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There is a bidirectional relationship between intestinal flora and bile acids,and the imbalance of intestinal flora-bile acid axis metabolism is closely related to hypertension.Based on classical TCM literature and clinical practice,this article found that"earth deficiency"is the important pathological basis of hypertension,"wood depression"is the initiating factor of hypertension,and"earth deficiency and wood depression"is the key pathogenesis of hypertension.Combined with the research results of modern medicine and molecular biology,it is considered that the imbalance of intestinal flora and abnormal bile acid metabolism are closely related to the"earth deficiency"and"wood depression"of TCM respectively,and the imbalance of intestinal flora-bile acid axis coincides with the"earth deficiency and wood depression"of TCM in the process of hypertension.It is of great theoretical and practical significance to explore the biological connotation of hypertension"earth deficiency and wood depression"from the perspective of intestinal flora-bile acid axis for guiding TCM to prevent and treat hypertension.
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ObjectiveTo observe the therapeutic effect of Shugan Huazheng prescription on hepatic fibrosis model rats induced by carbon tetrachloride （CCl4） and explore whether it plays its role through hypoxia-induced factor-1α/vascular endothelial growth factor/transforming growth factor-β1 （HIF-1α/VEGF/TGF-β1） pathway. MethodA total of 54 male SPF SD rats were randomly divided into six groups： blank group， model group， colchicine group （0.2 mg·kg-1）， and high-， medium-， and low-dose groups （29.52， 14.76， and 7.38 g·kg-1） of Shugan Huazheng prescription， with nine rats in each group. The molding was conducted three times a week for eight weeks. Administration began the day after the first injection， and the drug intervention was once a day for eight weeks. On the day after the last administration， the rats were deprived of food and water， and they were killed the next day， during which the physiological status of each group of rats was dynamically monitored. The pathological changes in the liver were observed by hematoxylin-eosin （HE） staining， and the content of hydroxyproline （HYP） and angiotensin Ⅱ （AngⅡ） in liver tissue were detected by enzyme-related immunosorbent assay （ELISA）. Real-time fluorescent quantitative PCR （Real-time PCR） was used to determine the mRNA expression levels of HIF-1α， VEGF， and TGF-β1 in liver tissue， and immunohistochemical method （IHC） and Western blot were used to detect the protein expression levels of HIF-1α， VEGF， and TGF-β1 in liver tissue. ResultCompared with the blank group， the overall condition of rats in the model group decreased significantly. The proliferation of connective tissue and the increase in adipose cells between hepatocytes were obvious. The content of HYP and Ang was increased. The mRNA and protein expressions of HIF-1α， VEGF， and TGF-β1 were increased to varying degrees （P<0.05）. Compared with the model group， the proliferation of connective tissue and inflammatory cell infiltration in the liver tissue of colchicine and Shugan Huazheng prescription groups were reduced. The content of HYP and Ang was decreased. The mRNA and protein expression levels of HIF-1α， VEGF， and TGF-β1 were decreased， and the colchicine group and high-dose group of Shugan Huazheng prescription were the most significant （P<0.05）. ConclusionShugan Huazheng prescription has an obvious therapeutic effect on CCl4-induced hepatic fibrosis model rats. Its therapeutic mechanism may be related to the regulation of the HIF-1α/VEGF/TGF-β1 signaling pathway and the improvement of hepatic hypoxia， vascular remodeling， and the syndrome of Qi deficiency and blood stasis in hepatic fibrosis.
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It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.
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ObjectiveTo observe the effect of Zhengan Xifengtang on blood pressure and fecal microflora of spontaneously hypertensive rats （SHRs）. MethodA total of 75 male SHRs aged nine weeks were randomly divided into SHR group， Benazepril group （1.00 mg·kg-1·d-1）， high-dose Zhengan Xifengtang group （34.5 g·kg-1·d-1）， medium-dose Zhengan Xifengtang group （17.25 g·kg-1·d-1）， and low-dose Zhengan Xifengtang group （8.625 g·kg-1·d-1）. A total of 15 male Wistar-Kyoto （WKY） rats aged nine weeks were selected as the normal group. The normal group and SHR group were administrated with an equal volume of distilled water for eight weeks. During the administration， the blood pressure of the rats was measured regularly. After the intervention， fresh feces were collected with a sterile frozen storage tube， and 16S amplicon information was collected and analyzed. Plasma， hippocampus， and ileum of rats were collected for ultra-high performance liquid chromatography-tandem mass spectrometry（UPLC-MS/MS） detection. ResultZhengan Xifengtang decreased the systolic blood pressure and diastolic blood pressure of SHRs. Compared with the SHR group， Zhengan Xifengtang decreased the diversity of fecal microflora of SHRs. At the phylum level， Zhengan Xifengtang increased the relative abundance of SHR Verrucomicrobia and Actinobacteria and decreased the relative abundance of Synergistetes， Tenericutes， and Candidatus Saccharibacteria. Compared with the SHR group， Zhengan Xifengtang increased the relative abundance of Blautia wexlerae， Fusicatenibacter saccharivorans， and Akkermansia muciniphila and decreased the relative abundance of Clostridium lavalense， Intestinimonas butyriciproducens， Acetatifactor muris， Alloprevotella rava， and Oscillibacter valericigenes. Spearman correlation analysis showed that the systolic blood pressure of rats was negatively correlated with the relative abundance of Ethanoligenens， Aerococcus， Butyrivibrio， Olsenella， Bifidobacterium， Clostridium XIVb， Allobaculum， and Fusicatenibacter and positively correlated with the relative abundance of Alloprevotella. Zhengan Xifengtang increased the contents of plasma， hippocampal 5-hydroxy tryptamine（5-HT）， and 5-hydroxyindole acetic acid（5-HIAA） in SHRs and decreased the contents of 5-HT and 5-HIAA in the ileum， and the content of 5-HT in the hippocampus was negatively correlated with that in the ileum. ConclusionZhengan Xifengtang can reduce the blood pressure of SHRs， which may be related to reducing the diversity of SHR microflora， regulating the structure of the microflora， increasing the relative abundance of 5-HT and short-chain fatty acids bacteria， and lowering the relative abundance of pathogenic bacteria related to intestinal inflammation.
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With the change of medical technology from "access management" to "filing management" in China, it is necessary for medical institutions, as the main responsibility, to pass standardized ethical review and supervision. However, there are many problems at present, such as the absence of regulations and guidelines for ethical review of clinical application of medical technology, the lack law of medical technology ethical review standard operating procedures, the insufficient review capacity, the lack of standardization in the choice of ethical review methods, the elements of informed consent and its examination need to be discussed, the lack of appropriate continuing review mode, as well as the confirmation of technical team members and department qualifications is not clearly defined. In order to safeguard the safety and rights of patients, it is important to take the following measures, including carrying out the whole-process supervision of medical institutions, clarifying the supervision process, improving the multi-departmental communication and cooperation mechanism, establishing a management committee for clinical application of medical technology, standardizing the review system of the medical technology ethics committee, clarifying submit the list of materials for ethical review, implementing classified ethical review and supervision to improve efficiency, exploring the tracking review mode, ensuring the whole-process supervision, and carrying out popular and professional ethics training. In the review of ethics committee, more attention should be paid to the main points of review, such as technical scheme, informed consent, qualifications of technical team members and departments, management system, risk assessment and emergency plan, patient compensation and other materials. While ensuring the safety and rights of patients, it also helps to accelerate the healthy development of medical technology.
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Taking the current situation and problems of medical humanities education as the background, the concept of narrative medicine was used to sort out and integrate various course materials of medical humanities, explore the multi-link linkage mode of medical humanities education, and organically integrate medical humanities courses scattered in medical education activities such as medical ethics, health law, doctor-patient communication, and health policy science with teaching stages, teaching resources, and teaching methods, forming vivid narrative medical materials throughout the entire process of medical humanities education, and improving teaching efficiency by sharing and optimizing resources. Through questionnaire analysis, it was found that there are many unsatisfactory aspects of medical humanities education. Further analysis of the issues focuses on the contradiction between learning willingness and time allocation, the lack of synchronization between teaching and social development, the lack of integration between courses, and insufficient innovation in teaching methods. Based on these, countermeasures were put forward to integrate narrative medical materials of medical humanities courses and build a platform for the application and communication of narrative medical materials.
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Objective To study the mechanism of ferulic acid(FA)on hepatic fibrosis(HF)based on network pharmacology,and establish an in vitro model of rat hepatic stellate Cell-T6(HSC-T6)according to the results.Methods The potential targets of FA were screened through PubChem,swisstargetprediction and pharmmapper,and overlapped with the FA targets screened in disgenet,genecards and OMIM.Then,protein protein interaction(PPI)was analyzed by using string platform.Gene ontology(go)and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis were carried out for key targets by using R64 4.0.3,and the"component target disease"network diagram was constructed by Cytoscape 3.7.2 software.Based on this,the proliferation of HSC-T6 was detected by cell counting kit-8(CCK-8)method,and the grouping was determined:blank group and low-dose group(100 μg·mL-1 FA),medium dose group(200 μg·mL-1 FA),high dose group(400 μg·mL-1 FA)and positive control group(200 μg·mL-1 colchicine),the migration ability of HSC-T6 was detected by scratch test,and the content of HSC-T6 was detected by enzyme linked immunosorbent assay(ELISA)α-Alpha smooth muscle actin,α-Flow cytometry was used to detect the changes of HSC-T6 cycle,quantitative real time polymerase chain reaction(qRT-PCR)was used to detect the relative expression of JAK2 and STAT3 mRNA,and Western Blot was used to detect the molecular expression of JAK2 and STAT3 protein.Results 254 intersection targets of FA and HF were obtained.The core targets were signal transducer and activvator of Transcription(STAT3),albumin(ALB),protein kinase B(AKT1),tumor suppressor protein p53(TP53),epidermal growth factor receptor(EGFR)and caspase-3(CASP3).KEGG analysis showed that the action pathway of FA on HF mainly involved phosphatidylinositol 3 kinase protein kinase B(PI3K-Akt),vascular endothelial growth factor(VEGF),Janus kinase/signal transducer and activator of transcription(JAK/STAT)Tumor necrosis factor(TNF)and other pathways.The experimental results showed that in CCK-8 experiment,scratch experiment and ELISA experiment,compared with the blank group,the cell proliferation rate,migration ability and the expression of α-SMA protein decreased significantly(P<0.05).Compared with the blank group,the cycle arrest rate of low,medium and high dose groups and positive control group increased significantly(P<0.05).Compared with the blank group,the molecular weight and mRNA expression of JAK2 and STAT3 protein in low,medium and high dose groups and positive control group decreased gradually(P<0.05).Conclusion FA has the characteristics of multi-channel and multi-target.FA may inhibit the apoptosis of hepatic stellate cell(HSC)by down regulating JAK2 and STAT3 targets.
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Objective:To study the clinical efficacy of surgical resection combined with iodine-131 ( 131I) therapy in elderly patients with differentiated thyroid cancer and its influence on complications. Methods:Totally 82 elderly patients with differentiated thyroid cancer who were admitted to Chengde Central Hospital from March 2019 to March 2021 were selected and divided into observation group (41 cases) and control group (41 cases) according to the random number table. The control group underwent total thyroidectomy + neck lymph node dissection, and the observation group was treated with 131I after the operation on the basis of the control group. The indicators in the two groups were evaluated (postoperative observation time cutoff was 3 months), including perioperative indexes, postoperative complications, Karnofsky (KPS) score, serum levels of lymphocyte activating gene-3 (LAG-3) and recombinant human Dick-kopfx related protein-1 (DKK-1) before and after treatment, and the efficacy. Results:There was no significant difference between the two groups in the amount of intraoperative bleeding and operation time ( P > 0.05); the hospitalization time in the observation group [(6.72 ± 1.39) d] was shorter than that in the control group [(8.78 ± 1.43) d, P < 0.001]. The incidence of complications in the observation group (31.71%, 13/41) was lower than that in the control group (53.66%, 22/41, P = 0.045). After treatment, KPS scores in the two groups were higher than those before treatment ( P < 0.001); after treatment, KPS score in the observation group was higher than that in the control group ( P < 0.001). After treatment, the serum LAG-3 levels in the two groups were higher than those before treatment, while DKK-1 levels were lower than those before treatment ( P < 0.001); after treatment, the serum LAG-3 level in the observation group was higher than that in the control group, while the DKK-1 level was lower than that in the control group ( P < 0.001). The total effective rate of the observation group (95.12%, 39/41) was higher than that of the control group (80.49%, 33/41, P = 0.043). Conclusion:The clinical efficacy of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer is good, and it can reduce postoperative complications, up-regulate the expression of LAG-3 and down-regulate the expression of DKK-1.
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It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.
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At present, the development of biobank in China is still at the initial stage, and there are many problems, such as lack of scientific management and sharing mechanism, insufficient application of transformation and weak sustainable development. Through constructing the ethical challenge of biobank, the author draw out the rights protection claims of biological sample sources, such as the informed consent of samples source and the privacy protection of samples management. In order to achieve the balance between the protection and sharing of biobank construction, we should improve the awareness of privacy protection, take effective means of privacy protection and fully consider and foresee ethical issues after rapid development of technology. Finally, it is pointed out that the principle of public welfare, the principle of fairness in the distribution of results and the predictive principle should be reflected in the transformation of results.
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In the new era, innovating medical ethics education and cultivating high-quality medical talents with noble medical ethics, excellent medical skills and both virtues and skills are important topics worthy of study. School history resources are rich in medical ethics ideological nutrients, containing the demonstration effect of medical ethics, strengthening the emotional cultivation of medical ethics, stimulating the establishment of medical ethics beliefs. Therefore, it is suggested that we should continue to tap school history resources, save the source of medical ethics education, organize school history resources and integrate them into the development of medical ethics education platform, and coordinate school history resources to promote the normal development of medical ethics education.
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It has been more than a decade since Charon put forward the definition of narrative medicine.During this period,narrative medicine has developed to a certain extent in other countries and has made some achievements.However,it is still in the stage of conceptual discussion especially in China,and its potential has not been fully excavated.This paper aimed to analyze the current situation of narrative medicine,to compare the differences of domestic and overseas narrative medicine,and thus to explore its training path in China.This paper mainly discussed from the following aspects:enriching the teaching material of narrative medical,digging narrative methods from traditional culture,establishing the training system of narrative medicine,integrating narrative medicine curriculum resources,and so on.It laid a foundation for the construction of Chinese characteristic narrative medical training mode.
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Chinese traditional health concepts are rooted in traditional culture,absorb the essence of various health concepts from Confucianism,Buddhism,Daoism and other schools,and form the unique and rich connotation health concepts.These simple concepts of health are historical origin and precious wealth of modem health concepts.Through analyzing the health outlook in traditional books and quoting some thoughts about physical health,mental health,human and social harmony,and ethical health,this paper excavated the character and limitation of traditional health concepts,and explored the enlightenment to modern health ideas.
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Through the interpretation of traditional Honesty, this article is to understand the semantics of credibility andintegrity in traditional ethical culture, to analyze the relationship between the concept of honesty and medical skills, deriving goodness and endowing novelty, further to reveal the revelation for medical professional personality cultivation. Meanwhile, it points out that we should try our best to overcome the shortcomings of tradi-tional concept of honesty,clarify the connotation of honesty and find out the evidence of honesty culture in tradition-al Chinese ethics. This is the tracing and deepening of the connotation of honesty, as well as the highlighting of honesty as the content of medical professional personality. It is further beneficial to strengthen the pathway con-struction of medical profes.
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Objective To observe the curative effect of eliminating epileptic decoction combined with acu-puncture treatment of epilepsy in children .Methods In our hospital in 2013 July to 2014 year in March 70 cases of epileptic children with occult , were randomly divided into two groups .Chinese medicine group of 35 cases were trea-ted with eliminating epileptic decoction combined with acupuncture treatment ;According to the epilepsy type , western medicine group of 35 cases were given appropriate antiepileptic drug treatment .The therapeutic effect was evaluated after 2 months.Results The total effective rate was 88.57%in traditional Chinese medicine group , and in western medicine group, the total effective rate was 74.29%(p0.05).In the Chinese medicine group after treatment, the normal rate of 51.43%, significantly higher than the control group (p0.05).The western medicine group arithmetic , understanding, similar score slightly lower but the difference was not significant (p>0.05);the back number rating decreased greatly , compared with those before treatment (p<0.05). Conclusion The elimination of epileptic decoction combined with acupuncture is an effective method for treatment of children with epilepsy , and had no significant effect on intelligence .The curative effect is better than western medi-cine treatment .
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Objective To explore the influencing mechanism of Zhengan Xifeng Decoction on blood pressure and gastrointestinal motility in SHR. Methods After 15 WKY and 90 SHR rats were were randomly divided into normal control group, model group, Benner Pury group, amlodipine group, Zhengan Xifeng Decoction high, middle, and low dose groups. The normal control group and model group were fed with distilled water daily. Rats in treatment group were administered with corresponding drugs daily. Blood pressure, gastric residual and intestinal propulsive ratio of rats was detected after eight-week intervention. Results Compared with the blank control group, systolic pressure, diastolic pressure, and mean arterial pressure were significantly higher than WKY rats of same age (P<0.05). Compared with the model group, the systolic pressure, diastolic pressure, and mean arterial pressure of treatment groups were significantly reduced (P<0.05). Compared with the blank control group, gastric residual rate of rats in the model group significantly decreased (P<0.05). Compared with the model group, the gastric residual rate in Zhengan Xifeng high dose group increased significantly, and intestinal propulsive ratio significantly increased (P<0.05), without statistical significance in the other treatment groups. Conclusion Zhengan Xifeng Decoction can reduce blood pressure in SHR, and regulate gastrointestinal motility.
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This article started with the different views to death in Confucianism , Taoism, and Buddhism .And then explore the simple bioethics spirit in Chinese traditional culture , such as cherishing life , equal spirit , the spir-it of benevolence .Finally the research significance is summarized .In the bioethics development era background , researching naive ethics thought in the Chinese traditional culture has important significance to tamp multicultural foundation of bioethics , promote the development of bioethics in China , transform the ancient Chinese bioethics wisdom into the common wealth of mankind and perfectly handle ethical confusion in the development of biology and medicine.
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Objective To study the status of surface plasmon resonance (SPR) detection of cervical human papillomavirus (HPV) infection in clinical practice.Methods 502 cases of cervical HPV in patients with cervical cell's genetic subtypes were diagnosed using SPR.Positive rates of HPV lesions of cervical levels detected by SPR and nucleic acid molecules rapid flow-through hybridization gene chip (HybriMax) technology were compared.Results Twenty-two kinds of subtypes were detected by SPR.106 women were found with single infection of HPV,including 47 women (44.34％) with abnormal cytological results,while 36 women were found with multiple infection of HPV,including 16 women (44.44％) with abnormal cytological results,and the difference was not significant (P＞0.05).Among 106 women with single infection of HPV,93 women were found with high risk HPV infection,including 45 women (48.39％) with abnormal cytological results,while 13 women were found with middle-low risk HPV infection,including 2 women (15.38％) with abnormal cytological results,and the difference was statistically significant (P＜0.005).Comparison of SPR and HybriMax technology showed that the two test results showed no significant difference (P＞0.05).Conclusions SPR for detection of HPV infection is more reliable,it can combine HybriMax as the primary means of clinical detection.
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Objective To establish a stable in vitro model of blood-brain barrier (BBB) simulating in vivo state using the primary-cultured rat brain microvascular endothelial cells (BMVECs) and pericytes.Methods The primary rat BMVECs and pericytes were isolated,purified and cultured.The isolated cells were identified by immunocytochemical staining method.An in vitro model of BBB was constructed using Transwell inserts (pore size 0.4 μm) coculture.Its barrier function was evaluated by the 4-hour leakage test,tight junction protein identification,transendothelial resistance detection,and permeability test.The difference between the cocultured model and simple BMVEC model across the membrane resistance values,and the permeability difference of the small molecule sodium fluorescein (Na-F) were compared.Results Confluent BMVEC monolayers demonstrated a typical cobblestone appearance and the pericytes displayed irregular shape and overlapping growth.Immunodouble labeling technique identification showed that the pericytes positively expressed α-srmooth muscle actin (α-SMA) and neuron-glial antigen 2 (NG2); after the fusion of cocultured model endothelial cells,the surface leakage test became positive; immnocytochemical staining shows that a continuous and dense tight junction formed between the endothelial cells; compared to the BMVEC model,the transendothelial electrical resistance of the cocultured model increased significantly (190.762 ± 10.326 Ω/cm2 vs.96.503 ± 8.012 Ω/cm2; t=- 24.489,P ＜0.01),and the permeability decreased significantly (56.149％ ± 3.572％ of the single endothelial model; t =19.330,P ＜ 0.01 ).Conclusions The primary isolated rat BMVECs and pericytes cocultured the morphology,structure and barrier function of in vitro model have the basic characteristics of BBB,and they have provided a useful tool for the research of BBB.
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Both ginseng and American ginseng can not be replanted on the same soil consecutively. The article reviews the development and progress of studies on the replant failure of ginseng and American ginseng with a special focus on allelopathy in recent years. The allelopathy effect in ginseng and American ginseng is reviewed from following aspects: collecting and extracting allelochemicals, effects of such allelochemicals on seeds germination, seedlings growth, antioxidant enzyme activities in ginseng roots, growth of ginseng pathogens and ginseng callus, and more. It is presumed that inhibitory allelopathy is one of the many possible factors contributing to the replant failure of ginseng and American ginseng. Based on that, the paper points out problems in current researches on the allelopathic effect of ginseng and American ginseng: the allelochemicals are consist of a mixture, which one plays the specific role is not clear; concentrating on a single allelochemical while ignoring the interaction among allelochemicals. It is suggested that further study for this area should be focused on the interactions among allelochemicals and interactions between allelochemicals and environmental impact factors. Another area of needed research is that of the migration and transformation of allelochemicals in soil and microbial involvement in allelopathy on the growth of ginseng and American ginseng.