ObjectiveTo establish a quality evaluation method for Zhuye Shigao granules（Zhuye Shigaotang） based on fingerprint and determination of index components， and to investigate the therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome. MethodsThe fingerprint of Zhuye Shigao granules was established by high performance liquid chromatography（HPLC）， and the methods for determination of total calcium， orientin， isoorientin， ginsenosides Rg₁， Re and Rb₁ and other 2 index components were established. Fifty ICR mice were randomly divided into the blank group， model group， Zhuye Shigao granules low， medium and high dose groups（9.3， 18.6， 37.2 g·kg^-1·d^-1）， with 10 mice in each group. In addition to the blank group， the model mice with cold-dampness pestilence attacking lung syndrome was prepared by nasal drip of lipopolysaccharide combined with cold-dampness environment. Each administration group was given the corresponding liquid by gavage according to the dose， while the blank group and model group were given the same volume of normal saline by gavage. Then， the body temperature and organ index of mice in each group were measured， hematoxylin-eosin（HE） staining was used to investigate the lung tissue injury of mice in each group， and enzyme-linked immunosorbent assay（ELISA） was used to detect the changes of tumor necrosis factor-α（TNF-α）， interleukin（IL）-lβ， IL-6， IL-10 levels in serum and lung tissue， as well as immunoglobulin（Ig）A and IgM levels in serum. ResultsThe fingerprint similarity of 10 batches of Zhuye Shigao granules was>0.950， and 20 common peaks were calibrated. Seven of them were identified， including peak 11（isoorientin）， peak 12（orientin）， peak 14（apioside liquiritin）， peak 15（liquiritin）， peak 17（apioside isoliquiritin）， peak 19（isoliquiritin） and peak 20（liquiritigenin）. The results of quantitative analysis showed that the content range of each index component in 10 batches of Zhuye Shigao granules was as follows：Total calcium of 9.978-11.294 mg·g^-1， isoorientin of 0.033-0.041 mg·g^-1， orientin of 0.046-0.055 mg·g^-1， ginsenoside Rg₁+ginsenoside Re of 0.748-0.762 mg·g^-1， ginsenoside Rb₁ of 0.151-0.197 mg·g^-1， liquiritin of 1.106-1.366 mg·g^-1， glycyrrhizic acid of 0.904-1.182 mg·g^-1_. Compared with the blank group， the body temperature of mice in the model group was significantly increased， the organ indexes of liver， lung and spleen were significantly decreased， the organ index of thymus was significantly increased， HE staining of lung tissue showed infiltration of inflammatory cells， a small amount of serous exudation was observed in the alveoli， and lung tissue was damaged. After the intervention of Zhuye Shigao granules， the pathological changes were improved compared with the model group. The expression levels of IL-1β， IL-6 and TNF-α were significantly increased， the expression level of IL-10 was significantly decreased in serum and lung tissue. The levels of IgA and IgM in serum were significantly decreased（P<0.01）. Compared with the model group， the body temperature， the organ indexes and immune factor levels in serum and lung tissue of mice in the Zhuye Shigao granules medium and high dose groups were significantly reduced（P<0.05， P<0.01）. ConclusionIn this study， the quality evaluation of Zhuye Shigao granules was carried out based on fingerprint combined with determination of index components， and the fingerprint of four herbs（Lophatheri Herba， Ophiopogonis Radix， Pinelliae Rhizoma and Glycyrrhizae Radix et Rhizoma） in this formula and the determination of 8 index components were established. The therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome may be related to inhibiting inflammatory response and mediating immune regulation.

Objective:To investigate the effects of melatonin(MLT)on hypothalamic-pituitary-adrenal(HPA)axis in posttraumatic stress disorder(PTSD)rats induced by foot shocks.Methods:The rat model of PTSD was prepared by plantar electroshock,and MLT was given by intraperitoneal injection.The behavioral changes of rats were detected by rejection reaction test,the mRNA expression of corticotropin-releasing hormone(CRH)in hypothalamus was detected by real time RT-PCR,and the contents of adrenocorticotropin hormone(ACTH),epinephrine(EPI)and glucocorticoid(GC)in serum were detected by enzyme-linked immunosorbent assay(ELISA).Results:In the PTSD group,the rejection reaction was obvious,the expression of CRH mRNA in hypothalamus was increased(P＜0.05),the serum ACTH and EPI were increased(P＜0.05),but the GC level was decreased(P＜0.05).After MLT treatment,the rejection reaction of PTSD rats was significantly alleviated,CRH mRNA expression in hypothalamus was decreased(P＜0.05),serum ACTH and EPI levels were decreased(P＜0.05),and GC levels were increased(P＜0.05).Conclusion:MLT treatment can relieve the symptoms of PTSD and restore the neuroendocrine balance of HPA axis in rats.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

To investigate the effects of sanguinarine (Sang) combined with cisplatin (Cis) in accelerating the apoptosis of bladder cancer EJ cells, CCK-8 method was used to detect the proliferation of bladder cancer EJ cells treated with different concentrations of Sang with the IC50 values calculated. Annexin V FITC/PI method was used to detect cell apoptosis in the control group, Sang group, Cis group and the combination group. Flow cytometer was used to detect cell cycle arrested. Western blot was used to detect the influence of Bcl-2 expression in the control group, Sang group, Cis group and the combination group. Nude mouse subcutaneous tumor model was constructed to verify that the combination group could accelerate the apoptosis of bladder cancer EJ cells and reduce the side-effects on mice. The safety of the Sang was evaluated by HE staining of vital organs in mice. In vitro, Sang could significantly inhibit the proliferation of EJ cells. Compared with the control group, the number of apoptosis EJ cells in the combination group was significantly increased (P < 0.05), and more cells were arrested in G2/M phase. The expression of Bcl-2 was significantly down-regulated in the combination group (P <0.001). In vivo, compared with the control group, the tumor growth was significantly slower, and a large number of apoptotic cells were inspected (P < 0.05) of the combination group. The side effects of cisplatin were reduced in the combination group. Sang has high biosafety and little side effect. Combined Sang and Cis can increase cell cycle G2/M block, down-regulate Bcl-2 expression, promote cell apoptosis and inhibit tumor growth.

OBJECTIVE:To determine the contents of citric acid in fentanyl citrate raw materials and its injection by ion chro-matography. METHODS:The determination was performed on Thermo Dionex IonPacTM AS11-HC column with mobile phase con-sisted of potassium hydroxide (gradient elution) at the flow rate of 1.0 mL/min. The column temperature was 35 ℃,and sample size was 20 μL. The detector was suppressed conductivity detector. RESULTS:The linear range of citric acid were 0.1157-74.05 μg/mL(r=0.9995). The limit of quantitation was 0.1150 μg/mL,and the limit of detection was 0.0400 μg/mL;RSDs of preci-sion,stability and reproducibility tests were all lower than 2.0%;the average recoveries were 99.6%-101.5%(RSD=0.68%,n=9). CONCLUSIONS:The method is environmentally-friendly and simple with good accuracy and precision,and suitable for the contents determination of citric acid in fentanyl citrate raw materials and injection.

Objective To introduce the concept of health promotion to brucellosis comprehensive prevention and control and then the effect was evaluated.We expect this article could provide scientific basis for prevention and control of brucellosis.Methods The study began in March 2014,a high-incidence district of brucellosis in Dali County was selected.Our study populations were divided to primary target groups and secondary target groups by the extent of exposure to sheep.We implemented general health campaigns,targeted health education,intervention and inducement,promotion of establish leading groups,and released relevant policies and rules for target population.According to the information from the questionnaire survey designed by us,before and after the intervention,the difference between the awareness rate of knowledge on brucellosis control,the health behavior formation rate and the effects of different intervention measures in primary target groups,were compared.The correct diagnostic rate in time (in 3 months),the eligible rate of trained health works,the change of the incidence of brucellosis in human cases,the perfection of the relevant policies on brucellosis control were analyzed,and the effectiveness of comprehensive prevention and control and health promotion strategies were evaluated.Results The disease awareness rate of target audience was 62.49％ (12 695/20 315) after the intervention which was 20.23％ (3 746/18 517) before the intervention.The awareness rate of primary target groups and secondary target groups was increased by 39.69％ [before intervention:33.75％ (1 624/4 812),after intervention:73.44％ (3 569/4 860)] and 43.57％ [before intervention:15.48％ (2 122/13 705),after intervention:59.05％ (9 126/15 455)],respectively.South of Luohe and north of Luohe increased by 37.70％ [before intervention:36.81％ (731/1 986),after intervention:74.51％ (1 453/1 950)] and 35.86％ [before intervention:35.06％ (711/2 028),after intervention:70.92％ (1 366/1 926)] after the intervention.The success rate of prevention and control skill on brucellosis in medical staff was 88.52％ (594/671);the correct diagnostic rate of new cases was 93.73％ (370/383).The proportion of new cases in the selected county in 2014 was 18.26％ (269/1 473) of the whole Shaanxi Province,the ratio decreased compared to that of the previous year.The proportion of new cases in 2015 was 6.14％ (75/1 221).The proportion of new cases in 2016 was 3.48％ (33/948).Conclusions Through the implementation of health promotion,health education and health promotion comprehensive measures,the disease awareness rate in target population has increased substantially.These measures are also able to lead focused population to develop health behavior and to decrease the incidence of brucellosis among people,and to realize the sustainable control of human brucellosis.

Objective To compare the benefits and harms of cervical disc arthroplasty ( CDA) with anterior cervical discectomy and fusion( ACDF) for symptomatic cervical disc disease at mid? to long?term follow?up? Methods Electronic searches were made in PubMed,EMBASE,and the Cochrane Library for randomized controlled trials with at least 48 moths follow?up?Outcomes were reported as relative risk or standardized mean difference?Meta?analysis was carried out using Revman version 5?3 and Stata version 12?0. Results Seven trials were included, involving 2 302 participants?The results of this meta?analysis indicated that CDA brought about fewer secondary surgical procedures,lower neck disability index (NDI) scores,lower neck and arm pain scores,greater SF?36 Physical Component Summary (PCS) and Mental Component Summary( MCS) scores,greater range of motion ( ROM) at the operative level and less superior adjacent?segment degeneration ( P<0?05 ) than ACDF?CDA was not statistically different from ACDF in inferior adjacent?segment degeneration,neurological success,and adverse events (P>0?05)? Conclusions CDA can significantly reduce the rates of secondary surgical procedures compared with ACDF?Meanwhile, CDA is superior or equivalent to ACDF in other aspects?As some studies without double?blind are included and some potential biases exites,more randomized controlled trials with high quality are required to get more reliable conclusions.

Objective To compare the benefits and harms of cervical disc arthroplasty ( CDA) with anterior cervical discectomy and fusion( ACDF) for symptomatic cervical disc disease at mid? to long?term follow?up? Methods Electronic searches were made in PubMed,EMBASE,and the Cochrane Library for randomized controlled trials with at least 48 moths follow?up?Outcomes were reported as relative risk or standardized mean difference?Meta?analysis was carried out using Revman version 5?3 and Stata version 12?0. Results Seven trials were included, involving 2 302 participants?The results of this meta?analysis indicated that CDA brought about fewer secondary surgical procedures,lower neck disability index (NDI) scores,lower neck and arm pain scores,greater SF?36 Physical Component Summary (PCS) and Mental Component Summary( MCS) scores,greater range of motion ( ROM) at the operative level and less superior adjacent?segment degeneration ( P<0?05 ) than ACDF?CDA was not statistically different from ACDF in inferior adjacent?segment degeneration,neurological success,and adverse events (P>0?05)? Conclusions CDA can significantly reduce the rates of secondary surgical procedures compared with ACDF?Meanwhile, CDA is superior or equivalent to ACDF in other aspects?As some studies without double?blind are included and some potential biases exites,more randomized controlled trials with high quality are required to get more reliable conclusions.

Objective To explore the prevalence of health literacy in China in 2011-2013.Methods The eligible studies were identified by searching China National Knowledge Infrastructure (CNKI),Chinese BioMedical Literature Database (CBM),VIP Database for Chinese Technical Periodicals (VIP),Wanfang database,PubMed and Embase.The Meta-analysis was applied with Stata 12.0 software.Subgroup analysis and sensitivity analysis were performed to test the robust of the results.Results A total of 28 studies,including 53 308 residents,were finally included in the review.Meta-analysis revealed the prevalence of health literacy in China to be 16％ (95％CI 15％-16％),and the prevalence of health concepts and knowledge was 25％ (95％CI 25％-26％),and healthy lifestyles and behaviors was 13％ (95％CI 12％-14％),and health skills was 32％ (95％CI 31％-32％).Conclusions The health literacy levels of residents showed a rising trend.There were differences between rural and urban health literacy levels and different regions.Rural residents' health literacy level increased more significantly than that of the city.Due to limited kinds of methods,more scientific and effective methods were needed to evaluate the health literacy.