"Omics" and bioinformatics have brought new ideas to the study of traditional Chinese medicine. This study used metabonomics and network pharmacology to investigate the pharmacodynamic basis and regulation of Qishen Yiqi dropping pill (QDP) improving cardiac energy metabolism in rats with heart failure (HF). ¹H NMR metabonomics analysis showed that eight metabolites, including carnitine, glutamine, creatine, proline, homocitrulline, lactic acid, taurine and alanine appeared significant callback after QDP treatment for HF. The results indicate that QDP regulates the metabolism of carbohydrate, lipid, ATP and protein. The animal experiment was conducted in accordance with the regulations of the Ethics Committee for Experimental Animal Management and Animal Welfare of Institute of Materia Medica, Chinese Academy of Medical Sciences. A "drug-component-target-disease" network was established using network pharmacology, and the "component-target" sub-network related to the above energy metabolism processes was extracted by combining metabonomics results. Results revealed 79 chemical compounds and 47 potential targets of QDP involved in the regulation of energy metabolism, and identified key chemical components including ursolic acid, notoginsenoside G, ginsenoside-Rh1, and core targets such as INS, PPARG, and AKT1. The results also demonstrated the complex multi-target and multi-component relationship between QDP and HF from the perspective of energy metabolism. The molecular docking technique verified a strong interaction between some targets and chemical compounds, with affinities less than -5 kcal·mol^-1. The results of this study provide useful information for the clinical application, development, and utilization of QDP.

Objectives:To systematically analyze the framework and contents of World Health Organization (WHO) policy and action strategies on rehabilitation using the theory of WHO health service components, to explore the theoretical bases, methodology, framework and core elements of WHO's international rehabilitation policy. Methods:WHO has launched rehabilitation-related policy documents, mainly including Rehabilitation in Health Systems, Rehabilitation in Health Systems: Guide for Action, Rehabilitation Indicator Menu: a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation (FRAME), Template for Rehabilitation Information Collection (TRIC): a tool accompanying the Systematic Assessment of Rehabilitation Situation (STARS), and established systems of international rehabilitation policy architecture system. Using content analysis, this study analyzed in detail the theoretical basis and methodology of international rehabilitation policy, the policy framework, and the core elements of the action strategy and priority areas of rehabilitation service development in perspective of WHO six building blocks of health system, namely leadership and governance, financing, human resources for health, service delivery, medical technology, and health information systems. Results:WHO rehabilitation policy is developed based on WHO's theories of person-centered health services, social determinants of health, and functioning, disability and health of International Classification of Functioning, Disability and Health. WHO rehabilitation policy recognized that the development of rehabilitation was an important pathway achieving United Nations 2030 Sustainable Development Goals 3, ensure healthy lives and promote well-being for all at all ages, i.e. Unlversal Health Coverage. This paper systematically analyzed WHO's international policy framework, action strategies, and development areas, content and priorities in six major areas: leadership and governance, financing, human resources for health, service delivery, medicine and technology, and health information systems. WHO rehabilitation policies advocates to develop national rehabilitation plans, to establish and improve rehabilitation leaderships and the development of mechanism and capacity of rehabilitation governance, to develop multiple approaches of rehabilitation financing, to integrate rehabilitation into health service system, provides different levels of rehabilitation services in the health service continuum, and to build networks of service delivery, to train professionals, to foster rehabilitation information system within health system, to enhance service quality and service coverage, to focus on key areas and priority programs to meet the diverse needs of different populations, and achieve universal health coverage; to include assistive technology into the rehabilitation service system as a field of medicine and technology; and to collect information on functioning and rehabilitation needs, outcomes and impacts of rehabilitation services in the health information system, and conduct evidence-based researches on rehabilitation systems. Conclusion:The framework and contents of WHO's international rehabilitation policies have systematically reviewed at the macro, meso, and micro levels with the perspective of WHO six building blocks of the health system. The goal of rehabilitation development is to achieve universal rehabilitation coverage. The conceptual theories of rehabilitation are based on the theories of people-centered health services and social determinants of health. Rehabilitation is an important initiative to achieve the United Nations 2030 Sustainable Development Goals. The international rehabilitation health policy system is built on six major areas of rehabilitation: leadership and governance, rehabilitation financing, rehabilitation human resources, rehabilitation service delivery, rehabilitation-related medicine and technology, and rehabilitation and health information system. The policy and action strategies for rehabilitation development, as well as specific implementation paths and methods, at macro, meso and micro levels: theory and policy, policy action, and implementation methods and tools have been reviewed and discussed. The implementation of the WHO rehabilitation policies advocates to take the following actions: strengthening the leadership, governance, planning and coordination capacity of rehabilitation services; constructing a reasonable rehabilitation financing mechanism and raising necessary funds for rehabilitation; improving the training and guarantee mechanism of rehabilitation human resources; enhancing the professional capacity of rehabilitation personnel, improving the capacity of rehabilitation service delivery and improving service quality; improving the quality and accessibility of assistive products and assistive technology services; establishing health information system covering functioning, disability and rehabilitation, and conducting scientific researches on rehabilitation.

Studies have found that metformin is not only the preferred drug for lowering blood sugar, but also shows lipid-lowering and weight-loss effects. The purpose of this study was to use a hyperlipidemia hamster model to investigate the lipid-lowering effect of metformin and its effect on important metabolic pathways in lipid metabolism disorders. Fifty golden hamsters were divided into a control group, a model group, metformin high- and low-dose groups, and a simvastatin group. A high-fat diet was fed for 1 week to create the model, and then drug was administered for 11 weeks with the high-fat diet. Serum was taken for measurement of blood lipid and blood glucose at 2, 6, and 9 weeks after administration, and at weeks 3, 5, and 9 feces and urine were collected for ¹H NMR metabolomics tests. After 11 weeks of intravenous injection of [U-¹³C₆] glucose, serum was collected for a ¹³C NMR metabolic flux test. The results showed that the administration of metformin can significantly reduce blood lipids and glucose levels and can significantly affect metabolic pathways such as sugar metabolism, lipid metabolism, ketone metabolism, amino acid metabolism, and intestinal flora metabolism. The results of the metabolic flux analysis showed that the high-fat diet reduced the metabolism of tricarboxylic acids by 37.48%. After administration of low and high doses of metformin the metabolism of tricarboxylic acid increased by 98.14% and 143.10%, respectively. After administration of simvastatin tricarboxylic acid metabolism increased by 33.18%. The results indicate that metformin has a significant effect on promoting energy metabolism. This study used a combination of metabolomics and metabolic flow to explore the effect of metformin on lipid metabolism disorders and quantifies changes in the key pathway of energy metabolism-the tricarboxylic acid cycle. This study provides useful information for the study of the efficacy and mechanism of metformin, as well as a practical technical method for the screening of lipid-lowering drugs based on a hamster model.

Heart failure is the end stage of many cardiovascular diseases. It seriously affects the safety and quality of life of nearly 40 million people worldwide. At present, the clinical and pathophysiological characteristics of some types of heart failure are unknown, and there is no effective diagnosis and treatment. In recent years, genomics, transcriptomics, epigenomics, proteomics, metabolomics and other omics technologies have been widely used in disease research, providing new opportunities for the prevention, diagnosis and treatment of diseases. These strategies have also brought hope for the reduction in heart failure mortality. Based on the current status of clinical treatment of heart failure, this article reviews the roles and potential applications of these various omics technologies and their opportunities in the study of the pathogenesis of heart failure, clinical diagnosis and treatment, and related drug pharmacodynamics and mechanism of action.

Glioma is the most common primary intracranial tumor, among which glioblastoma (GBM) is the most malignant subtype. Because of its high heterogeneity and invasiveness, GBM can't be completely removed by surgical resection and is also resistance to chemotherapy and radiotherapy. Even after a standard therapy, the median survival time is only 14.6 months, the five-year survival rate is less than 10%, and the relapse of GBM is common. Immunotherapy, a new treatment paradigm, treats cancer through regulating the autologous immune system and the tumor microenvironment. As a promising method to improve the prognosis of GBM, immunotherapy has attracted more and more attention. This paper gives a review to the difficulty, the mainly existing strategies and the bottlenecks in GBM immunotherapy, aiming at providing new direction to improve the prognosis of GBM patients.

Objective: To analyze the clinical effect of traditionaldog-days acupoint application and Magic Acupuncture Patch (Manji) in the prevention and treatment of chronic bronchitis (CB) in remission stage in the past five years, and explore the principle of action and effective stimulation, to provide the evidence for treating CB by acupoint application. Methods: A retrospective study was conducted on 405 patients with CB who met the inclusion criteria. All patients were treated with dog-days acupoint application or Magic Acupuncture Patch between 2013 and 2017. The clinical data of 405 patients were statistically analyzed to compare the prevention and treatment effects of dog-days acupoint application and Magic Acupuncture Patch, and different degrees of stimulation of dog-days acupoint application. Results: Among the dog-days acupoint application groups, the total effective rate was 63.6％ in the light stimulation group, 93.1％ in the moderate stimulation group, and 94.8％ in the strong stimulation group. The differences in the total effective rate between the light stimulation group and the moderate stimulation group, as well as the strong stimulation group, were statistically significant (both P<0.05). There was no significant difference in the total effective rate between the moderate stimulation group and the strong stimulation group (P>0.05). The total effective rate was 83.9％ in the dog-days acupoint application group, versus 45.4％ in the Magic Acupuncture Patch group, and there was a statistically significant difference between the two groups (P<0.05). Conclusion: The efficacy of dog-days acupoint application in the prevention and treatment of CB is better than that of Magic Acupuncture Patch; the degree of stimulation is the basis for the effect of dog-days acupoint application on prevention and treatment of CB, and the moderate and strong stimulations are more appropriate.

The aim of this study is to apply 3D printing technology to hospital drug dosing operations, and explore its feasibility and scalability. Drugs often dosed in hospitals are selected as models. The commercially available drug was ground into powder, diluted with medicinal excipients and then mixed with 75% ethanol and binder to prepare a paste for 3D printing. The dose and physicochemical properties of divided tablets were controlled by setting print parameters and printing models in computer software. Different 3D printers were employed to evaluate the impact of the device on the dosing tablet. Two drugs were dosed in this study to explore the scalability of 3D printing technology between different drugs. The drug content of the three divided dose tablets (warfarin sodium 1 mg, 2 mg, hydrochlorothiazide 5 mg) was 1.02±0.03, 1.96±0.01, 5.19±0.06 mg. The content uniformity was 1.0, 5.3, 2.6, respectively. The drug dissolution rate was (99.3±1.2)%, (101.5±0.3)%, (98.1±0.8)% in 45, 45 and 30 min. The mechanical properties of the three sub-doses and the stability within 30 days were in line with the Chinese Pharmacopoeia (2015) requirements. At the same time, it was found that the printing parameters and prescriptions can affect the properties of the divided dose tablets. By controlling the dilution ratio of commercial drug and printing parameters, the drug release rate can be customized to achieve individualized treatment. Both different modes of 3D printers can produce qualified sub-doses, and 3D print dispensing technology was also versatile between the two drugs. 3D printing can prepare small-volume, high-precision, high-repetition dosing tablets, with all properties in compliance with pharmacopoeia regulations. Thus, this method can be used as a new and scalable sub-dosing method.

Objective:To analyze the effect of different glucocorticoid administration routes in the treatment of children's secretory otitis media and impacts on immunologic function.Methods:Clinical data of children with secretory otitis media received treatment at our hospital from January 2016 to June 2016 were analyzed.Patients were divided into two groups by different glucocorticoid administration routes,Group A:intratympanic injection;Group B:oral administration.After one week,clinical effects and immunologic functions were tested and compared between the two groups.Results:A total of 87 patients were analyzed,Group A 45 cases,Group B 42 cases.After one week treatment,both of the two groups got significantly improved in audiology indexe (P<0.05),however,these index were more better in Group A when compared with those of Group B(P<0.05).Meanwhile,Group A patients got higher cure rate than that of Group B (91.1%,41/45 vs 73.8%,31/42;X2=4.558,P=0.033).Both of the two groups got significantly improved in CD3+T,CD4+T and CD4/CD8 (P<0.05) and decreased in CD8,IL-4,IFN-γ and IL-4/IFN-γ(P<0.05),but these markers changed more significant in Group A (P<0.05).Group A patients had a lower recurrence rate than Group B patients one year after treatment, the difference was statistically significant (9.76%,4/41 vs 29.03%,9/31;Log-rank X2=4.698,P=0.030).Conclusion:The treatment of children's secretory otitis media,the intratympanic injection of glucocorticoid shows a better effect than that of oral cortico-steroids.

Objective To observe the effect of the intensive training of core stabilization on the general function of patients with femoral neck fractures in old patients after hip arthroplasty. Methods From January, 2011 to December, 2012, 60 old patients accepted hip arthroplas-ty for femoral neck fractures were randomly divided into control group (n=30) and observation group (n=30). The control group received routine rehabilitation training 50 minutes each time, and the observation group received intensive training of core muscles 20 minutes each time based on the routine rehabilitation training 30 minutes each time, twice a day, five days a week for two weeks. Both groups were evalu-ated with Harris Hip Score (HHS), Charnley Hip Score (CHS) and modified Barthel Index (MBI) before training and one week, two weeks and three months after training. Results There was no significant difference in the scores of HHS, CHS and MBI before and one week after training (P>0.05). All the scores increased with time in both groups (F>248.165, P<0.001). The scores of HHS, CHS and MBI were signifi-cantly higher in the observation group than in the control group two weeks and three months after training (t>3.211, P<0.001). Conclusion Early intensive training of core stabilization may facilitate to recover hip function and activity of daily living in old patients after hip arthro-plasty.

BACKGROUNDBloodstream infections (BSIs) remain a major cause of morbidity and mortality in patients undergoing surgery. This study aimed at elucidating the clinical characteristics of community-acquired BSIs (CABs) and nosocomial BSIs (nBSIs) in patients admitted to the surgical wards of a teaching hospital in Beijing, China.

METHODSThis cross-sectional study compared 191 episodes of BSIs in 4074 patients admitted to the surgical wards between January 2008 and December 2011. Cases of BSIs were classified as CABs or nBSIs, and the characteristics, relevant treatments, and outcomes of CABs and nBSIs were compared.

RESULTSOf the 191 BSIs, 52 (27.2%) and 139 (72.8%) were CABs and nBSIs, respectively. Escherichia coli, coagulasenegative staphylococci, and Klebsiella spp, were the most frequently isolated microorganisms. There were significant differences between CABs and nBSIs with respect to the use of hormonal drugs, ventilation, acute physiology and chronic health evaluation (APACHE) II and American Society of Anesthesiologists scores, and prevalence of cancer (P < 0.05). Empirical antibacterial therapy did not decrease the crude mortality, but multivariate analysis showed that high APACHE II was independently associated with a risk of mortality (odds ratio = 0.97, 95% confidence interval: 0.93-1.02 for APACHE II).

CONCLUSIONSWe found significant differences in the clinical characteristics of surgical patients with CABs and nBSIs. The outcome of patients seems to be related to high APACHE II scores.

Anti-Bacterial Agents ; Bacteremia ; epidemiology ; China ; Community-Acquired Infections ; epidemiology ; microbiology ; Cross Infection ; epidemiology ; microbiology ; Cross-Sectional Studies ; Escherichia coli ; pathogenicity ; Female ; General Surgery ; statistics & numerical data ; Hospitals ; Humans ; Male ; Staphylococcus ; pathogenicity