ObjectiveTo evaluate pharmacological effects of Shengmai injection（SMI）on cerebral ischemia and study its neuroprotective mechanism. MethodsMale specific pathogen-free （SPF） Sprague-Dawley （SD） rats were randomly divided into a sham group， a model group， a low-dose SMI group（3 mL·kg^-1）， a middle-dose SMI group（6 mL·kg^-1）， a high-dose SMI group（12 mL·kg^-1）， and a Ginaton group（4 mL·kg^-1）according to the random number table method， with 12 rats in each group. The rat model of cerebral ischemia-reperfusion（MCAO/R）was prepared via the suture method. The administration groups were intraperitoneally injected with corresponding concentrations of SMI or Ginaton injection after reperfusion， which was conducted for 3 consecutive days. The sham group and model group were administered the equivalent volume of physiological saline. The pharmacological effects of SMI on brain injury in MCAO/R rats were evaluated by neurological function scores， cerebral infarction area， hematoxylin-eosin （HE） staining， Nissl staining， terminal deoxynucleotidyl transferase dUTP nick-end labeling （TUNEL） staining， and Western blot. The dominant link and key protein of SMI treating cerebral injury were explored using proteomic analysis. The related mechanisms of SMI were further validated using enzyme-linked immunosorbent assay （ELISA）， Western blot， and chloride ion fluorescence probe with oxygen-glucose deprivation/reoxygenation（OGD/R）-treated PC12 cells and MCAO/R rats. ResultsCompared with the sham group， the model group showed significantly increased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly decreased density of Nissl bodies and neurons（P<0.01）. Compared with the model group， the SMI groups exhibited significantly decreased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly increased density of Nissl bodies and neurons （P<0.05）. The proteomic analysis results showed that oxidative stress and inflammatory response were important processes of SMI intervening in MCAO/R injury， and the chloride intracellular channel protein 1 （CLIC1） was one of key proteins in its action network. The levels of representative indicators of oxidative stress and inflammatory response in the MCAO/R rats of the SMI groups were significantly reduced， compared with those in the model group（P<0.05， P<0.01）， and the expression levels of CLIC1 and downstream NOD-like receptor protein 3 （NLRP3） decreased （P<0.01）. In addition， the experimental results based on the OGD/R PC12 cells showed that SMI significantly increased the cell survival rate（P<0.01） and significantly decreased the intracellular chloride ion concentration（P<0.05）. ConclusionSMI has neuroprotective effects. Oxidative stress and inflammatory response are key processes of SMI intervening in MCAO/R injury. The potential mechanism is closely related to the regulation of CLIC1.

Objective:To analyze the problems existing in the cases of hospitals infringing upon patients′ informed consent right after the promulgation of the Civil Code of the People′ s Republic of China, and to provide reference for improving the legal system of informed consent. Methods:Search for judgment documents published from January 1, 2021 to June 30, 2023 on the China Judgment Document Network using the keyword " liability dispute for infringing on patients′ informed consent rights", and conduct descriptive and textual analysis on the cases in the judgment documents.Results:68 judgment documents were included in total.There were 11 judgment documents on infringement of patients′ right to informed consent, and all related cases have undergone appraisal. The content of infringement mainly included infringement of patients′ right to know their condition (12/20), infringement of patients′ right to access their medical records (6/20), infringement of patients′ right to bodily integrity without consent (2/20). There were 15 judgment documents which judge that the right of informed consent of patients wasn′t infringed, and only one case in the document has been appraised. The main focus of controversy was the issue of the priority of the exercise of the right to informed consent (2/15), the fulfillment of the obligation to inform the right to informed consent (5/15), the issue of surgery without notification (1/15), and the issue of determining the authenticity of medical records and providing medical materials (7/15).Conclusions:The legal protection of patients′ right to informed consent still faces judicial difficulties such as unclear order of the exercise of rights subject, insufficient specificity of the scope of the exercise of the right, conflicts between the right to informed consent and medical intervention, and lack of unified identification methods for infringement liability. It is suggested to standardize the order of the exercise subject of the right to informed consent, clarify the content of the obligation of the medical party to inform, construct a system for medical intervention, and unify the identification methods for disputes related to the right to informed consent.

ObjectiveBased on the integrated strategy of "empirical prescriptions in ancient books-medical cases by prestigious doctors-computational analysis"， this study aims to explore and analyze the prescriptions and medical cases for treating tremors in traditional Chinese medicine （TCM）， predict their efficacy， and obtain the core prescriptions for treating tremors in TCM， providing references for clinical application and new drug development. MethodThe Chinese Medicine Prescription Database and the China National Knowledge Infrastructure （CNKI） were searched for relevant prescriptions and medical cases for treating tremors in TCM to establish a database of prescriptions for tremors. The Traditional Chinese Medicine Inheritance Computer System （V3.0） was used to analyze and explore the medication rules including drug frequency， properties， flavor， meridian tropism， and pharmacological effects， as well as core drugs and formula associations. A multi-target drug efficacy prediction platform based on network robustness was used to evaluate the predicted efficacy of the core prescriptions obtained. Based on the integration of ancient prescriptions， prestigious doctors' medical cases， and network analysis results， the priority level of the developed prescriptions was determined through comprehensive evaluation. ResultA total of 81 ancient prescriptions were screened， involving 246 drugs， and 171 prescriptions were screened from prestigious doctors' medical cases， involving 278 drugs. The frequently used TCM drugs were mostly warm in nature and sweet in flavor， mainly acting on the liver， spleen， and kidney meridians. In terms of efficacy， they were mainly effective in tonifying deficiency， soothing liver and extinguishing wind， activating blood and resolving blood stasis， clearing heat， and resolving exterior. Through association rules and K-means clustering， the core prescriptions were composed of high-frequency drugs such as Glycyrrhizae Radix et Rhizoma， Ginseng Radix et Rhizoma， Astragali Radix， Atractylodis Macrocephalae Rhizoma， Angelicae Sinensis Radix， Poria， Gastrodiae Rhizoma， and Uncariae Ramulus Cum Uncis. Drug combinations mainly focused on tonifying Qi and nourishing blood， with the additional functions of calming wind and dredging collaterals. Clustering analysis of core prescriptions from ancient prescriptions and prestigious doctors' medical cases， as well as multi-target drug efficacy prediction， showed that Combination 1 had the highest disturbance score on the disease network. Furthermore， comparative analysis revealed consistent results with both the analysis of ancient prescriptions and prestigious doctors' medical cases， indicating its optimal development potential based on theoretical inheritance and empirical practice. In comparison， Combinations 3， 2， and 4 were less utilized in contemporary clinical practice， with lower rankings in network disturbance scores， suggesting that their development value still warranted further exploration. ConclusionTCM clinical treatment of tremors emphasizes the regulation of the liver， spleen， and kidney. In line of syndrome differentiation， drugs potent in soothing liver， extinguishing wind， activating blood， and resolving blood stasis are added based on deficiency-tonifying drugs. The core prescriptions based on Glycyrrhizae Radix et Rhizoma， Angelicae Sinensis Radix， Paeoniae Radix Alba， Astragali Radix， Poria， and Atractylodis Macrocephalae Rhizoma （combination 1） have the highest potential development value. The integrated strategy "empirical prescriptions in ancient books-medical cases by prestigious doctors-computational analysis" can be used for the screening of candidate prescriptions for new TCM drugs.

BACKGROUND:Adjustable piezoelectric effect can promote tissue regeneration and repair.Piezoelectric materials are widely used in weight-bearing tissue engineering. OBJECTIVE:To prepare a piezoelectric film material that can promote bone regeneration,and to explore its structural characterization,electrical output performance,biocompatibility,and effect of electrical output on osteogenic differentiation of rabbit bone marrow mesenchymal stem cells. METHODS:Using poly-3-hydroxybutyrateco/4-hydroxybutyrate(P34HB)as raw material,barium calcium stannate titanate powder(Ba0.94Ca0.06Sn0.08Ti0.92O3,BCST)was added according to mass ratios of 0%,5%,10%,15%,and 20%.Dichloromethane was added to solve P34HB,and the thickness of 150-200 μm BCST/P34HB piezoelectric film was prepared by vacuum drying method.After polarization in the oil bath,the surface morphology,crystal phase composition,piezoelectric coefficient and open circuit voltage were tested.The effect of BCST/P34HB electrical output at 110 Hz and 0.25 N force on the proliferation and osteogenic differentiation of rabbit bone marrow mesenchymal stem cells was tested. RESULTS AND CONCLUSION:(1)Scanning electron microscopy,X-ray diffraction,water contact angle,piezoelectric coefficient and electrical output performance tests showed that when the mass ratio of BCST increased to 20%,the BCST/P34HB piezoelectric film had good piezoelectric properties(d33=5.9 pC/N)and electrical output performance(180 mV),which was closer to the suitable range of 500 mV for electrical stimulation.(2)Live and dead staining showed that on the first day of co-culture,15%group and 20%group showed less red fluorescence.On the 5th day of culture,the number of green fluorescence in each group was significantly higher than that on the first day,and the red fluorescence was not observed in the 10%,15%and 20%groups,and only a small amount of red fluorescence was observed in the 0%and 5%groups.(3)On the 1st,3rd and 5th days of co-culture with rabbit bone marrow mesenchymal stem cells,Almar blue staining exhibited that the number of cells in each group showed an increasing trend with the increase of time.On the 5th day of culture,the number of cells in the 20%group was significantly more than that in the 0%group(P<0.05).(4)On day 10 of osteogenic induction,alkaline phosphatase staining results showed that the positive rate of the 20%group was significantly higher than that of the 0%group(P=0.000 1).On day 21,alizarin red staining and quantitative analysis of calcium nodules showed a similar trend to alkaline phosphatase staining.Compared with the 0%group,the 15%group and 20%group showed significant differences(P<0.01,P<0.000 1).(5)The results showed that 20%BCST/P34HB films had good piezoelectric properties,electrical output properties,biocompatibility and the ability of promoting osteogenic differentiation of bone marrow mesenchymal stem cells.

ObjectiveTo explore the mechanism of Naoxintong capsules' intervention in cerebral ischemia-reperfusion by building a mouse cerebral ischemia-reperfusion model based on short-chain fatty acids. MethodC57BL/6J male mice were randomly divided into the sham group， model group， Naoxintong group （158.9 mg∙kg^-1）， and Ginaton group （12.1 mg∙kg^-1） according to the random number table method. The model of cerebral ischemia-reperfusion （MCAO/R） was prepared via the filament occlusion method. The effect of Naoxintong capsules on brain injury in MCAO/R mice was evaluated by the neuroethological score， cerebral infarction area determination， Nissl staining， and immunofluorescence staining. Hematoxylin-eosin （HE） staining and Western blot were employed to evaluate the effect of Naoxintong capsules on the intestinal barrier in MCAO/R mice. The content of short-chain fatty acids in mouse feces was detected by LC-MS/MS. ResultCompared to the sham group， the model group exhibited significant increases in the cerebral infarction area， neuroethological score， and cell apoptosis rate （P<0.01）， with a notable decrease in the number of Nissl bodies （P<0.01）. The protein expression levels of Claudin-1 and Occludin were significantly reduced （P<0.05）. Compared with the model group， the intervention of Naoxintong capsules significantly decreased the cerebral infarction area （P<0.05） and improved the neuroethological score （P<0.01） and cell apoptosis rate （P<0.01）， with the number of Nissl bodies （P<0.01） and expression levels of Claudin-1 and Occludin proteins （P<0.01） increased. LC-MS/MS results showed that compared to the sham group， the model group featured a significantly reduced content of acetic acid， propionic acid， and butyric acid in feces （P<0.01）， while valeric acid， isovaleric acid， and isobutyric acid levels were increased （P<0.01）. The intervention of Naoxintong capsules notably lowered the content of valeric acid， isovaleric acid， and isobutyric acid （P<0.01）. ConclusionNaoxintong capsules can improve brain and intestinal barrier damage and play a protective role in cerebral ischemia-reperfusion by regulating the content of short-chain fatty acids.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.

Objective:Using quantitative analysis to explore the health care industry policy documents of the Yangtze River Del-ta,reveal the exising policies problems,and provide scientific references for the healthy development of the health care industry.Methods:It uses the open coding method of qualitative research to code health care industry policy texts of Zhejiang,Jiangsu,Anhui and Shanghai,and carries out quantitative analysis based on the policy tool and health care format.Results:The policies and measures related to the health care industry in the Yangtze River Delta are scattered in the policy documents such as health pen-sion,health care,health care travel,etc.There is no special policy to guide the overall development of the health care industry.In the use of policy tools,there is a shortage of environmental tools,supply tools and demand tools,and there is an imbalance in the internal structure of various policy sub-tools;In terms of industrial format,the Yangtze River Delta can develop the advanta-geous format of health care industry based on local resource endowment,but there was insufficient attention to health and culture.Conclusion:The Yangtze River Delta should speed up the formulation of special policies for health care industry,strengthen the construction of health care service standards and product quality evaluation system,increase the proportion of demand-oriented tools,increase the supply of health care and culture policies,and promote the development of health care industry.