Abstract Background Angiogenesis is an important mechanism of recovery from ischemic stroke. Recent studies have found that there is a close relationship between the VEGF/Notch pathway and angiogenesis. It is unknown whether EA can exert a brain protection effect and promote angiogenesis by acting on the VEGF/Notch signaling pathway after focal cerebral ischemia‐reperfusion injury (CIRI). Methods The Middle Cerebral Artery occlusion/Reperfusion (MCAo/R) model was established, in which rats were subjected to occlusion with ischemic intervention for 30 min, followed by reperfusion for 8 h, 1 day, 3 days, and 7 days. The first EA treatment was performed 90 min after the animal model was successfully established, and then EA treatments were performed once a day for 7 days. The 2,3,5‐triphenyltetrazolium chloride staining and neurological deficit examination were performed to assess the level of CIRI and neuroprotection by EA. Expression levels of VEGFA, Notch1, and Hes1 proteins were measured via western blotting, while the morphological changes of ECs and microvasculature in the cortex were determined using an ultrastructural observation method. Results EA treatment of PC6, GV26, and SP6 can significantly improve the neurological function of MCAO/R rats, reduce the volume of cerebral infarction, and modulate the ultrastructure of ECs and microvessels in pathological states. Western blotting revealed that EA increased VEGFA protein expression at 8 h and 3 days after CIRI, as well as Notch1 protein expression at 1 and 7 days. Subsequently, EA activated the VEGF/Notch pathway, increasing the expression of the downstream target protein Hes1, reversing EC death, and promoting angiogenesis. Conclusion Our findings showed that EA plays a role in promoting angiogenesis following focal CIRI, and we hypothesized that this was due to the regulation of ECs by the EA‐activated VEGF/Notch signaling pathway.
The new round of medical and health system reform launched in China takes "drug reform" first, and is committed to breaking the mechanism of "supporting doctors with drugs" and alleviating the problem of "difficult and expensive medical treatment". For more than ten years since the implementation of centralized drug procurement, the effect of controlling medical expenses is not significant. The phenomenon of falsely high drug prices still exists, and medical expenses continue to rise. The reason is that there are some problems in centralized drug procurement, such as imperfect laws and regulations, dislocation of procurement subjects, separation of bidding and procurement, and non linkage between quantity and price. Therefore, it is imperative to reform the method of drug procurement. Based on this, this paper discusses and analyzes the impact of volume procurement on the drug market, and puts forward corresponding optimization suggestions. Through investigation and interview with relevant government departments, medical institutions, drug enterprises and their relevant personnel, this paper investigates the comparison of bid winning prices and price reduction before and after the implementation of volume procurement policy in a city, as well as the division statistics of area a and B of the second batch of volume procurement. The results show that, Compared with the previous round, the bid price of the three batches of drugs purchased in the city decreased by an average of 56%, while the average decrease of the third batch of drugs purchased in the city was only 43%, which was significantly narrowed compared with the first two batches. The highest single product decreased by 93% and the lowest by only 2%. There were great individual differences in drugs; The second batch of two districts with volume procurement in the city calculate the quantity of agreed procurement targets respectively, and the bidding drug manufacturers will conduct bidding respectively to reduce the possibility of exclusive bid winning, one dominating the market and maliciously excluding other products. The VP mode has positive significance both in theory and practice.
To evaluate the prognostic value of early white blood cell count (WBC) in patient of acute paraquat poisoning.The literatures about the studies on early WBC and prognosis after paraquat poisoning published in journals at home and abroad were searched. The Chinese literature database contained CNKI, VIP, Wanfang Database, and China Biomedicine Database (CBM), and the journals were limited to the core journals. The foreign language database included PubMed, Embase and Cochrane library clinical controlled trial database. The retrieval date was from the initial publication to April 22nd in 2019, without the limitation of languages. Two researchers independently extracted literature information, and the Newcastle-Ottawa Scale (NOS) was used to evaluate literature quality. The odds ratio (OR), sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the summary receiver operating characteristic (SROC) were combined and analyzed through the Stata 15.0 software to evaluate the predictive value of early WBC after acute paraquat poisoning. Publication bias was analyzed by Deeks funnel graph.There were 7 retrospective studies and 1 prospective study in a total of 980 paraquat poisoning patients, 5 of them were English literatures, the others were Chinese literatures. There was no heterogeneity among the studies (I2 = 43.5%, P > 0.05). The OR and its 95% confidence interval (95%CI) of the literature was combined through the fixed effect model. The Meta-analysis results were statistically significant (OR = 18.63, 95%CI = 13.63-25.48, P < 0.001), suggesting that the WBC was significantly correlated with the mortality of patients. The combined sensitivity, specificity, PLR, NLR and DOR were 0.75 (95%CI = 0.66-0.82), 0.85 (95%CI = 0.80-0.90), 5.14 (95%CI = 3.86-6.86), 0.29 (95%CI = 0.22-0.39), 17.53 (95%CI = 12.23-25.13) respectively, and the area under the SROC of the WBC was 0.88 (95%CI = 0.85-0.91). Deeks funnel plot was symmetrical (P = 0.21), and there was no obvious publication bias.The early WBC has a certain predictive value for the prognosis of acute paraquat poisoning patients.
Abstract Background: To investigate the effect of transabdominal hysterectomy on the diversity of the intestinal flora in patients with uterine fibroids. Patients with uterine fibroids were selected from September 2018 to December 2018, in the Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, and stool specimens were collected from patients before and after surgery. Results :High-throughput sequencing of the 16S rRNA gene was used to detect the changes in microbial community structure and diversity, and the effects of total hysterectomy on the intestinal flora were further analyzed. Estrogen levels decreased after trans-abdominal hysterectomy. High-throughput sequencing showed that after abdominal hysterectomy, the abundance and diversity of the intestinal flora decreased. The abundance changes were mainly due to Proteobacteria, where their abundance increased. Conclusions :Trans-abdominal hysterectomy changes the intestinal flora of the body by lowering the level of estrogen in the body, which reduces the diversity and abundance of the intestinal flora . Key words: intestinal flora, uterine fibroids, hysterectomy, estrogen,high-throughput sequencing,16sRNA
To investigate the effect of transabdominal hysterectomy on the diversity of the intestinal flora in patients with uterine fibroids. Patients with uterine fibroids were selected from September 2018 to December 2018, in the Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, and stool specimens were collected from patients before and after surgery.High-throughput sequencing of the 16S rRNA gene was used to detect the changes in microbial community structure and diversity, and the effects of total hysterectomy on the intestinal flora were further analyzed. Estrogen levels decreased after trans-abdominal hysterectomy. High-throughput sequencing showed that after abdominal hysterectomy, the abundance and diversity of the intestinal flora decreased. The abundance changes were mainly due to Proteobacteria, where their abundance increased.Trans-abdominal hysterectomy changes the intestinal flora of the body by lowering the level of estrogen in the body, which reduces the diversity and abundance of the intestinal flora.
Abstract Background: To investigate the effect of transabdominal hysterectomy on the diversity of the intestinal flora in patients with uterine fibroids. Patients with uterine fibroids were selected from September 2018 to December 2018, in the Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, and stool specimens were collected from patients before and after surgery.Results: High-throughput sequencing of the 16S rRNA gene was used to detect the changes in microbial community structure and diversity, and the effects of total hysterectomy on the intestinal flora were further analyzed. Estrogen levels decreased after trans-abdominal hysterectomy. High-throughput sequencing showed that after abdominal hysterectomy, the abundance and diversity of the intestinal flora decreased. The abundance changes were mainly due to Proteobacteria, where their abundance increased.Conclusions: Trans-abdominal hysterectomy changes the intestinal flora of the body by lowering the level of estrogen in the body, which reduces the diversity and abundance of the intestinal flora.
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