened (minutes: 9.88±1.95 vs. 10.95±2.69, P > 0.05), and the proportion of DNT control within 40 minutes was significantly increased [75.0% (24/32) vs. 16.7% (5/30), P < 0.01], the 7-day NIHSS score was decreased significantly (8.66±4.12 vs. 13.00±5.63, P < 0.01), 7-day Barthel index was increased significantly (71.6±16.7 vs. 54.7±17.1, P < 0.01), the length of hospital stay was significantly shortened (days: 9.69±4.06 vs. 12.47±3.83, P < 0.01), the hospital costs were significantly reduced (Yuan: 16 338±5 481 vs. 19 470±5 495, P < 0.05), the satisfaction of patients was improved significantly [(91.38±2.69)% vs. (86.53±2.78)%, P < 0.01]. In terms of the implementation rate of quality indicators such as pre-application evaluation of thrombolytic drugs, evaluation of dysphagia, and evaluation of vascular function, health education of ACI, rehabilitation evaluation and implementation within 24 hours, etc., the lean group was significantly improved as compared with the control group [(87.5% (28/32) vs. 53.3% (16/30), 96.9% (31/32) vs. 73.3% (22/30), 78.1% (25/32) vs. 43.3% (13/30), 100.0% (32/32) vs. 76.7% (23/30), 75.0% (24/32) vs. 33.3% (10/30), all P < 0.05]. Conclusion Lean thinking can realize the standardization of stroke center process, effectively utilize medical resources, improve medical quality and reduce the cost of cerebral infarction single disease.

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Adult ; Asian Continental Ancestry Group* ; China ; Comorbidity ; Developed Countries ; Developing Countries ; Diagnosis* ; Epidemiologic Studies ; Epidemiology ; Global Health ; Humans ; Hypersensitivity* ; Prevalence ; Rhinitis, Allergic*

Objective To evaluate the anti-osteoporotic effect of xanthohumol(XN)in animal and osteoblast.Methods The anti-osteoporotic study on XN was performed with ovariectomized mice model.Serum biochemical indexes,bone mineral density(BMD)and bone histomorphology were measured using Elisa kits and Micro-CT analysis.In vitro test,the effect of XN on osteoblastic proliferation,differentiation and mineralization were assayed.The expression of protein related to bone for-mation was measured by Western blot analysis.Results In vivo experiments,XN significantly increased the estrogen level, reduced the high bone turnover rate,improved the microenvironment and BMD in ovariectomized mice.In vitro experiments, XN protected bone loss not only by promoting osteoblastic proliferation,ALP activity and bone mineralization,but also through increasing the expression of osteopontin(OPN),bone sialoprotein(BSP)and bone morphogenetic protein-2(BMP-2). Conclusion This is the first report to confirm that XN has anti-osteoporotic effect,which provides a new approach for the clin-ical treatment of osteoporosis.

Objective To translate Chinese version of the Family Impact of Childhood Bronchial Asthma-Revised(IFABI-R), and to evaluate its reliability and validity in family caregivers for children with asthma. Methods The English version of IFABI-R was translated into Chinese by means of translation, back translation, expert consultation and cultural debugging to form a Chinese version of the questionnaire. A total of 158 parents of the children with asthma treated in the First Affiliated Hospital of Zhengzhou University from January to June 2016 were investigated by the Chinese version IFABI-R. The reliability and validity was tested. Results The Chinese version of IFABI-R has 14 entries. The content validity (I-CVI) of the items ranged from 0.80 to 1.0, and the content validity (S-CVI) of the total scale was 0.98. Exploratory factor analysis extracted 3 factors, the cumulative contribution rate is 68.362%. The Cronbach's alpha coefficient of the scale was 0.843, and the Guttman split half coefficient was 0.842, with the test-retest reliability 0.796. Conclusions The Chinese version of IFABI-R has good cultural applicability, with good reliability and validity. It can be used to assess the quality of life of parents with asthma in children.

Objective To observe the clinical effect ofJiedu-Huayu granule for the Dengue Fever (DF).Methods The patients with DF were randomly divided into the treatment group and control group. Both groups received the conventional treatment, and the treatment group addedJiedu-Huayu granule. The clinical effects were detected.Results At the baseline, the ALT and AST in the treatment were significantly higher than those in the control group (t=2.830,P=0.014;t=2.109,P=0.044). But after treatment, there was no difference between groups. The ALT in the treatment group showed a gradual change and AST recovery time showed short. Compared with control group, the concentration of sVCAM-1 in the treatment group was higher at baseline and the third day (t=2.780,P=0.018;t=2.130,P=0.460), but the concentration of MCP-1 desceased significantly on the 6th day (t=-2.164,P=0.042).Conclusions Compared with the western medicine, the treatment of western medicine andJiedu-Huayu granule could alleviate liver injure, shorten the recovery time, and reduce the concentration of sVCAM-1 and MCP-1.

Objective To discuss the application and effect of predictive care in stage divided treatment and salvage of children's persistent status of epilepsy (SE).Methods Sixty-four children with SE were admitted to the First Peoples Hospital of Wenling in Zhejiang Province from December 2014 to December 2016 as the research objects, a controlled study was adopted, in which the stage divided therapeutic method was compared with the conventional method for treatment of SE, and the children were divided into an observation group and a control group, 32 cases in each group. Foresight treatment method was used in the observation group: the first stage of treatment (early treatment or pre-hospital treatment) was intravenous injection of the first-line drugs (benzodiazepines); the second stage of treatment (progressive stage treatment or initial treatment) mainly used epileptic drugs to prevent recurrence; the third stage treatment (referred to after the first-line drug in combination with one second line antiepileptic drug treatment, the disease was still unable to be controlled) adopted the mild hypothermia therapy to reduce the SE attack amplitude and decrease recurrence; in terms of aspects of predictive nursing measures, the respiratory tract nursing, basic nursing, the prediction of complications and their nursing, etc. were implemented. The routine nursing without care about the stages was carried out in the control group. The SE control time, skin lesions, false aspiration, lung infection, tongue bite, cerebral edema, etc. the incidenceof complications were observed in two groups of children.Results The SE control time was significantly shorter in observation group than that in the control group (minutes: 18.13±3.15 vs. 25.19±2.69,P < 0.05), and the incidence of complications was obviously lower in observation group than that in the control group [6.25% (2/32) vs. 28.13% (9/32),P < 0.05]. Conclusion Using different therapy at different stages of children SE combined with predictive care can effectively shorten the SE control time, decrease the incidence of complications and elevate the therapeutic and nursing effects.

OBJECTIVETo compare the difference in the short-term and long-term efficacy on cervical spondylosis of neck type between warm needling therapy in the regions of both neck and lumbus and that only in the region of neck.

METHODSEighty-one patients of cervical spondylosis of neck type were randomized into group A (41 cases) and group B (40 cases), in which 2 cases dropped out. Finally, 40 cases in the group A and 39 cases in the group B accomplished the trial. In the group A, the warm needling therapy was applied to the acupoints in the region of neck and the lumbus. Fengchi (GB 20), Tianzhu (BL 10), Neck-Bailao (EX-HN 15), Wangu (GB 12), Tianyou (TE 16) and(including the tender points and code-like masses on palpation) were selected in the region of neck. Dachangshu (BL 25), Qihaishu (BL 24) and Jiaji (EX-B 2) of L5 were selected in the region of lumbus. The warm needling was applied to Fengchi (GB 20), Tianzhu (BL 10), Dachangshu (BL 25). In the group B, the warm needling therapy was applied only to the acupoints in the neck, which were same as the group A. The treatment was given once every two days, three times a week in the two groups. Separately, before treatment, 1 week after treatment, at the end of 2-week treatment and at the end of 1 month follow-up, the score of neck pain questionnaire (NPQ), the score of range of motion (ROM) in the cervical region and the score of the cervical symptoms were recorded. The efficacy at the end of treatment and in the follow-up was evaluated.

RESULTSCompared with those before treatment, the scores at all the observation time points were significantly improved in the two groups after treatment (all<0.05). In the follow-up, NPQ score, ROM score and the score of cervicalsymptoms were different significantly between the two groups (all<0.05). The results in the group A were better than those in the group B. At the end of 2-week treatment, the total effective rate was 92.5% (37/40) in the group A and was 87.2% (34/39) in the group B (>0.05). In the follow-up, the total effective rate was 87.5% (35/40) in the group A, better than 64.1% (25/39) in the group B (<0.05).

CONCLUSIONSThe treatment for both neck and lumbar regions with warm needling therapy and the treatment in the local area all achieve the short-term efficacy on cervical spondylosis of neck type. For the long-term efficacy, the treatment for both neck and lumbar regions achieves the better result as compared with the routine treatment in the region of neck.

Objective To study the influence of obesity on outcome of rehabilitation for the hemiplegic post stroke. Methods 118 hospitalized stroke patients were divided into the normal weight, overweight and obesity groups according to the Body Mass Index. All the patients received rehabilitation for 12 weeks. They were assessed with National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after rehabilitation. Results The scores of NIHSS, FMA, BBS and MBI improved significantly after rehabilitation in all the groups (P<0.001), and improved the lest in the obesity group in the scores of NIHSS, BBS and MBI (P<0.05). There was no significant difference in FMA score among groups (P>0.05). Conclusion Obesity influences the outcome of rehabilitation, results in poor functioning.