Multicenter Clinical Randomized Controlled Trial and Network Pharmacology Analysis of Zhenzhu Qingyuan Granules for the Treatment of Gastroesophageal Reflux Disease

Objective To evaluate the clinical efficacy and safety of Zhenzhu Qingyuan Granules through a clinical randomized controlled trial and to analyze the potential action targets and pathways of this formula using network pharmacology.Methods Patients with gastroesophageal reflux disease(GERD)of liver–stomach stagnant heat pattern who met the inclusion and exclusion criteria were randomly divided into the control group and the observation group.The control group received oral rabeprazole,whereas the observation group were given Zhenzhu Qingyuan Granules in addition to the rabeprazole.The treatment duration was 8 weeks.Clinical efficacy was observed in both groups after 8 weeks.Network pharmacology was used to analyze the action targets of ZhenzhuQingyuanGranules and the genes related to GERD,and core targets were inferred.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were conducted to explore the potential mechanisms of this formula.Results The clinical research results showed that the total effective rate in the treatment group was 92.68%,compared with 70.00%in the control group,with a statistically significant difference(p<0.05).After treatment,both Chinese medicine syndrome score and endoscopic score improved in both groups compared with before treatment(p<0.05),and the treatment group showed greater improvement than the control group(p<0.05).Network pharmacology identified effective components of Zhenzhu Qingyuan Granules for treating GERD,including quercetin,luteolin,andβ-sitosterol,with potential action targets such as tumor protein 53(TP53),protein kinase B(AKT1),and tumor necrosis factor.Conclusion Zhenzhu Qingyuan Granules can significantly improve clinical symptoms in patients with GERD of liver–stomach stagnated heat pattern,enhance clinical efficacy,and have high safety.This formula may exert therapeutic effects through multiple targets and pathways.

从一道导数题的解法看放缩法的应用

一、放缩法的定义 放缩法是指要证明不等式A〈B成立．有时可以将它的一边放大或缩小，寻找一个中间量，如将A放大成C，即A〈C，后证C〈B，这种证法便是放缩法，是不等式的证明里的一种方法．

“后置审批”无实质影响,留学中介未来竞争加剧

无论是前置审批还是后置审批,要想开展留学中介服务活动,按规定都必须获得"中介资质认定书","照证"两全才可以开展留学中介服务,行业准入要求并没有降低。日前,国务院印发《关于取消和调整一批行政审批项目等事项的决定》,将31项工商登记前置审批事项改为后置审批,其中包括"自费出国留学中介服务机构资格认定"。政策一出,在留学行业中引起了不小震动,许多媒体和业内人士将"前置审批"改为"后置审批"

焦作市地产交易中心“四严四要”服务经济发展

焦作市地产交易中心在规范地产交易市场管理摸索、实践中,主动适应新常态,总结出了“四严四要”的工作方法,更好地服务经济发展。严初审,要规范。焦作市地产交易中心从业务源头上抓管理,制定首问负责制,责任落实到人,谁出错,谁负责。在土地使用权抵押登记和转让程序工作中,对报件严格土地权属来源的审核,认真对照证书文号,实地勘查土地现状,详细核实地籍档案资料;对每宗抵押、转让地块的实地勘查,仔细对照合同约定内容,做好详细的资料审核、登记。

Review of salt consumption and stomach cancer risk:Epidemiological and biological evidence

Stomach cancer is still the fourth most common cancer;thus,it remains an important public health burden worldwide,especially in developing countries.The remarkable geographic variations in the rates of stomach cancer indicate that dietary factors,including a range of food groups to which salt and/or nitrates have been added,may affect stomach cancer risk.In this paper,we review the results from ecologic,case-control and cohort studies on the relationship between salt or salted foods and stomach cancer risk.The majority of ecological studies indicated that the average salt intake in each population was closely correlated with gastric cancer mortality.Most case-control studies showed similar results,indicating a moderate to high increase in risk for the highest level of salt or salted food consumption.The overall results from cohort studies are not totally consistent,but are suggestive of a moderate direct association.Since salt intake has been correlated with Helicobacter pylori(H pylori) infection,it is possible that these two factors may synergize to promote the development of stomach cancer.Additionally,salt may also cause stomach cancer through directly damaging gastric mucus,improving temporary epithelial proliferation and the incidence of endogenous mutations,and inducing hypergastrinemia that leads to eventual parietal cell loss and progression to gastric cancer.Based on the considerable evidence from ecological,case-control and cohort studies worldwide and the mechanistic plausibility,limitation on salt and salted food consumption is a practical strategy for preventing gastric cancer.

The Application of PBL in Surgery Theory Teaching Research

objective： to study the problem oriented （PBL） teaching method application in surgery theory teaching effect. Methods： according to the student id number of single and double the surgical theory study stage of the 160 cases of medical students divided into two groups, the number into the control group （80 cases）, double number into the experimental group （80 cases）, traditional teaching method and PBL teaching method, respectively with the method of questionnaire survey to evaluate the two teaching methods. Results： after the introduction of PBL method in the experimental teaching, the students＇ classroom situation, knowledge situation, learning efficiency index score significantly higher than the control group, and the ability training all indicators were significantly higher than that of control group （P 〈 0.05）. Conclusion： the introduction of PBL in surgery theory teaching method, the feasibility of high, can provide a good decision for surgical theory teaching.

Current situation on the reporting quality of randomized controlled trials in 5 leading Chinese medical journals

Objective:The Consolidated Standards for Reporting of Trials(CONSORT) statement has already proved to be an efficient standard for reporting quality of randomized controlled trials(RCTs).However,most of the Chinese medical journals have not endorsed the CONSORT statement.The current situation about the reporting quality of RCTs in Chinese medical journals is still unclear.The purpose of the study was to evaluate the reporting quality of RCTs on papers published in 5 leading Chinese medical journals.Methods:We evaluated 232 original RCT papers using a reporting quality scale based on CONSORT statement from 2001 to 2006 in 5 Chinese medical journals(Journal type 1) without adoption of CONSORT and Chinese Journal of Evidence-based Medicine(Journal type 2) which adopted CONSORT in 2004.We measured the inclusion of 26 items for the reporting quality scale and 6 core items of each RCT report,gave score to each item and calculated the total score obtained in each report and the proportion of reports including individual items.The reporting quality of RCT trials from 2001 to 2003(pre-adoption period) was compared with that from 2004 to 2006(post-adoption period).Results:The average reporting quality of RCTs was moderate(mean score,15.18),and the mean score of the 6 core items was low(mean score,1.09) in 5 leading journals.The difference in the total score and the score of the 6 core items between pre-adoption period(2001-2003) and post-adoption period(2004-2006) was statistically significant(P=0.003;P=0.000).Interaction between journal type and period was not significant(F=0.76;P=0.383).We concluded that the change tendency of reporting quality between Journal type 1 and 2 was not different.But as to the core items of sequence concealment and intention-to-treat analysis,the increases were greater for Journal type 2 when evaluated against Journal type 1(P=0.038;P=0.016).Conclusion:The reporting quality of RCT trials in 5 leading Chinese medical journals is improving.However,the lack of important items in RCT trials remains a serious problem.We recommend the endorsement of the Consolidated Standards for Reporting of Trials statement in Chinese medical journals and the continuing education on evidence-based medicine in China.

浅谈私营企业税收征管问题

在改革开放方针指引下,深圳市私营企业得到很大的发展,对促进生产,搞活经济,扩大就业,增加财政收入,起到了积极作用。税务机关贯彻执行对私营企业的税收政策,加强征收管理,做了许多工作,取得一定成绩。但是,由于私营企业发展较快,我们的征管措施一时还未相应跟上,因而也存在一些问题: 一、照实不符和照证不符现象较多。有些私营企业的营业执照内容与实际经济性质、经营方式范围不相符合。有的挂国营、集体招牌,实为私营经济。有的领取营业执照后,转让或承包他人经营。

Moxibustion for maintenance hemodialysis patients in deficiency syndrome:a randomized controlled trial

Objective To explore the effective therapy for deficiency syndrome in the maintenance hemodialysis patients of end-stage renal disease. Methods Ninety-seven maintenance hemodialysis patients of end-stage renal disease were divided into an observation group （51 cases） and a control group （46 cases） randomly, and routine western medicines were used in both groups. On this base, moxibustion was given at Zusanli （足三里 ST 36） and Sanyijiao （三阴交 SP 6） with a paper-tube-moxibustion equipment in the observation group. The therapeutic effects on syndromes were evaluated by comparing the symptom scores in two groups before and after treatment. Results After treatment, all the symptom scores in the observation group were improved significantly （all P〈0.05）, with fatigue and weakness, short breath and aversion to talking, poor appetite, lassitude in loin and knees, aversion to cold, cool extremities and so on most obviously improved, and the total effective rate on the syndrome in observation group （64.7%, 33/51） was significantly higher than that in control group （23.9%, 11/46）, with a significant difference between the two groups （P〈0.05）. Conclusion Moxibustion can improve the clinical symptoms of maintenance hemodialysis patients of end-stage renal disease, and it has some therapeutic effect on the deficiency syndrome.

Electroacupuncture at Qiuxu (GB 40) for Treatment of Migraine——A Clinical Multicentral Random Controlled Study

Objective： To observe the therapeutic effects of electroacupuncture （EA） at Qiuxu （GB 40） for treatment of migraine so as to provide clinical evidence for compilation of the Acupoints＇ Dictionary of the People＇s Republic of China. Methods： 275 migraine patients admitted in 3 hospitals were randomly divided into a treatment group treated by EA at Qiuxu （GB 40）, and a control group treated by EA at Tianshu （ST 25）. The indexes of the migraine symptoms and the 5-HT level were observed in both the groups before and after treatment. Results： There was an significant difference in VAS score between the two groups of the 3 clinical centers （P〈0.01）. The therapeutic effects of a 4-week treatment were much better in the treatment group than that of the control group. The 3-month follow-up survey showed that the long-term effects were in favor of the treatment group of the first and third clinical centers, though no significant difference was found in the treatment group of the second clinical center as compared with the control group. The results from the 6-month follow-up survey showed better effects in the treatment group of all the 3 clinical centers. Conclusion： EA at Oiuxu （GB 40） may show effect for migraine.

Summaries and Recommendations of the Global Impression Method

With the increase in the number of acupuncture clinical trials, systematic reviews are used to summarize key results across many disciplines. Meta-analysis is a popular method for synthesizing evidence as it provides a succinct way of summarizing evidence quantitatively. Due to clinical heterogeneity, however, it is not always possible to use meta-analysis. Instead, a qualitative method is used. The purpose of this paper is to summary the findings of current research on the Global Impression Method （GIM）; a method used to synthesize the results of clinically heterogeneous randomized controlled trial （RCT） in systematic reviews. The results indicate that there is moderate to substantial intra-rater and inter-rater agreement when judging the results of the forest plots using a global impression and simplified version of the best evidence synthesis （BES） method when compared to the results of meta-analyses. Thus, the GIM can be used for researchers to synthesize results of RCT. The quality of the individual study can be taken into consideration after this process to determine a more precise strength of the evidence, therefore, GIM worthy to be used in acupuncture or other studies.

Integrated traditional and Western medicine for treatment of depression based on syndrome differentiation:a meta-analysis of randomized controlled trials based on the Hamilton depression scale

OBJECTIVE:To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale(HAMD) following syndrome differentiation of depression.METHODS:We searched six English and Chinese electronic databases for randomized clinical trials(RCTs) on integrated traditional and Western medicine for treatment of depression.Two authors extracted data and independently assessed the trial quality.RevMan 5 software was used for data analyses with an effect estimate presented as weighted mean difference(WMD) with a 95% confidence interval(CI).RESULTS:Seven RCTs with 576 participants were identified for this review.All trials were eligible for the meta-analysis and were evaluated as unclear or having a risk of bias.Meta-analysis showed,compared with Western medicine alone,integrated traditional and Western medicine based on syndrome differentiation could improve the effect of treatment represented by the HAMD [WMD=-2.39,CI(-2.96,-1.83),Z=8.29,P<0.00001].There were no reported serious adverse effects that were related to integrated traditional and Western medicine based therapies in these trials.CONCLUSIONS:Integrated traditional and Western medicine based therapies for the syndrome differentiation of depression significantly improved the HAMD,illustrating that combining therapies from integrated traditional and Western medicine for treatment of depression is better than Western medicine alone.However,further large,rigorously designed trials are warranted due to the insufficient methodological rigor seen in the trials included in this study.

Multi-scale validation strategy for satellite albedo products and its uncertainty analysis

Coarse-resolution satellite albedo products are important for climate change and energy balance research because of their capability to characterize the spatiotemporal patterns of land surface parameters at both the regional and global scales. The accuracy of coarse-resolution products is usually assessed via comparison with in situ measurements. The key issue in the comparison of remote sensing observations with in situ measurements is scaling and uncertainty. This paper presents a strategy for validating 1-km-resolution remote sensing albedo products using field measurements and high-resolution remote sensing observations. Field measurements were collected to calibrate the high-resolution(30 m) albedo products derived from HJ-1a/b images. Then, the calibrated high-resolution albedo maps were resampled(i.e., upscaled) to assess the accuracy of the coarse-resolution albedo products. The samples of field measurements and high-resolution pixels are based on an uncertainty analysis. Two types of coarse-resolution albedo datasets, from global land surface satellite(GLASS) and moderate-resolution imaging spectroradiometer(MODIS), are validated over the middle reaches of the Heihe River in China. The results indicate that the upscaled HJ(Huan Jing means environment in Chinese and this refers to a satellite constellation designed for environment and disaster monitoring by China) albedo, which was calibrated using field measurements, can provide accurate reference values for validating coarse-resolution satellite albedo products. However, the uncertainties in the upscaled HJ albedo should be estimated, and pixels with large uncertainties should be excluded from the validation process.