[Brief introduction of population medicine and value-based healthcare].

Three healthcare revolutions and four medical paradigm shifts have had a profound impact on the development of healthcare system, which has greatly improved human health, however, the COVID-19 pandemic has exposed hidden dangers and problems in the construction of the healthcare system. In this paper, we made a brief introduction of population medicine and value-based healthcare for the purpose of suggesting new ideas and directions for the future development of healthcare system.

[Risk factors for preterm birth, low birth weight and small for gestational age: a prospective cohort study].

Objective: To study the relationship between exposure factors in early pregnancy and preterm birth (PB), low birth weight (LBW) and small for gestational age (SGA) of neonates. Methods: A total of 3 172 pregnant women who were enrolled in the project of Chinese Pregnant Women Cohort Study-Peking Union Medical College (CPWCS-PUMC) from July 25, 2017 to July 24, 2018 and delivered before December 31, 2018 were selected as subjects in this study. The relationship between exposure factors in early pregnancy and adverse outcomes of neonatal delivery was analyzed by using binary logistic regression analysis. Results: The incidence rates of PB, LBW and SGA were 4.76%, 3.53% and 5.74%, respectively. In terms of PB, the analysis results showed that the gestational weight gain (GWG) and living in northern China were protective factors, while premature rupture of membranes, gestational hypertension, dental examination or treatment within 1-3 years and family with 3-4 members were risk factors. In the respect of LBW, GWG and daily consumption of milk and dairy products were the protective factors, while premature rupture of membranes, gestational hypertension, sedentary working time more than 6 hours, dental examination or treatment within 1-3 years and passive smoking were risk factors. For SGA, baby girl, passive smoking, peanut oil consumption and unsalted taste were risk factors, while folic acid supplementation was protective factor. Conclusion: The risk factors for PB, LBW and SGA were multifactorial, and relevant specific measures should be taken to reduce the occurrence of adverse neonatal outcomes.

Berberine binds RXRα to suppress ß-catenin signaling in colon cancer cells.

Berberine, an isoquinoline alkaloid, is a traditional oriental medicine used to treat diarrhea and gastroenteritis. Recently, we reported that it could inhibit the growth of intestinal polyp in animals and in patients with the familial adenomatous polyposis by downregulating ß-catenin signaling. However, the intracellular target mediating the effects of berberine remains elusive. Here, we provide evidence that berberine inhibits ß-catenin function via directly binding to a unique region comprising residues Gln275, Arg316 and Arg371 in nuclear receptor retinoid X receptor alpha (RXRα), where berberine concomitantly binding to and synergistically activating RXRα with 9-cis-retinoic acid (9-cis-RA), a natural ligand binding to the classical ligand-binding pocket of RXRα. Berberine binding promotes RXRα interaction with nuclear ß-catenin, leading to c-Cbl mediated degradation of ß-catenin, and consequently inhibits the proliferation of colon cancer cells. Furthermore, berberine suppresses the growth of human colon carcinoma xenograft in nude mice in an RXRα-dependent manner. Together, our study not only identifies RXRα as a direct protein target for berberine but also dissects their binding mode and validates that berberine indeed suppresses ß-catenin signaling and cell growth in colon cancer via binding RXRα, which provide new strategies for the design of new RXRα-based antitumor agents and drug combinations.

[Expression characteristics of epithelial markers in human embryonic stem cells differentiating into keratinocytes].

OBJECTIVE: To differentiate human embryonic stem cells (hESCs) into keratinocytes (K-hESCs) and analyse the expression characteristics of biomarkers of K-hESCs. METHODS: The hESCs of line H9 were seeded on matrigel in mTeSR1 medium. The hESCs were directly differentiated into keratinocytes in epithelial differentiation medium with bone morphogenetic protein 4, retinoic acid and N2 supplement. The karyotype of K-hESCs was analyzed, comparing the gene expression differences of K-hESCs with human gingival epithelial cells (HGECs), human immortalized oral epithelial cells (HIOECs) and HaCaT by Real-time PCR. Molecular characteristics of the cell differentiation were observed throughout the process by immunocytochemical techniques. RESULTS: H9-hESCs were successfully differentiated into the cells that exhibited characteristics of keratinocytes in epithelial differentiation medium. The karyotype of K-hESCs was 46, XX; and the keratinocyte gene p63 expression in K-hESCs was significantly lower than that in HaCaT (P < 0.05), but there was no significant difference of p63 expression in K-hESCs, comparing with that in HGECs and HIOECs (P > 0.05). CONCLUSION: H9-hESCs could be directly differentiated into K-hESCs. The gene expression of K-hESCs was similar to that of epithelial cells in the early stage of monolayer cells differentiation with high proliferative activity.

Prospective Study of Serum 25-hydroxy Vitamin D and Tooth Loss.

Vitamin D deficiency and oral diseases (periodontitis, caries, and tooth loss) are highly prevalent in Germany. Previous studies suggested that vitamin D might be a modifiable and protective factor for periodontitis, caries, and tooth loss. However, prospective studies investigating such associations are limited. We explored the association between the concentration of serum 25-hydroxy vitamin D (25OHD) and incidence of tooth loss, progression of clinical attachment loss (CAL) ≥ 3 mm, and progression of restorative and caries status in a population-based longitudinal study. We analyzed data from 1,904 participants from the Study of Health in Pomerania with a five-year follow-up. Generalized estimating equation models were applied to evaluate tooth-specific associations between serum 25OHD and incidence of tooth loss, progression of CAL ≥ 3 mm, and progression of restorative and caries status. Age, sex, education, smoking status, alcohol drinking, waist circumference, dental visit frequency, reasons of dental visit, vitamin D or calcium supplements, and season of blood draw were considered as confounders. Serum 25OHD was inversely associated with incidence of tooth loss. A significant dose-response relationship (p = .0022) was observed across the quintiles of serum 25OHD. After adjusting for multiple confounders, each 10-µg/L increase of serum 25OHD was associated with a 13% decreased risk of tooth loss (risk ratio: 0.87; 95% confidence interval: 0.79, 0.96). The association was attenuated for changes of CAL ≥ 3 mm when adjusting for multiple confounders. No significant association was found between serum 25OHD and caries progression. Vitamin D might be a protective factor for tooth loss. The effect might partially be mediated by its effect on periodontitis.

Hydrogen gas reduced acute hyperglycemia-enhanced hemorrhagic transformation in a focal ischemia rat model.

Hyperglycemia is one of the major factors for hemorrhagic transformation after ischemic stroke. In this study, we tested the effect of hydrogen gas on hemorrhagic transformation in a rat focal cerebral ischemia model. Sprague-Dawley rats (n=72) were divided into the following groups: sham; sham treated with hydrogen gas (H(2)); Middle Cerebral Artery Occlusion (MCAO); and MCAO treated with H(2) (MCAO+H(2)). All rats received an injection of 50% dextrose (6 ml/kg i.p.) and underwent MCAO 15 min later. Following a 90 min ischemic period, hydrogen was inhaled for 2 h during reperfusion. We measured the level of blood glucose at 0 h, 0.5 h, 4 h, and 6 h after dextrose injection. Infarct and hemorrhagic volumes, neurologic score, oxidative stress (evaluated by measuring the level of 8 Hydroxyguanosine (8OHG), 4-Hydroxy-2-Nonenal (HNE) and nitrotyrosine), and matrix metalloproteinase (MMP)-2/MMP-9 activity were measured at 24 h after ischemia. We found that hydrogen inhalation for 2 h reduced infarct and hemorrhagic volumes and improved neurological functions. This effect of hydrogen was accompanied by a reduction of the expression of 8OHG, HNE, and nitrotyrosine and the activity of MMP-9. Furthermore, a reduction of the blood glucose level from 500+/-32.51 to 366+/-68.22 mg/dl at 4 h after dextrose injection was observed in hydrogen treated animals. However, the treatment had no significant effect on the expression of ZO-1, occludin, collagen IV or aquaporin4 (AQP4). In conclusion, hydrogen gas reduced brain infarction, hemorrhagic transformation, and improved neurological function in rats. The potential mechanisms of decreased oxidative stress and glucose levels after hydrogen treatment warrant further investigation.

[Microscopic identification of Rhodiola henryi].

OBJECTIVE: To study the microscipic characteristics of the rhizoma, root, stem, leaf and powder of Rhodiola henryi. METHOD: By microscopic observation. RESULTS: The brown substance was always found in the rhizoma and root of Rhodiola henryi. There was a fiber ring in the cambium region of the stem, and some fiber bundles surrounded the pholem. The epidemis cells of the leaf were different in size, and some were very large. Most stomata were anisocytic. The pollen grains were spherical or oblate, with irregularly reticular veins on the outer walls and three germ pore furrows. CONCLUSION: The above-mentioned characteristics provided a basis for the identification of Rhodiola henryi.

[The status quo survey of false and inferior species in Chinese medicinal materials market in Hubei Province].

By taking a sample, unqualified varieties were investigated found in Chinese medicinal material examinatorial work near twenty years of six regional level and three countrylish level institutes for drug control and one comprehensive level-three grade-A hospital. By mail, false and inferior species and their origin of Chinese medicinal material were investigated found by sixteen institutes for drug control near ten years in Hubei province. 539 kinds of adulterants (750 cases) including 24 toxic species were found in above-mentioned investigations. Fales and inferior species are rampant in minority regions, which threatens people's health severely. It is urgent for supervising department to gorem the condition strictly.

[Analysis of tendency of false and inferior species from Chinese medicinal materials markets].

OBJECTIVE: To offer information on the supervision by analysing the change of origin of false and inferior species from Chinese medicinal materials (CMM) markets. METHOD: 750 cases false and inferior species from Hubei province were compared classifiedly. RESULTS: In recent ten years, distributive characteristics of false and inferior species from CMM markets is as follows. First, false and inferior species from prepared medicinal herb increase, so do with man-made adulteration and poisonous species. Second, false and inferior species increase in rural area, country fairs, individual clinics and medicine booths. Last, extracted products are sold and used as certified products. CONCLUSION: CMM country fairs, outlying rural area, individual clinics and private medicine booths are the center of further supervision hereafter.

[The identification of Hippocampus by HPCE].

Hippocampus from various origins were identified by HPCE. And their character spectrums were established.

[Morphological and histological studies of herba sedum aizoon].

The description characters of Herba Sedum aizoon were recounted. And the histological characters of the root, rhizome, stem, leaf and flower of the plant were reported. The characters of the isolated tissue and powder were also involved. These results provided valuable reference information for putting the medicinal resource to rational exploitage and use.

[Characterization of the Pt/CeO2-ZrO2/Al2O3 catalysts by spectra].

The performance of Pt/Al2O3 catalysts with CeO2-ZrO2 in difference ways was studied by NIR-FT-Raman, BET, H2 chemisorption, XRD. It shows that the dispersion of Pt on Al2O3 is improved with the increasing of dispersion of CeO2-ZrO2 on the surface of Al2O3, owing to the strong interacting between CeO2-ZrO2 and Pt. And adding with salts is priority.

[Effect of emodin on development of hepatic fibrosis in rats].

OBJECTIVE: To investigate the effect of emodin on the development of hepatic fibrosis in rats. METHODS: Forty percent of carbon tetrachloride (CCl4) dissolved in olive oil was injected subcutaneously to rats twice a week, for 6 weeks to produce hepatic fibrosis model, the rats of treated group were simultaneously injected with CCl4, treated with emodin in low, medium and high dose (20, 40 and 80 mg/kg body weight respectively) once a day for 42 days, which was dissolved in 0.5% sodium carboxymethylcellulose (CMC), while for rats of the control group, they only received CCl4 and CMC. Changes of serum hyaluronic acid, laminin and liver hydroxyproline were determined and histopathologic changes of liver was examined by optical microscopy and electronmicroscopy. RESULTS: Compared with the model group, in the emodin treated group: (1) Serum hyaluronic acid and laminin were markedly reduced (P < 0.05 or 0.01); (2) liver hydroxyproline was significantly decreased (P < 0.05 or 0.01); (3) degree of fibrosis was reduced (P < 0.05 or 0.01); (4) hepatocyte injury was ameliorated. CONCLUSION: Emodin has therapeutic effect on the development of hepatic fibrosis in rats. The effect might be related to slowing hepatocyte injury.

[Active antisenile constituents in Cistanche deserticola Y. C. Ma].

From the dry bulbs of Cistanche deserticola a branch of orobahchacease plant growing in Inner Mongolia two active antisenile constituents (D-mannitol and polysaccharide) were isolated and identified. Chemical analysis and spectroscopic tests show that D-mannitol corresponds to the authentic standard, and polysaccharide is condensed from rhamnose, xylose, arabinose and galactose.

[Tissue culture and rapid propagation of Pinellia ternata (Thunb) Breit].

In this papar, selection of the explaints and morphogenesis of the plantlet involved in the tissue culture of Pinellia ternata have been investigated, the effect of different combinations of growth-regulating substances on the morphogenesis has been studied, and the result of the establishment of clonal rapid propagation system and the transplanting of test-tube Pinellia seedlings has also been reported.

[Study on effect of mediation principle in retarding progression of chronic renal failure].

100 Patients with chronic renal failure(CRF) were treated mainly by the mediation principle (MP). Results showed that the progression of CRF with MP was slower than that without MP. There was very significant difference (P < 0.01) between the regression coefficient. In addition, the effect of MP on the factors in promoting the progression of CRF, e.g., hypertension, albuminuria, hyperlipemia and immune function etc. was discussed in detail.

[Protective effects of ginsenoside on myocardiac ischemic and reperfusion injuries].

Thirty mitral valvular surgical patients were randomly divided into three groups for study of protective effects of Ginsenoside on myocardiac ischemic and reperfusion injuries. In GI, 11 patients (controls), no Ginsenoside was used, in GII, 11, Ginsenoside in total was added into the cardioplegic solusion made in our hospital, and in GIII, 8, instead of Ginsenoside in total Ginsenoside Rb was added. During operation comparative studies were made of pre- and postoperative cardiac functions with intraoperative transesophageal echocardiography and ultrastructures of myocardiac cells with electromicroscopy. We conclude that both Ginsenoside in total and Ginsenoside Rb have protective effects on myocardiac ischemic and reperfusion injuries in open heart surgery, and the effect of Ginsenoside in total is even better than that of Ginsenoside Rb.

[Statistical analysis of age-related macular degeneration (AMD) in the differentiation of symptoms and signs].

Ninety-eight individuals according with entry criterion were allowed to participate in the study. Their clinical symptoms and signs were classified to seven symptoms by means of epidemiology. The results indicated syndrome of vital energy in patient group had more significant than controlled group, the others had not. In the syndrome of deficiency of vital energy, the frequency that the corpalent tongue or margin and tip of the tongue look jagged and the pulse lost its vitality emerged in the patient group surpassed significantly the controlled group. So, we initially considered that traditional Chinese medicine syndrome of AMD patient is mainly the deficiency of vital energy. The happening and development of AMD is probably related to the physique of deficiency of vital energy, it is a key point of determination of treatment with traditional chinese medicine based on differentiation of symptoms and signs.