Insomnia Burden among Informal Caregivers of Hospitalized Lung Cancer Patients and Its Influencing Factors / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers (ICs) of hospitalized patients with lung cancer.@*METHODS@#A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31, 2020 to December 31, 2021. ICs' burden was assessed using the Caregiver Reaction Assessment (CRA), Hospital Anxiety and Depression Scale (HADS), and Insomnia Severity Index (ISI). Linear and logistic regression models were used to identify the influencing factors.@*RESULTS@#Among 289 ICs of hospitalized patients with lung cancer, 83 (28.72%), 53 (18.34%), and 14 (4.84%) ICs experienced mild, moderate, and severe insomnia, respectively. The scores concerning self-esteem, lack of family support, financial problems, disturbed schedule, and health problems were 4.32 ± 0.53, 2.24 ± 0.79, 2.84 ± 1.14, 3.63 ± 0.77, and 2.44 ± 0.95, respectively. ICs with higher Activities of Daily Living Scale (ADLS) scores were associated with a lower risk of insomnia, with an odd ratio ( OR) and 95% confidence interval ( CI) of 0.940 (0.898-0.983). Among the ICs, female gender ( OR = 2.597), alcohol consumption ( OR = 3.745), underlying medical conditions ( OR = 11.765), long-term caregiving experience ( OR = 37.037), and higher monthly expenses ( OR = 5.714) were associated with a high risk of insomnia.@*CONCLUSION@#Of the hospitalized patients with lung cancer, 51.9% experienced insomnia. Patients' ADL, ICs gender, alcohol consumption, underlying medical conditions, caregiving duration, and monthly expenses were influencing factors. Therefore, prompt screening and early intervention for ICs of patients with lung cancer is necessary.

Early identification and influencing factors of post-traumatic stress disorder in high-stress rescue workers / 中华预防医学杂志

Objective: To explore the risk intensity and related influencing factors of post-traumatic stress disorder (PTSD) among high-stress rescue workers, and to provide effective tools for the risk assessment of PTSD in military rescue workers. Method: From June to August 2022, cluster sampling was used to select the high-stress rescue personnel of an Army department as the survey subjects. The acute Stress reaction (ASD) scale and PTSD checklist were used to evaluate the risk of PTSD in military rescue personnel. Multivariate logistic regression were used to analyze the influencing factors of PTSD. Results: The age of 4 460 subjects was (24.38±4.072) years old, including 4 396 males (98.6%). The positive rate of initial screening for ASD was 2.85% (127/4 460). The positive rate of PTSD was 0.67% (30/4 460). Multivariate logistic regression model analysis showed that female, older age, recent trauma exposure history, passive smoking and alcohol consumption were at higher risk of ASD, the values of OR (95%CI) were 4.183 (1.819-9.618), 6.278 (1.363-28.912), 3.094 (1.500-6.379), 2.059 (1.298-3.267) and 2.607 (1.614-4.211), respectively; Lower education level was associated with lower risk of ASD, OR (95%CI) was 0.593 (0.359-0.978); People who are older, thinner, have a history of mental illness, and drink alcohol were at higher risk for PTSD, the values of OR (95%CI) were 20.144 (2.459-165.043), 10.287 (2.218-47.700), 91.104 (8.592-965.980) and 2.866 (1.144-7.180), respectively. Conclusion: Gender, age, education level, passive smoking, alcohol consumption, past history of mental illness and body mass index may be related to the potential risk of PTSD in rescue workers,passive smoking, alcohol consumption, and weight controlling should be focused on to reduce potential risks of PTSD.

Combined Effect of Smoking and Obesity on Coronary Heart Disease Mortality in Male Veterans: A 30-year Cohort Study / 生物医学与环境科学（英文）

Objective@#Evidence is lacking regarding the combined effects of smoking and obesity on mortality from coronary heart disease in male veterans. This study aimed to explore the combined effect of smoking and obesity on coronary heart disease mortality in male veterans in China.@*Methods@#A cohort of 1,268 male veterans from 22 veteran centers in Xi'an (Shaanxi Province, China) were followed up once every 2 years from February 1, 1987 to October 30, 2016. The endpoint was death from any cause. The hazard ratio ( @*Results@#The total follow-up was 24394.21 person-years; each subject was followed up for a mean duration of 19.24 years. By the end of the study, of the 1,268 veterans, 889 had died, 363 were alive, and 16 were lost to follow-up. Cox regression analysis results revealed that current smoking ( @*Conclusion@#Our results suggest that obese veterans who smoke might be an important target population for coronary heart disease mortality control.

Analysis of Factors Influencing Insomnia and Construction of a Prediction Model: A Cross-sectional Survey on Rescuers / 生物医学与环境科学（英文）

Objective@#To determine the factors influencing insomnia and construct early insomnia warning tools for rescuers to informbest practices for early screening and intervention.@*Methods@#Cluster sampling was used to conduct a cross-sectional survey of 1,133 rescuers from one unit in Beijing, China. Logistic regression modeling and R software were used to analyze insomnia-related factors and construct a PRISM model, respectively.@*Results@#The positive rate of insomnia among rescuers was 2.74%. Accounting for participants' age, education, systolic pressure, smoking, per capita family monthly income, psychological resilience, and cognitive emotion regulation, logistic regression analysis revealed that, compared with families with an average monthly income less than 3,000 yuan, the odds ratio ( ) values and the [95% confidence interval ( )] for participants of the following categories were as follows: average monthly family income greater than 5,000 yuan: 2.998 (1.307-6.879), smoking: 4.124 (1.954-8.706), and psychological resilience: 0.960 (0.933-0.988). The ROC curve area of the PRISM model (AUC) = 0.7650, specificity = 0.7169, and sensitivity = 0.7419.@*Conclusion@#Insomnia was related to the participants' per capita family monthly income, smoking habits, and psychological resilience on rescue workers. The PRISM model's good diagnostic value advises its use to screen rescuer early sleep quality. Further, advisable interventions to optimize sleep quality and battle effectiveness include psychological resilience training and smoking cessation.

Research progress on PD-1/PD-L1 resistance mechanism and combination therapy / 医学研究生学报

PD-1/PD-L1 plays a pivotal role in the inhibition of T lymphocytes and tumor immune escape. Immunological checkpoint inhibitors of PD-1/PD-L1 can restore inactivated T cells and enhance the ability of killing tumor cell. At present, PD-1/PD-L1 inhibitors have been used in a variety of tumor types. Although some patients prove significant effects, there are still some patients with primary or acquired resistance to PD-1/PD-L1 inhibitors. The mechanism of resistance is related to the loss of the first signal or costimulatory signal, the expression of PD-1/PD-L1,the expression of other immune checkpoints on the surface of T cells, the immunosuppressive tumor microenvironment and systemic immunity. And we will find ways to prolong the survival time of patients through the combination therapy. This article mainly reviews the resistance mechanism and combination therapy of PD-1/PD-L1.

Feasibility of evaluating the left ventricular function in patients with cardiovascular diseases by fully automatic quantified three-dimensional transthoracic echocardiography / 中华心血管病杂志

Objective: To investigate the clinical value of left ventricular function assessment in patients with cardiovascular disease by fully automatic quantified three-dimensional transthoracic echocardiography. Methods: One hundred and ninety-seven patients with cardiac diseases were examined by three-dimensional transthoracic echocardiography from September 2017 to May 2019. Data from 61 patients with grade 1 echocardiographic image quality were used to determine the default boundary values of endocardial end-diastolic and end-systolic phases. Clinical features were analyzed based on electronic medical records. The accuracy and repeatability of this strategy was evaluated by comparing left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) measured by automated quantitative three-dimensional echocardiography and those measured by conventional manual transthoracic echocardiography, the latter served as gold standard. Results: The levels of LVEDV, LVESV and LVEF measured by automatic three-dimensional echocardiography were positively correlated with values obtained by manual measurement（r=0.97，0.97, 0.98, 0.97, 0.97, 0.96；P<0.05). The levels of LVEDV and LVESV measured by full-automatic three-dimensional echocardiography were significantly higher than those obtained by manual three-dimensional echocardiography（all P<0.05）. The classification and correlation of systolic dysfunction in patients with abnormal ventricular wall motion by automatic three-dimensional echocardiography were significantly improved after manual calibration (κ=0.74, P=0.00) as compared to without manual calibration (κ=0.63, P=0.00). The inter-observer and intra-observer variability of fully automated three-dimensional echocardiography were significantly smaller than manual three-dimensional echocardiography（both P<0.05）. Conclusion: Fully automatic quantified three-dimensional transthoracic echocardiography possesses excellent accuracy and repeatability in measuring left ventricular volume and function， and it is feasible for clinical application.

Clinical features and prognosis of diffuse large B-cell lymphoma with hepatitis B virus infection / 医学研究生学报

Objective　The association of hepatitis B virus (HBV) infection with the clinical features and prognosis of diffuse large B-cell lymphoma (DLBCL) remains unclear. This study aimed to investigate the relationship between HBV infection and the clinical characteristics and prognosis of DLBCL.　Methods　This retrospective included 199 cases of DLBCL initially treated in our Department of Oncology from January 2012 to December 2017, which fell into an HBV group (n = 92) and a non-HBV group (n = 107). We recorded the clinical features, liver function before and during the treatment, progression-free survival and overall survival of the patients. Based on the level of lactate dehydrogenase (LDH) and the presence of HBV infection, we again divided the patients into four groups: normal (non-HBV infection and normal LDH, n = 67), high LDH (without HBV infection, n = 40), HBV (HBV infection with normal LDH, n = 59), and HBV+high LDH (with both HBV infection and high LDH, n = 33), and compared the results of treatment among different groups.　Results　The incidence rate of liver damage was significantly higher in the HBV than in the non-HBV group before chemotherapy (P 0.05). The rate of therapeutic effectiveness was remarkably lower in the HBV+high LDH than in the normal, high LDH and HBV groups (30.3% vs 82.1%, 87.5% and 88.1%, P < 0.01). The progression-free survival was markedly longer in the non-HBV than in the HBV group ([63.9 ± 2.4] vs [45.7 ± 2.9] mo, P = 0.004).　Conclusion　HBV infection is involved in the development and progression of DLBCL, and may act synergetically with high LDH and exerts a negative effect on the therapeutic efficacy.

Prevalence and Metabolic Abnormalities of Fatty Liver Disease among Adults in Mianyang City,Sichuan Province / 中国医学科学院学报

Objective To understand the prevalence and metabolic abnormalities of fatty liver disease among adults in Mianyang City,Sichuan Province,and to analyze their influencing factors.Methods Totally 294 603 adults aged 18 years and older were enrolled by using a multi-stage stratified random sampling method in Mianyang City from November 1,2014 to September 30,2015.Fatty liver was diagnosed by abdominal ultrasound.The general demographic characteristics,smoking history,drinking history,and history of chronic disease were collected through questionnaires.Meanwhile,10 217 subjects were randomly selected for biochemical tests[fasting plasma gluose(FPG),triacylglycerol(TG),total cholesterol(TC),and alanine aminotransferase(ALT)].Results Of these 294 603 subjects,17 105(5.81%)had fatty liver.After having been age-adjusted based on the results of the sixth national census in 2010,the standardized prevalence was 5.32%.The prevalence was significantly higher in males(6.76%;standardized prevalence:7.24%)than in females(5.09%;standardized prevalence:4.08%)(=365.814,<0.001)。The prevalence of fatty liver disease was significantly higher in people with current smokers(8.52%)/ex-smokers(8.89%),occasional alcohol users(6.79%)/regular alcohol users(10.51%)/daily alcohol users(10.62%),and patients with hypertension(12.14%)/diabetes(15.19%)/coronary heart disease(10.22%)than those without corresponding characteristics(all <0.001).Abnormal increase in body mass index,diastolic blood pressure,FPG,TG,TC,and ALT were risk factors for fatty liver in Logistic regression model.Conclusions The prevalence of fatty liver in adults is relatively low in Mianyang City.Patients with fatty liver usually have varying degrees of abnormal increase in blood lipids,blood glucose,blood pressure,and ALT.Healthy lifestyles and comprehensively assessment of metabolic status are conducive to the prevention and treatment of fatty liver and extrahepatic complications.

Regulatory roles of rno-miR-30b-5p in the expression of Atg5, Atg12 and Becn1 autophagy genes in rats with experimental autoimmune uveitis / 眼科新进展

Objective To investigate the regulatory roles of rno-miR-30b-5p in the expression of Atg5,Atg12 and Becn1 autophagy genes and their expressions in rats with experimental autoimmune uveitis (EAU).Methods Application of dual luciferase report system was conducted to detect the regulatory roles of rno-miR-30b-5p in Atg5,Atg12 and Becn1 gene expression.Lewis rats were randomly divided into control group and EAU group,with 6 rats in each group.Next,rats in EAU group were immunized to establish EAU model.After treatments,Genesis-D fundus camera was used to observe the fundus inflammation every day.After immunization for 12 days,the pathological features of rat ciliary body and retina were detected,and meanwhile,the spleen and lymph nodes in both groups were isolated to detect the expressions of rno-miR-30b-5p,Atg5,Atg12 and Becn1 genes by quantitative PCR (Q-PCR);the levels of autophagy related proteins were determined by ELISA.Results Dual luciferase report gene expression assay confirmed that Atg5,Atg12 and Becn1 were target genes of rno-miR-30b-5p.Twelve days after immunization,compared with the control group,rats in the EAU group had severe iris adhesions and severe blood vessel swelling,and pathological examination revealed massive infiltration of inflammatory cells in the ciliary body and retina.Furthermore,rno-miR-30b-5p mRNA was 0.46 ±0.01,0.29 ±0.17in the spleen and lymph nodes in EAU group,respectively,which was down-regulated when compared with the control group (P ＜0.01);whereas the expressions of Atg5,Atg12 and Becn1 were significantly upregulated,and the differences were statistically significant (all P ＜ 0.05).ELISA results showed that Atg5,Atg 12 and Becn 1 protein expression levels in the spleen and lymph nodes in EAU rats were significantly higher than those in the control group (all P ＜ 0.05).Conclusion rno-miR-30b-5p can regulate the expressions of Atg5,Atg12 and Becn1 autophagy-related genes.The down-regulation of rno-miR-30b-5p expression in the spleen and lymph nodes in EAU rats can significantly up-regulate the expressions of Atg5,Atg12 and Becn1 genes,thereby regulating the pathogenesis of uveitis.

Inhibitory effects of Longdan Xiegan Decoction on Notch signaling in rats with experimental autoimmune uveitis / 眼科新进展

Objective To investigate the effects of Longdan Xiegan Decoction on the expression of Notch signaling-related genes in rats with experimental autoimmune uveitis (EAU).Methods Totally 24 Lewis rats were randomly divided into normal control group,EAU model group and Longdan Xiegan Decoction treatment group.A rat model of EAU was established in the EAU model group and Longdan Xiegan Decoction treatment group,followed by intragastrical administration of Longdan Xiegan Decoction in the latter group after successful modeling.On day 12 after different treatments,the spleen and lymph nodes were isolated from rats of all the three groups for the collection of CD4 + T ceils,and the levels of both Th17 and Treg cells were analyzed by flow cytometry to calculate the ratio of Th17 to Treg cells.Meanwhile the levels of Notch1,Notch2,Notch3,Notch4 mRNAs expression were monitored by qRT-PCR.Moreover,the expressions of Notch signaling-related proteins were further detected using ELISA technique.Results Flow cytometry showed increased Th17 cell level but decreased Treg cell level in the EAU model group when compared with the normal control group.However,after treatment with Longdan Xiegan Decoction,the Th17 level was decreased,whereas the Treg level was increased,and the ratio of Th17 to Treg gradually restored to equilibrium when compared to EAU model group.qRT-PCR results showed that the expression levels of Notch1,Notch2 and Notch4 mRNAs in Longdan Xiegan Decoction treatment group were significantly higher than those in the normal control group (all P ＜ 0.01),but lower than those in EAU model group on day 12 after treatment (all P ＜ 0.01),without Notch 3 expression in the spleen and lymph nodes.In addition,Notch 1,Notch 2 and Notch 4 protein levels of the spleen and lymph nodes in Longdan Xiegan Decoction treatment group showed the similar tendency as compared to those of Notch 1,Notch 2 and Notch 4 mRNAs (all P ＜ 0.01),and the expression of Notch 3 protein was still not observed.Conclusion Longdan Xiegan Decoction can effectively relieve the imbalance of Th17/Treg cells in EAU rats,and its mechanism may involve the differentiation of naive CD4+ T cells into Th17 and Treg cells,which is regulated by Notch signaling.

Teratomas on the palate and tongue with cleft palate: a case report / 华西口腔医学杂志

Teratomas is a germ cell tumors, which is rare in the upper palatal and lingual. This article presents a patient with teratomas on the palate and tongue accompanied with cleft palate. The clinical manifestations and histopathological characteristics of teratomas are discussed according to relevant literatures.

The influence and cohesion suggestions of the MAH system on the current regulatory systems / 中国卫生政策研究

Objectives:This research specifically reviews the pharmaceuticalproduct life-cycle managementreg-ulatory systems closely related to the Marketing Authorization Holder(MAH) systemin the whole cycle management of drugs toidentifyits impact on these regulatory systems before and after its implementation, to propose targeted cohesion recommendations and provide references on the comprehensive implementation of the system itself. Methods :Through the literature research and system comparison methods, the changes in the supporting regulatory systemsclosely related to the MAH systemintroducedbefore and after its implementation were detailed and compared. Results :The MAH system implementationbrought remarkablechanges and impacts on the technology transfer system, drug entrusted introduction system, the original equipment manufacturing system, the business license system, the adverse reaction monitoring and evaluation system and the damage liabilitysystem of pharmaceutical products as well. Conclusions :In order to promote the MAH system implementation, policy makers should amend the Drug Administration Law and revise relevant regulations tosimplify theproperty rights and site change procedures. This paper also suggests putting in place the main responsibility of the individual to carry outpharmacovigilance concerning MAH to fully guarantee the drug quality and legitimatizethepatients' rights and interests.

Awareness of Acquired Immune Deficiency Syndrome and Its Influencial Factors among College Students in Universities Implementing "Red Ribbon in Colleges" Event across China / 中国医学科学院学报

Objective To investigate the college students'awareness of acquired immune deficiency syndrome (AIDS) and its influencial factors in universities implementing "Red Ribbon in Colleges" event.Methods A multistage random sampling method was used to select 2057 students from 8 universities. Among them,1977 students were surveyed by quantitative questionnaires and 80 students were interviewed qualitatively. SPSS 24.0 software was used for data processing and analysis.Results A total of 1977 students was investigated,among whom the overall awareness rate of AIDS-related knowledge was 88.21%. The awareness rate of the three major routes of AIDS transmission (i.e. sexual transmission,blood transmission,and mother-to-child transmission) were more than 90%,and the awareness rate of "Can mosquito bites spread AIDS" was lowest (72.99%). The awareness rate of AIDS-related knowledge was significantly higher among students who had attended the "Red Ribbon in Colleges" event (95.36%,P<0.001),followed by those who had received AIDS prevention education as a freshman (92.22%,P<0.001),had filled in AIDS prevention questionnaires (91.42%,P<0.001),and had attended other AIDS-related health education events in schools or colleges (91.36%,P<0.001),and the differences were statistically significant when compared with students who had not attended any of these events. Multivariate unconditional Logistic regression analysis showed that attending the "Red Ribbon in Colleges" event (OR=2.973,95%CI=1.684-5.249,P<0.001),receiving AIDS prevention education as a freshman (OR=2.944,95%CI=2.073-4.181,P<0.001),attending other AIDS-related health education in schools or colleges (OR=1.590,95%CI=1.141-2.217,P=0.006),majoring in engineering disciplines (OR=2.756,95%CI=1.846-4.114,P<0.001),junior students (OR=1.916,95%CI=1.216-3.020,P=0.005),living in central China (OR=1.868,95%CI=1.085-3.218,P=0.024),and living in northern China (OR=1.774,95%CI=1.159-2.716,P=0.008) were favourable factors for high awareness rate. Qualitative analysis indicated that students rated highly of the "Red Ribbon in Colleges" event.Conclusion The "Red Ribbon in Colleges" event and other AIDS education programs help to increase the college students'awareness of AIDS-related knowledge.

The relationship between nursing work errors and job satisfaction, job burnout: Empirical study on some tertiary hospitals / 中国卫生政策研究

Objectives:To analyze the statistics of nursing errors of nursing staff in the top three hospital during last year,and the relationship between nursing staff's job satisfaction and job. Methods:From February 2017 to Au-gust 2017,a cluster randomized sampling method was used to select 320 cases of standard nursing staff in the top three hospitals. The questionnaires for general information, questionnaires for nursing job errors, job satisfaction questionnaire,and job burnout survey questionnaire for nursing staff were used to investigate and analyze,and to ex-plore the relevance of nursing work errors, job satisfaction and job burnout. Results:The incidence of nursing error rate was 65.61%. Statistical analysis shows that the occurrence of nursing work errors was related to job satisfaction and job burnout. Among them, nursing staff's personal sense of achievement, personality and overload work, work not recognized, lack of management, unclear responsibility, and low welfare benefits easily led to nursing errors. Conclusions:Based on the impact of job satisfaction and job burnout on the work of nursing staff,improving the nurs-ing staff satisfaction,alleviating the job burnout would reduce the occurrence of nursing errors through the optimiza-tion of scheduling,welfare,management communication and other development opportunities.

Applications of nanomaterial-based drug delivery carriers in treating eye diseases / 国际眼科杂志(Guoji Yanke Zazhi)

In view of the anatomical and physiological barrier of the ocular surface and the intraocular structure, the conventional ophthalmic agents cannot efficiently reach the lesion site.Currently, the different types of nanomaterials possess great advantages in delivering drugs due to their characteristics of small size, easy preparation, degradability, strong targeting and less irritation to biological tissue.As drug delivery carriers, nanomaterials have been widely used in ocular drug delivery so as to treat different types of eye diseases.In this paper, the applications of nanomaterials as drug delivery carriers in treating eye diseases are briefly reviewed.

Research progress on anti-liver fibrosis effect of ginsenoside / 中草药

Ginsenoside is a kind of important natural product widely planted in nature. It is not only distributed widely in nature with a variety of physiological activities, but also important bioactive constituent in the various medicinal plants. The results of recent research have demonstrated that ginsenosides made great progress in antitumor treatment, while also have an outstanding effect in liver fibrosis. Therefore ginsenosides have great value in treatment of liver fibrosis. This paper reviewed ginsenoside on the mechanism of liver fibrosis in order to provide a theoretical basis for further research.

Research progresses of relative importance of temporal envelope cues in different frequency regions / 上海交通大学学报（医学版）

Based on the dominant fluctuation rates, the speech information in temporal domain could be divided into temporal envelope, periodic fluctuation information and temporal fine structure. Temporal envelope cues are essential for speech recognition, which could be transmitted to cochlear implanters by cochlear imlpants. The roles of temporal envelope cues from various frequency regions in speech recognition are diverse. Influenced by the testing materials, research methods, listening backgrounds and the parameters used to extract temporal envelope, the relative weights of temporal envelope across frequency regions would change accordingly. The research methods as well as their advantages or disadvantages and research results of relative weights of temporal envelope cues in different frequency regions are reviewed, and the possible reasons why the relative weights of temporal envelope cues in different frequency regions for non-tonal language and tonal language were different were discussed simply.

Post-conditioning with gradually increased reperfusion provides better cardioprotection in rats / 世界急诊医学杂志（英文）

BACKGROUND:Rapid and complete reperfusion has been widely adopted in the treatment of patients with acute myocardial infarction (AMI), but this process sometimes can cause severe reperfusion injury. This study aimed to investigate different patterns of post-conditioning in acute myocardial ischemia-reperfusion injury, and to detect the role of mitogen activated protein kinase (MAPK) during the injury. METHODS:Rats were randomly divided into five groups:sham group, reperfusion injury (R/I) group, gradually decreased reperfusion group (GDR group, 30/10-25/15-15/25-10/30 seconds of reperfusion/ischemia), equal reperfusion group (ER group, 20/20 seconds reperfusion/ischemia, 4 cycles), and gradually increased reperfusion group (GIR group, 10/30-15/25-25/15-30/10 seconds of reperfusion/ischemia). Acute myocardial infarction and ischemic post-conditioning models were established in the rats. Six hours after reperfusion, 3 rats from each group were sacrificed and myocardial tissues were taken to measure the expressions of phosphorylation of extracellular signal-regulated protein kinase (P-ERK), phosphorylated c-Jun N-terminal kinase (P-JNK), mitogen-activated protein kinase p38 (p38 MAPK), tumor necrosis factor-α (TNF-α), caspases-8 in the myocardial tissue, and cytochrome c in the cytosol using Western blot. Hemodynamics was measured at 24 hours after reperfusion, the blood was drawn for the determination of cardiac enzymes, and the heart tissue was collected for the measurement of apoptosis using TUNEL. One-way analysis of variance and the Q test were employed to determine differences in individual variables between the 5 groups. RESULTS:Three post-conditioning patterns were found to provide cardioprotection (P<0.05) compared with R/I without postconditioning. GIR provided the best cardioprotection effect, followed by ER and then GDR. Apoptotic index and serum marker levels were reduced more significantly in GIR than in ER (P<0.05). The enhanced cardioprotection provided by GIR was accompanied with significantly increased levels of P-ERK 1/2 (1.82±0.22 vs. 1.54±0.32,P<0.05), and lower levels of p-JNK, p38 MAPK, TNF-α, caspase-8, caspase-9 and cytochrome in the cytoplasm (P<0.05), compared with ER. The infarct size was smaller in the GIR group than in the ER group, but this difference was not significant (16.30％±5.22％ vs. 20.57％±6.32％,P<0.05). Allthe measured variables were improved more significantly in the GIR group than in the GDR group (P<0.05). CONCLUSION:Gradually increased reperfusion in post-conditioning could attenuate reperfusion injury more significantly than routine method, thereby the MAPK pathway plays an important role in this process.

Countermeasures for promoting internationalization of Chinese materia medica by virtue of formula granule / 中草药

The development of Chinese materia medica (CMM) formula granule is a great reform on CMM. Compared with the traditional herbal pieces, CMM formula granule is not only convenient and rapid-acting as boiling-free, but also advanced in producing techniques, and easily handled in both storage and quality-control. It could perfectly meet the basic reqirement on modern drugs and have a broad market prospect both at home and abroad. The popularization and application of CMM formula granule could be a new way to promote the internalization of CMM. Through the analysis of the pushing effects, international competitive advantages, and problems on accessing to the international market, this essay tries to put forward some effective countermeasures for CMM formula granule with expecting to provide a new idea and a new route for the internationalization of CMM.

Difficulties in registration for export of traditional Chinese medicines to EU under directive 2004/24/EC and countermeasures / 中国中药杂志

During the seven-year transitional period of European Union Directive 2004/24/EC, only a few of traditional Chinese medicines had been approved for registration. In other words, the EU directive has become an unavoidable registration barrier to hinder Chinese enterprises from entering EU market. By analyzing difficulties of enterprises in registration in EU and studying the only successful case in China--Di Ao Group, this article proposes countermeasures in the hope of providing effective reference for Chinese enterprises in expanding EU market, and promoting the internationalization progress of traditional Chinese medicine.