OBJECTIVE: To observe the effects of Tongdu Tiaoshen acupuncture (acupuncture for unblocking the obstruction in the governor vessel and regulating the spirit) on the depression-like behavior and the hippocampal neuronal ferroptosis mediated by solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) pathway in depression rats, and explore the mechanism of this therapy for depression. METHODS: Of 30 male SD rats of SPF grade, 24 rats were selected. According to the random number table, they were divided into a normal group (n=8) and a modeling group (n=16). The rats in the modeling group were subjected to chronic unpredictable mild stress (CUMS) for 28 consecutive days to establish depression model. After modeling, 16 successfully-modeled rats were randomly divided into a model group and an acupuncture group, 8 rats in each one. In the acupuncture group, Tongdu Tiaoshen acupuncture was applied to "Dazhui"(GV14), "Shuigou" (GV26), "Baihui" (GV20) and "Shenting" (GV24). This intervention measure was deliveredonce a day, continuously for 6 days. The intervention discontinued on day 7, and was completed in 4 weeks. Before and after modeling, and after intervention completion, the behavioristics detection was performed using sucrose preference experiment and open field experiment. After intervention, using hematoxylin-eosin (HE) and Nissl staining, the morphology of hippocampal neurons was observed; with Western blot method, the protein expression of GPX4, SLC7A11, Ferritin and acyl-CoA synthetase long-chain family 4 (ACSL4) in hippocampal tissues was detected; with the real-time fluorescence quantitative PCR adopted, the mRNA expression of GPX4, SLC7A11, Ferritin and ACSL4 was detected; and using colorimetry, the hippocampal iron content was determined. RESULTS: After modeling, the sucrose preference rates, the total distance of movement, the standing times and the boxes of horizontal crossing in the model group and the acupuncture group were lower than those in the normal group (P<0.01). After the intervention, the sucrose preference rates, the total distance of movement, the standing times and the boxes of horizontal crossing in the acupuncture group were higher than those in the model group (P<0.01, P<0.05). Compared with the normal group, the number of necrotic cells increased and the number of Nissl bodies decreased in the model group; and when compared with the model group, the neuronal pyknosis and necrosis were ameliorated, the cells were arranged more regularly, the neuronal structure was clear, the matrix was dense, the blood vessels were enriched and the number of Nissl bodies increased in the acupuncture group. In comparison with the normal group, the relative expression of protein and mRNA of hippocampal GPX4, SLC7A11 decreased (P<0.01), it increased in the expression of hippocampal Ferritin and ACSL4 (P<0.01) in the model group. When compared with the model group, in the acupuncture group, the relative expression of protein and mRNA of hippocampal GPX4, SLC7A11 was elevated (P<0.01, P<0.05), it was dropped for hippocampal Ferritin and ACSL4 (P<0.01). In the model group, the hippocampal iron content was elevated when compared with that in the normal group (P<0.01); and it was reduced in the acupuncture group when compared with that in the model group (P<0.05). CONCLUSION Tongdu Tiaoshen acupuncture attenuates depression-like behaviors in the depression rats, which may be related to regulating SLC7A11/GPX4 pathway and inhibiting neuronal ferroptosis in the hippocampus.
Animals ; Ferroptosis ; Male ; Hippocampus/cytology* ; Rats, Sprague-Dawley ; Rats ; Depression/enzymology* ; Phospholipid Hydroperoxide Glutathione Peroxidase/genetics* ; Acupuncture Therapy ; Neurons/metabolism* ; Humans ; Acupuncture Points ; Amino Acid Transport System y+/genetics* ; Glutathione Peroxidase/genetics*

Objective To analyze the policy texts related to pediatric medications in China over the past decade,to explore the deficiencies in existing policy formulation from the perspective of stakeholders,and to propose reasonable optimization suggestions based on the current situation.Methods Collecting national-level policies related to pediatric drugs in China from 2013 to 2023,a two-dimensional policy analysis framework of"Policy tools-Stakeholder"were established.And the content analysis method was used to code,categorize,and statistically analyze the policy texts.Results A total of 54 pediatric drug policies were included in the analysis.In terms of policy tools,a total of 197 policy codes were formed,with environmental tools being the most prevalent with 92 codes(46.70％),primarily consisting of regulatory management tools(28 codes,30.43％).This was followed by supply-oriented tools with 53 codes(26.90％),mainly focused on the issuance of technical guidelines(21 codes,39.62％).Demand-oriented tools accounted for the least with 52 codes(26.40％),with inter-departmental collaboration tools having the highest proportion(17 codes,32.69％).In the dimension of stakeholders,a total of 223 policy codes were formed,with the government having the highest number of codes at 133(59.64％),followed by medical institutions with 56 codes(25.11％).The proportions for medical personnel,pharmaceutical companies,and patients were similar,with 14 codes(6.28％),11 codes(4.93％),and 9 codes(4.04％),respectively.Conclusions Pediatric drugs face challenges with policy tools where supply-oriented tools,particularly those providing financial support,suffer from insufficient policy depth and customization.The demand-oriented tools have a low proportion,leading to structural imbalance and underutilized effectiveness;the environment-oriented tools focus more on regulation than incentives,restricting the accessibility of pediatric drugs;the potential of multiple stakeholders is not fully activated,and there is a lack of policies centered around pediatric patients.To address these issues,supply-oriented policy tools need to establish a diversified financial support model and clearly define the scope of coverage.Demand-oriented policy tools require further adjustments to the catalog,procurement upgrades,and international collaborative research to reshape the pediatric drug security system.Environmental policy tools should enhance economic support,strengthen intellectual property rights,and implement targeted education to build a development ecosystem for pediatric drugs.Regarding stakeholders,it is essential to strengthen multi-stakeholder collaboration and optimize pediatric drug policy tools with a patient-centered approach.

Objective:Based on value orientation,it aimed to scientifically define the concept and connotation of accessibility to novel anticancer drugs,in order to deeply understand the nature and current status of the accessibility issues of novel anticancer drugs,and to provide a reference for the formulation and optimization of policies related to novel anticancer drugs.Methods:Data was collected through literature review and expert interviews,and the concept of drug accessibility was defined using the atomic diagram method.Results:The core images include"affordability","availability","high quality"and"patients".The concept of accessibility to novel anticancer drugs is defined as"the process of ensuring the sustainable supply,equitable access,affordability,and rational use of high-quality anticancer drugs to safeguard the realization of patient benefit goals."The connotation of the value orientation in policies on the accessibility of novel anticancer drugs is profoundly reflected in the multi-dimensional value-driven approach to ensure the ultimate benefit of patients,which includes quality,sustainability,equity,affordability,and rational use.Conclusion:The proposal of the concept and connotation of accessibility provides a theoretical basis for a deep understanding of the accessibility of novel anticancer drugs and offers valuable references for subsequent policy-making and practical operations.

Objective:Based on value orientation,it aimed to scientifically define the concept and connotation of accessibility to novel anticancer drugs,in order to deeply understand the nature and current status of the accessibility issues of novel anticancer drugs,and to provide a reference for the formulation and optimization of policies related to novel anticancer drugs.Methods:Data was collected through literature review and expert interviews,and the concept of drug accessibility was defined using the atomic diagram method.Results:The core images include"affordability","availability","high quality"and"patients".The concept of accessibility to novel anticancer drugs is defined as"the process of ensuring the sustainable supply,equitable access,affordability,and rational use of high-quality anticancer drugs to safeguard the realization of patient benefit goals."The connotation of the value orientation in policies on the accessibility of novel anticancer drugs is profoundly reflected in the multi-dimensional value-driven approach to ensure the ultimate benefit of patients,which includes quality,sustainability,equity,affordability,and rational use.Conclusion:The proposal of the concept and connotation of accessibility provides a theoretical basis for a deep understanding of the accessibility of novel anticancer drugs and offers valuable references for subsequent policy-making and practical operations.

Objective To analyze the policy texts related to pediatric medications in China over the past decade,to explore the deficiencies in existing policy formulation from the perspective of stakeholders,and to propose reasonable optimization suggestions based on the current situation.Methods Collecting national-level policies related to pediatric drugs in China from 2013 to 2023,a two-dimensional policy analysis framework of"Policy tools-Stakeholder"were established.And the content analysis method was used to code,categorize,and statistically analyze the policy texts.Results A total of 54 pediatric drug policies were included in the analysis.In terms of policy tools,a total of 197 policy codes were formed,with environmental tools being the most prevalent with 92 codes(46.70％),primarily consisting of regulatory management tools(28 codes,30.43％).This was followed by supply-oriented tools with 53 codes(26.90％),mainly focused on the issuance of technical guidelines(21 codes,39.62％).Demand-oriented tools accounted for the least with 52 codes(26.40％),with inter-departmental collaboration tools having the highest proportion(17 codes,32.69％).In the dimension of stakeholders,a total of 223 policy codes were formed,with the government having the highest number of codes at 133(59.64％),followed by medical institutions with 56 codes(25.11％).The proportions for medical personnel,pharmaceutical companies,and patients were similar,with 14 codes(6.28％),11 codes(4.93％),and 9 codes(4.04％),respectively.Conclusions Pediatric drugs face challenges with policy tools where supply-oriented tools,particularly those providing financial support,suffer from insufficient policy depth and customization.The demand-oriented tools have a low proportion,leading to structural imbalance and underutilized effectiveness;the environment-oriented tools focus more on regulation than incentives,restricting the accessibility of pediatric drugs;the potential of multiple stakeholders is not fully activated,and there is a lack of policies centered around pediatric patients.To address these issues,supply-oriented policy tools need to establish a diversified financial support model and clearly define the scope of coverage.Demand-oriented policy tools require further adjustments to the catalog,procurement upgrades,and international collaborative research to reshape the pediatric drug security system.Environmental policy tools should enhance economic support,strengthen intellectual property rights,and implement targeted education to build a development ecosystem for pediatric drugs.Regarding stakeholders,it is essential to strengthen multi-stakeholder collaboration and optimize pediatric drug policy tools with a patient-centered approach.

Objective To explore the latent class and influencing factors between different behavioral lifestyles in community patients with diabetes, to classify the population and reveal the behavioral lifestyle characteristics of different types of diabetes, and to provide a scientific basis for active health management of diabetes, the identification of high-risk groups and maximization of the effect of intervention measures. Methods From June to August 2022, a behavioral and lifestyle follow-up survey was conducted on 1 179 diabetes patients with electronic health records from 18 community health service centers in Pingshan District, Shenzhen. The latent class analysis (LCA) method was used to cluster the life and behavior style of the study subjects, and the disordered multi-classification logistic regression was used to analyze the influencing factors of each class. Results The LCA results showed that there were three latent classes of community diabetes patients: ^“overweight and obese group^” (28.4%), ^“balanced diet group^” (30.8%), and ^“vegetarian but persistent exercise group^” (40.8%). Logistic regression analysis results showed that age, total cholesterol , LDL , fasting blood glucose, comorbidities, and hypertension history affected the latent classes of behavioral lifestyle in diabetic patients in the community (P<0.05). Conclusion The behavioral lifestyle of community diabetes patients has obvious classification characteristics and obvious differentiation in terms of eating behavior. Doctors and health managers can issue corresponding lifestyle medicine prescriptions and formulate corresponding active health management measures to prevent the occurrence of risk factors related to diabetes patients in advance and formulate personalized intervention measures.

Objective To observe the effect of rosuvastatin on vascular cell adhesion molecule-1 (VCAM -1),C-reactive protein (CRP),TG,TC and LDC in patients with acute cerebral infarction at the early stage.Methods According to the random number expression method,90 patients with acute cerebral infarction were divided into rosuvastatin treatment group and control group,with 45 cases in each group.The course of treatment was 21 days.The control group was given conventional western medicine (aspirin,mannitol etc.),the treatment group received rosuvastatin on the basis of the control group.Before and after treatment,the plasma VCAM-1,CRP,TG,TC,LDLch levels,clinical efficacy,efficacy of regulating dyslipidemia and drug safety were compared.Results After treatment,the CRP levels in the two groups were improved.After treatment for 7 days,14 days,the CRP levels of the treatment group were (23.68 ± 5.23) mg/L,(16.68 ± 6.76) mg/L,respectively,which improved more significantly than those of the control group [(30.12 ± 6.68) mg/L,(21.12 ± 6.35) mg/L],the differences were statistically significant (t =5.092,3.230,all P ＜ 0.05).After 21 days of treatment,the CRP of treatment group was better than the control group,but the difference was not statistically significant (P ＞ 0.05).The VCAM-1 levels of the two groups after treatment were improved.After treatment for 7 days,14 days,the VCAM-1 levels of the treatment group were (1 205.1 ±61.8)mg/L,(852.1 ± 60.2)mg/L,respectively,which were improved more significantly than those of the control group[(1 415.6 ± 62.9) mg/L,(963.1 ± 53.3) mg/L],there were statistically significant differences between the two groups (t =21.815,9.261,all P ＜ 0.05),21 days after treatment,there was no statistically significant difference (P ＞ 0.05).The levels of TG,TC,LDC in the two groups were all decreased after treatment for 7 days,14 days and 21 days,and the improvement in the treatment group was more obvious,the differences between the two groups were statistically significant (t =5.219,7.303,4.044,2.232,4.336,3.612,2.689,7.817,11.057,all P ＜0.05).Conclusion Compared with the conventional western medicine treatment,rosuvastatin can decrease the plasma levels of CRP,VCAM-1,TG,TC,LDC,further improve the pathological basis of ischemic cerebrovascular disease,eliminate the risk factors,it is more conducive to the prognosis of acute cerebral infarction.

Objective To investigate the application and effects of navigation guidance in the diagnosis and treatment of patients so as to standardize the process of medical activities,provide convenience for patients and improve the quality of clinical service. Methods A total of 582 patients from outpatient clinic,306 hospitalized patients with MRI examinations and 124 medical staff from May 2015 to June 2015 in Hu'nan People's Hospital were randomly selected as control group. A number of 582 patients from outpatient clinic,306 hospitalized patients with MRI examinations and 124 medical staff from July 2015 to August 2015 were randomly selected as experimental group. Patients in control group went for waiting doctor,treatment,examination and taking medicine with the guidance of responsible nurses. Patients in experimental group were guided with additional navigation guidance which was designed depend on the hospital. Treatment time of patients from outpatient clinic,MRI examination time of hospitalized patients,satisfaction of patients and medical staff to treatment time,treatment procedure and clinical service were compared between two groups. Results After the usage of navigation guidance,treatment time of patients from outpatient clinic in experimental group (63.53±32.97) was shorter than that in control group (67.94±39.44). The difference was statistically significant (P < 0.05). MRI examination time of hospitalized patients in experimental group (30.90±12.19) was shorter than that in control group (33.75±13.38), with significant difference (P<0.05). Satisfaction rates of patients to waiting time,treatment procedure and clinical service in experimental group were higher than those in control group (t=-3.977,-3.355,-4.843,P<0.001). Average satisfaction rate of medical staff to treatment procedure in experimental group (84.26±9.80)% was significant higher than that in control group (80.27±9.40)% (P<0.05). Conclusions Application of navigation guidance improves the standardization and specification of diagnosis and treatment procedure and clinical service levels. It is an effective management method which could significantly short patients' treatment and examination time so as to promote the satisfaction rate of medical staff and patients.

Objective To analyze the relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronic liver failure (ACLF).Methods One hundred and nineteen patients with chronic hepatitis B (CHB group) and 98 patients with ACLF(ACLF group) were enrolled.HBsAg and HBeAg were assayed with Roche electrochemical luminescence method.HBV DNA was quantified using a real-time polymerase chain reaction (PCR) assay.HBsAg and HBV DNA levels were compared between two groups and between HBeAg-positive and HBeAg-negative patients in ACLF group respectively,also the correlationbetween HBsAg and HBV DNA was studied.Results The proportions of HBeAg-negative patients were 68.4％(67/98) and 42.9％(51/119) in ACLF group and CHB group respectively,and there was significant difference between two groups (P ＜0.01).There was no significant difference in HBV DNA between two groups (P ＞ 0.05).HBV DNA in HBeAg-positive patients was higher than that in HBeAg-negative patients in two groups(P ＜ 0.05).There was no significant difference in HBsAg between HBeAg-positive patients and HBeAg-negative patients in ACLF group (P ＞ 0.05 ),but they were higher than that in HBeAg-positive patients in CHB group (P＜ 0.05).HBsAg was correlated to ALT,AST in HBeAg-positive patients (P ＜ 0.05).No significant correlation was found among HBsAg and HBV DNA as well as biochemical changes (P＞ 0.05).There was no significant difference in the ratio of different HBsAg levels among the patients of different HBV DNA in ACLF group (P＞ 0.05).Conclusion The level of HBsAg does not directly correlate with serum HBV DNA level,and has no directly correlation with the severity of the disease in patients with HBV-related ACLF.