Current status of prevention and treatment of respiratory diseases in primary care in China: a cross-sectional study.

BACKGROUND: China launched its new round of health care reform to develop primary care in 2009, establishing 954,390 primary care institutions that employed over 10 million staff by 2019. However, some studies have shown that the prevention and management of respiratory diseases is inadequate in these institutions. METHODS: We conducted a cross-sectional survey of grassroots institutions throughout China between September and December 2020 based on the standardized Prevention and Treatment System and Capacity Building Project of Respiratory Diseases in primary care settings. The operation of the respiratory department in primary health care institutions was evaluated in terms of facilities, drugs, personnel and management of chronic diseases by means of questionnaires. Descriptive analyses were performed to calculate percentages and frequencies of key parameters. RESULTS: A total of 144 primary health care institutions were surveyed, including 51 in the east, 82 in the west, 9 in the central and 2 in the northeast. Approximately 60% of institutions had spirometers and pulse oximeters. The majority had short-acting bronchodilators, theophylline, systemic corticosteroids, antibiotics, and traditional Chinese medicine. More than half had at least one respiratory physician and operator for spirometry. Half of the institutions carried out screening of chronic obstructive pulmonary disease within the jurisdiction. The institutions in the east were superior to those in the west regarding the equipment, common drugs, medical staff, and management of respiratory diseases. CONCLUSIONS: The study reveals that the overall operation of the respiratory department in primary care settings needs to be further strengthened. It is crucial to provide adequate essential equipment, medical professionals, and medicines for proper diagnosis and treatment of chronic respiratory diseases, as well as improving the management of diseases.

A novel arthritis model induced by wind, damp, cold and heat in female rats.

Animal models are in constant development to benefit scientific research. Rheumatoid arthritis (RA) is considered a very complex disease due to its complicated pathogenesis, and patients with rheumatic disease around the world are still unable to obtain effective, simple and curable treatment. In order to obtain a clear insight into the pathogenesis of RA, a rat model was established based on the concept of Bi syndrome in Traditional Chinese Medicine by simulating the conditions of RA as much as possible via the change in the physical conditions wind, damp, cold and heat (WDCH). For the first time, a new WDCH-induced RA model in female rats was successfully established and evaluated by body-weight change, paw swelling, blood cells analysis, spleen and thymus coefficients, autoantibodies and serum cytokine changes and histopathology. This model is characterised by its objectivity, no exogenous induction, short modelling time, extremely elevated expression level of autoantibodies and obvious histopathological change. The establishment of such a new model may provide more benefits in the research of the pathogenesis of RA.

Optimization of Ultrasound-Assisted Extraction Followed by Macroporous Resin Purification for Maximal Recovery of Functional Components and Removal of Toxic Components from Ginkgo biloba Leaves.

In the present study, the process of ultrasound-assisted extraction (UAE) followed by macroporous resin purification was successfully developed to achieve maximal recovery of functional components (flavonoids and ginkgolides) with minimal contents of toxic components (alkylphenols) from Ginkgo biloba leaves. Three effective extracted factors including HAc%, EtOH%, and UAE power were screened by Plackett-Burman design (PBD). The important variables were further optimized by rotatable central composite design (RCCD). By combination of PBD and RCCD, the resulting optimal UAE conditions were as follows: HAc% of 1.8%, EtOH% of 63%, ultrasound power of 303 W, G. biloba leaves powder amount of 1.0 g (solvent-to-solid ratio 40 mL/g), particle size of 60 mesh, extraction time of 40 min, and extraction temperature of 45°C. Under the optimum conditions, the yield of flavonoids was 25.1 ± 0.81 mg/g, ginkgolides was 10.6 ± 0.57 mg/g, and alkylphenols was 3.96 ± 0.31 mg/g. Moreover, the further enriching the functional components and removing toxic components from the obtained extracts of G. biloba leaves using the above optimum UAE condition was successfully achieved by macroporous resin DA-201. After column adsorption and desorption on DA-201, the content of total flavonoids was 36.51 ± 1.53%, ginkgolides was 13.24 ± 0.85%, and alkylphenols was 7.0 ± 1.0 µg/g from the obtained dry extracts (drug to extract ratio of 45-50:1) of G. biloba leaves which were complied with Chinese pharmacopoeias.

Predicting biofilm thickness and biofilm viability based on the concentration of carbon-nitrogen-phosphorus by support vector regression.

Current tools to predict biofilm thickness and viability in spatial distribution are poor, especially those based on chemical oxygen demand (COD), total nitrogen (TN), and total phosphate (TP) due to their limited data and complex calculations. Here, support vector regression (SVR) was used to predict biofilm thickness and viability in a reactor filled with carriers of crushed stone globular aggregates. Analyses combined confocal laser scanning microscopy and flow cytometry with Kriging interpolation revealed that biofilm thickness varied from 22 to 31 µm, and biofilm viability decreased from 80 to 30% in the flow direction of the reactor. The biofilm thickness at the bottom was thicker than that in the upper layer, but biofilm viability contrasted with biofilm thickness in the vertical distribution. The values of biofilm thickness and viability were predicted at a layer 35 cm from the bottom of the reactor with mean squared error values of 0.014 and 0.011, respectively. Correlation coefficients were 0.996 and 0.997 between carbon-nitrogen-phosphorus (C-N-P) removal with biofilm thickness and viability in spatial distribution, respectively. This study provided an important mathematical method to predict biofilm thickness and viability in spatial distribution based on the concentration of C-N-P.

Effects of Ziziphus jujuba fruit extracts on cytochrome P450 (CYP1A2) activity in rats.

Drug-drug interactions have become a serious problem in the clinic, since plant-based medicines are extensively used. The present study investigated the effects of Ziziphus jujuba fruit (ZJ) extract on the pharmacokinetics of phenacetin, a typical substrate of a cytochrome P450 enzyme CYP 1A2, in rats. The rats were pretreated with the water extract (1.0 g · kg(-1)) or the ethanolic extract (3.6 g · kg(-1)) of ZJ for 10 days, and the pharmacokinetics of phenacetin was investigated after intravenous administration. In an in vitro assay, acetaminophen formation in the hepatic microsomes of ZJ-treated rats was investigated to assess CYP1A2 activity. Our results demonstrated that the treatment with the water and ethanolic extracts of ZJ decreased the plasma concentration of phenacetin and increased the plasma concentration of acetaminophen, resulting in a 43.2% and 15.5% reduction in the AUC0-120 of phenacetin, respectively, and a 53.2% and 64.9% increase in the AUC0-120 of acetaminophen, respectively after intravenous administration. The water or ethanolic extract of ZJ significantly increased the clearance of phenacetin and acetaminophen formation in hepatic microsomes. In conclusion, ZJ extracts displayed effects on the pharmacokinetics of phenacetin and increased the CYP1A2 activity in rats. Therefore, precaution on drug-drug interactions should be taken when ZJ is co-administered with drugs metabolized by CYP1A2, which may result in decreased concentrations of these drugs.

In vitro and in vivo assessment of CYP2C9-mediated herb-herb interaction of Euphorbiae Pekinensis Radix and Glycyrrhizae Radix.

According to traditional Chinese medicine theories, Euphorbiae Pekinensis Radix and Glycyrrhizae Radix should not be used together in one prescription, because their interaction leads to an unexpected consequence. However, the mechanism remains unclear. The purpose of this study was to find out whether CYP2C9 was involved in this herb-herb interaction by using tolbutamide as a probe substrate in vivo and in vitro. Both Euphorbiae Pekinensis Radix and Glycyrrhizae Radix showed induction activity toward CYP2C9, while the combination of them showed a more potent induction activity toward CYP2C9 in vivo. In vitro study revealed only the combination of the herbs could induce the activity of CYP2C9. Thus, both in vivo and in vitro study indicated combination of Glycyrrhizae Radix and Euphorbiae Pekinensis Radix could induce the activity of CYP2C9 to a high level, which may result in decreased plasma levels of major active ingredients of these two herbs, as well as other herbs in the prescriptions. Further research also appears to be necessary to identify the main enzymes involved in the metabolism of the active ingredients in Glycyrrhizae Radix and Euphorbiae Pekinensis Radix.

A fully human monoclonal antibody to Staphylococcus aureus iron regulated surface determinant B (IsdB) with functional activity in vitro and in vivo.

A fully human monoclonal antibody (CS-D7, IgG1) specific for the iron regulated surface determinant B (IsdB) of Staphylococcus aureus was isolated from the Cambridge Antibody Technology (CAT) scFv antibody library. As compared to previously described IsdB specific murine monoclonals, CS-D7 has a unique, non-overlapping binding site on IsdB, and exhibits increased in vivo activity. The antibody recognizes a conformational epitope spanning amino acids 50 to 285 and has a binding affinity of 340 (± 75) pM for IsdB. CS-D7 bound to a wide variety of S. aureus strains, but not to an isdB deletion mutant. The antibody mediated opsonophagocytic (OP) killing in vitro and mediated significant protection in vivo. In a murine lethal sepsis model, the antibody conferred protection from death when dosed prior to challenge, but not when dosed after challenge. Importantly, in a central venous catheter (CVC) model in rats, the antibody reduced bacteremia and prevented colonization of indwelling catheters. Protection was observed when rats were dosed with CS-D7 prior to challenge as well as post challenge. IsdB is currently being investigated for clinical efficacy against S. aureus infection, and the activity of this human IsdB specific antibody supplements the growing body of evidence to support targeting this antigen for vaccine development.

[Effect of phosphorus on copper tolerance in Achyranthes bidentata].

OBJECTIVE: To study the effect of phosphorus on copper tolerance in Achyranthes bidentata. METHOD: A PVC pipe experiment was conducted to study the interactive effects of phosphorus (P) and copper (Cu), on growth, elemental accumulation and chemical constituents of A. bidentata. Two levels of elemental P were applied at 0 (P0) and 100 ( P100) mg x kg(-1) soil with 5 levels of Cu at 0 (Cu0), 100 (Cu100), 200 (Cu200), 200 (Cu400), 200 (Cu600) mg x kg(-1) soil, respectively. RESULT AND CONCLUSION: The biomass production between different Cu treatments, phosphorus treatment showed significant differences. The biomass reached the maximum value as the concentration of Cu and P was 100 mg x kg(-1). Low concentration of Cu improved the growth of A. bidentata. The growth was blocked as Cu concentration reached 200 mg x kg(-1) in soil, however the contents of oleanolic acid and ecdysterone in roots of A. bidentata had not influenced by Cu. P could improved the copper tolerance in A. bidentata and increased root yield. The Cu concentration in soil of the cultivation bases must be below 200 mg x kg(-1) in order to produce good quality of medicinal material.