OBJECTIVE: To observe the effects of "olfactory three needles" on cognition, learning and memory abilities, as well as hippocampal microglia (MG) phagocytic activity in vascular dementia (VD) rats, and explore the mechanisms of acupuncture in regulating MG activation and improving remyelination, so as to ameliorate VD. METHODS: Among 38 SD rats meeting experimental requirements, 9 rats were randomly assigned to a sham-operation group, and the remaining rats underwent permanent bilateral common carotid artery ligation to establish VD model. Eighteen successfully modeled rats were randomly divided into a model group and an electroacupuncture (EA) group, with 9 rats in each one. In the EA group, EA was performed at "olfactory three needles" ("Yintang" [GV24⁺] and bilateral "Yingxiang" [LI20]), at disperse-dense wave, the frequency of 2 Hz/15 Hz and the current intensity of 1 mA, for 15 min per intervention, once daily. One course was composed of 7 days, and 2 courses were required, with the interval of 2 days. The novel object recognition test was employed to assess the cognition of rats, and the Morris water maze was adopted to observe learning and memory abilities. Luxol fast blue (LFB) staining was performed to evaluate myelin sheath loss in the hippocampus, the Western blot was used to detect the protein expression of triggering receptor expressed on myeloid cells-2 (TREM2) and proteolipid protein (PLP) in the hippocampus; and the immunofluorescence staining was used to detect the positive expression of PLP, sex determining region Y-box 10 (SOX10), ionized calcium binding adaptor molecule 1 (Iba1)⁺ TREM2⁺ and Iba1⁺ lysosome-associated membrane protein 1 (LAMP1)⁺ in the hippocampus. RESULTS: Compared with the sham-operation group, the rats in the model group exhibited the prolonged escape latency on day 3 and 4 (P<0.05, P<0.01), the increase of the total distance traveling (P<0.01) and the decrease of the recognition index (RI) and platform crossing frequency (P<0.01). Compared with the model group, the rats in the EA group showed the shortened escape latency on day 3 and 4 (P<0.05), the decrease of total distance traveling (P<0.01) and the increase of RI and platform crossing frequency (P<0.05, P<0.01). When compared with the sham-operation group, the rats of the model group presented uneven staining, sparse arrangement of myelin sheath fibers, unclear contours, and prominent vacuole-like changes in the hippocampal CA1 region. When compared with the model group, the EA group showed more dense staining, the increase of myelin sheath fibers with more orderly alignment, and fewer vacuolar changes in the hippocampal CA1 region. Compared with the sham-operation group, the model group exhibited the increase of TREM2 protein expression and the decrease of PLP protein expression in the hippocampus (P<0.01), whereas the EA group showed the up-regulation of TREM2 and PLP protein expression when compared with the model group (P<0.01, P<0.05). The positive expression of the hippocampal PLP, SOX10, and Iba1⁺LAMP1⁺ in the model group was reduced in comparison with the sham-operation group (P<0.05, P<0.01), and the positive expression of Iba1⁺ TREM2⁺ was elevated (P<0.05). In the EA group, the positive expression of PLP, SOX10, Iba1⁺TREM2⁺, and Iba1⁺ LAMP1⁺ was higher compared with that in the model group (P<0.05, P<0.01). CONCLUSION "Olfactory three needles" can improve the learning and memory, and cognitive functions of VD rats, and its mechanism may be associated with the up-regulation of TREM2 and LAMP1 to adjust MG phagocytic activity and intracellular degradation, and promote remyelination.
Animals ; Dementia, Vascular/metabolism* ; Rats ; Rats, Sprague-Dawley ; Microglia/metabolism* ; Male ; Acupuncture Therapy/instrumentation* ; Acupuncture Points ; Humans ; Remyelination ; Memory ; Hippocampus/cytology* ; Cognition ; Electroacupuncture ; Needles

Objective To explore the effect of management model of clinical pharmacists participating in multidisciplinary collaborative diagnosis and treatment(MDT)for new anti-tumor drugs in the national medical insurance drug negotiation(hereinafter referred to as"national negotiation"),including efficacy,safe-ty,economy and rationality.Methods The medical records of 326 cases using novel anti-tumor drugs by na-tional negotiation and conforming to the including and excluding standards in this hospital from July 2018 to June 2023 were retrospectively analyzed.The patients were divided into the MDT group(n=122)and non-MDT group(n=204).The patients diagnosed as non-small cell lung cancer(NSCLC)in the two groups were extracted and defined as the MDT-NSCLC subgroup(n=41)and non-MDT-NSCLC subgroup(n=77).The progression-free survival(PFS),overall survival(OS),disease control rate(DCR)and the indexes such as survival quality and medical quality control were compared between the groups.Results The median PFS in the two groups was 12.7 months and 8.0 months,the median OS was 75.2 months and 56.3 months,DCR was 96.72％and 81.86％respectively,and the differences were statistically significant(P＜0.05).The COX multivariate regression analysis indicated that the HR value of clinical pharmacists participating in MDT was higher than the other influencing factors.The median PFS time in the MDT-NSCLC subgroup and non-MDT-NSCLC subgroup was 10.5 months and 6.7 months,DCR was 97.30％and 75.64％respectively,and the differences were statistically significant(P＜0.05),the median OS time was 55.1 months and 40.3 months respectively,and the difference was statistically significant(P＞0.05).The COX multivariate regression anal-ysis indicated that the HR value with clinical pharmacists participating in MDT was higher than the other in-fluencing factors;The adverse reaction occurrence rate in the MDT group and non-MDT group was 45.9％and 58.3％respectively,and the difference was statistically significant(P＜0.05).The KPS score after treatment in the MDT group was higher than that in the non-MDT group,and the difference was statistically significant;in the aspect of medical quality control,the average drug proportion in the MDT group and non-MDT group was 63.93％and 64.54％respectively,the rational drug rate of comments on prescription was 98.36％and 88.73％respectively,the patient satisfaction average value was 90.69 points and 87.36 points respectively and the differences were statistically significant(P＜0.05).Conclusion Clinical pharmacists participating in MDT related to novel anti-tumor drugs by national negotiation is beneficial to improve the therapeutic effects,living quality and patient satisfaction,also benefit to management and control of off-label drug use and medical quality control indexes.

Objective To comapre and analyze the differences and commonalities of expression profiles of serum exosomal microRNA between patients with thyroid nodules and healthy persons at different iodine levels,and then provide evidence for screening early diag-nostic markers of thyroid nodules at different iodine levels.Methods The peripheral blood samples from 10 patients with thyroid nod-ules and healthy volunteers at different iodine levels were collected.Their serum iodine levels were measured by the arsenic cerium cat-alytic spectrophotometry.Serum exosomal microRNA were extracted and the expression levels of microRNA were determined by the high-throughput sequencing technology.The differential target genes were predicted and further performed Gene ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Results Compared with healthy volunteers,there were 6 downreg-ulated miRNAs in the patients with thyroid nodules at different iodine levels,namely miR-324-5p,miR-6511b-3p,miR-9903,miR-550a-3p,miR-5001-3p,and miR-3688-3p.Differentially expressed exosomal microRNA could regulate the MAPK signaling path-way,PI3K-AKT signaling pathway,VEGF signaling pathway,and NF-κB signaling pathway.Conclusion Six differentially expressed microRNAs is identified,which may serve as biological markers for the early diagnosis of thyroid nodules at different iodine levels.

Objective To investigate the correlation between the expression of long non-coding ribonucleic acid growth arrest specific 5(lncRNA GAS5),phospholysine phosphohistidine inorganic pyrophosphate phos-phatase(LHPP)and epithelial-mesenchymal transition(EMT)in cancer tissues of patients with non-small cell lung cancer(NSCLC)and its clinical significance.Methods Cancer tissues and adjacent tissues of 90 patients with NSCLC who underwent surgical resection in the First Hospital Affiliated to Hebei North College from June 2018 to January 2020 were collected.The expressions of lncRNA GAS5,LHPP and EMT-associated pro-teins[E-calmodulin(E-Cad),N-calmodulin(N-Cad),and vimentin(VIM)]were detected by real-time fluores-cence quantitative polymerase chain reaction.The relationship between lncRNA GAS5 and LHPP mRNA and clinicopathological features in cancer tissues of NSCLC patients was analyzed,and the correlation between ln-cRNA GAS5 and LHPP mRNA and EMT-associated proteins expression in cancer tissues of NSCLC patients was analyzed by Pearson correlation.Kaplan-Meier method was used to plot the survival curves of NSCLC pa-tients with different lncRNA GAS5 and LHPP mRNA expressions,and multivariate Cox regression was used to analyze the prognostic factors of NSCLC patients.Results The expressions of lncRNA GAS5,LHPP mR-NA and E-Cad mRNA in cancer tissues of NSCLC patients were lower than those in adjacent tissues,while the expressions of N-Cad mRNA and VIM mRNA were higher than those in adjacent tissues,with statistical sig-nificance(P＜0.05).Pearson correlation analysis showed that lncRNA GAS5 in cancer tissues of NSCLC pa-tients was positively correlated with E-Cad mRNA expression(r=0.724,P＜0.001),and negatively correla-ted with N-Cad mRNA and VIM mRNA expression(r=-0.699,-0.689).P＜0.001);lncRNA GAS5 was positively correlated with LHPP mRNA expression(r=0.651,P＜0.001).The mRNA expressions of ln-cRNA GAS5 and LHPP in cancer tissues of NSCLC patients with different degrees of differentiation,tumor TNM stage and lymph node metastasis were significantly different(P＜0.05).Kaplan-Meier survival curve a-nalysis showed that the 3-year overall survival rate in the lncRNA GAS5 high expression group[68.18％(30/44)]was higher than that in the lncRNA GAS5 low expression group[36.96％(17/46)].The 3-year overall survival rate in the high LHPP mRNA expression group[67.39％(31/46)]was higher than that in the lowLHPP mRNA expression group[36.36％(16/44)],and the difference was statistically significant(x2=10.274,10.322,P＜0.05).Low differentiation,TNM stage Ⅲ and lymph node metastasis were independent risk factors for death in NSCLC patients,and lncRNA GAS5≥1.32 and LHPP mRNA≥1.12 were independ-ent protective factors(P＜0.05).Conclusion The low expression of lncRNA GAS5 and LHPP mRNA in cancer tissues of patients with NSCLC is related to EMT-associated proteins expression,differentiation de-gree,tumor TNM stage,lymph node metastasis and prognosis,and may become a new target for the diagnosis and treatment of NSCLC.

Objective Genotypes(G)1,3,and 5 of the Japanese encephalitis virus(JEV)have been isolated in China,but the dominant genotype circulating in Chinese coastal areas remains unknown.We searched for G5 JEV-infected cases and attempted to elucidate which JEV genotype was most closely related to human Japanese encephalitis(JE)in the coastal provinces of China. Methods In this study,we collected serum specimens from patients with JE in three coastal provinces of China(Guangdong,Zhejiang,and Shandong)from 2018 to 2020 and conducted JEV cross-neutralization tests against G1,G3,and G5. Results Acute serum specimens from clinically reported JE cases were obtained for laboratory confirmation from hospitals in Shandong(92 patients),Zhejiang(192 patients),and Guangdong(77 patients),China,from 2018 to 2020.Seventy of the 361 serum specimens were laboratory-confirmed to be infected with JEV.Two cases were confirmed to be infected with G1 JEV,32 with G3 JEV,and two with G5 JEV. Conclusion G3 was the primary infection genotype among JE cases with a definite infection genotype,and the infection caused by G5 JEV was confirmed serologically in China.

Since the new medical reform,the scale of public hospitals at all levels and types in China has grown rapidly,resulting in a series of problems such as continued increase in financial burden,excessive growth in health expenses,and serious imbalance in the distribution of social basic medical insurance funds.Due to the ambiguous understanding of the connotation of the scale of China's public hospitals and the underlying driving forces of growth,and the traditional economic explanation of the growth of public hospital scale in China is not convincing.In view of this,revealing the essential driving framework for the scale growth of public hospitals in China from a new economic perspective has become a key theoretical issue to guide the next stage of high-quality development of public hospitals in China.It used the complex system modeling method to measure the growth of China's public hos-pitals since the new medical reform,and summarized the increasingly complex institutional spectrum of contempo-rary public hospitals.Drawing on the perspectives of the system's own costs and system change costs in new insti-tutional economics,starting from the analysis of system costs,it is proposed that under the premise of price regula-tion,it is the best strategy for public hospitals to compensate for institutional costs through scale growth.Finally,based on the three situations of prisoner's dilemma game,deer hunting game,and rule-abiding game experienced by public hospitals since the new health reform,the development path of public hospitals from single scale growth to extended scale growth,and then to collaborative scale growth was summarized.

Since the new medical reform,the scale of public hospitals at all levels and types in China has grown rapidly,resulting in a series of problems such as continued increase in financial burden,excessive growth in health expenses,and serious imbalance in the distribution of social basic medical insurance funds.Due to the ambiguous understanding of the connotation of the scale of China's public hospitals and the underlying driving forces of growth,and the traditional economic explanation of the growth of public hospital scale in China is not convincing.In view of this,revealing the essential driving framework for the scale growth of public hospitals in China from a new economic perspective has become a key theoretical issue to guide the next stage of high-quality development of public hospitals in China.It used the complex system modeling method to measure the growth of China's public hos-pitals since the new medical reform,and summarized the increasingly complex institutional spectrum of contempo-rary public hospitals.Drawing on the perspectives of the system's own costs and system change costs in new insti-tutional economics,starting from the analysis of system costs,it is proposed that under the premise of price regula-tion,it is the best strategy for public hospitals to compensate for institutional costs through scale growth.Finally,based on the three situations of prisoner's dilemma game,deer hunting game,and rule-abiding game experienced by public hospitals since the new health reform,the development path of public hospitals from single scale growth to extended scale growth,and then to collaborative scale growth was summarized.

Since the new medical reform,the scale of public hospitals at all levels and types in China has grown rapidly,resulting in a series of problems such as continued increase in financial burden,excessive growth in health expenses,and serious imbalance in the distribution of social basic medical insurance funds.Due to the ambiguous understanding of the connotation of the scale of China's public hospitals and the underlying driving forces of growth,and the traditional economic explanation of the growth of public hospital scale in China is not convincing.In view of this,revealing the essential driving framework for the scale growth of public hospitals in China from a new economic perspective has become a key theoretical issue to guide the next stage of high-quality development of public hospitals in China.It used the complex system modeling method to measure the growth of China's public hos-pitals since the new medical reform,and summarized the increasingly complex institutional spectrum of contempo-rary public hospitals.Drawing on the perspectives of the system's own costs and system change costs in new insti-tutional economics,starting from the analysis of system costs,it is proposed that under the premise of price regula-tion,it is the best strategy for public hospitals to compensate for institutional costs through scale growth.Finally,based on the three situations of prisoner's dilemma game,deer hunting game,and rule-abiding game experienced by public hospitals since the new health reform,the development path of public hospitals from single scale growth to extended scale growth,and then to collaborative scale growth was summarized.

Since the new medical reform,the scale of public hospitals at all levels and types in China has grown rapidly,resulting in a series of problems such as continued increase in financial burden,excessive growth in health expenses,and serious imbalance in the distribution of social basic medical insurance funds.Due to the ambiguous understanding of the connotation of the scale of China's public hospitals and the underlying driving forces of growth,and the traditional economic explanation of the growth of public hospital scale in China is not convincing.In view of this,revealing the essential driving framework for the scale growth of public hospitals in China from a new economic perspective has become a key theoretical issue to guide the next stage of high-quality development of public hospitals in China.It used the complex system modeling method to measure the growth of China's public hos-pitals since the new medical reform,and summarized the increasingly complex institutional spectrum of contempo-rary public hospitals.Drawing on the perspectives of the system's own costs and system change costs in new insti-tutional economics,starting from the analysis of system costs,it is proposed that under the premise of price regula-tion,it is the best strategy for public hospitals to compensate for institutional costs through scale growth.Finally,based on the three situations of prisoner's dilemma game,deer hunting game,and rule-abiding game experienced by public hospitals since the new health reform,the development path of public hospitals from single scale growth to extended scale growth,and then to collaborative scale growth was summarized.

Since the new medical reform,the scale of public hospitals at all levels and types in China has grown rapidly,resulting in a series of problems such as continued increase in financial burden,excessive growth in health expenses,and serious imbalance in the distribution of social basic medical insurance funds.Due to the ambiguous understanding of the connotation of the scale of China's public hospitals and the underlying driving forces of growth,and the traditional economic explanation of the growth of public hospital scale in China is not convincing.In view of this,revealing the essential driving framework for the scale growth of public hospitals in China from a new economic perspective has become a key theoretical issue to guide the next stage of high-quality development of public hospitals in China.It used the complex system modeling method to measure the growth of China's public hos-pitals since the new medical reform,and summarized the increasingly complex institutional spectrum of contempo-rary public hospitals.Drawing on the perspectives of the system's own costs and system change costs in new insti-tutional economics,starting from the analysis of system costs,it is proposed that under the premise of price regula-tion,it is the best strategy for public hospitals to compensate for institutional costs through scale growth.Finally,based on the three situations of prisoner's dilemma game,deer hunting game,and rule-abiding game experienced by public hospitals since the new health reform,the development path of public hospitals from single scale growth to extended scale growth,and then to collaborative scale growth was summarized.