Objective To summarize and analyze the"Qiangzhi"drugs in Shennong's Classic of the Materia Medica,and to explore the effect and mechanism of improving memory impairment.Methods To screen the drugs with the effect of"Qiangzhi"in Shennong's Classic of the Materia Medica,and summarize their properties and tastes.By searching the common action targets of"Qiangzhi"traditional Chinese medicine through network pharmacology,it is speculated that it may be the basis for playing the role of"Qiangzhi".Animal experiments were carried out,and 80 mice were divided into blank group,model group,Radix Aucklandiae group,Radix Polygalae group,Eucommiae Cortex group,Rubi Fructus group,Euryale Semen group,Fructus Xanthii group,Epimedium group(0.06 g·d1)and Pilose Antler group(0.018 g·d1),with 8 mice in each group,and the corresponding dosage was given by gavage for 30 days.From the 23th day,scopolamine(2 mg·kg-1)was injected intraperitoneally in all groups except the blank group.On the 31th day,the platform test and water maze test were carried out on the mice in each group.After the experiment,the mice were killed and the materials were taken.The damage of neurons in the cortex and hippocampus of the mice was observed by LFB staining.According to the results of network pharmacology,Use ELISA kit to detect prostaglandin endoperoxide synthase 2(COX-2),monoamine oxidase A(MAOA),serotonin(5-HT),serotonin receptor 2A(5-HT2AR),acetylcholine(Ach),acetylcholinesterase(AchE),adenosine receptor A2a(A2aR)and adenosine receptor A1(A1R)in hippocampus of mice.Western blot was used to detect the expression of nuclear transcription factor-κB(NF-κB)and 5-HT transporter(SERT)in hippocampus of mice.Results There are eight kinds of drugs for"Qiangzhi"in Shennong's Classic of the Materia Medica,including Radix Aucklandiae,Cortex et Radix Polygalae,Eucommiae Cortex,Rubi Fructus,Euryale Semen,Fructus Xanthii,Herba Epimedii,and Cornu Cervi Pantotrichum.The main drugs are pungent and sweet,and the main drugs are warm,and most of them belong to the kidney meridian.According to the network pharmacology analysis,their common targets are COX-2,MAOA,5-HT2AR,AchE,A2aR,A1R.In the behavioral experiment,compared with the model mice,the latency of jumping off the platform was significantly increased,the number of jumping off the platform was significantly reduced,and the latency of water maze was significantly shortened(P＜0.05 or P＜0.01),and the mice in each Qiangzhi drug group were obviously more familiar with the swimming route.The results of LFB staining showed that each Qiangzhi drug could reduce the neuronal damage in cortex and hippocampus of mice.The results of ELISA showed that compared with the model group,the contents of COX-2,Ach,AchE,MAOA,A1R,A2aR in the hippocampus of mice in each Qiangzhi drug group were significantly decreased(P＜0.05 or P＜0.01),while the contents of 5-HT and 5-HT2AR were significantly increased(P＜0.01).Western blot method was used to detect the contents of NF-κB and SERT in hippocampus of mice in each"Qiangzhi"drug group,which was significantly lower than that in model group.Conclusion Eight"Qiangzhi"drugs all have the effect of improving memory impairment in different degrees.The mechanism of their"Qiangzhi"effect and improving memory impairment may be related to various ways,such as inhibiting NF-κB/COX-2 inflammatory pathway,reducing 5-HT hydrolysis and increasing 5-HT2A receptor content,stabilizing the contents of Ach and AchE,and reducing the contents of adenosine A1 and A2a receptors.

Objective To summarize and analyze the"Qiangzhi"drugs in Shennong's Classic of the Materia Medica,and to explore the effect and mechanism of improving memory impairment.Methods To screen the drugs with the effect of"Qiangzhi"in Shennong's Classic of the Materia Medica,and summarize their properties and tastes.By searching the common action targets of"Qiangzhi"traditional Chinese medicine through network pharmacology,it is speculated that it may be the basis for playing the role of"Qiangzhi".Animal experiments were carried out,and 80 mice were divided into blank group,model group,Radix Aucklandiae group,Radix Polygalae group,Eucommiae Cortex group,Rubi Fructus group,Euryale Semen group,Fructus Xanthii group,Epimedium group(0.06 g·d1)and Pilose Antler group(0.018 g·d1),with 8 mice in each group,and the corresponding dosage was given by gavage for 30 days.From the 23th day,scopolamine(2 mg·kg-1)was injected intraperitoneally in all groups except the blank group.On the 31th day,the platform test and water maze test were carried out on the mice in each group.After the experiment,the mice were killed and the materials were taken.The damage of neurons in the cortex and hippocampus of the mice was observed by LFB staining.According to the results of network pharmacology,Use ELISA kit to detect prostaglandin endoperoxide synthase 2(COX-2),monoamine oxidase A(MAOA),serotonin(5-HT),serotonin receptor 2A(5-HT2AR),acetylcholine(Ach),acetylcholinesterase(AchE),adenosine receptor A2a(A2aR)and adenosine receptor A1(A1R)in hippocampus of mice.Western blot was used to detect the expression of nuclear transcription factor-κB(NF-κB)and 5-HT transporter(SERT)in hippocampus of mice.Results There are eight kinds of drugs for"Qiangzhi"in Shennong's Classic of the Materia Medica,including Radix Aucklandiae,Cortex et Radix Polygalae,Eucommiae Cortex,Rubi Fructus,Euryale Semen,Fructus Xanthii,Herba Epimedii,and Cornu Cervi Pantotrichum.The main drugs are pungent and sweet,and the main drugs are warm,and most of them belong to the kidney meridian.According to the network pharmacology analysis,their common targets are COX-2,MAOA,5-HT2AR,AchE,A2aR,A1R.In the behavioral experiment,compared with the model mice,the latency of jumping off the platform was significantly increased,the number of jumping off the platform was significantly reduced,and the latency of water maze was significantly shortened(P＜0.05 or P＜0.01),and the mice in each Qiangzhi drug group were obviously more familiar with the swimming route.The results of LFB staining showed that each Qiangzhi drug could reduce the neuronal damage in cortex and hippocampus of mice.The results of ELISA showed that compared with the model group,the contents of COX-2,Ach,AchE,MAOA,A1R,A2aR in the hippocampus of mice in each Qiangzhi drug group were significantly decreased(P＜0.05 or P＜0.01),while the contents of 5-HT and 5-HT2AR were significantly increased(P＜0.01).Western blot method was used to detect the contents of NF-κB and SERT in hippocampus of mice in each"Qiangzhi"drug group,which was significantly lower than that in model group.Conclusion Eight"Qiangzhi"drugs all have the effect of improving memory impairment in different degrees.The mechanism of their"Qiangzhi"effect and improving memory impairment may be related to various ways,such as inhibiting NF-κB/COX-2 inflammatory pathway,reducing 5-HT hydrolysis and increasing 5-HT2A receptor content,stabilizing the contents of Ach and AchE,and reducing the contents of adenosine A1 and A2a receptors.

Purpose To investigate the clinicopathological characteristics and genetic variations of stage Ⅰ lung adenocarci-noma with high-grade components,according to the new grading system of the WHO classification of thoracic tumors(2021).Methods A retrospective analysis was conducted on the clini-cal data of 785 patients with stage Ⅰ lung adenocarcinoma.HE,EnVision immunohistochemistry and Victoria blue staining were used,common genetic variation(EGFR/KRAS/ALK/ROS1/RET)were detected by PCR method.The correlation between different high-grade components and clinical pathological charac-teristics as well as genetic variations in stage Ⅰ lung adenocarci-noma were analyzed.Results A total of 785 cases of stage Ⅰlung adenocarcinoma were enrolled,including 332 cases with high-grade components and 453 cases without high-grade compo-nents.Among the adenocarcinomas with high-grade components,there were 7 cases of grade 1,150 cases of grade 2,and 175 ca-ses of grade 3.The positive rates of tumor cells spreading through airspace(STAS),vascular invasion,and pleural inva-sion in grade 2 adenocarcinoma with two high-grade components(61.5％,21.2％,26.9％)were significantly higher than that of the adenocarcinomas with only one high-grade component(20.4％,7.1％,5.1％),but there was no significant differ-ence in grade 3 adenocarcinoma.The positive rate(39.0％)of STAS in the micropapillary group with one high-grade component in grade 2 adenocarcinoma was significantly higher than that in the complex glandular group(9.3％)and the solid group(0),while there was no significant difference between the latter two groups.Among the three groups there were no statistically signif-icant differences in grade 3 adenocarcinoma.In 167 cases of ad-enocarcinoma with two or more high-grade components,there were 74 cases(44.3％)of complex glands combined with mi-cropapillary components,67 cases(40.1％)of complex glands combined with solid components,8 cases(4.8％)of micropap-illary combined with solid components,and 18 cases(10.8％)of three types of components.The positive rates of pleural inva-sion and KRAS gene mutation or fusion gene(ALK/ROS1/RET)in the group of complex glands combined with solid(49.3％,28.3％)were significantly higher as compared to those in the group of complex glands combined with micropapil-lary(27.0％,8.6％).The positive rate of psammoma bodies in the group with high-grade components(24.7％)was significant-ly higher than that in those without high-grade components(3.5％,P＜0.001),and the positive rate of psammoma bodies in group of gene mutation(EGFR/KRAS)(40.4％)was higher than that in the no-gene mutation group(26.7％,P＜0.05).Conclusion The clinicopathological features of different high-grade components in stage Ⅰ lung adenocarcinoma are not identi-cal,suggesting that their invasiveness may have different biologi-cal backgrounds.Characteristic morphological observations are helpful.

Objective:By investigating the demand of " Internet-based health education" for urban and rural residents, to identify the main functions of " Internet-based health education" platform and the priority order that platform design should follow, in an effort to help promote the accurate dissemination of health education.Methods:Since April 2019, a stratified random sampling method was used to collect urban and rural residents in 3 counties and cities of a city. The survey mainly investigated the importance of the preliminary function and the specific demand of residents for " Internet-based health education" . With data collected and based on Kano model, the Better-Worse coefficient was used for quantitative analysis.Results:There are 14 main functions of the function item identification and discovery platform; among them, privacy, and without product placement are regarded requisites of the platform, while simple and stable operation among others rank the expected functions. in addition, artistic interface, fun experience, etc. were seen as the undifferentiated functions.Conclusions:The platform design for " Internet-based health education" should follow the priority order of privacy, without product placement, simple and stable operation, information authority, low attrition, comprehensive functions, perfect supervision, free service and high popularity.

The family physicians contracted service is an important means to promote hierarchical diagnosis and treatment and realize healthy Chinese strategy. With the continuous introduction of family physicians contracted service policy, it is very important to raise awareness, effectively promote and put into place.This study analyzed the family physicians contracted service policy from the perspective of public policy, and used the multiple streams theory framework to analyze the driving factors of the policy proposed. In addition, it explored the influence of problem stream, policy stream, and political stream on the policy launch process.These efforts can help improvement the policy awareness in the process, and help ensure sustainable progress of the policy.

Objective To analyze the residents′ willingness to hierarchical medical system and their intention of first visit hospitals.Methods Customized questionnaire was used for in-home survey of 1 500 households in three cities of Shandong province,with 773 of the residents aware of hierarchical medical system used as the study samples.Descriptive analysis and multi factor Logistic regression were employed for statistical analysis of their intention.Results 85.0% the residents expressed willingness to embrace hierarchical medical system.55.0% of the residents prefer primary medical institutions as their first visit in case of mild illness,a choice chosen by more rural residents(58.9%)than urban residents(48.0%),a difference of statistical significance(P<0.01).In the case of severe illness,87.3% of them prefer major hospitals as their first visit,and more urban residents(94.3%)take this option than the rural residents(83.3%),a difference of statistical significance(P<0.01).Service ability of medical institutions and residents′ concept for medical service played a key role in their choice of first visit hospitals.Conclusions The key to ensuring the implementation effect of hierarchical medical system lies in better service ability of primary medical institutions and correction of residents′ irrational medication concepts.

Objective To analyze the correlation factors that promote or impede the residents to preferentially use essential medicines.Methods Adopting stratified random sampling method,1 700 households selected from 5 cities of Shandong province were investigated with a questionnaire.The framework of Andersen behavior model of health service utilization was used as the framework,with such methods as descriptive analysis and univariate logistic regression models for the analysis and evaluation of relevant information.Results The residents′ tendency factor,ability factor and environmental factor influence their preference to use essential medicines,while the requirement factor plays a minimal role.There was a significant difference for the preference of combined medication,first visit preference and self-medication experience,the efficacy and policy response of essential medicine from logistic regression analysis.Conclusion At present,the government should focus on the construction of the formation mechanism of the residents′drug use behavior and the policy response mechanism of essential medicine system.

Objective To compare the work well-being among physicians between two surveys (2007 and 201 1 )performed in public hospital of Shandong province.Methods The constituent ratios and Pearson correlation coefficient of two surveys with 1 520 and 1 910 respondents were compared.Results The proportion of satisfied physicians decreased from 6.8% between the two surveys.Those approvingwork autonomy dropped 21.1%;those satisfied with their social standing dropped 9.1%,and those recognizing media coverage increased 12.3%.In year 2007,the top five issues most concerned with work satisfaction wereincome equity,embodiment of professional value,balance between income and workload,equity of academic title appraisal,andhealth reform policy (r were 0.53,0.5 1,0.52, 0.5 1,and 0.45,with P average< 0.01 ).While in year 201 1,the top five issues most concerned with work satisfaction were patient turst,medical lawsuit,income equity,health reform policy,dissension dealing(r were 0.50,0.50,0.50,0.49,0.48 ).Attention to medical reports rising the most (r from 0.04 to 0.45).Conclusion There was little positive change on physicians'work well-being before and after new health reform while physicians are bearing tiredness and high risk under high expectation and low trust.Rebuilding the patients'trust,dispersing risks of the medical profession and improving the practicing environment are the keys to motivating physicians.