Objective: To investigate the current beliefs and attitudes of nurses in Yunnan Province toward prescriptive authority, analyze the influencing factors, and provide evidence for future research and policy formulation ...Objective: To investigate the current beliefs and attitudes of nurses in Yunnan Province toward prescriptive authority, analyze the influencing factors, and provide evidence for future research and policy formulation to support the establishment of nurses’ prescriptive authority in China. Method: A cross-sectional survey was conducted among 937 nurses in Yunnan Province using the Beliefs and Attitudes Scale on Nurses’ Prescriptive Authority. The scale assessed four dimensions: perceived need, self-efficacy, perceived benefits, and perceived barriers. Multiple linear regression analysis was used to identify factors influencing the overall score and each dimension. Results: The total score of the Beliefs and Attitudes Scale was 89.17 ± 17.69, indicating a moderate level of awareness and positive attitude among nurses. The highest-scoring dimension was perceived benefits (34.94 ± 8.04), while the lowest was perceived barriers (15.23 ± 3.5). Age was identified as a significant factor influencing the overall score and self-efficacy dimension (P < 0.05). Years of practice influenced the perceived benefits dimension (P = 0.051), while gender, age, and professional title were key factors affecting the perceived barriers dimension (P < 0.05). Male nurses and senior nurses demonstrated more caution toward potential risks associated with prescriptive authority. Conclusion: Nurses in Yunnan Province exhibit moderate levels of belief in and attitudes toward prescriptive authority, with age being the most significant influencing factor. Tailored training programs, policy promotion, and practical guidance are recommended to enhance nurses’ understanding and support for prescriptive authority, thereby improving nursing practices and addressing regional healthcare challenges.展开更多
Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of ...Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of practice of their prescriptive authority in certain circumstances.The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives.Methods:Based on a literature search and semistructured interviews,a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives.This stage included nursing experts(20)and medical experts(16)engaged in midwifery in many tertiary Grade A hospitals in China.Subsequently,consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts(18)and medical experts(14)engaged in midwifery in many tertiary Grade A hospitals in China.The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority,training content,circumstances,scope of practice for prescriptive authority,and the prescription forms.Results:Among the consulted experts,70.59%(the highest acceptance rate)considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority,85.29%(the highest acceptance rate)considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority,and 50%(the highest acceptance rate)considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority.The applicants should at least be practicing at Grade C hospitals,which was the consensus among 91.18%of the consulted experts.Among the consulted experts,100%,100%,97.06%,94.12%,and 94.12%agreed that the applicants should have knowledge in pharmacology,laws and ethics,nursing,diagnostics,and midwifery,respectively.The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority,including uterine atony,excessive uterine contraction,postpartum hemorrhage,premature rupture of fetal membranes,normal labor,and neonatal asphyxia.Under these 6 circumstances,the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives.Of these prescriptions,51.5%were independent prescriptions,30.3%were protocol prescriptions,and the remaining 18.2%were both independent and protocol prescriptions.Conclusions:Midwives who have an undergraduate degree,supervisor nurse position,and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority.Partial prescriptive authority could be granted after regulated training in fundamental theories and practices,which could improve the independence and professionalism of midwifery.展开更多
English grammar is thought as one of the most important parts in both language learning and teaching. While few people know there is more than one kind of English grammar. This essay provides the features and comparis...English grammar is thought as one of the most important parts in both language learning and teaching. While few people know there is more than one kind of English grammar. This essay provides the features and comparison between two commonly used English grammar, namely descriptive grammar and prescriptive grammar, and assist English teachers to explore further in grammar teaching.展开更多
A scalar equilibrium (SE) is defined for n-person prescriptive games in normal form. When a decision criterion (notion of rationality) is either agreed upon by the players or prescribed by an external arbiter, the res...A scalar equilibrium (SE) is defined for n-person prescriptive games in normal form. When a decision criterion (notion of rationality) is either agreed upon by the players or prescribed by an external arbiter, the resulting decision process is modeled by a suitable scalar transformation (utility function). Each n-tuple of von Neumann-Morgenstern utilities is transformed into a nonnegative scalar value between 0 and 1. Any n-tuple yielding a largest scalar value determines an SE, which is always a pure strategy profile. SEs can be computed much faster than Nash equilibria, for example;and the decision criterion need not be based on the players’ selfishness. To illustrate the SE, we define a compromise equilibrium, establish its Pareto optimality, and present examples comparing it to other solution concepts.展开更多
Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasu...Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasures and references for promoting the standardized implementation of nurses’non-pharmacological prescription authority.Methods:A secondary analysis of literature was conducted to systematically search for domestic and international literature related to nurses’non-pharmacological prescription authority.Meta-analysis was performed on eligible literature to evaluate the implementation effects.Simultaneously,semi-structured in-depth interviews were conducted with healthcare workers,patients,and policymakers.Content analysis was used to organize the interview data and extract core issues and barriers.Results:A total of 46 international articles were included in the Meta-analysis,which revealed that the implementation of nurses’non-pharmacological prescription authority significantly improved patients’health management outcomes,enhanced healthcare service efficiency,and increased patient satisfaction.Conclusion:The implementation of nurses’non-pharmacological prescription authority has demonstrated significant positive effects.However,China faces multiple barriers in its advancement,necessitating efforts in optimizing policy systems,constructing collaborative models,strengthening professional skills training,and improving social awareness to guide the scientific and rational implementation of nurses’non-pharmacological prescription authority.展开更多
Insect-derived traditional Chinese medicine(TCM)constitutes an essential component of TCM,with the earliest records found in“52 Bingfang”(Prescriptions of fifty-two diseases,which is one of the earliest Chinese medi...Insect-derived traditional Chinese medicine(TCM)constitutes an essential component of TCM,with the earliest records found in“52 Bingfang”(Prescriptions of fifty-two diseases,which is one of the earliest Chinese medical prescriptions).展开更多
Pinelliae Rhizoma(PR),known as Banxia in Chinese,Hange in Japanese,and Banha in Korean,is a renowned herbal medicine in East Asia derived from the dry tuber of Pinellia ternata(Thunb.)Breit.(PT).It is extensively util...Pinelliae Rhizoma(PR),known as Banxia in Chinese,Hange in Japanese,and Banha in Korean,is a renowned herbal medicine in East Asia derived from the dry tuber of Pinellia ternata(Thunb.)Breit.(PT).It is extensively utilized in dispensing granules,classical prescriptions,and herbal formulas to treat various conditions,including cough,infection,phlegm,nausea,asthma,and inflammation.Despite numerous studies on PR and its classical prescriptions over recent decades,a comprehensive synthesis of available evidence regarding its multifunctional roles and therapeutic potential is lacking.This review aims to address this gap by examining emerging evidence from metabonomics,preclinical studies,and clinical trials,while exploring potential trends and prospects for future research.A systematic literature search was conducted across six electronic databases,including Pub Med,Web of Science,Scopus,Science Direct,Wanfang,and China National Knowledge Infrastructure,to identify relevant articles on PR published until March 2023.PR contains 107 compounds with diverse pharmacological activities,including anti-inflammatory,immune regulatory,anti-viral,anti-cancer,anti-asthma,antitussive and expectorant,antioxidant,anti-obesity,anti-atherosclerosis,antimicrobial,emetic and anti-emetic,anti-convulsant and anti-epileptic,sedative and hypnotic,learning and memory enhancement,and anti-depressant effects.Metabonomic studies suggest that raw PR may exhibit cardiotoxicity and pregnancy toxicity while showing no apparent hepatorenal toxicity.However,limited pharmacokinetic investigations on PR constrain its clinical translation.Furthermore,clinical safety data on PR is scarce,with only four clinical trials assessing its positive effects in pediatric epilepsy,nausea and vomiting,soft tissue injury,and chronic sinus tract.This review aims to enhance understanding of PR and provide valuable information and recommendations for further research and development of herbal medicine.展开更多
Objective Randomized controlled trials(RCTs)of Chinese patent medicines and classic tra-ditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023.A p...Objective Randomized controlled trials(RCTs)of Chinese patent medicines and classic tra-ditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023.A preliminary summary and evaluation were conducted on the generation and translation of clinical evidence for these treatments.This analysis aims to inform future research on clinical efficacy evaluation and guide the rational application of evidence.Methods RCTs of Chinese patent medicines and classic traditional Chinese prescriptions published in 2023 were comprehensively retrieved from the Artificial Intelligence Clinical Evi-dence Database for Chinese Patent Medicine(AICED-CPM),with supplementary searches conducted in China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Sci-ence and Technology Journal Database(VIP),Chinese Biomedical Literature Database(SinoMed),Cochrane Library,PubMed,Embase,and Web of Science.The study characteris-tics and methodological quality of these RCTs were systematically analyzed and evaluated.Results A total of 1443 RCTs of Chinese patent medicines were included,comprising 1399 Chinese articles and 44 English articles.Additionally,334 RCTs of classic traditional Chinese medicine prescriptions were found,with 331 published in Chinese and 3 in English.196567 participants were included,covering 585 types of Chinese patent medicines(487 oral,61 in-jectable,and 37 topical)and 179 classic traditional Chinese medicine prescriptions.The in-volved studies encompassed 22 types of diseases,with research primarily focusing on dis-eases of the circulatory system,the respiratory system,and the genitourinary system.The sample sizes ranged from 18 to 3777 participants,and most studies were conducted at a sin-gle center.Methodologically,the implementation of allocation concealment and blinding re-mained insufficiently emphasized.Conclusion Overall,compared with 2022,both the number of RCT publications and their methodological quality have improved in 2023,with heightened attention to research on diseases of the genitourinary system.However,quality control and standardized management in the design and implementation processes still require enhancement to produce more high-quality clinical evidence and accelerate the translation and application of this evidence.展开更多
OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determ...OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determined via linear ion trap/electrostatic field orbital trap tandem highresolution mass spectrometry,and the identified compounds were performed network pharmacological analysis to predict possible pathways of the effects of GL on CP.A CP rat model was established by carrageenan,and rats were randomly assigned into a Control group,Sham group,CP group,GL low dose(3.5 g/kg)group,GL medium dose(7 g/kg)group,and GL high dose(14 g/kg)group.Hematoxylin-eosin staining of the prostate,and prostate blood-perfusion measured by laser speckle contrast analysis were used to evaluate the efficacy of GL.Expression of intercellular cell adhesion molecule-1(ICAM-1)and induce nitric oxide synthase(i NOS)were determined by immunohistochemistry,and the content of interferon-γ(IFN-γ),interleukin-1β(IL-1β),interleukin-4(IL-4),interleukin-10(IL-10),chemokine ligand 1(CXCL1)and tumor necrosis factor-α(TNF-α)were determined by electro-chemiluminescence assays.The expression of p38 mitogen-activated protein kinase(p38 MAPK),phosphatidylinositol 3-kinase(PI3K),ribosomeassociated complex-alpha serine/threonine-protein kinase(Akt),nuclear factor-κ-gene binding p65(NF-κB p65),inhibitor of NF-κB-α(IκBα),glycogen synthase kinase-3β(GSK-3β),and their phosphorylated forms were tested by Western blot.RESULTS:In GL,a total of 48 compounds were identified,including 14 flavonoids,14 alkaloids,11 carboxylic acids,4 lactones,2 glycosides,2 terpenoids and 1 aldehyde.Network pharmacological analysis suggested that the mechanism of GL may be related to PI3K-Akt signaling pathway and cytokine expression.After treatment with GL,inflammatory pathological changes in the prostate of rats were significantly improved,and blood perfusion of the prostate was significantly decreased.GL reduced the expression of IFN-γ,CXCL1,TNF-α,IL-1β,i NOS,ICAM-1,p38 MAPK,p-p38 MAPK,PI3K,p-PI3K,NF-κB,p-NF-κB,IκBα,p-IκBα,GSK-3β,p-GSK-3β,p-Akt in CP rats,and increased the expression of IL-4 and IL-10 in CP rats.CONCLUSION:The chemical compositions of GL were first identified.GL can improve pathological changes in the prostate and recover the prostate blood perfusion of CP rats.The possible mechanisms of GL on CP involve increasing the expression of anti-inflammatory cytokines IL-4 and IL-10,inhibiting pro-inflammatory cytokines TNF-α,IL-1β,and IFN-γ,and down regulating the expression of CXCL1,i NOS,and ICAM-1 via inhibiting PI3K-Akt and NF-κB signaling pathway.展开更多
Colorectal cancer(CRC)is one of the most prevalent malignancies worldwide,ranking among the highest in both incidence and mortality rates.Traditional Chinese medicine,with a history spanning thousands of years,has dem...Colorectal cancer(CRC)is one of the most prevalent malignancies worldwide,ranking among the highest in both incidence and mortality rates.Traditional Chinese medicine,with a history spanning thousands of years,has demonstrated unique efficacy and advantages in the prevention and treatment of CRC,playing a pivotal role at all levels of China’s healthcare system.This article provides a comprehensive analysis and summary of traditional Chinese medicine’s contri-butions to CRC prevention,antitumor therapy,palliative care for advanced tumors,perioperative rehabilitation,and postoperative functional recovery.展开更多
Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,p...Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].展开更多
OBJECTIVES:To investigate the therapeutic effect of Huluan decotion(护卵汤,HLD)on cyclophosphamideinduced premature ovarian failure(POF)in mice and its regulatory mechanisms.METHODS:Female BALB/c mice were administere...OBJECTIVES:To investigate the therapeutic effect of Huluan decotion(护卵汤,HLD)on cyclophosphamideinduced premature ovarian failure(POF)in mice and its regulatory mechanisms.METHODS:Female BALB/c mice were administered cyclophosphamide and administered received different doses of HLD for 28 d.Levels of sex hormone,such as estradiol(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)in the sera,were assessed using enzyme-linked immunosorbent assay(ELISA).Follicular structure variances were observed through hematoxylin and eosin(HE)staining,while Forkhead box L2(FOXL2)expression were analyzed via immuneohistochemical staining.The primary mechanism of POF were investigated through Western blot analysis.RESULTS:E2 levels decreased,and FSH and LH levels increased in POF model mice,but these trends were reversed with HLD or premarin administration,the expressions of WNT family member 4(Wnt4),β-Catenin and FOXL2 were downregulated in POF model mice,whereas high expression levels were observed in control mice and other groups.CONCLUSION:HLD effectively treats POF induced with cyclophosphamide in mice by enhancing expressions of Wnt4,β-Catenin and FOXL2.展开更多
Objective To configure the complex traditional Chinese medicine(TCM)prescription using digit topology circle and to derive digit topology circle.Methods The basic digit topology circles were constructed.Different digi...Objective To configure the complex traditional Chinese medicine(TCM)prescription using digit topology circle and to derive digit topology circle.Methods The basic digit topology circles were constructed.Different digit topology circles were derived using basic digit topology circle,the character strings,and the digit groups.Different digit topology circles with ternary Chinese medicine were derived by adding ternary Chinese medicine into digit topology circles.The valuable TCM prescriptions were configured using the derived digit topology circles.Results Nine simple basic digit topology circles were constructed from the character strings.Multiple digit topology circles and some digit topology circles with ternary Chinese medicine were derived using basic digit topology circles,the character strings,and the digit groups.Four complex TCM prescriptions were configured using four derived digit topology circles digit topology circles,respectively.Conclusion The digit topology circles can be used to configure some existing TCM prescriptions and many novel TCM prescriptions.It has been verified that some existing TCM prescriptions have been used successfully to treat patients with diseases.Some novel valuable TCM prescriptions configured by digit topology circles may be used to treat patients with diseases.展开更多
Allergic diseases,encompassing a wide array of conditions such as allergic rhinitis(AR),allergic asthma(AAS),atopic dermatitis(AD),and food allergy(FA),among others,represent a significant menace to global public heal...Allergic diseases,encompassing a wide array of conditions such as allergic rhinitis(AR),allergic asthma(AAS),atopic dermatitis(AD),and food allergy(FA),among others,represent a significant menace to global public health.The heterogeneity of these diseases,along with their intricate pathogenesis and propensity for recur-rence,has spurred an escalating demand for efficacious therapeutic strategies.Notwithstanding the advance-ments in western medicine(WM),treatment modalities like antihistamines,sulfonamides,and glucocorticoids exhibit side effects,especially for the neurotoxicity and the adverse reactions of the digestive system.Addi-tionally,physical therapies utilized in allergy management frequently perturb skin metabolism,potentially resulting in stratum corneum impairment,atrophy,pigmentation,and relapse,thereby mandating further investigation and optimization.The management of allergic disorders is often typified by recurrence and diffi-culties in attaining a definitive cure,instigating the pursuit of alternative or adjunctive therapeutic regimens.In this regard,Traditional Chinese Medicine(TCM),which adopts a comprehensive and holistic view of health and disease,confers remarkable advantages in the treatment of allergic conditions.TCM accentuates the significance of personalized treatment,custom-tailored to each patient’s idiosyncratic constitution and disease manifestations,a principle that is especially germane in allergic conditions where standardized treatments frequently fall short.Moreover,TCM interventions,including herbal remedies,acupuncture,and other modalities,are generally associated with a lower incidence of adverse effects compared to conventional therapies,rendering them appealing options for long-term management.The holistic paradigm of TCM permits the concurrent modulation of multiple physiological systems,not only alleviating the symptoms but also rectifying the underlying imbalances that underpin the development and perpetuation of allergic diseases.This approach,in conjunction with the capacity to individualize treatments,implies that TCM harbors sub-stantial potential in conferring more comprehensive and sustainable relief from allergic symptoms.This article delves into the TCM perspective on allergic diseases and the contemporary value of TCM in their treatment.It further explores the developmental pathway of TCM in addressing allergic diseases,dissects the intersection points between traditional theories and modern science,summarizes the key findings and conclusions,and emphasizes the potential and prospects of TCM in this domain.展开更多
OBJECTIVES To examine 5-year trends and variations in dual antiplatelet therapy(DAPT)prescription among multiethnic Malaysian patients aged 60 years and older.METHODS Using the Malaysian National Cardiovascular Diseas...OBJECTIVES To examine 5-year trends and variations in dual antiplatelet therapy(DAPT)prescription among multiethnic Malaysian patients aged 60 years and older.METHODS Using the Malaysian National Cardiovascular Disease-Acute Coronary Syndrome(NCVD-ACS)registry,DAPT 5-year temporal trends prescribing patterns at discharge were examined.Multivariate logistic regression was used to calculate the adjusted odds ratio(aOR)of DAPT prescription.The 1-year all-cause mortality by Cox proportional hazard regression model(adjusted hazard ratio,aHR)using inverse proportional weighting covariates adjustment was performed to assess DAPT prognostic impacts.RESULTS Data of patients aged 60 years and older were extracted from 2013 to 2017(n=3718,mean age:68±6.74 years,men:72%,and Malay ethnicity:43%).The majority of patients were diagnosed with non-ST-segment elevation acute coronary syndrome(63%),predisposed hypertension(76%)and were overweight(74%),while only 35%of patients underwent percutaneous coronary intervention.Over the five years,there was a significant increasing trend in DAPT prescriptions(P<0.001),with the aspirinclopidogrel combination being the most common.Aspirin-ticagrelor prescriptions have also increased over the years.Variations in DAPT prescriptions were observed based on patient characteristics.Patients who underwent percutaneous coronary intervention were more likely to be prescribed DAPT in general(aOR=2.53,95%CI:1.95–3.28,P<0.001)and aspirin-ticagrelor specifically(aOR=7.76,95%CI:5.65–10.68,P<0.001).Patients with chronic lung disease(aOR=0.62,95%CI:0.42–0.92,P=0.02)and a history of angina within two weeks(aOR=0.69,95%CI:0.56–0.85,P<0.001)were approximately 30%less likely to be prescribed DAPT.Approximately 15%of 1-year all-cause mortality were reported.Older patients prescribed DAPT showed significantly higher survival rates than those who were not(aHR<1.0,P<0.001).Aspirin-ticagrelor was associated with higher survival rates than aspirin-clopidogrel(aHR=0.21,95%CI:0.11–0.40,P<0.001).CONCLUSIONS Despite the optimal prescription rate and variation of DAPT in the older Malaysian population,there is room for investigation and improvement in the prescription of newer DAPT combinations that have been suggested to improve patient survival.展开更多
[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mech...[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mechanism.[Methods]96 patients with PHN were divided into the control group(group A)and observation group(group B)(n=48).In group A,the patients were given gabapentin orally and treated by cotton moxibustion.In group B,the patients were treated by the external application of self-prepared Chinese prescription decoction on the basis of the above basic treatment.The total effective rate,apparent time and recurrence rate of the two groups were compared.[Results]The cure rate(72.91%)and total effective rate(95.83%)of patients in group B were higher than those in group A(54.16%,83.33%).The average apparent time[(5.79±1.40)d]and recurrence rate(5.97%)of patients in group B were significantly lower than those in group A[(7.03±4.37)d,10.45%],and the difference between the two groups was statistically significant(P<0.05).[Conclusions]The external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion therapy had a significant curative effect and low recurrence rate.展开更多
OBJECTIVE:To determine the effect of Traditional Chinese Medicine(TCM)Fuzheng Xuanfei Huashi prescription(扶正宣肺化湿方,FZXF)on lipopolysaccharide(LPS)-induced pneumonia in mice and identify the mechanism of FZXF in ...OBJECTIVE:To determine the effect of Traditional Chinese Medicine(TCM)Fuzheng Xuanfei Huashi prescription(扶正宣肺化湿方,FZXF)on lipopolysaccharide(LPS)-induced pneumonia in mice and identify the mechanism of FZXF in the treatment of LPS-induced lung inflammation.METHODS:The pneumonia model was established by intraperitoneal injection of 5 mg/kg LPS in mice.Cytokines were detected by enzyme-linked immuneosorbent assay(ELISA),macrophages in lung tissue were determined by immunofluorescence,and pathwayrelated data were determined by quantitative real-time polymerase chain reaction(qPCR)and Western blot.RESULTS:The liver,thymus,and spleen index values and the levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)obviously increased in LPS-treated mice.FZXF decreased the white blood cell count and reduced the increase in the lung wet weight/dry weight ratio caused by LPS.The hematoxylin-eosin staining result showed that FZXF could maintain the integrity of lung tissue structure,alleviate interstitial oedema and alveolar wall thickening,and reduce inflammatory cell infiltration.Moreover,FZXF markedly reduced the expression of proinflammatory cytokines.FZXF also significantly reduced LPS-induced malondialdehyde production and increased superoxide dismutase level in the lung.By immunofluorescence,we found that FZXF could reduce macrophage infiltration.The mRNA expression levels of cyclooxygenase-2(COX-2),prostaglandin E2(PGE2),toll-like receptor 4(TLR4)and nuclear transcription factorκB(NF-κB)in the lung tissue of mice were decreased by treatment with FZXF.In addition,FZXF inhibited the protein expression of TLR4,p-p65 and COX-2.These results indicated that FZXF could inhibit the inflammatory response of LPS induced cytokine storm in mice through TLR4/NF-κB and COX-2/PGE2 signaling pathway.CONCLUSION:These findings were suggested that FZXF prescription suppresses inflammation in LPSinduced pneumonia in mice via TLR4/NF-κB and COX-2/PGE2 pathway.展开更多
Traditional Chinese medicine(TCM)exerts integrative effects on complex diseases owing to the characteristics of multiple components with multiple targets.However,the syndrome-based system of diagnosis and treatment in...Traditional Chinese medicine(TCM)exerts integrative effects on complex diseases owing to the characteristics of multiple components with multiple targets.However,the syndrome-based system of diagnosis and treatment in TCM can easily lead to bias because of varying medication preferences among physicians,which has been a major challenge in the global acceptance and application of TCM.Therefore,a standardized TCM prescription system needs to be explored to promote its clinical application.In this study,we first developed a gradient weighted disease-target-herbal ingredient-herb network to aid TCM formulation.We tested its efficacy against intracerebral hemorrhage(ICH).First,the top 100 ICH targets in the GeneCards database were screened according to their relevance scores.Then,SymMap and Traditional Chinese Medicine Systems Pharmacology(TCMSP)databases were applied to find out the target-related ingredients and ingredient-containing herbs,respectively.The relevance of the resulting ingredients and herbs to ICH was determined by adding the relevance scores of the corresponding targets.The top five ICH therapeutic herbs were combined to form a tailored TCM prescriptions.The absorbed components in the serum were detected.In a mouse model of ICH,the new prescription exerted multifaceted effects,including improved neurological function,as well as attenuated neuronal damage,cell apoptosis,vascular leakage,and neuroinflammation.These effects matched well with the core pathological changes in ICH.The multi-targets-directed gradient-weighting strategy presents a promising avenue for tailoring precise,multipronged,unbiased,and standardized TCM prescriptions for complex diseases.This study provides a paradigm for advanced achievements-driven modern innovation in TCM concepts.展开更多
This paper, an addendum to “Dialectical Thermodynamics’ solution to the conceptual imbroglio that is the reversible path”, this journal, 10, 775-799, was written in response to the requests of several readers to pr...This paper, an addendum to “Dialectical Thermodynamics’ solution to the conceptual imbroglio that is the reversible path”, this journal, 10, 775-799, was written in response to the requests of several readers to provide further evidence of the said “imbroglio”. The evidence here presented relates to the incompatibility existing between the total-entropy and the Gibbs energy prescriptions for the reversible path. The previously published proof of the negentropic nature of the transformation of heat into work is here included to validate out conclusions about the Gibbs energy perspective.展开更多
文摘Objective: To investigate the current beliefs and attitudes of nurses in Yunnan Province toward prescriptive authority, analyze the influencing factors, and provide evidence for future research and policy formulation to support the establishment of nurses’ prescriptive authority in China. Method: A cross-sectional survey was conducted among 937 nurses in Yunnan Province using the Beliefs and Attitudes Scale on Nurses’ Prescriptive Authority. The scale assessed four dimensions: perceived need, self-efficacy, perceived benefits, and perceived barriers. Multiple linear regression analysis was used to identify factors influencing the overall score and each dimension. Results: The total score of the Beliefs and Attitudes Scale was 89.17 ± 17.69, indicating a moderate level of awareness and positive attitude among nurses. The highest-scoring dimension was perceived benefits (34.94 ± 8.04), while the lowest was perceived barriers (15.23 ± 3.5). Age was identified as a significant factor influencing the overall score and self-efficacy dimension (P < 0.05). Years of practice influenced the perceived benefits dimension (P = 0.051), while gender, age, and professional title were key factors affecting the perceived barriers dimension (P < 0.05). Male nurses and senior nurses demonstrated more caution toward potential risks associated with prescriptive authority. Conclusion: Nurses in Yunnan Province exhibit moderate levels of belief in and attitudes toward prescriptive authority, with age being the most significant influencing factor. Tailored training programs, policy promotion, and practical guidance are recommended to enhance nurses’ understanding and support for prescriptive authority, thereby improving nursing practices and addressing regional healthcare challenges.
基金project was supported by the Shanxi Province Soft Science Research Program in China(No.2017041041-1)
文摘Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of practice of their prescriptive authority in certain circumstances.The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives.Methods:Based on a literature search and semistructured interviews,a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives.This stage included nursing experts(20)and medical experts(16)engaged in midwifery in many tertiary Grade A hospitals in China.Subsequently,consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts(18)and medical experts(14)engaged in midwifery in many tertiary Grade A hospitals in China.The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority,training content,circumstances,scope of practice for prescriptive authority,and the prescription forms.Results:Among the consulted experts,70.59%(the highest acceptance rate)considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority,85.29%(the highest acceptance rate)considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority,and 50%(the highest acceptance rate)considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority.The applicants should at least be practicing at Grade C hospitals,which was the consensus among 91.18%of the consulted experts.Among the consulted experts,100%,100%,97.06%,94.12%,and 94.12%agreed that the applicants should have knowledge in pharmacology,laws and ethics,nursing,diagnostics,and midwifery,respectively.The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority,including uterine atony,excessive uterine contraction,postpartum hemorrhage,premature rupture of fetal membranes,normal labor,and neonatal asphyxia.Under these 6 circumstances,the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives.Of these prescriptions,51.5%were independent prescriptions,30.3%were protocol prescriptions,and the remaining 18.2%were both independent and protocol prescriptions.Conclusions:Midwives who have an undergraduate degree,supervisor nurse position,and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority.Partial prescriptive authority could be granted after regulated training in fundamental theories and practices,which could improve the independence and professionalism of midwifery.
文摘English grammar is thought as one of the most important parts in both language learning and teaching. While few people know there is more than one kind of English grammar. This essay provides the features and comparison between two commonly used English grammar, namely descriptive grammar and prescriptive grammar, and assist English teachers to explore further in grammar teaching.
文摘A scalar equilibrium (SE) is defined for n-person prescriptive games in normal form. When a decision criterion (notion of rationality) is either agreed upon by the players or prescribed by an external arbiter, the resulting decision process is modeled by a suitable scalar transformation (utility function). Each n-tuple of von Neumann-Morgenstern utilities is transformed into a nonnegative scalar value between 0 and 1. Any n-tuple yielding a largest scalar value determines an SE, which is always a pure strategy profile. SEs can be computed much faster than Nash equilibria, for example;and the decision criterion need not be based on the players’ selfishness. To illustrate the SE, we define a compromise equilibrium, establish its Pareto optimality, and present examples comparing it to other solution concepts.
基金Scientific Research Fund Project of Yunnan Provincial Department of Education(Project No.:2024J2130)。
文摘Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasures and references for promoting the standardized implementation of nurses’non-pharmacological prescription authority.Methods:A secondary analysis of literature was conducted to systematically search for domestic and international literature related to nurses’non-pharmacological prescription authority.Meta-analysis was performed on eligible literature to evaluate the implementation effects.Simultaneously,semi-structured in-depth interviews were conducted with healthcare workers,patients,and policymakers.Content analysis was used to organize the interview data and extract core issues and barriers.Results:A total of 46 international articles were included in the Meta-analysis,which revealed that the implementation of nurses’non-pharmacological prescription authority significantly improved patients’health management outcomes,enhanced healthcare service efficiency,and increased patient satisfaction.Conclusion:The implementation of nurses’non-pharmacological prescription authority has demonstrated significant positive effects.However,China faces multiple barriers in its advancement,necessitating efforts in optimizing policy systems,constructing collaborative models,strengthening professional skills training,and improving social awareness to guide the scientific and rational implementation of nurses’non-pharmacological prescription authority.
基金funded by the National Natural Science Foundation of China(Grant Nos.:82222068,82070423,82270348,and 82173779)the Innovation Team and Talents Cultivation Pro-gram of National Administration of Traditional Chinese Medicine,China(Grant No:ZYYCXTD-D-202206)+1 种基金Fujian Province Science and Technology Project,China(Grant Nos.:2021J01420479,2021J02058,2022J011374,and 2022J02057)Fundamental Research Funds for the Chinese Central Universities,China(Grant No.:20720230070).
文摘Insect-derived traditional Chinese medicine(TCM)constitutes an essential component of TCM,with the earliest records found in“52 Bingfang”(Prescriptions of fifty-two diseases,which is one of the earliest Chinese medical prescriptions).
基金funded by the Macao Science and Technology Development Fund(FDCT Nos.001/2023/ALC,0123/2022/A,0006/2020/AKP,and 005/2023/SKL)the Natural Science Foundation of Guangdong Province,China(No.2020A1515010922)+1 种基金the Shenzhen-Hong Kong-Macao S&T Program(Category C,No.SGDX2020110309420200)the Research Fund of University of Macao(Nos.MYRG-GRG2023-00198-ICMS,CPG2024-00038-ICMS and SRG2022-00052-ICMS)。
文摘Pinelliae Rhizoma(PR),known as Banxia in Chinese,Hange in Japanese,and Banha in Korean,is a renowned herbal medicine in East Asia derived from the dry tuber of Pinellia ternata(Thunb.)Breit.(PT).It is extensively utilized in dispensing granules,classical prescriptions,and herbal formulas to treat various conditions,including cough,infection,phlegm,nausea,asthma,and inflammation.Despite numerous studies on PR and its classical prescriptions over recent decades,a comprehensive synthesis of available evidence regarding its multifunctional roles and therapeutic potential is lacking.This review aims to address this gap by examining emerging evidence from metabonomics,preclinical studies,and clinical trials,while exploring potential trends and prospects for future research.A systematic literature search was conducted across six electronic databases,including Pub Med,Web of Science,Scopus,Science Direct,Wanfang,and China National Knowledge Infrastructure,to identify relevant articles on PR published until March 2023.PR contains 107 compounds with diverse pharmacological activities,including anti-inflammatory,immune regulatory,anti-viral,anti-cancer,anti-asthma,antitussive and expectorant,antioxidant,anti-obesity,anti-atherosclerosis,antimicrobial,emetic and anti-emetic,anti-convulsant and anti-epileptic,sedative and hypnotic,learning and memory enhancement,and anti-depressant effects.Metabonomic studies suggest that raw PR may exhibit cardiotoxicity and pregnancy toxicity while showing no apparent hepatorenal toxicity.However,limited pharmacokinetic investigations on PR constrain its clinical translation.Furthermore,clinical safety data on PR is scarce,with only four clinical trials assessing its positive effects in pediatric epilepsy,nausea and vomiting,soft tissue injury,and chronic sinus tract.This review aims to enhance understanding of PR and provide valuable information and recommendations for further research and development of herbal medicine.
基金National Multidisciplinary Innovation Team of Traditional Chinese Medicine (ZYYCXTD-D-202204)Science and Technology Project of Haihe Laboratory of Modern Chinese Medicine (22HHZYSS00013)。
文摘Objective Randomized controlled trials(RCTs)of Chinese patent medicines and classic tra-ditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023.A preliminary summary and evaluation were conducted on the generation and translation of clinical evidence for these treatments.This analysis aims to inform future research on clinical efficacy evaluation and guide the rational application of evidence.Methods RCTs of Chinese patent medicines and classic traditional Chinese prescriptions published in 2023 were comprehensively retrieved from the Artificial Intelligence Clinical Evi-dence Database for Chinese Patent Medicine(AICED-CPM),with supplementary searches conducted in China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Sci-ence and Technology Journal Database(VIP),Chinese Biomedical Literature Database(SinoMed),Cochrane Library,PubMed,Embase,and Web of Science.The study characteris-tics and methodological quality of these RCTs were systematically analyzed and evaluated.Results A total of 1443 RCTs of Chinese patent medicines were included,comprising 1399 Chinese articles and 44 English articles.Additionally,334 RCTs of classic traditional Chinese medicine prescriptions were found,with 331 published in Chinese and 3 in English.196567 participants were included,covering 585 types of Chinese patent medicines(487 oral,61 in-jectable,and 37 topical)and 179 classic traditional Chinese medicine prescriptions.The in-volved studies encompassed 22 types of diseases,with research primarily focusing on dis-eases of the circulatory system,the respiratory system,and the genitourinary system.The sample sizes ranged from 18 to 3777 participants,and most studies were conducted at a sin-gle center.Methodologically,the implementation of allocation concealment and blinding re-mained insufficiently emphasized.Conclusion Overall,compared with 2022,both the number of RCT publications and their methodological quality have improved in 2023,with heightened attention to research on diseases of the genitourinary system.However,quality control and standardized management in the design and implementation processes still require enhancement to produce more high-quality clinical evidence and accelerate the translation and application of this evidence.
基金National Major Scientific and the Technological Special Project:Establishment of a Clinically Oriented Preclinical Research and Development Technology Platform for New Chinese Medicines based on Famous Doctors'Prescriptions(No.2017ZX09301011)"Decoding Traditional Chinese Medicine"Project of Beijing University of Chinese Medicine:New Drugs Research and Development of Chinese Medicine based on Famous Doctors and Famous Prescriptions(No.90010961020020)the Horizontal Project:Preclinical Pharmacology and Pharmacodynamic Research of a New Chinese Medicine—Guilong Granules(No.2016110031007799)。
文摘OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determined via linear ion trap/electrostatic field orbital trap tandem highresolution mass spectrometry,and the identified compounds were performed network pharmacological analysis to predict possible pathways of the effects of GL on CP.A CP rat model was established by carrageenan,and rats were randomly assigned into a Control group,Sham group,CP group,GL low dose(3.5 g/kg)group,GL medium dose(7 g/kg)group,and GL high dose(14 g/kg)group.Hematoxylin-eosin staining of the prostate,and prostate blood-perfusion measured by laser speckle contrast analysis were used to evaluate the efficacy of GL.Expression of intercellular cell adhesion molecule-1(ICAM-1)and induce nitric oxide synthase(i NOS)were determined by immunohistochemistry,and the content of interferon-γ(IFN-γ),interleukin-1β(IL-1β),interleukin-4(IL-4),interleukin-10(IL-10),chemokine ligand 1(CXCL1)and tumor necrosis factor-α(TNF-α)were determined by electro-chemiluminescence assays.The expression of p38 mitogen-activated protein kinase(p38 MAPK),phosphatidylinositol 3-kinase(PI3K),ribosomeassociated complex-alpha serine/threonine-protein kinase(Akt),nuclear factor-κ-gene binding p65(NF-κB p65),inhibitor of NF-κB-α(IκBα),glycogen synthase kinase-3β(GSK-3β),and their phosphorylated forms were tested by Western blot.RESULTS:In GL,a total of 48 compounds were identified,including 14 flavonoids,14 alkaloids,11 carboxylic acids,4 lactones,2 glycosides,2 terpenoids and 1 aldehyde.Network pharmacological analysis suggested that the mechanism of GL may be related to PI3K-Akt signaling pathway and cytokine expression.After treatment with GL,inflammatory pathological changes in the prostate of rats were significantly improved,and blood perfusion of the prostate was significantly decreased.GL reduced the expression of IFN-γ,CXCL1,TNF-α,IL-1β,i NOS,ICAM-1,p38 MAPK,p-p38 MAPK,PI3K,p-PI3K,NF-κB,p-NF-κB,IκBα,p-IκBα,GSK-3β,p-GSK-3β,p-Akt in CP rats,and increased the expression of IL-4 and IL-10 in CP rats.CONCLUSION:The chemical compositions of GL were first identified.GL can improve pathological changes in the prostate and recover the prostate blood perfusion of CP rats.The possible mechanisms of GL on CP involve increasing the expression of anti-inflammatory cytokines IL-4 and IL-10,inhibiting pro-inflammatory cytokines TNF-α,IL-1β,and IFN-γ,and down regulating the expression of CXCL1,i NOS,and ICAM-1 via inhibiting PI3K-Akt and NF-κB signaling pathway.
基金Supported by Hunan Provincial Natural Science Foundation,No.2025JJ90028Changsha Natural Science Foundation Project,No.kq2502190.
文摘Colorectal cancer(CRC)is one of the most prevalent malignancies worldwide,ranking among the highest in both incidence and mortality rates.Traditional Chinese medicine,with a history spanning thousands of years,has demonstrated unique efficacy and advantages in the prevention and treatment of CRC,playing a pivotal role at all levels of China’s healthcare system.This article provides a comprehensive analysis and summary of traditional Chinese medicine’s contri-butions to CRC prevention,antitumor therapy,palliative care for advanced tumors,perioperative rehabilitation,and postoperative functional recovery.
基金supported by the Ministry of Science and Technology of the People’s Republic of China under the“New Generation Artificial Intelligence”Major Project of Science and Technology Innovation 2030(2020AAA0105002).
文摘Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].
基金Fujian Natural Science:Study on Potential Protein Targets of Huluan Decotion in the Intervention of Premature Ovarian Failure(No.2021J011173)Major Project Cultivation Plan Project of Ningde Normal University:the Effect of Huluan Decotion on the Decreased Ovarian Reserve Function Induced by Cyclophosphamide is Studied based on Forkhead box L2(No.2019ZDK06)。
文摘OBJECTIVES:To investigate the therapeutic effect of Huluan decotion(护卵汤,HLD)on cyclophosphamideinduced premature ovarian failure(POF)in mice and its regulatory mechanisms.METHODS:Female BALB/c mice were administered cyclophosphamide and administered received different doses of HLD for 28 d.Levels of sex hormone,such as estradiol(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)in the sera,were assessed using enzyme-linked immunosorbent assay(ELISA).Follicular structure variances were observed through hematoxylin and eosin(HE)staining,while Forkhead box L2(FOXL2)expression were analyzed via immuneohistochemical staining.The primary mechanism of POF were investigated through Western blot analysis.RESULTS:E2 levels decreased,and FSH and LH levels increased in POF model mice,but these trends were reversed with HLD or premarin administration,the expressions of WNT family member 4(Wnt4),β-Catenin and FOXL2 were downregulated in POF model mice,whereas high expression levels were observed in control mice and other groups.CONCLUSION:HLD effectively treats POF induced with cyclophosphamide in mice by enhancing expressions of Wnt4,β-Catenin and FOXL2.
基金National Natural Science Foundation of China(91748125)National Administration of Traditional Chinese Medicine’s National Inheritance Studio Construction Project for Famous Veteran Traditional Chinese Medicine Experts([2022]75)。
文摘Objective To configure the complex traditional Chinese medicine(TCM)prescription using digit topology circle and to derive digit topology circle.Methods The basic digit topology circles were constructed.Different digit topology circles were derived using basic digit topology circle,the character strings,and the digit groups.Different digit topology circles with ternary Chinese medicine were derived by adding ternary Chinese medicine into digit topology circles.The valuable TCM prescriptions were configured using the derived digit topology circles.Results Nine simple basic digit topology circles were constructed from the character strings.Multiple digit topology circles and some digit topology circles with ternary Chinese medicine were derived using basic digit topology circles,the character strings,and the digit groups.Four complex TCM prescriptions were configured using four derived digit topology circles digit topology circles,respectively.Conclusion The digit topology circles can be used to configure some existing TCM prescriptions and many novel TCM prescriptions.It has been verified that some existing TCM prescriptions have been used successfully to treat patients with diseases.Some novel valuable TCM prescriptions configured by digit topology circles may be used to treat patients with diseases.
基金supported by the General program of National Natural Science Foundation of China(No.82174243,82204948)the General project of Beijing Natural Science Foundation(No.7242227).
文摘Allergic diseases,encompassing a wide array of conditions such as allergic rhinitis(AR),allergic asthma(AAS),atopic dermatitis(AD),and food allergy(FA),among others,represent a significant menace to global public health.The heterogeneity of these diseases,along with their intricate pathogenesis and propensity for recur-rence,has spurred an escalating demand for efficacious therapeutic strategies.Notwithstanding the advance-ments in western medicine(WM),treatment modalities like antihistamines,sulfonamides,and glucocorticoids exhibit side effects,especially for the neurotoxicity and the adverse reactions of the digestive system.Addi-tionally,physical therapies utilized in allergy management frequently perturb skin metabolism,potentially resulting in stratum corneum impairment,atrophy,pigmentation,and relapse,thereby mandating further investigation and optimization.The management of allergic disorders is often typified by recurrence and diffi-culties in attaining a definitive cure,instigating the pursuit of alternative or adjunctive therapeutic regimens.In this regard,Traditional Chinese Medicine(TCM),which adopts a comprehensive and holistic view of health and disease,confers remarkable advantages in the treatment of allergic conditions.TCM accentuates the significance of personalized treatment,custom-tailored to each patient’s idiosyncratic constitution and disease manifestations,a principle that is especially germane in allergic conditions where standardized treatments frequently fall short.Moreover,TCM interventions,including herbal remedies,acupuncture,and other modalities,are generally associated with a lower incidence of adverse effects compared to conventional therapies,rendering them appealing options for long-term management.The holistic paradigm of TCM permits the concurrent modulation of multiple physiological systems,not only alleviating the symptoms but also rectifying the underlying imbalances that underpin the development and perpetuation of allergic diseases.This approach,in conjunction with the capacity to individualize treatments,implies that TCM harbors sub-stantial potential in conferring more comprehensive and sustainable relief from allergic symptoms.This article delves into the TCM perspective on allergic diseases and the contemporary value of TCM in their treatment.It further explores the developmental pathway of TCM in addressing allergic diseases,dissects the intersection points between traditional theories and modern science,summarizes the key findings and conclusions,and emphasizes the potential and prospects of TCM in this domain.
文摘OBJECTIVES To examine 5-year trends and variations in dual antiplatelet therapy(DAPT)prescription among multiethnic Malaysian patients aged 60 years and older.METHODS Using the Malaysian National Cardiovascular Disease-Acute Coronary Syndrome(NCVD-ACS)registry,DAPT 5-year temporal trends prescribing patterns at discharge were examined.Multivariate logistic regression was used to calculate the adjusted odds ratio(aOR)of DAPT prescription.The 1-year all-cause mortality by Cox proportional hazard regression model(adjusted hazard ratio,aHR)using inverse proportional weighting covariates adjustment was performed to assess DAPT prognostic impacts.RESULTS Data of patients aged 60 years and older were extracted from 2013 to 2017(n=3718,mean age:68±6.74 years,men:72%,and Malay ethnicity:43%).The majority of patients were diagnosed with non-ST-segment elevation acute coronary syndrome(63%),predisposed hypertension(76%)and were overweight(74%),while only 35%of patients underwent percutaneous coronary intervention.Over the five years,there was a significant increasing trend in DAPT prescriptions(P<0.001),with the aspirinclopidogrel combination being the most common.Aspirin-ticagrelor prescriptions have also increased over the years.Variations in DAPT prescriptions were observed based on patient characteristics.Patients who underwent percutaneous coronary intervention were more likely to be prescribed DAPT in general(aOR=2.53,95%CI:1.95–3.28,P<0.001)and aspirin-ticagrelor specifically(aOR=7.76,95%CI:5.65–10.68,P<0.001).Patients with chronic lung disease(aOR=0.62,95%CI:0.42–0.92,P=0.02)and a history of angina within two weeks(aOR=0.69,95%CI:0.56–0.85,P<0.001)were approximately 30%less likely to be prescribed DAPT.Approximately 15%of 1-year all-cause mortality were reported.Older patients prescribed DAPT showed significantly higher survival rates than those who were not(aHR<1.0,P<0.001).Aspirin-ticagrelor was associated with higher survival rates than aspirin-clopidogrel(aHR=0.21,95%CI:0.11–0.40,P<0.001).CONCLUSIONS Despite the optimal prescription rate and variation of DAPT in the older Malaysian population,there is room for investigation and improvement in the prescription of newer DAPT combinations that have been suggested to improve patient survival.
文摘[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mechanism.[Methods]96 patients with PHN were divided into the control group(group A)and observation group(group B)(n=48).In group A,the patients were given gabapentin orally and treated by cotton moxibustion.In group B,the patients were treated by the external application of self-prepared Chinese prescription decoction on the basis of the above basic treatment.The total effective rate,apparent time and recurrence rate of the two groups were compared.[Results]The cure rate(72.91%)and total effective rate(95.83%)of patients in group B were higher than those in group A(54.16%,83.33%).The average apparent time[(5.79±1.40)d]and recurrence rate(5.97%)of patients in group B were significantly lower than those in group A[(7.03±4.37)d,10.45%],and the difference between the two groups was statistically significant(P<0.05).[Conclusions]The external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion therapy had a significant curative effect and low recurrence rate.
基金Emergency Corona Virus Disease 2019(COVID-19)Response Project of Dongguan:Clinical Efficacy Observation and Mechanism Study of Fuzheng Xuanfei Huashi Formula in the Treatment of COVID-19 Based on the Lingnan Theory of Epidemic Diseases(No.202071715002124)National Natural Science Foundation of China:Study on the Mechanism of Lung Inflammatory Injury Induced by Gut-derived Lipopolysaccharide and Skatole in Spleen Deficiency Animals based on Pulmonary Alveolus Macrophage Heterogeneity(No.82274381)Guangdong Basic and Applied Basic Research Foundation:Development and Industrialization of Traditional Chinese Medicine Classic and Famous Prescription Compound Formulations(No.2021ZD006)。
文摘OBJECTIVE:To determine the effect of Traditional Chinese Medicine(TCM)Fuzheng Xuanfei Huashi prescription(扶正宣肺化湿方,FZXF)on lipopolysaccharide(LPS)-induced pneumonia in mice and identify the mechanism of FZXF in the treatment of LPS-induced lung inflammation.METHODS:The pneumonia model was established by intraperitoneal injection of 5 mg/kg LPS in mice.Cytokines were detected by enzyme-linked immuneosorbent assay(ELISA),macrophages in lung tissue were determined by immunofluorescence,and pathwayrelated data were determined by quantitative real-time polymerase chain reaction(qPCR)and Western blot.RESULTS:The liver,thymus,and spleen index values and the levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)obviously increased in LPS-treated mice.FZXF decreased the white blood cell count and reduced the increase in the lung wet weight/dry weight ratio caused by LPS.The hematoxylin-eosin staining result showed that FZXF could maintain the integrity of lung tissue structure,alleviate interstitial oedema and alveolar wall thickening,and reduce inflammatory cell infiltration.Moreover,FZXF markedly reduced the expression of proinflammatory cytokines.FZXF also significantly reduced LPS-induced malondialdehyde production and increased superoxide dismutase level in the lung.By immunofluorescence,we found that FZXF could reduce macrophage infiltration.The mRNA expression levels of cyclooxygenase-2(COX-2),prostaglandin E2(PGE2),toll-like receptor 4(TLR4)and nuclear transcription factorκB(NF-κB)in the lung tissue of mice were decreased by treatment with FZXF.In addition,FZXF inhibited the protein expression of TLR4,p-p65 and COX-2.These results indicated that FZXF could inhibit the inflammatory response of LPS induced cytokine storm in mice through TLR4/NF-κB and COX-2/PGE2 signaling pathway.CONCLUSION:These findings were suggested that FZXF prescription suppresses inflammation in LPSinduced pneumonia in mice via TLR4/NF-κB and COX-2/PGE2 pathway.
基金supported by the National Natural Science Foundation of China(Grant Nos.:82174259 and 82304997)China Postdoctoral Followship Program of CPSF(Grant No.:GZC20233202)+4 种基金China Postdoctoral Science Foundation(Grant No.:2024M753698)the Key Research and Development Program of Hunan Province of China(Grant Nos.:2023SK2021 and 2022SK2015)the Natural Science Foundation of Hunan Province,China(Grant Nos.:2024JJ6632,2022JJ40853,and 2021JJ31117)the Hunan Traditional Chinese Medicine Scientific Research Program,China(Grant Nos.:B2024113,B2024114,and 2021032)the Fundamental Research Funds for the Central Universities of Central South University,China(Grant No.:1053320232786).
文摘Traditional Chinese medicine(TCM)exerts integrative effects on complex diseases owing to the characteristics of multiple components with multiple targets.However,the syndrome-based system of diagnosis and treatment in TCM can easily lead to bias because of varying medication preferences among physicians,which has been a major challenge in the global acceptance and application of TCM.Therefore,a standardized TCM prescription system needs to be explored to promote its clinical application.In this study,we first developed a gradient weighted disease-target-herbal ingredient-herb network to aid TCM formulation.We tested its efficacy against intracerebral hemorrhage(ICH).First,the top 100 ICH targets in the GeneCards database were screened according to their relevance scores.Then,SymMap and Traditional Chinese Medicine Systems Pharmacology(TCMSP)databases were applied to find out the target-related ingredients and ingredient-containing herbs,respectively.The relevance of the resulting ingredients and herbs to ICH was determined by adding the relevance scores of the corresponding targets.The top five ICH therapeutic herbs were combined to form a tailored TCM prescriptions.The absorbed components in the serum were detected.In a mouse model of ICH,the new prescription exerted multifaceted effects,including improved neurological function,as well as attenuated neuronal damage,cell apoptosis,vascular leakage,and neuroinflammation.These effects matched well with the core pathological changes in ICH.The multi-targets-directed gradient-weighting strategy presents a promising avenue for tailoring precise,multipronged,unbiased,and standardized TCM prescriptions for complex diseases.This study provides a paradigm for advanced achievements-driven modern innovation in TCM concepts.
文摘This paper, an addendum to “Dialectical Thermodynamics’ solution to the conceptual imbroglio that is the reversible path”, this journal, 10, 775-799, was written in response to the requests of several readers to provide further evidence of the said “imbroglio”. The evidence here presented relates to the incompatibility existing between the total-entropy and the Gibbs energy prescriptions for the reversible path. The previously published proof of the negentropic nature of the transformation of heat into work is here included to validate out conclusions about the Gibbs energy perspective.
