1.The implementation situations, opportunities, and challenges of China’s integrated elderly care and medical services model and comprehensive care for the elderly
Chinese Medical Ethics 2025;38(3):289-295
China’s integrated elderly care and medical services model is mainly reflected in the close cooperation between medical institutions and pension institutions, providing comprehensive care services for the elderly, and has been promoted nationwide. However, this model still faces challenges, such as uneven resource distribution, inconsistent service standards, and a lack of talent. As the aging process of the population deepens continuously, the demand for integrated elderly care and medical services has increased, and relevant policies issued by the government and social concerns have brought development opportunities for this model. Scientific and technological advancements will also promote the development of integrated elderly care and medical services towards intelligence and personalization. It is expected that continuous investment in policies, capital, technology, and other aspects will be made to promote the standardization, specialization, and popularization of services to meet the needs of the elderly and improve their quality of life. The joint efforts of all sectors of society are also needed to continuously innovate service models and improve service levels, to effectively address the challenges brought by an aging society.
2.Effects and mechanism of total alkaloids of Corydalis Rhizoma on the regulation of cuproptosis in rats with diabetic cardiomyopathy
Jun LI ; Yazhi QI ; Ya TANG ; Rui CAO ; Qiang XU ; Yusheng HAN
China Pharmacy 2025;36(7):801-806
OBJECTIVE To investigate the effects and mechanism of total alkaloids of Corydalis Rhizoma (TAC) on the regulation of cuproptosis in rats with diabetic cardiomyopathy (DCM) based on silence information regulator 1(Sirt1)/tumor protein 53(P53)signaling pathway. METHODS DCM rat model was induced by high-fat and high-sugar diet and intraperitoneal injection of streptozotocin. Thirty-two model rats were randomly divided into model group, TAC low-dose, medium-dose and high-dose groups (7, 10.5, 14 mg/kg), with 8 rats in each group. An additional 8 rats were assigned to normal control group. Related drugs or normal saline were administered intragastrically in each group, once a day, for 4 weeks. After the last medication, the fasting blood glucose (FBG) levels of the rats were measured. The levels of myocardial creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and lactate dehydrogenase (LDH) in serum and myocardial tissue of rats were all detected. The pathological morphology, fibrosis degree, and Cu2+ deposition of myocardial tissue in rats were observed. The levels of Cu2+ and glutathione (GSH) in myocardial tissue, the expressions of Sirt1/P53 signaling pathway-related proteins [Sirt1, P53, solute carrier family 7 membrane 11 (SLC7A11)], and iron-sulfur cluster-related proteins [ferredoxin 1 (FDX1), lipoic acid synthetase (LIAS), aconitase 2 (ACO2), NADH-ubiquinone oxidoreductase core subunit S8 (NDUFS8), dihydrolipoamide acetyltransferase (DLAT), dihydrolipoamide succinyltransferase (DLST)], and heat shock protein 70 (HSP70) were all determined. RESULTS Compared with normal control group, the model group exhibited significantly elevated levels of FBG, CK, CK-MB and LDH in both serum and myocardial tissue, as well as increased 2+ levels of Cu in myocardial tissue and the expression of P53 and HSP70 proteins (P<0.05); the level of GSH and the expression levels of Sirt1, SLC7A11, FDX1, LIAS, ACO2, NDUFS8, DLAT, and DLST proteins in myocardial tissue were all significantly decreased (P<0.05); the myocardial tissue exhibited severe pathological damage, with numerous inflammatory cell infiltrations and significant fibrosis, as well as increased deposition of Cu2+. Compared with model group, most of the above quantitative indicators in rats were significantly reversed in TAC groups (P<0.05); the pathological damage to the myocardial tissue was alleviated, with reduced fibrosis and Cu2+ deposition. CONCLUSIONS TAC can ameliorate DCM in rats, and its mechanism of action may be related to activating the activity of the Sirt1/P53 signaling pathway, promoting the chelation of GSH with Cu2+, and inhibiting cuproptosis of cardiomyocyte.
3.Therapeutic effect of Jiangya Yishen granules combined amlodipine on elderly essential hypertension and its impact on serum levels of HbA1c and renalase protein
Can LIU ; Ya-Wei CAO ; Shu-Xia ZHANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2024;33(1):50-55
Objective:To investigate the therapeutic effect of Jiangya Yishen granules(JYG)combined with amlodip-ine on elderly patients with essential hypertension(EH)and its impact on serum levels of glycosylated hemoglobin(HbA1c)and renalase protein.Methods:A total of 125 elderly EH patients treated in our hospital were selected.According to random number table,they were divided into amlodipine group(n=40),JYG group(n=40)and combined treatment group(n=45,received amlodipine combined with JYG).Each group received corresponding treatment for eight weeks.Therapeutic effect,antihypertensive effect,serum levels of renalase protein and HbA1c were compared among three groups before and after treatment.Results:Total effective rate of combined treatment group was significantly higher than those of amlodipine group and JYG group(88.9%vs.65.0%vs.70.0%),P<0.05 or<0.01;compared with amlodipine group and JYG group after treatment,there were significant improve-ments in blood pressure variability indexes(P<0.05 or<0.01),significant rise in renalase protein level[(1380.17 ±120.13)pg/ml vs.(1480.17±110.93)pg/ml vs.(1845.43±112.38)pg/ml],and significant reduction in HbA1c level[(5.92±0.35)%vs.(5.83±0.36)%vs.(5.31±0.35)%]in combined treatment group,P=0.001 all.Conclusion:Jiangya Yishen granules combined with amlodipine can strengthen antihypertensive effect,reduce HbA1c level and increase renalase protein level in elderly patients with essential hypertension,which can benefit the patients.
4.Simultaneous GC-MS determination of sixteen pesticide residues and safety assessment for Lycii Fructus
Jia-Qi QIN ; Qiang-Qiang QI ; Ya-Jun ZHANG ; Yan WANG ; Si-Yuan ZHAO ; De-Yan CAO ; Mei-Lin ZHU
Chinese Traditional Patent Medicine 2024;46(1):143-149
AIM To establish a GC-MS method for the simultaneous content determination of sixteen pesticide residues in Lycii Fructus and perform safety assessment.METHODS The analysis was performed on DB-5MS chromatographic column(30 m×0.25 mm,0.25 μm)subjected to the programmed heating,with splitless injection of 1.0 μL dissolved sample at a flowing rate of 1.0 mL/min.Other parameters were as follows:injection port temperature of 250℃,electron impact ionization(EI),electron energy of 70 eV;ion source temperature of 230℃,multi-reaction monitoring mode,and collision gas.of high-purity N2.Pesticide residues with relatively high dietary risk were analyzed and discussed with regard to residue levels,dietary intake risk,risk ranking and cumulative exposure assessment.RESULTS Sixteen pesticides showed good linear relationships within their own ranges(r≥0.994 4),whose average recoveries were 70%-114%,with the RSDs of less than 2%.The highest average cyfluthrin residue of 0.999 2 mg/kg in Lycii Fructus of production regions and the highest average cypermethrin residue of 0.088 4 mg/kg in Lycii Fructus commodities were both detected.In Lycii Fructus of production regions with chronic hazard index(HI)value of 0.012 9 and acute HI value of 0.065 5 and their commodities with chronic HI of 0.001 2 and acute HI of 0.005 4,the pesticide residue of cypermethrin was the leading cause of chronic and acute dietary risk,and additionally,pyridaben within maximum residue limit(MRL)was the only detectectable highly toxic pesticide among the other most concerning pestcides of deltamethrin,pyridaben,chlorpyrifos,dichlorvos and methidathion.CONCLUSION There exist pesticide residues within MRL values in some samples of Lycii Fructus and the use of cypermethrin should be well-controlled.
5.TSHR Variant Screening and Phenotype Analysis in 367 Chinese Patients With Congenital Hypothyroidism
Hai-Yang ZHANG ; Feng-Yao WU ; Xue-Song LI ; Ping-Hui TU ; Cao-Xu ZHANG ; Rui-Meng YANG ; Ren-Jie CUI ; Chen-Yang WU ; Ya FANG ; Liu YANG ; Huai-Dong SONG ; Shuang-Xia ZHAO
Annals of Laboratory Medicine 2024;44(4):343-353
Background:
Genetic defects in the human thyroid-stimulating hormone (TSH) receptor (TSHR) gene can cause congenital hypothyroidism (CH). However, the biological functions and comprehensive genotype–phenotype relationships for most TSHR variants associated with CH remain unexplored. We aimed to identify TSHR variants in Chinese patients with CH, analyze the functions of the variants, and explore the relationships between TSHR genotypes and clinical phenotypes.
Methods:
In total, 367 patients with CH were recruited for TSHR variant screening using whole-exome sequencing. The effects of the variants were evaluated by in-silico programs such as SIFT and polyphen2. Furthermore, these variants were transfected into 293T cells to detect their Gs/cyclic AMP and Gq/11 signaling activity.
Results:
Among the 367 patients with CH, 17 TSHR variants, including three novel variants, were identified in 45 patients, and 18 patients carried biallelic TSHR variants. In vitro experiments showed that 10 variants were associated with Gs/cyclic AMP and Gq/11 signaling pathway impairment to varying degrees. Patients with TSHR biallelic variants had lower serum TSH levels and higher free triiodothyronine and thyroxine levels at diagnosis than those with DUOX2 biallelic variants.
Conclusions
We found a high frequency of TSHR variants in Chinese patients with CH (12.3%), and 4.9% of cases were caused by TSHR biallelic variants. Ten variants were identified as loss-of-function variants. The data suggest that the clinical phenotype of CH patients caused by TSHR biallelic variants is relatively mild. Our study expands the TSHR variant spectrum and provides further evidence for the elucidation of the genetic etiology of CH.
6.Effect of amygdalin on fracture healing in osteoporosis rats
Wen-Juan WANG ; Hai-Ming WANG ; Sheng-Jun WANG ; Ya-Chao HUANG ; Jian CAO
The Chinese Journal of Clinical Pharmacology 2024;40(8):1198-1202
Objective To investigate the effect of amygdalin(AD)on fracture healing in osteoporotic(OP)rats and its possible mechanism.Methods SD rats were randomly divided into sham group,model group,inhibitor group and low,medium,high dose experimental groups,12 rats in each group.The OP rat model was established by bilateral ovariectomy.After the model was successfully established,rats in low,medium and high dose experimental groups were intraperitoneally injected with 0.1,0.5 and 1.0 mg·kg-1 AD;the inhibitor group was intraperitoneally injected with 5.0 mg·kg-1 H-89[cyclic adenosine monophosphate/protein kinase A/cyclic adenosine monophosphate response element binding protein(cAMP/PKA/CREB)pathway inhibitor]+1.0 mg·kg-1 AD;sham group and model group were intraperitoneally injected with the same amount of 0.9%NaCl,once a day for 90 days.Micro-computer tomography was applied to observe the microstructure of the epiphysis in rats;the biomechanical status of femur was evaluated by orthopedic biomechanical test;the contents of serum osteocalcin(OC),C-terminal telopeptides of type Ⅰ collagen(CTX-Ⅰ),bone morphogenetic protein 2(BMP-2)and cAMP were detected by enzyme-linked immunosorbent assay(ELISA);the level of oxidative stress products in rat serum was detected by kit;Western blot was used to detect the expression of alkaline phosphatase(ALP)and cAMP/PKA/CREB signaling pathway protein(p-PKA/PKA,p-CREB/CREB)in rat bone tissue.Results The bone mineral density of sham group,model group and low,medium,high dose experimental groups,inhibitor group were(251.54±15.41),(135.82±10.92),(173.57±12.65),(204.31±14.48),(235.62±11.37)and(187.83±13.64)mg·cm-3;the contents of cAMP were(0.85±0.06),(0.20±0.03),(0.34±0.07),(0.48±0.09),(0.81±0.12)and(0.57±0.06)μmol·L-1;the expression of p-PKA/PKA were 0.96±0.08,0.06±0.02,0.35±0.04,0.67±0.07,0.94±0.09 and 0.37±0.05;p-CREB/CREB protein were 0.92±0.12,0.04±0.01,0.28±0.03,0.59±0.06,0.91±0.10 and 0.29±0.04,respectively.There were significant differences in the above indexes between sham group and model group,between low,medium,high dose experimental groups and model group,between inhibitor group and high dose experimental group(all P<0.05).Conclusion AD can reduce oxidative stress,promote fracture healing and alleviate OP symptoms in rats.The mechanism may be related to the activation of cAMP/PKA/CREB signaling pathway.
7.Effects of circular RNA_0054633 on hydrogen peroxide-induced oxidative damage in myocardial cells
Yan-Wei WANG ; Bian-Wen WU ; Lei CAO ; Jie MA ; Ya-Li FENG
The Chinese Journal of Clinical Pharmacology 2024;40(11):1560-1564
Objective To investigate whether circular RNA(circRNA)circ_0054633 targets microRNA-375(miR-375)to regulate the oxidative damage of cardiomyocytes induced by hydrogen peroxide(H2O2).Methods H9C2 cardiomyocytes were divided into control group(normal culture without any treatment),hydrogen peroxide(H2 O2)group(150 μmol·L-1 H2 O2 treated cardiomyocytes for 6 h),H2O2+si-NC group,H2O2+si-circ_0054633 group,H2O2+miR-NC group,H2O2+miR-375 group,H2O2+si-circ_0054633+anti-miR-NC group,H2O2+si-circ_0054633+anti-miR-375 group(cardiomyocytes were transfected with si-NC,si-circ_0054633,miR-NC,miR-375 mimics,si-circ_0054633+anti-miR-NC,si-circ_0054633+anti-miR-375,respectively;24 h after transfection,cardiomyocytes were treated with 150 μmol·L-1 H2O for 6 h).Real-time fluorescence quantitative polymerase chain reaction was used to determine the expression of miR-375,the content of malondialdehyde(MDA)and the activity of superoxide dismutase(SOD)were determined by kit,apoptosis was determined by flow cytometry.Results The expression levels of miR-375 in cardiomyocytes of control group,H2O2 group,H2O2+si-NC group,H2O2+si-circ_0054633 group,H2O2+miR-NC group,H2O2+si-circ_0054633+anti-miR-NC group,H2O2+si-circ_0054633+anti-miR-375 group were 1.00±0.00,0.42±0.05,0.40±0.06,0.69±0.08,1.00±0.00,3.41±0.28,1.00±0.00 and 0.26±0.02,respectively;MDA contents were(3.19±0.32),(13.46±1.27),(15.39±1.04),(5.26±0.51),(16.05±1.36),(9.18±0.85),(4.89±0.44)and(10.05±0.92)nmol·L-1,respectively;SOD activities were(64.69±5.81),(18.23±1.33),(17.07±1.41),(55.74±5.13),(17.12±1.64),(47.66±4.59),(56.77±4.71)and(27.95±2.47)U·mL-1,respectively;the apoptosis rates were(6.21±0.59)%,(29.22±2.19)%,(30.94±2.85)%,(10.05±0.92)%,(31.14±2.83)%,(13.74±1.24)%,(10.39±0.88)%and(21.31±1.92)%,respectively.The above indexes of H2O2 group were compared with the control group,the above indexes of H2O2+si-circ_0054633 group was compared with the H2O2+si-NC group,the above indexes of H2O2+miR-375 group was compared with the H2O2+miR-NC group,the above indexes of H2O2+si-circ_0054633+anti-miR-375 group were compared with H2O2+si-circ_0054633+anti-miR-NC group,the differences were statistically significant(all P<0.05).Conclusion Interfering with the expression of circ_0054633 can reduce the oxidative stress and apoptosis of cardiomyocytes induced by hydrogen peroxide by targeting miR-375,thereby protecting cardiomyocytes from oxidative damage.
8.Association of frailty index with the risk for cardiovascular disease in adults
Chunfa ZHANG ; Lehui LI ; Nan ZHANG ; Ning CAO ; Lei XU ; Jinli YAN ; Ya WANG ; Xinyue ZHAO ; Yuxin YANG ; Tao YAN ; Xingguang ZHANG
Chinese Journal of Epidemiology 2024;45(11):1520-1527
Objective:To explore the association between frailty index (FI) and the risk for cardiovascular disease (CVD) in adults in Inner Mongolia Autonomous Region, and provide new evidence for the prevention of CVD in adults in Inner Mongolia Autonomous Region.Methods:The FI was constructed by using the data from a prospective cohort with a sample size of 25 055 individuals in 6 years of follow-up, and the prevalence of frailty in adults in Inner Mongolia Autonomous Region was described by the FI, and Cox proportional hazard regression model was used to evaluate the association between the FI and the incidence of CVD in adults in Inner Mongolia Autonomous Region.Results:The FI of the study population was 0.24±0.09. The population in the pre-frail (FI: 0.21-0.27) and frail (FI≥0.28) phases had increased risk for CVD compared to non-frail (FI≤0.20) population [pre-frail: hazard ratio ( HR)=1.232, 95% CI: 1.127-1.347; frail phase: HR=1.418, 95% CI:1.299-1.548]. For every 0.10 increase in FI, the risk for cardiovascular disease increased by 20.3% ( HR=1.203,95% CI:1.156-1.252). Conclusions:In this study, we constructed a FI, which can suggest the risk for CVD. As the increase of frailty degree, the risk for CVD increases.
9.Synthesis and activity evaluation of 6-azazindole derivatives for pancreatic cancer therapy
Yang CAO ; Qian LI ; Ya-ling WANG ; Wen-hui CUI ; Chen-liang QIAN ; Xin-xin SI
Acta Pharmaceutica Sinica 2024;59(10):2828-2835
Fragment with some anti-pancreatic cancer activity was identified by screening our internal chemical library. Eighteen compounds in 4 classes were synthesized by systematic modification and their anti-pancreatic cancer activity were evaluated. Ⅱ-1 (IC50 = 6.40 ± 0.34 μmol·L-1) and Ⅱ-2 (IC50 = 7.15 ± 0.51 μmol·L-1) exhibited outstanding activity. Subsequently, the anti-migration ability and invasion ability of Ⅱ-1 was evaluated by wound healing assay and invasion assay, Ⅱ-1 exhibited good anti-migration ability and outstanding anti-invasion ability. Using molecular docking technology and molecular dynamics simulation technology, the potential target was locked on bispecific tyrosine phosphorylation regulates kinase 1A (DYRK1A). By enzyme activity testing, the inhibitory capacity of Ⅱ-1 and Ⅱ-2 was 48% and 32%, respectively.
10.Printing Process Quality Control of Bioprinting Medical Devices
Neng XIE ; Qixin CAO ; Jinwu WANG ; Yuanjing XU ; Changru ZHANG ; Ya WANG ; Zitong WANG
Chinese Journal of Medical Instrumentation 2024;48(3):245-250
Objective This study analyzes the risk points in the quality control of bioink and the main processes of bioprinting,clarifies and explores the quality control and supervision model for bioprinting medical devices,and provides theoretical and practical guidance to ensure the safety and effectiveness of bioprinting medical devices.Methods The quality control risk points throughout the bioprinting process were comprehensively analyzed,with a particular focus on bioprinting materials and key processes.The regulatory model and methods for bioprinting medical devices were examined.This research concentrated on critical technologies such as extrusion,laser-assisted,and in situ bioprinting,assessing their potential for clinical applications and regulatory challenges.Results Bioink from different sources should meet regulatory requirements.It is essential to ensure aseptic handling of raw materials and to validate sterilization under"worst-case"conditions.Conclusion As bioprinting technology advances rapidly,corresponding research into materials,processes,and quality risk control should be conducted to ensure the concurrent development of the regulatory system.This will continuously contribute to the orderly progression of the entire industry and human health.

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