The establishment of provincial medical consumables catalogue is one of the pivotal measures for promoting the advancement of China's medical security system,and scientific and standardized management holds paramount importance.Using literature research method,it analyzed the management policy from the catalog classification and management mode,and employed comparative analysis to explore the advantages and disadvantages of the three management models of"hierarchical management","joint management"and"unified management".It proffers suggestions such as reasonable determination of classification accuracy,scientific determination of payment standard,and promotion of provincial payment policy unification step by step,with a view to providing references for improve the management of provincial medical insurance catalogue of medical consumables.

PURPOSE: To assess the relationship between dislocation and functional outcomes in supination-external rotation (SER) ankle fractures. METHODS: A retrospective case series study was performed on patients with ankle fractures treated surgically at a large trauma center from January 2015 to December 2021. The inclusion criteria were young and middle-aged patients of 18 - 65 years with SER ankle fractures that can be classified by Lauge-Hansen classification and underwent surgery at our trauma center. Exclusion criteria were serious life-threatening diseases, open fractures, fractures delayed for more than 3 weeks, fracture sites ≥ 2, etc. Then patients were divided into dislocation and no-dislocation groups. Patient demographics, injury characteristics, surgery-related outcomes, and postoperative functional outcomes were collected and analyzed. The functional outcomes of SER ankle fractures were assessed postoperatively at 1-year face-to-face follow-up using the foot and ankle outcome score (FAOS) and American Orthopedic Foot and Ankle Society ankle hindfoot score and by 2 experienced orthopedic physicians. Relevant data were analyzed using SPSS version 22.0 by Chi-square or t-test. RESULTS: During the study period, there were 371 ankle fractures. Among them, 190 (51.2%) were SER patterns with 69 (36.3%) combined with dislocations. Compared with the no-dislocation group, the dislocation group showed no statistically significant differences in gender, age composition, fracture type, diabetes, or smoking history, preoperative waiting time, operation time, and length of hospital stay (all p > 0.05), but a significantly higher Lauge-Hansen injury grade (p < 0.001) and syndesmotic screw fixation rate (p = 0.033). Moreover, the functional recovery was poorer, revealing a significantly lower FAOS in the sport/rec scale (p < 0.001). Subgroup analysis showed that among SER IV ankle fracture patients, FAOS was much lower in pain (p = 0.042) and sport/rec scales (p < 0.001) for those with dislocations. American Orthopedic Foot and Ankle Society ankle hindfoot score revealed no significant difference between dislocation and no-dislocation patients. CONCLUSION Dislocation in SER ankle fractures suggests more severe injury and negatively affects functional recovery, mainly manifested as more pain and poorer motor function, especially in SER IV ankle cases.
Humans ; Ankle Fractures/physiopathology* ; Male ; Female ; Retrospective Studies ; Adult ; Middle Aged ; Supination ; Aged ; Young Adult ; Rotation ; Joint Dislocations/surgery* ; Fracture Fixation, Internal/methods* ; Adolescent ; Recovery of Function ; Treatment Outcome

Compounds isolated from Epimedium include the total flavonoids of Epimedium , icariin, and its metabolites (icaritin, icariside I, and icariside II), which have similar molecular structures. Modern pharmacological research and clinical practice have proved that Epimedium and its active components have a wide range of pharmacological effects, especially in improving sexual function, hormone regulation, anti-osteoporosis, immune function regulation, anti-oxidation, and anti-tumor activity. To date, we still need a comprehensive source of knowledge about the pharmacological effects of Epimedium and its bioactive compounds on the male reproductive system. However, their actions in other tissues have been reviewed in recent years. This review critically focuses on the Epimedium , its bioactive compounds, and the biochemical and molecular mechanisms that modulate vital pathways associated with the male reproductive system. Such intrinsic knowledge will significantly further studies on the Epimedium and its bioactive compounds that protect the male reproductive system and provide some guidances for clinical treatment of related male reproductive disorders.
Male ; Epimedium/chemistry* ; Humans ; Genitalia, Male/drug effects* ; Flavonoids/therapeutic use* ; Animals

Objective To evaluate the value of pre-ascent 6-minute walking test performed at a high altitude in predicting the incidence of acute mountain sickness(AMS)induced by rapid ascent to a very high altitude.Methods After baseline information was collected,participants completed the 6-minute walking test at a high altitude of 2 900 m.Then,they rapidly ascended to a very high altitude of 5 000 m.The Lake Louise score was recorded to assess AMS.Results The AMS group showed a shorter pre-ascent 6-minute walking distance(6MWD)at the high altitude than the non-AMS group[480.00(450.00,521.75)m vs.546.00(516.50,568.50)m,P=0.006].No difference was observed regarding the pre-ascent heart rate or peripheral oxygen saturation(both P>0.05).The pre-ascent 6MWD at the high altitude was negatively correlated with the Lake Louise score assessed after rapid ascent to the very high altitude(r=-0.497,P=0.012).Logistic regression analysis confirmed that the pre-ascent 6MWD at the high altitude was associated with the risk of AMS induced by rapid ascent to the very high altitude(OR=0.971,95% CI=0.947-0.996,P=0.022).The results indicated that the pre-ascent 6MWD demonstrated ideal prediction performance(area under receiver operating characteristic curve=0.846,P=0.006).Conclusion The pre-ascent 6MWD recorded at the high altitude is a convenient and reliable predictor of the AMS induced by rapid ascent to the very high altitude.
Humans ; Altitude Sickness/diagnosis* ; Male ; Adult ; Female ; Young Adult ; Middle Aged ; Acute Disease ; Walk Test ; Walking ; Altitude ; Exercise Test

The establishment of provincial medical consumables catalogue is one of the pivotal measures for promoting the advancement of China's medical security system,and scientific and standardized management holds paramount importance.Using literature research method,it analyzed the management policy from the catalog classification and management mode,and employed comparative analysis to explore the advantages and disadvantages of the three management models of"hierarchical management","joint management"and"unified management".It proffers suggestions such as reasonable determination of classification accuracy,scientific determination of payment standard,and promotion of provincial payment policy unification step by step,with a view to providing references for improve the management of provincial medical insurance catalogue of medical consumables.

OBJECTIVE To learn the practical experience of medical insurance payment standards adjustment in Japan and South Korea， which will serve as a reference for the improvement of simple renewal mechanism in China. METHODS Retrieving relevant literature from CNKI and related policy documents from official websites of Japan and South Korea， the medical insurance payment standards adjustment practice in Japan and South Korea would be elucidated from 2 perspectives of adjustment criteria and formulas， and then were compared with the current simple renewal mechanism in China to clarify the areas where simple renewal mechanism in China can be optimized and propose several suggestions. RESULTS & CONCLUSIONS In terms of adjustment methods， Japan and South Korea were similar to China. For excessive drugs， the reduction rate of drugs was calculated based on the situation of excess and adjustments were implemented； however， there were differences in the specific adjustment criteria and formulas. Japan and South Korea adopted a linear price reduction approach for drugs with significant oversupply， while China adopted a gradient price reduction approach for drugs with both current and expected oversupply. The results of the comparative analysis show that China has initially established simple renewal mechanisms that are in line with the national conditions and the actual medical insurance situation， and has taken some innovative measures， including considering the current and expected oversupply of drugs and introducing a halving mechanism in the adjustment formula. However， there are also certain shortcomings， such as a relatively single set of indicators for adjusting conditions and a too broad range of gradient price reduction in adjustment formulas， which fail to fully reflect the market-oriented mechanism of “volume for price”. It is recommended that China’s medical insurance department increase consideration of drug fund expenditures， refine the gradient price reduction range of adjustment formulas， increase policy preferences for special category drugs when adding new indications， and further improve the mechanism for simple renewal.

Objective To investigate the impact of matrine(Mat)on renal injury in rats with chronic glomerulonephritis by regulating the monocyte chemotactic protein-1(MCP-1)/chemokine C-C-motif receptor 2(CCR2)signaling pathway.Methods The rat model of chronic glomerulonephritis was established by subcutaneous injection of bovine serum albumin,the rats were randomly grouped into control group,model group,low and high dose matrine groups(Mat-L group,Mat-H group),and matrine+CCR2 group(Mat+CCR2 group),with 10 rats in each group.After continuous gavage for 4 weeks,24-hour urine protein excretion was measured;spleen and thymus were removed and organ index was calculated;The levels of blood urea nitrogen(BUN)and serum creatinine(Scr)in the serum of each group were detected,the pathological changes of renal tissue were observed by HE staining;the levels of tumor necrosis factor α(TNF-α)and interleukin(IL)-6 in renal tissue were detected by ELISA;Flow cytometry was applied to detect the proportion of T lymphocyte subsets in peripheral blood of rats in each group;Western blotting was applied to determine the expression of MCP-1 and CCR2 proteins.Results The spleen index and thymus index of rats in the model group rats were obviously reduced,and there were a large number of inflammatory cell infiltration in the renal tissue,the 24-hour urine protein,BUN,Scr,TNF-α,IL-6,and the expression of MCP-1 and CCR2 obviously increased,the peripheral blood T cell subpopulations CD3+,CD4+,and CD4+/CD8+ratio obviously reduced,the proportion of CD8+obviously increased(P＜0.05);The spleen index and thymus index of rats in the Mat-L and Mat-H groups of rats increased,and the phenomenon of renal tissue inflammation and infiltration improved,the 24-hour urine protein,BUN,Scr,TNF-α,IL-6,and the expression of MCP-1 and CCR2 obviously decreased,the peripheral blood T cell subpopulations CD3+,CD4+,and CD4+/CD8+ratio obviously increased,the proportion of CD8+obviously decreased(P＜0.05);CCR2 attenuated the effect of Mat-H on immune function in rats with chronic glomerulonephritis.Conclusion Matrine can alleviate the inflammatory damage and improve the peripheral immune function of rats with chronic glomerulonephritis,and its mechanism may be related to the inhibition of MCP-1/CCR2 signaling pathway.

Objective To investigate the improvement effect of 18kD translocator protein(TSPO)ligand YL-IPA08 on lipopolysaccharide(LPS)-induced depressive,anxiety-like behaviors and cognitive dysfunction in mice and the related anti-inflammatory mechanism.Methods(1)50 male C57BL/6J mice were randomly divided into control group,LPS model group,LPS+YL-IPA08(1.0 or 3.0 mg/kg)group and YL-IPA08(3.0 mg/kg)group,with 10 mice in each group.Mice in LPS model group were intraperitoneally injected with LPS(0.5 mg/kg)once on day 1 and day 8.Mice in LPS+YL-IPA08(1 or 3 mg/kg)and YL-IPA08(3.0 mg/kg)groups were intragastrically administered YL-IPA08(1.0 or 3.0 mg/kg)for 13 consecutive days,once a day.From the 9th to 12th day,the open field test,tail suspension test,forced swimming test,novel object recognition test and elevated-plus maze test were used to evaluate the depressive,anxiety-like behaviors and cognitive function of mice.Western blotting was used to detect the expression levels of postsynaptic density protein 95(PSD95)and brain-derived neurotrophic factor(BDNF)in the prefrontal cortex of mice.(2)BV2 mouse microglia cells were divided into control group(phosphate buffered saline incubation for 1 h),LPS model group(incubated with 1.0 mg/L LPS for 6 h),LPS+YL-IPA08(0.5 or 1.0 μmol/L)group(incubated with 0.5 or 1.0 μmol/L YL-IPA08 for 1 h and then incubated with 1 mg/L LPS for 6 h),and YL-IPA08 group(incubated with 1.0 μmol/L YL-IPA08 for 1 h).ELISA was used to detect the expression levels of inflammatory factors interleukin-1β(IL-1β),interferon-γ(IFN-γ),IL-4,IL-10 and transforming growth factor-β1(TGF-β1).Western blotting was used to detect the expression levels of the members of Smad protein family(Smad2,Smad3)mediating signal transduction of TGF-β.Results(1)The results of behavioral experiments showed that there was no significant difference in the total movement distance of mice in each group in the open field test(P>0.05).Compared with the control group,the number of entries and duration time in the central area of mice in LPS model group were significantly decreased(P<0.05);the immobility time in the tail suspension test and the forced swimming test was significantly prolonged(P<0.05);the recognition index in the novel object recognition test,the percentage of entries into the open arms and the percentage of duration time in the open arm in the elevated-plus maze test were significantly decreased(P<0.05),and the expression levels of PSD95 and BDNF in the prefrontal cortex were significantly decreased(P<0.05).Compared with LPS model group,above behavioral and expression changes in LPS+YL-IPA08(3.0 mg/kg)group were significantly reversed(P<0.05).(2)Compared with control group,the expression levels of pro-inflammatory factors IL-1β and IFN-γ in BV2 cells in LPS model group were significantly increased(P<0.05),and the expressions of anti-inflammatory factors IL-4,IL-10 and TGF-β1 were significantly decreased(P<0.05),and the expression levels of Smad2 and Smad3 were significantly decreased(P<0.05).Compared with LPS model group,the expression level of IFN-γ in BV2 cells in LPS+YL-IPA08(0.5 μmol/L)group was significantly decreased,and the expression levels of IL-4 and TGF-β1 were significantly increased(P<0.05);the above changes were significantly reversed in LPS+YL-IPA08(1.0 μmol/L)group(P<0.05).Conclusion YL-IPA08 can significantly attenuate LPS-induced depressive and anxiety-like behaviors in mice and alleviate the decline in cognitive dysfunction,which mechanism may be related to improving neuroinflammation and regulating the TGF-β/Smad pathway.

AIM To investigate the consistency of chemical constituents between formula granules and standard decoction of Coptidis Rhizoma.METHODS Eighteen batches of standard decoctions were prepared,after which the extraction rate and contents,transfer rates of magnolflorine,jatrorrhizine,columbamine,epiberberine,coptisine,palmatine,berberin were determined,HPLC characteristic chromatograms were established.RESULTS There were 11 common peaks in the characteristic chromatograms of 18 batches of standard decoctions and 24 batches of formula granules with the similarities of 0.861-1.000,which were clusterd into two categories.The formula granules and standard decoction demonstrated approximated extraction rate and contents,transfer rates of index constituents.CONCLUSION The chemical constituents between formula granules and standard decoction of Coptidis Rhizoma display good consistency,which can provide references for the quality control,process research and clinical application of the former.

Sleep-wake disorder is one of the most common nonmotor symptoms of Parkinson's disease (PD). Melatonin has the potential to improve sleep-wake disorder, but its mechanism of action is still unclear. Our data showed that melatonin only improved the motor and sleep-wake behavior of a zebrafish PD model when melatonin receptor 1 was present. Thus, we explored the underlying mechanisms by applying a rotenone model. After the PD zebrafish model was induced by 10 nmol/L rotenone, the motor and sleep-wake behavior were assessed. In situ hybridization and real-time quantitative PCR were used to detect the expression of melatonin receptors and lipid-metabolism-related genes. In the PD model, we found abnormal lipid metabolism, which was reversed by melatonin. This may be one of the main pathways for improving PD sleep-wake disorder.
Animals ; Zebrafish ; Melatonin/pharmacology* ; Lipid Metabolism/drug effects* ; Disease Models, Animal ; Rotenone/pharmacology* ; Sleep Wake Disorders/metabolism* ; Parkinson Disease/metabolism* ; Motor Activity/drug effects* ; Sleep/drug effects*