提高大学生网络自主学习能力研究

文章突破网络自主学习理论性研究,探讨大学生网络自主学习面临的困扰,通过不断完善校园网络教学平台,切实加强教师与学生互动,从而提升学生对网络自主学习的积极性和学习的能力。

矮地茶HPLC指纹图谱及5个化学成分定量分析

目的:建立矮地茶的HPLC指纹图谱并测定其中5个化学成分含量,为矮地茶药材的质量控制提供实验依据。方法:采用Ultimate XB-C_(18)(250 mm×4.6 mm, 5μm)色谱柱;以0.1%磷酸溶液-乙腈为流动相,梯度洗脱;流速为0.6 mL/min;检测波长为230 nm;柱温为30℃;进样量为5μL。采用“中药色谱指纹图谱相似度评价系统(2012版)”建立10批矮地茶HPLC指纹图谱,并对其中5个成分进行含量测定。结果:建立了矮地茶HPLC指纹图谱,共标定了14个色谱峰,指认了其中5个成分,矮地茶中没食子酸、岩白菜素、表儿茶素、槲皮苷、杨梅苷含量分别为0.21~0.61 mg/g、2.85~9.59 mg/g、0.67~1.52 mg/g、0.26~1.01 mg/g、0.51~3.36 mg/g。结论:该研究建立的矮地茶HPLC指纹图谱及5个成分含量测定方法稳定、简便,可为矮地茶质量评价提供参考。

Clinical Intelligent Diagnosis Path Based on the Chief Complaint

Goals of traditional Chinese medicine(TCM)include precision,accuracy,and recognition by clinical practice.Establishment of a diagnosis and treatment system that closely conforms to the principle-method-recipe-medicines system and derivation of an accurate diagnosis and treatment plan should be considerations of TCM.Artificial intelligence research based on computer technology is one of the effective ways to solve this problem.In the research of intelligent diagnosis path,reflecting the characteristics of the overall view and dialectical treatment of TCM such as"Combination of four diagnostic methods""overall examination""combination of disease and syndrome"and"treatment individualized to patient,season and locality"are key for successful research of artificial intelligence in TCM diagnosis or recognition by clinical practice.

The prescription rule analysis of the New Theory on Spleen Dampness Syndrome by Academician TONG Xiaolin

Objective To analyze the basic characteristics,drug features,prescription rules,and drug-symptom relationships of patients in the splenic deficiency and impairment stage,by data mining of medical records under the New Theory on Spleen Dampness Syndrome(Pi Dan Xin Lun,《脾瘅新论》).Methods Medical records listed in the“New Theory on Spleen Dampness Syndrome-Under-standing and Treatment of Metabolic Syndrome from the Perspective of Traditional Chinese Medicine”,and which were diagnosed with the spleen dampness syndrome at the splenic de-ficiency and impairment stage,during January 2004 and December 2016 were selected.These patients’data,including basic information,clinical symptoms,laboratory examination res-ults,traditional Chinese medicine(TCM)and western medicine diagnoses,treatment meth-ods,prescriptions,etc.,were collected.The collected data were subsequently compiled into a medical record database using the Epidata 3.1 data management software,followed by the use of Apriori algorithm provided in the SPSS Modeler 14.2 statistical software to investigate the association rules between drug-drug,drug-symptom,and drug-western medicine indices.Results(i)A total of 51 medical records were included,involving 17 types of syndromes.Among them,the top three with frequency≥3 included“Phlegm and blood stasis,and thoracic obstruction”“Deficiency-weakness of the spleen Qi,and static blood blocking collat-erals”,and“Deficiency-weakness of the spleen Qi,and static blood blocking collaterals”.Al-ternatively,of the 14 treatment methods,the top three treatments with frequency of≥3 in-cluded“Activating Yang and eliminating turbidity,and removing phlegm and dredging chan-nel blockage”“Strengthening the spleen and benefiting Qi,and eliminating phlegm to activ-ate the channels”,and“Warming Yang and benefiting Qi,and expelling cold to remove ob-structions”.Among the 15 prescriptions,the top three used with frequency≥3 included Huangqi Guizhi Wuwu Tang(黄芪桂枝五物汤),Gualou Xiebai Banxia Tang(瓜蒌薤白半夏汤),and Ganjiang Huangqin Huanglian Renshen Tang(干姜黄芩黄连人参汤).Lastly,of the 83 drugs used for a total of 476 times,those with frequency≥15 included Huanglian(Coptid-is Rhizoma),Huangqi(Astragali Radix),Jiudahuang(Wine-processed Rhei Radix et Rhizoma),Jixueteng(Spatholobi Caulis),Shengjiang(Zingiberis Rhizoma Recens),Huangqin(Scutellariae Radix),and Guizhi(Cinnamomi Ramulus).(ii)For the drug-drug associations,under the criteria of support≥15%and confidence=100%,seven second-order association rules,seven third-order rules,and six fourth-order roles were identified.The top-ranking rule of each was“Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”“Ganjiang(Zingiberis Rhizoma)+Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”,and“Baishao(Paeoniae Radix Alba)+Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatho-lobi Caulis)→Huangqin(Scutellariae Radix)”,respectively.Alternatively,the drug-symptom associations were analyzed under the criteria of support≥5%and confidence=100%,which derived eight second-order association rules,31 third-order rules,and 30 fourth-order rules.The top-ranking association rule of each order was“Huangqi(Astragali Radix)→Limb ed-ema”“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)→Limb numbness and pain”,and“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)+Huangqi(As-tragali Radix)→Limb numbness and pain”,respectively.Similarly,the drug-western medi-cine index associations were investigated under the criteria of support≥5%and confidence=100%,and five second-order association rules,16 third-order rules,and 16 fourth-order rules were identified.In this category,the top-ranking association rule of each order was“Qinpi(Fraxini Cortex)→Uric acid”“Huanglian(Coptidis Rhizoma)+Ganjiang(Zingiberis Rhizoma)→Glycated hemoglobin”,and“Huanglian(Coptidis Rhizoma)+Ganjiang(Zing-iberis Rhizoma)+Huangqin(Scutellariae Radix)→Glycated hemoglobin”,respectively.Conclusion Through association rule mining,this study objectively and quantitatively demonstrated the drug-drug,drug-symptom,and drug-physicochemical index associations of patients with the spleen dampness syndrome at the splenic deficiency and impairment stage treated by Academician TONG Xiaolin.The results indicated that treatment for these patients adopted the“state-target”syndrome differentiation method.The drug combination was characterized by“small prescriptions”,targeting both the patient’s symptoms and signs(syndrome target)and western medicine indices(treatment target).This study could provide references for future research on the academic thoughts and medical experience of Academi-cian TONG Xiaolin.

肾上腺少见肿瘤CT表现

目的回顾性总结肾上腺少见肿瘤的CT表现特征,以提高诊断水平。方法回顾性分析16例经手术和病理证实的肾上腺少见肿瘤,观察其CT表现特征。结果 16例中,肾上腺节细胞神经瘤3例,均匀较低密度,轻度强化;肾上腺血管瘤及肾上腺神经鞘瘤各2例,密度混杂,增强扫描肾上腺血管瘤不均匀明显强化,肾上腺神经鞘瘤呈轻至中度强化;肾上腺淋巴瘤4例,单侧或双侧较均匀密度软组织肿块,增强扫描具有延迟强化特点,肿瘤较大者周围血管可被包埋;肾上腺皮质癌5例,单侧密度不均匀软组织肿块,增强扫描见肿瘤血管影及邻近脏器受侵犯、下腔静脉癌栓、腹膜后淋巴结转移等恶性征象。结论肾上腺少见肿瘤各具有一定的CT表现特点及诊断价值。

Mechanism of Pingyang Jiangya Formula in treating hypertension based on network pharmacology and in vivo study

Objective This study aimed to analyze the mechanism of action of the Pingyang Jiangya Formula(平阳降压方,PYJYF)in treating hypertension,based on network pharmacology,and to verify the subsequent predictions through animal experiments.Methods The active components and related target genes of PYJYF were screened using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM),Encyclopedia of Traditional Chinese Medicine(ETCM),and Drug Bank databases and available literature.The hypertension target genes were screened based on Therapeutic Target Database(TTD),GeneCards,Online Mendelian Inheritance in Man(OMIM),UniProt,and relevant literature.The component-disease-target network intersection target genes were inputted into the STRING database,and the key target genes were selected according to the degree algorithm.Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses were performed to explore the multitarget mechanism of action and molecular regulatory network of PYJYF in the treatment of hypertension.To verify this prediction,we used PYJYF to intervene in spontaneously hypertensive rats(SHRs)and Wistar–Kyoto rats(WKY)as normal control,and the noninvasive tail artery manometry method was used to measure systolic blood pressure(SBP)in the rat tail before PYJYF intervention.After drug intervention,the SBP of each group rats were measured and compared every week.Enzyme-linked immunosorbent assay(ELISA)was used to test plasma renin,angiotensin II(Ang II),and aldosterone(Ald)levels,and hematoxylin-eosin(HE)staining was used to observe pathological damage to the renal vessels in each group of rats.Western blot and reverse transcription real-time quantitative PCR(RT-PCR)were used to detect the protein and mRNA expression levels of PI3 K,AKT1,BAX,and Bcl-2,respectively.Results A total of 4123 hypertension targets were obtained from related databases.From the TCMSP and chemical databases,78 active components of PYJYF and the corresponding 401 drug targets were retrieved.Data analysis revealed that 208 drug targets directly interacted with the hypertension targets in PYJYF.The 10 targets most closely related to hypertension target proteins in PYJYF were directly retrieved from relevant databases.GO analysis revealed that 10 direct target proteins were involved in all aspects of the antihypertensive effects of PYJYF,as well as molecular biological processes,such as the regulation of blood pressure,renin-angiotensin-aldosterone system(RAAS),angiotensin-mediated ligand reactions,and biological stimulation of cardiomyocyte apoptosis.KEGG pathway enrichment analysis revealed that PYJYF directly affected 20 signaling pathways associated with hypertension.In animal experiments,PYJYF reduced the protein and m RNA levels of PI3 K,Akt,and Bax and upregulated the expression of the protein and m RNA levels of Bcl-2,reduced plasma renin,Ang II,and Ald levels,improved the hyperactivity of RAAS,and significantly reduced SBP in SHRs.Conclusion PYJYF is effective for hypertension therapy that acts through multiple compounds and targets.The possible underlying molecular mechanism includes regulating the PI3 K/Akt signaling pathway to suppress RAAS,increasing the ratio of Bcl-2/Bax proteins,and inhibiting apoptosis,thereby mediating the repair of renal and renal vascular damage caused by hypertension.These findings warrant further research for use in clinical settings.

Effect of Huanglian Jiedu Decoction on cardiac endoplasmic reticulum stress in spontaneously hypertensive rats

Huanglian Jiedu Decoction(HLJDD)is a quintessential prescription renowned for its heat-clearing and detoxifying properties.It is primarily prescribed to counteract the syndrome characterized by the excessive heat of the Sanjiao fire.Notably,the hyperactivity of liver fire is frequently linked with hypertension,where wind fire and wind toxicity emerge as pivotal pathogenic factors.This study aimed to investigate the impact of HLJDD on the endoplasmic reticulum in spontaneously hypertensive rats(SHR),further delving into the interplay between endoplasmic reticulum stress(ERS)and myocardial remodeling and damage.Fifty SHR rats were stratified randomly into five cohorts:model,low-dose HLJDD,medium-dose HLJDD,high-dose HLJDD,and captopril groups.For comparison,a set of Wistar-Kyoto(WKY)rats served as the baseline control group,with each group comprising 10 rats.While the model and control groups received equivalent volumes of normal saline via gavage,the other groups were administered the respective drug dosages through the same route daily for a span of 6 weeks.Upon the experiment’s conclusion,metrics such as the heart mass index(HWI)and left ventricular mass index(LVWI)were assessed.Cardiac tissue anomalies were identified using H&E staining,while ERS-related protein and mRNA expression levels were ascertained via Western blotting analysis and qPCR.Moreover,TUNEL staining was employed to detect cardiomyocyte apoptosis.The findings indicated that increasing HLJDD concentrations corresponded with escalated HWI and LVWI in rat hearts(P<0.05).There was a marked enhancement in myocardial structural integrity,accompanied by a notable reduction in collagen fibers.The mRNA and protein expressions of myocardial inositol-dependent enzyme 1α(IRE1α),X-box binding protein 1(XBP1),glycoregulatory protein 78(GRP78),and CCAAT enhancer binding protein homologous protein(CHOP)in the medium and high-dose groups saw significant declines(P<0.05).These effects mirrored those observed in the captopril group.The study underscored HLJDD’s efficacy in mitigating myocardial tissue damage in SHR.This therapeutic effect was potentially attributed to the downregulation of IRE1α,XBP1,GRP78,and CHOP,curbing excessive ERS,diminishing cardiomyocyte apoptosis,and thereby conferring cardioprotection.

Electroacupuncture combined with thunder-fire moxibustion for knee osteoarthritis of cold-damp type:A randomized controlled trial

Objective:To observe the clinical effect differences of knee osteoarthritis(KOA)with cold-damp type between electroacupuncture(EA)combined with thunder-fire moxibustion and medication.Methods:A total of 72 cases of KOA patients with cold-damp type were randomly divided into a combined treatment group of EA and thunder-fire moxibustion(combined treatment group)and a medication group,36 cases in each group.In the combined treatment group,the acupoints for EA were Dubi(犊鼻ST35),Neixiyan(内膝眼EX-LE4),Zusanli(足三里ST36),Yanglingquan(阳陵泉GB34),Yinlingquan(阴陵泉SP9),Xuehai(血海SP10),Liangqiu(梁丘ST34)and Heding(鹤顶EX-LE2).During the period of EA,the suspending thunder-fire moxibustion was applied to Shenque CV8)and Guanyuan(关元CV4).In the medication group,diclofenac sodium double release intestine-sol capsule and Fugui gutong capsules were prescribed for oral administration.The treatment for 14 days was taken as one course and the consecutive 2 courses of treatment were required in each group.Before and after treatment,as well as in the follow-up visit,the pain score(visual analogue scale,VAS),the knee function score(Western Ontario and McMaster University,WOMAC,the expressions of interleukin 6(IL-6)and transforming growth factorβ1(TGF-β1)in the joint fluid as well as the difference in the clinical therapeutic effect were observed in the two groups separately.Results:(1)The pain score:compared with those before treatment,the VAS scores were all reduced after treatment and in the follow-up in the two groups(all P<0.05).After treatment and in the follow-up,VAS scores in the combined treatment group were lower than those in the medication group(both P<0.05).(2)The knee function score:WOMAC score of each item,i.e.pain,stiffness and function,as well as the total score after treatment and the follow-up were all lower than those before treatment in the patients of the two groups(all P<0.05).The score of each item,i.e.pain and function,as well as the total score in the combined treatment group were all lower than those in the medication group after treatment and the follow-up respectively(all P<0.05).(3)The expressions of IL-6 and TGF-β1:the level of IL-6 in the joint fluid was reduced after treatment as compared with that before treatment in either group and the level of TGF-β1 was increased,indicating the statistical differences(all P<0.05).After treatment,the level of IL-6 in the combined treatment group was lower than that in the medication group and the level of TGF-β1 was higher than that of the medicating group,indicating the statistical significance(both P<0.05).(4)The total effective rate in the combined treatment group was 97.1%,higher than 78.8%in the medication group,indicating the statistical significance(P<0.05).Conclusion:The clinical effect of the combined treatment of electroacupuncture and the thunder-fire moxibustion is remarkable on knee osteoarthritis of cold-damp type.The combined treatment presents a more advantageous at the sustainability of the therapeutic effect as compared with medication.

Meta-analysis and trial sequential analysis on blood uric acid and joint function in gouty arthritis treated with fire needling therapy in comparison with western medication

Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.

Pharmacist-led interventions to reduce inappropriate drug use in the orthopaedics department in China

As the demand for pharmaceutical services continues to grow, more and more attention has been paid to the pharmaceutical care effect. However, in China, the training pathways and practical work of clinical pharmacy are still in the exploratory stage. In the present review, we aimed to discuss the impact of pharmacist-led interventions in reducing inappropriate drug use in orthopaedics. Results showed clinical pharmacists can assist orthopaedists and nurses in the rational use of medication in all aspects of antibiotic therapy, pain control and anticoagulation therapy. The clinical interventions by pharmacists have greatly reduced medication errors and medical costs. However, there is still a long time to develop pharmacy service, improve the professional quality of pharmacists and enact the Chinese Pharmacist Law.

Proteomic changes in rat kidney injured by adenine and the regulation of anemoside B4

Adenine is commonly used to establish the animal models for chronic kidney injury and its renal interstitial fibrosis. As an endogenous substance, adenine-induced kidney damage has not yet been fully studied and elucidated, except for inflammatory reaction. Here we analyzed the proteomics of kidney of rats after adenine overloading using LS-MS/MS assay, and observed the role of anemoside B4(B4). The results showed that adenine could down-regulate 285 proteins and up-regulate 164 proteins in rat kidney tissue compared with the normal group. Down-regulated proteins mainly affected related pathways, such as energy metabolism, while up-regulated proteins affected inflammatory response pathways and metabolic pathways. B4 could significantly reverse the down-regulation of about 40 proteins, which were involved in mitochondria, redox processes, extracellular exosomes, acetylation and other signaling pathways. Simultaneously, B4 could inhibit the up-regulation of five proteins caused by adenine, which were involved in cell cycle, oocyte meiosis, PI3 K-Akt and other signaling pathways. Further experimental results of mRNA expression using real-time PCR assay supported the proteomic analysis. Therefore, we proposed that the damage of rat kidney caused by adenine was more complicated, not only with an inflammatory reaction, but also with extensive effects to various metabolic processes in the body. This work provided a valuable clue for comprehensive understanding of adenine-induced renal damage.

Status quo of resource allocation of Chinese grass-roots food and drug administrations: from 2011 to 2016

County grass-root food and drug administrations （CGFDA） undertake the front-line supervision of food and drug safety, whose resource allocation is vital to the regulation efficiency and performance. In this article, we aimed to analyze the status quo of resource allocation of CGFDA from the aspects of regulatory organization, staff, funding and equipment using official panel data from 2011 to 2016. The results illustrated that the total amount of regulatory resources of CGFDA was increased annuall y, reaching a rather large scale. However, many problems still existed in its allocation. Therefore, a series of measures should be taken to optimize the resource allocation of CGFDA, such as improving the network of institutional CGFDA, increasing the recruitment requirements on educational level and major, reallocating the structure of resources and guaranteeing the resource demand in less-developed areas.

Treatment of insomnia in suboptimal health status with Zhuang medicine herbal-thread moxibustion:A randomized clinical trial

Objective:The objective of this study is to explore the clinical effect and safety of Zhuang medicine herbal-thread moxibustion therapy for the treatment of suboptimal health status-related insomnia through a randomized clinical trial.Methods:A total number of 60 patients with insomnia of suboptimal health status(SHS) were enrolled from the Clinic of Zhuang Medicine,Renai Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine and the Clinic of Zhuang Medicine,the First Affiliated Hospital of Guangxi University of Chinese Medicine,as well as Guangxi University of Chinese Medicine.According to the random number table method,they were randomized into a Zhuang medicine herbal-thread moxibustion therapy group(30 patients) and a western medication group(30 partients).The outcome assessors were blinded for patients allocation.In the herbal-thread moxibustion group,Zhuang medicine herbal-thread moxibustion therapy was provided once daily.In the western medication group,alprazolam tablets were prescribed for oral administration once daily.One course consisted of 10 treatments.After three consecutive courses of treatment,the score of the Pittsburgh sleep quality index(PSQI) was compared between groups,and both clinical effect and safety were assessed.Results:Sixty eligible patients were enrolled,and thirty were assigned to each group and included in the data analysis.After treatment,the score of each PSQI indicator(sleep latency,sleep duration,sleep efficiency,sleep disturbance,and daytime dysfunction) and total PSQI score were compared with those before treatment in both groups(all changes were statistically significant when P <0.05).Scores in the herbal-thread moxibustion group were superior to those in the western medication group(all values were statistically significant at P <0.05).The total effective rate was 93.3% in the herbal-thread moxibustion group and 80.0% in the western medication group(P <0.05).During treatment,no adverse reactions were reported in the herbal-thread moxibustion group.In the western medication group,three patients reported dizziness and headache,and one patient reported dry mouth,the incidence of adverse reactions was 13.3%.Conclusion:The Zhuang medicine herbal-thread moxibustion therapy is a safe and effective management strategy for the clinical symptoms of suboptimal health status-related insomnia.

Influence of stuck-needle technique on joint function and related inflammatory markers in patients with knee osteoarthritis:A randomized controlled trial

Objective:To observe the differences of clinical effect and influence on joint function and inflammatory markers in joint fluid between stuck-needle technique and regular acupuncture in patients with knee osteoarthritis.Methods:Seventy-two patients with knee osteoarthritis were randomly divided into a stuck-needle technique group and a regular acupuncture group,with 36 cases in each one.The selection of acupoints,retaining time of needles,and treatment course were all the same in both groups.The visual analog scale(VAS)score,Lequesne index score,and the content of related inflammatory indexes in joint fluid before and after treatment were observed,and the therapeutic effect were evaluated.Results:After treatment,the VAS scores,Lequesne index scores,interleukin-1 beta(IL-1β),and the tumor necrosis factor a(TNF-α)of the two groups were all lower than those before treatment(all P<0.05).After treatment,the VAS scores,Lequesne index scores,IL-1β,and TNF-αof the stuck-needle technique group were all lower than those of the regular acupuncture group(all P<0.05).The total effective rate of the stuck-needle technique group was 96.97%(32/33),higher than 93.75%(30/32)of the regular acupuncture group(P<0.05).Conclusion:Stuck-needle technique can effectively relieve the pain and improve the joint functions,being more effective than regular acupuncture for the treatment of knee osteoarthritis.