Indobufen is a new generation of antiplatelet agents and has been shown to have antithrombotic effects in animal models. However, its therapeutic potential and mechanisms against cerebral ischemia/reperfusion (I/R) injury remain unclear. In this study, we evaluated the in vivo neuroprotective effects of indobufen through both pretreatment and posttreatment regimens in a rat model of middle cerebral artery occlusion/reperfusion (MCAO/R). In vitro, human umbilical vein endothelial cells (HUVECs) subjected to oxygen-glucose deprivation/reoxygenation (OGD/R) were employed to investigate the relationship between indobufen and the pyroptosis-associated NF-κB/Caspase-1/GSDMD pathway. The pharmacodynamic tests revealed that indobufen ameliorated I/R injury by decreasing the level of thromboxane B2 (TXB2), infarct size, brain edema and neurological impairment in rats and rescuing cell pyroptosis in HUVECs. The underlying mechanisms were probably related to pyroptosis suppression by regulating the NF-κB/Caspase-1/GSDMD pathway. Overall, these studies indicate that indobufen exerts protective and therapeutic effects against I/R injury by pyroptosis suppression via downregulating NF-κB/Caspase-1/GSDMD pathway.

Chronic obstructive pulmonary disease （COPD） is a common clinical chronic airway disease with high morbidity， high mortality， a heavy disease burden， and complex mechanisms that have not been fully elucidated. Clinical problems promote the continuous progress of basic research. The establishment and evaluation of animal models is an important way to delve into the pathogenesis and treatment strategies of COPD. On the basis of the etiology， pathogenesis， diagnostic criteria， and syndrome differentiation of COPD in traditional Chinese medicine （TCM） and Western medicine， this paper summarizes the establishment methods and characteristics of existing animal models of COPD and analyzes the fitting degree of the models with the disease characteristics in Western medicine and syndrome characteristics in TCM. The results showed that the animal models of COPD in Western medicine were mainly induced by single factors and compound factors， and the model with the highest fitting degree was established by cigarette smoke combined with lipopolysaccharide and hormone. The model showed a fitting degree of 84% with the disease characteristics in Western medicine and 70% with the syndrome characteristics in TCM， being consistent with the clinical characteristics of COPD induced by multiple factors. Most of the animal models of COPD in TCM were established on the basis of disease models and combined with TCM etiology and pathogenesis characteristics， and prepared by syndrome differentiation. Among them， the model of accumulation of cold and water retention in lung had the highest fitting degree of 92% with the TCM diagnostic criteria. The models of phlegm-heat obstructing lung and phlegm-stasis obstructing lung had the fitting degree of 94% with clinical manifestations in Western medicine and the highest fitting degree with the diagnostic criteria in Western medicine. Different animal models of COPD have their own advantages and disadvantages， and most of them simply replicate the manifestations of COPD at a certain stage， failing to reflect the multiple causes and the dynamic changes of TCM etiology and pathogenesis. Moreover， the syndromes of these models fail to match the clinical syndromes in TCM. Therefore， establishing the animal models reflecting clinical characteristics of COPD in TCM and Western medicine and improving the model evaluation criteria are important contents to promote the overall development of integrated traditional Chinese and western medicine for COPD.

Objective:It aims to systematically evaluate the current status of knowledge,attitude,and practice(KAP)regarding universal commercial medical insurance among residents of the sample province from the demand-side perspective.Methods:Utilizing a quota sampling method,face-to-face surveys were conducted via the Questionnaire Star platform to collect demographic characteristics and KAP data of the participants.Comparisons of differences among different groups were made using t-tests,analysis of variance,and chi-square tests.Furthermore,multiple linear regression and structural equation modeling were utilized to analyze the influencing factors of KAP,as well as the pathways among these three factors.Results:Out of the 415 valid questionnaires collected,there were notable differences in KAP among respondents with diverse demographic backgrounds.Regression analysis revealed that education level,frequency of health check-ups,and engagement in other commercial health insurances significantly influenced knowledge;education level,involvement in other commercial health insurances,and self-assessed health status were pivotal in shaping attitudes;whereas age,education level,frequency of health check-ups,and participation in other commercial health insurances were critical in affecting practice.The path analysis results indicate that knowledge of universal commercial medical insurance has a significant direct association with attitude(β=0.379,P＜0.001)and practice(β=0.323,P＜0.001).It also influences practice through attitude as a mediator(β=0.016,P＜0.001),but the direct effect of attitude on practice is not significant(β=0.04,P=0.403).Conclusion:While residents in the sample province exhibit a positive attitude towards universal commercial medical insurance,there is a need to enhance their level of knowledge and engagement in practice.It is recommended to strengthen targeted educational and promotional measures to promote the healthy and sustainable development of universal insurance.

Objective To analyze the current status of stroke treatment in the hierarchical medical service network and the impact of referral on prognosis,to optimize the stroke treatment models,and to improve stroke treatment efficiency.Methods Totally 573 patients with acute ischemic stroke who were referred by the hierarchical medical service network in Lishui,Zhejiang Province from January 2020 to December 2022 were selected for analysis of treatment and clinical data.Based on whether they received endovascular treatment at a high-level stroke center,they were divided into an effective referral group(261 cases)and an ineffective referral group(312 cases).Demographic data,influencing factors,clinical characteristics,and laboratory tests were compared between the two groups,and the differences were analyzed by using single-factor analysis,and prognosis of the two groups of patients was assessed.Results Among 573 patients,197 received intravenous thrombolytic therapy and 261 received intravascular therapy.The effective referral rate was 45.55％.The proportion of patients in the effective referral group coronary artery disease and atrial fibrillation proportion is higher(x2=5.34,8.67,P＜0.05),more likely to show dysarthria,gaze,and consciousness disorder(x2=130.1,22.12,22.96,P＜0.05),and the baseline NIHSS score was higher(F=3.25,P＜0.05).Comparing the baseline blood cells counts of the two groups of patients at admission,the effective referral group showed lower eosinophil count,basophil count and lymphocyte(Z=-8.86,-5.39,F=0.598,P＜0.05).As for the prognosis,the proportion of neurological function improvement at discharge in the effective referral group was higher than that in the ineffective referral group.Binary Logistic regression analysis showed that baseline NIHSS score(OR=1.122,95％CI:1.074-1.172),eosinophil(OR=0.085,95％CI:0.013-0.564),and neutrophil count(OR=1.088,95％CI:1.011-1.172)were independent influencing factors for effective referrals.Conclusions The efficiency of the current regional stroke classification and treatment network needs to be further improved.Developing predictive models that include demographic characteristics,risk factors,symptoms,signs,and laboratory tests may help medical staff in stroke prevention and treatment centers quickly identify large vessel occlusion and improve acute ischemic stroke treatment efficiency.

Objective:It aims to systematically evaluate the current status of knowledge,attitude,and practice(KAP)regarding universal commercial medical insurance among residents of the sample province from the demand-side perspective.Methods:Utilizing a quota sampling method,face-to-face surveys were conducted via the Questionnaire Star platform to collect demographic characteristics and KAP data of the participants.Comparisons of differences among different groups were made using t-tests,analysis of variance,and chi-square tests.Furthermore,multiple linear regression and structural equation modeling were utilized to analyze the influencing factors of KAP,as well as the pathways among these three factors.Results:Out of the 415 valid questionnaires collected,there were notable differences in KAP among respondents with diverse demographic backgrounds.Regression analysis revealed that education level,frequency of health check-ups,and engagement in other commercial health insurances significantly influenced knowledge;education level,involvement in other commercial health insurances,and self-assessed health status were pivotal in shaping attitudes;whereas age,education level,frequency of health check-ups,and participation in other commercial health insurances were critical in affecting practice.The path analysis results indicate that knowledge of universal commercial medical insurance has a significant direct association with attitude(β=0.379,P＜0.001)and practice(β=0.323,P＜0.001).It also influences practice through attitude as a mediator(β=0.016,P＜0.001),but the direct effect of attitude on practice is not significant(β=0.04,P=0.403).Conclusion:While residents in the sample province exhibit a positive attitude towards universal commercial medical insurance,there is a need to enhance their level of knowledge and engagement in practice.It is recommended to strengthen targeted educational and promotional measures to promote the healthy and sustainable development of universal insurance.

Objective To analyze the current status of stroke treatment in the hierarchical medical service network and the impact of referral on prognosis,to optimize the stroke treatment models,and to improve stroke treatment efficiency.Methods Totally 573 patients with acute ischemic stroke who were referred by the hierarchical medical service network in Lishui,Zhejiang Province from January 2020 to December 2022 were selected for analysis of treatment and clinical data.Based on whether they received endovascular treatment at a high-level stroke center,they were divided into an effective referral group(261 cases)and an ineffective referral group(312 cases).Demographic data,influencing factors,clinical characteristics,and laboratory tests were compared between the two groups,and the differences were analyzed by using single-factor analysis,and prognosis of the two groups of patients was assessed.Results Among 573 patients,197 received intravenous thrombolytic therapy and 261 received intravascular therapy.The effective referral rate was 45.55％.The proportion of patients in the effective referral group coronary artery disease and atrial fibrillation proportion is higher(x2=5.34,8.67,P＜0.05),more likely to show dysarthria,gaze,and consciousness disorder(x2=130.1,22.12,22.96,P＜0.05),and the baseline NIHSS score was higher(F=3.25,P＜0.05).Comparing the baseline blood cells counts of the two groups of patients at admission,the effective referral group showed lower eosinophil count,basophil count and lymphocyte(Z=-8.86,-5.39,F=0.598,P＜0.05).As for the prognosis,the proportion of neurological function improvement at discharge in the effective referral group was higher than that in the ineffective referral group.Binary Logistic regression analysis showed that baseline NIHSS score(OR=1.122,95％CI:1.074-1.172),eosinophil(OR=0.085,95％CI:0.013-0.564),and neutrophil count(OR=1.088,95％CI:1.011-1.172)were independent influencing factors for effective referrals.Conclusions The efficiency of the current regional stroke classification and treatment network needs to be further improved.Developing predictive models that include demographic characteristics,risk factors,symptoms,signs,and laboratory tests may help medical staff in stroke prevention and treatment centers quickly identify large vessel occlusion and improve acute ischemic stroke treatment efficiency.

Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.

Objective To study the sedative and hypnotic effects of Yening Capsules and investigate its bioactive mechanism in mice.Methods The mice were randomly divided into control group,estazolam group(0.8 mg/kg),low,medium and high-dose Yening Capsules groups(400,600 and 800 mg/kg).The locomotor activity,latency to persistent sleep,sleep duration and sleep rate were determined respectively in mice via the open field test and injection of pentobarbital sodium in subthreshold and suprathreshold doses.The content of GABA,5-HT,DA and NE in brain tissue of mice were detected by enzyme-linked immunosorbent assay(ELISA).Results Compared with the control group,Yening Capsules medium and high dose group(P<0.05,P<0.01)significantly decreased the locomotor activity of mice.The sleep latency in Yening Capsules medium and high dose group were significantly shorten(P<0.05,P<0.05)and the sleep duration(P<0.05,P<0.01)were extended.The sleep rate of Yening Capsules medium and high dose groups(P<0.05,P<0.01)was significantly increased.Compared with the control group,high dose of Yening Capsules can significantly increase GABA(P<0.05),5-HT(P<0.05),DA(P<0.05),NE(P<0.01)in mouse brain tissue.Conclusion Yening Capsules had obvious sedative and hypnotic effects,and its mechanism may be related to the increasement of GABA,5-HT,DA and NE level in brain tissue of mice.

Objective To evaluate the clinical application of TCM nursing therapies and identify the problems during the therapy implementation, in order to explore the countermeasures to promote its clinical improvement. Methods A descriptive cross-sectional study was conducted,and a self-designed questionnaire was employed to investigate 218 nurses from 148 grade A class three TCM hospitals in China. Results 25 TCM nursing therapies were implemented in these hospitals. Ear acupressure therapy was the most frequently implemented,accounting for 83.5%(182/218);while wax therapy was the least implemented, accounting for 7.8%(17/218). The implementation frequency of these technologies varied significantly, 0~860 times a week. The top three of them were acupoint application therapy, hot compression of Chinese medicine and ear acupoints therapy.TCM nursing therapies were considered to be the most frequently used in insomnia, headache, edema, arthralgia, cold, epigastric pain, hypochondriac pain and fever.Storage of TCM nurses,lacking of TCM knowledge and inapposite therapy implementation were the main problems in the application. Conclusions Scientific and rational allocation of human resources, cultivation of the TCM-specific nursing professional, enhancement of nurses'awareness of Chinese medicine, establishment of a reasonable charging standard, and strengthening the risk management in implementation will promote its clinical development.

[Objective]To investigate the effect of pellino-1 gene overexpression by lentivirus vector on the ubiquitin of tumor necrosis factor receptor-associated factors 3 (TRAF3) and the activation of mitogen-activated protein kinases (MAPK) signaling pathway in endotoxin-tolerant kupffer cells (KCs).[Methods]Isolated KCs of C57BL/6 mouse were randomly divided into two groups:control group,which transfected with control lentivirus vector for 48 h,then pretreated with 10 ng/mL lipopolysaccharide (LPS)for 24 h,and next treated with 300 ng/mL LPS;overexpression group,which transfected with pellino-1 gene overexpression lentivirus vector for 48 h,then pretreated with 10 ng/mL lipopolysaccharide(LPS)for 24 h,and next treated with 300 ng/mL LPS. The protein expressions of pellino-1,K48-Ub,TRAF3,p38,p-p38,c-Jun N-terminal kinase(JNK)and p-JNK were analyzed by Western blot. The level of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)in superna-tants were measured by enzyme linked immunosorbent assay(ELISA).[Results]Compared with control group,the protein expres-sions of pellino-1,K48-Ub,p-JNK and p-p38 and the levels of IL-1β(P < 0.05),TNF-α(P < 0.05)in supernatants was in-creased in overexpression group,while the protein levels of TRAF3 and the levels of IL-10(P < 0.05)in supernatants were de-creased.[Conclusion]Overexpression of pellino-1 can promote TRAF3 K48 ubiquitination degradation,decrease the protein expres-sion of TRAF3,activate the downstream MAPK signaling pathway,and thus impair the formulation of endotoxin tolerance.