Immune checkpoint inhibitors(ICIs), as revolutionary drugs in cancer therapy, play an anti-tumor role by blocking immune checkpoint signals and enhancing the body's immune response to tumor cells, but also cause a series of immune-related adverse events(irAEs). Cutaneous irAEs(cirAEs) are one of the most common types. This paper reviewed the mechanism, clinical manifestations, treatment and prognosis of cirAEs, and briefly elaborated the relationship between cirAEs and well-known drug eruptions, aiming to increase the awareness of medical professionals about ICIsrelated cirAEs and provide guidance for clinical treatment.

Biological agents and oral small molecule(OSM) drugs provide a new approach for the treatment of pediatric skin diseases, such as atopic dermatitis, psoriasis, alopecia areata, and hidradenitis suppurativa. Although most biological agents and OSM drugs have only been approved for use in adult patients, with the continuous strengthening of their clinical safety evaluations and the gradual approval of their use in adolescents and children, biological agents and OSM drugs are expected to become new choices for pediatric skin disease medication in the future. This article comprehensively reviewed the biological agents and OSM drugs that have been approved by the US Food and Drug Administration in recent years or have potential for treating atopic dermatitis, psoriasis, alopecia areata, and hidradenitis suppurativa in children, in order to provide reference for the treatment of related diseases.

Objective To explore the effect of Wumei pill on the expression of Rho/ROCK signaling proteins in the colon of rats with ulcerative colitis(UC). Methods Thirty-two male SD rats were selected, 8 of which were randomly selected as the normal group, and the rest were established UC models by enema of 2, 4, 6-trinitrobenzenesulfonic acid.The model rats were divided into the Wumei pill group(given 28.8 g/kg by gavage), the positive control group(given 300 mg/kg of mesalazine suspension by gavage), and the model group, with 8 rats in each group. Both the normal group and the model group were treated with the same volume of 0.9% sodium cholride injection by gavage. The administration volume was 20 mL/kg. The administration was given once a day for 10 consecutive days. The activity of rats in each group was observed every day, the length and mass of the colon were measured, and the intestinal mass index was calculated. Colonic pathological changes and the score of colon macroscopic damage index(CMDI) were compared. The number of white blood cells and platelets in peripheral blood were detected by a blood analyzer. Western blot was used to detect the protein expressions of RhoA, Rho guanosine triphosphate(GTP) and Claudin-1 in colon tissue. Results Compared with the normal group, typical UC pathological changes occurred in the colonic mucosa of rats in the model group. The CMDI score, intestinal mass index, the number of white blood cells and platelets in peripheral blood, and the expressions of RhoA and RhoGTP in colonic tissue were significantly increased(P＜0.05), and the length of the colon was significantly shortened(P＜0.05). The expression of Claudin-1 protein was significantly down-regulated(P＜0.05). Compared with the model group, the mucosal UC pathological results in the Wumei pill treatment group and the positive control group improved, the CMDI score decreased(P＜0.05), and the intestinal mass index, the number of white blood cells and platelets in peripheral blood, and the protein expressions of RhoA and RhoGTP in colon tissue were significantly reduced(P＜0.05). The length of the colon increased significantly(P＜0.05), and the expression of Claudin-1 protein was significantly upregulated(P＜0.05). Conclusion Wumei pill can improve the barrier function of colonic mucosal endothelial cells by regulating the expression levels of related proteins in the Rho/ROCK signaling pathway, thereby effectively treating UC.

To explore the mechanism of high intraocular pressure on retinal ganglion injury in rats. Methods A high intraocular pressure rat model was established and randomly grouped into a low-dose group(25 mg/mL magnetic bead suspension), a high-dose group(50 mg/mL magnetic bead suspension), and a control group(sham operation group) by a random block design. The changes of intraocular pressure(IOP) in each group of rats were compared. The functional changes of the rat retina were detected by electroretinogram. The changes of delayed rectification type potassium channels in retinal ganglion cells(RGC) were detected by patch clamp. Results Compared with the control group, the IOP in the low-dose and high-dose groups increased at 7 and 21 days after modeling, and the high-dose group was higher than the low-dose group(P＜0.05). Compared with the control group, the amplitudes of a-wave and b-wave in the low-dose and high-dose groups gradually decreased, and the decrease in the high-dose group was greater than that in the low-dose group(P＜0.05). Compared with the control group, the current density inhibitory effect of the RGC delayed rectified potassium ion channel in the low-dose and high-dose groups was enhanced at 7, 21 and 35 days after modeling, and the high-dose group was higher than the low-dose group(P＜0.05). Conclusion The higher the intraocular pressure and the longer the duration, the more significant the damage to the retinal ganglia. This provides a theoretical basis for the clinical prevention and treatment of retinal damage caused by glaucoma and is helpful for assessing the risk of the disease.

Objective To explore the role of histone lactate modification in malignant biological behavior and cisplatin resistance of lung cancer cells and its potential molecular mechanism. Methods The modification levels of panlysine lactation(Pan-Kla) and histone lactation sites in lung cancer tissues and cells were detected by western blot. A549 and A549/DDP cells were treated with 2-deoxy-D-glucose(2-DG). Cell proliferation, migration, apoptosis and drug-resistant related indicators were analyzed by CCK-8 assay, Transwell assay, flow cytometry and western blot. By using the transcriptome sequencing to screen downstream target genes of H3K18la. The binding relationship was verified by chromatin immunoprecipitation(ChIP), and the expression level of USP7 was detected by real-time fluorescence quantitative PCR. Further study were conducted to investigate the effect of USP7 on the biological behavior of lung cancer cells and cisplatin resistance. Results The lactation modifications of Pan-Kla and H3K18la in lung cancer tissues and cells were significantly increased. After treatment with 2-DG, the levels of Pan-Kla and H3K18la in A549 and A549/DDP cells decreased in a dose-dependent manner(P＜0.01). Cell proliferation and migration in the 2-DG group were inhibited, the apoptosis rate increased, and the IC50 of drug resistance in A549/DDP cells decreased(P＜0.05). ChIP confirmed that H3K18la was enriched in the USP7 promoter region and promoted its transcription. The expression of USP7 was upregulated in lung cancer. Knocking down USP7 can inhibit cell proliferation and migration, promote apoptosis, and reduce the expression of drug resistance-related proteins(P＜0.01). Overexpression of USP7 can partially reverse the inhibitory effect of 2-DG. Conclusion In lung cancer, histone lactated modification(particularly H3K18la) can promote malignant biological behaviors and cisplatin resistance by upregulating the expression of USP7, and is involved in the progression of lung cancer.

Objective To observe the clinical efficacy of Zhilong Xuetong capsules combined with butylphthalide soft capsules in treatment of patients with convalescent cerebral infarction. Methods A total of 90 patients with convalescent cerebral infarction admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to December 2023 were selected, and divided into control group and treatment group, with 45 cases in each group. The control group was given routine treatment, and the treatment group was given Zhilong Xuetong capsules combined with butylphthalide soft capsules. Both groups were treated for 2 weeks. The curative effects of the two groups and the National Institute of Health stroke scale(NIHSS) score, activity of daily living(ADL) score, anterior cerebral artery(ACA) blood flow velocity, basilar artery(BA) blood flow velocity, middle cerebral artery (MCA) blood flow velocity and serum neuron-specific enolase(NSE), heart-fatty acid binding protein(HFABP) and S100B protein levels and adverse reactions were compared between the two groups. Results The total effective rate of the treatment group was higher than that of the control group(91.11% vs. 71.11%, P＜0.05). After treatment, NIHSS score in the treatment group was lower than that in the control group, ADL score was higher than that in the control group(P＜0.05), ACA, MCA and BA blood flow velocity were higher than those in the control group(P＜0.05), and seru m NSE, HFABP and S100hose in the control group were all lower than those in the control group(P＜0.05). There was no significant difference in the rate of adverse reactions between the two group(P＞0.05). Conclusion Zhilong Xuetong capsules combined with butylphthalide soft capsules has a significant effect on convalescent cerebral infarction, which can reduce the levels of serum NSE, HFABP and S100B protein, alleviate the damage of nerve function, and has high safety.

Objective To investigate the effect of secukinumab injection combined with tacrolimus ointment on the efficacy, serum cytokine levels and peripheral blood T cell subsets in patients with moderate to severe plaque psoriasis. Methods Seventy patients with moderate to severe plaque psoriasis were selected and randomly divided into control group and observation group, with 35 cases in each group. The control group was treated with secukinumab injection, while the observation group was treated with secukinumab injection combined with tacrolimus ointment, both were treated for 3 months. Psoriasis area severity index(PASI) score, cytokines and peripheral blood T cell subsets were compared between the two groups before and after treatment. The clinical efficacy and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group(97.14% vs. 77.14%, P＜0.05). After treatment, the PASI score, tumor necrosis factor-α, interleukin-17 A, interferon-γ and CD8＋ T cell levels in the two groups decreased, and those in the observation group were lower than the control group(P＜0.05). The levels of CD3 ＋, CD4 ＋, and CD4 ＋/CD8 ＋ increased, and the observation group was higher than the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05). Conclusion Secukinumab injection combined with tacrolimus ointment in the treatment of patients with moderate to severse plaque psoriasis can improve the clinical efficacy, regulate inflammatory response and immune function, and has good safety.

Objective To explore the potential advantages of Jiehe pills combined with the standard antituberculosis(TB) regimen(2HRZE/4HR) in improving clinical symptoms of newly diagnosed sputum-positive pulmonary TB patients in real-world settings, and to evaluate its safety. Methods A prospective observational study was conducted. A total of 480 newly diagnosed sputum-positive pulmonary TB patients from 5 hospitals between March 28, 2018, and April 28, 2021 were enrolled. Among them, 252 patients in the control group received the 2HRZE/4HR regimen alone, while 228 patients in the experimental group received Jiehe pills in addition to the control group. The sputum culture conversion rate, clinical symptom scores, quality of life scale scores, and incidence of adverse drug reactions were compared between the two groups after 6 months of treatment. Results After 6 months of treatment, the sputum culture conversion rate in the experimental group was slightly higher than the control group, but there was no statistical difference In terms of clinical symptoms, the total graded and quantified clinical symptom scores in the experimental group was significantly higher than the control group(difference in scores: experimental group vs. control group＝1.087). Additionally, the disappearance rate of chest pain symptoms in the experimental group was significantly higher than that in the control group(80.65% vs. 47.37%, P＝0.014). Conclusions The combination of Jiehe pills with the 2HRZE/4HR regimen did not significantly improve sputum culture conversion rates, but it effectively alleviated clinical symptoms—particularly chest pain. Moreover, it was safe and provided a new treatment option for newly diagnosed sputum-positive pulmonary TB patients, which could improve the quality of life of patients and hold significant clinical value.

Objective To explore the effect of Tingli Dazao Xiefei decoction as an adjuvant treatment for children with severe pneumonia(SP) of phlegm-heat obstructing lung syndrome, and its effect on receptor for advanced glycation end products(RAGE) and diamine oxidase(DAO) levels. Methods A total of 104 children with SP in our hospital from March 2022 to March 2024 were selected and randomly divided into the control group and the study group, with 52 cases in each group. All children were given conventional oxygen inhalation and anti-infection treatment. The control group was treated with phentolamine, and the study group was treated with phentolamine combined with Tingli Dazao Xiefei decoction. Both groups were treated for one week. The therapeutic effects, the traditional Chinese medicine(TCM) syndrome scores, arterial blood gas indicators[arterial partial pressure of oxygen(PaO2), arterial carbon dioxide(PaCO2), blood oxygen saturation(SpO2)], inflammatory factors[C-reactive protein(CRP), tumor necrosis factor(TNF)-α, interleukin(IL)-6], lung function, RAGE, and DAO levels between two groups were compared. The occurrence of adverse reactions of the two groups during the treatment process were recorded. Results After treatment, the clinical efficacy, PaO2, SpO2 and pulmonary function indexes of the study group were all better than those of the control group(P＜0.05), the TCM syndrome scores, PaCO2, CRP, TNF-α, IL-6, RAGE and DAO levels were all lower than those of the control group(P＜ 0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P＞ 0.05). Conclusion Tingli Dazao Xiefei decoction has a better adjuvant therapeutic effect on children with SP of phlegmheat obstructing lung syndrome. It can effectively improve clinical symptoms and arterial blood gas indicators, and reduce the levels of serum RAGE and DAO.

Objective To explore the effect of tacrolimus combined with sirolimus on patients with primary liver cancer after liver transplantation and its influence on the levels of serum interleukin(IL)-17A and regulatory T cell(Treg). Methods A total of 150 patients who underwent liver transplantation in the department of general surgery, Qinhuai medical area of eastern theater command general hospital were selected from January 2020 to December 2024 and divided into the control group(tacrolimus) and the study group(tacrolimus combined with sirolimus), with 75 cases in each group. All patients were treated for 3 months. The curative effects, changes in serum IL-17A, Treg and liver function indexes between the two groups were compared, and the occurrence of adverse reactions during the treatment course was recorded and statistically analyzed. Results After treatment, the clinical efficacy of the study group was higher than that of the control group(89.33% vs. 77.33%, P＜0.05). The levels of IL-17A, alanine aminotransferase, aspartate aminotransferase and total bilirubin in the study group were all lower than those in the control group(P＜0.05), and the level of Treg was higher than that in the control group(P＜0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P＞0.05). Conclusion The immunosuppressive regimen of tacrolimus combined with sirolimus can improve the levels of serum IL-17A and Treg in patients after liver transplantation and regulate the liver function indicators.

Objective To establish the drug use evaluation(DUE) standard for Yadanzi Oil Emulsion Injection, and to evaluate the rationality of its clinical use based on the technique for order preference by similarity to an ideal solution(TOPSIS) method. Methods Based on the drug instructions, clinical diagnosis and treatment guidelines, and the actual use of this drug in our hospital, the DUE standard was formulated. A total of 182 medical records of patients treated with Yadanzi Oil Emulsion Injection from June 2022 to May 2023 were randomly selected from the hospital information system of our hospital, and the weighted TOPSIS method was employed for comprehensive evaluation. Results The weight distribution of the 9 evaluation indicators is as follows, indications(17.778%), namely contraindications(11.852%), incompatible drug combinations(16.296%), usage and dosage(11.111%), combined medication(0.741%), precautions(2.222%), clinical efficacy and monitoring(14.815%), adverse reaction monitoring and treatment(15.556%), and physical condition assessment(9.630%). Among the 182 cases, 106 cases(58.24%) had Ci ≥80%, 58 cases(31.87%)had 60%≤Ci ＜80%, and 18 cases(9.89%) had Ci ＜60%. The irrational medication mainly focused on indications, usage and dosage, and adverse reaction monitoring. Conclusion The weighted TOPSIS method can objectively evaluate the rationality of the use of Yadanzi oil emulsion injection, and the evaluation results are consistent with the clinical practice. The method has the characteristics of intuitive operation and strong guidance, and can provide data support for rational use of drugs in clinical practice.

Objective To investigate the impact of the national centralized drug procurement(NCGPO) policy on the clinical use of anticoagulant and antiplatelet drugs in a hospital, and to provide evidence for optimizing pharmaceutical management. Methods Data on anticoagulant and antiplatelet drug usage were collected for one year before and after the implementation of the first, third, fourth, fifth, seventh, and eighth batches of NCGPO in a hospital, covering 11 selected drugs. The defined daily doses(DDDs), usage proportion of similar drugs, price reduction, expenditure, defined daily cost (DDC), and cost savings were compared before and after NCGPO. Results After NCGPO implementation, the unit prices of 28 drugs (including 11 selected drugs) decreased significantly. The DDDs and usage proportion of selected drugs were higher than those of non-NCGPO drugs. The usage of clopidogrel, ticagrelor, dabigatran etexilate, and rivaroxaban(10 mg) increased notably, with a higher proportion in their therapeutic categories. The DDC of all NCGPO drugs decreased, with the largest reduction observed in rivaroxaban tablets(10 mg)(99.20%). Cost savings per batch ranged from 24 200 to 2 814 400 CNY, totaling 8 594 100 CNY. Conclusion The NCGPO policy achieved “increased usage and reduced prices,” effectively alleviating patients’ financial burden and enhancing the medical security system.

Objective To explore the clinical effect of Buyang Huanwu decoction and Dihuang Yinzi decoction combined with Kaiqiao Jieyu acupuncture in the treatment of aphasia after stroke. Methods A total of 107 patients with aphasia after stroke admitted to our hospital from January 2022 to May 2024 were retrospectively selected and divided into two groups according to different clinical treatment methods. The control group(n＝54) was treated with acupuncture, and the experimental group(n＝53) was treated with acupuncture combined with Chinese medicine decoction. The efficacy, speech function improvement, nerve function, hemorheology and safety were compared between the two groups. Results The efficacy of the experimental group was higher than that of the control group(P＜0.05). After treatment, the Boston diagnostic aphasia examination grade and Chinese functional communication profile score of the two groups increased, and the experimental group was higher than the control group(P＜0.05). The levels of neuron-specific enolase, homocysteine,high-sensitivity C-reactive protein, interleukin-6, fibrinogen and D-dimer in the two groups were decreased, and those in the experimental group were lower than those in the control group(P＜0.05). There was no significant adverse reactions were observed in either group during the study. Conclusion Buyang Huanwu decoction and Dihuang Yinzi decoction combined with Kaiqiao Jieyu acupuncture in the treatment of aphasia after stroke can improve speech function and nerve function, promote blood flow, reduce inflammation, so as to effectively improve the efficacy and safety of medication.

Objective To investigate the effects of ginkgo leaf extract and armillaria mellea powders oral solution in coronary atherosclerotic heart disease(CAHD) with blood stasis syndrome combined with diabetes mellitus after percutaneous coronary intervention(PCI). Methods A total of 94 patients with CAHD and diabetes mellitus admitted to the Department of Cardiology, Shuangqiao Hospital, Chaoyang District, Beijing from January 2021 to November 2021 were selected. All patients received PCI treatment and were randomly divided into the control group(n＝47, receiving conventional treatment) and the experimental group(n＝47, receiving conventional treatment plus ginkgo leaf extract and armillaria mellea powders oral solution) through matched randomization. The differences of oxidative stress indexes, immune function indexes and serum cystatin(Cys)C expression levels before and after treatment were compared between the two groups. Results The expression levels of superoxide dismutase and glutathione peroxidase in experimental group were significantly higher than those in control group after treatment(P＜0.05). The expression levels of mmunoglobulin(Ig)G, interleukin-6 and IgM in experimental group were significantly higher than those in control group after treatment(P＜0.05). The expression level of serum CysC in experimental group after treatment was significantly lower than that in control group(P＜0.05). The clinical efficacy of the experimental group was higher than that of control group(91.49% vs. 73.91%, P＜0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05). Conclusion Ginkgo leaf extract and armillaria mellea powders oral solution can significantly improve the oxidative stress response and immune function of patients with CAHD complicated with diabetes after PCI, reduce the level of serum CysC, improve the clinical efficacy, and can be widely applied in clinical practice.

Objective To study the effects of continuous saphenous nerve block(SNB) and femoral nerve block on the rehabilitation process of patients after total knee replacement(TKA). Methods: A total of 66 patients who underwent unilateral TKA at the First People's Hospital of Mengcheng County, Anhui Province from February 2022 to December 2023 were proposed for analysis. When the research was carried out, there were 48 cases in the control group and 49 cases in the observation group. The control group received a single femoral nerve block after the operation, while the observation group received continuous SNB. The visual analogue scale(VAS) of knee joint pain, the time for the first postoperative ambulation, the range of motion of the knee joint and the occurrence of analgesia-related adverse events at 24, 48 and 72 hours after surgery in the two groups were observed. Results There was no statistically significant difference in the VAS score at 24 hours after the operation between the two groups(P＞0.05), while the VAS scores of the observation group at 48 and 72 hours after the operation were better than those of the control group(P＜0.05). The time for the first ambulation in the observation group was significantly earlier than that of the control group(P＜0.001). There was no statistically significant difference in the range of motion of the knee joint between the two groups 24 hours after the operation(P＞0.05), but at 48 and 72 hours after the operation, and the difference was statistically significant(P＜0.001). The analgesia-related adverse events in the observation group were significantly fewer than those in the control group(P＜ 0.05). Conclusion Continuous SNB can effectively relieve postoperative pain after TKA, and shorten the time for the first ambulation after surgery.

Objective To explore the effect of the method of resolving phlegm and lowering Qi in the treatment of polycystic ovary syndrome(PCOS) with liver depression and Qi stagnation syndrome, and its influence on glucose and lipid metabolism and sex hormone levels. Methods A total of 105 PCOS patients with phlegm-dampness obstruction syndrome who were treated in the endocrinology department of our hospital from June 2022 to December 2024 were selected and randomly divided into the experimental group(n＝53, treated with the method of resolving phlegm and lowering Qi combined with clomiphene) and the control group(n＝52, treated with clomiphene). The clinical efficacy, glycolipid metabolism, sex hormones, body mass index(BMI), waist-to-hip ratio(WHR), and the occurrence of adverse reactions were compared between the two groups. Results The total effective rate of the experimental group was higher than that of the control group(90.57% vs. 75.00%, P＜0.05). The levels of triglycerides, total cholesterol, fasting plasma glucose and fasting plasma insulin in both groups were lower than before(P＜0.05), and the levels in the experimental group were lower than those in the control group(P＜0.05). The levels of follicle-stimulating hormone, luteinizing hormone and testosterone in both groups were lower than before(P＜0.05), and the levels in the experimental group were lower than those in the control group(P＜0.05). After treatment, the BMI, WHR and traditional Chinese medicine syndrome scores of both groups decreased compared with before(P＜0.05), and the scores of the experimental group were lower than those of the control group(P＜0.05). The adverse reactions in the two groups mainly included stomachache, nausea and vomiting, and lower pelvic abdominal pain, etc., but there was no significant difference(P＞0.05). Conclusion The addition of the method of resolving phlegm and lowering Qi in the treatment of PCOS patients with liver depression and Qi stagnation syndrome has a good effect. It can effectively improve glucose and lipid metabolism and sex hormone levels without increasing safety risks.

Non-small cell lung cancer(NSCLC) is one of the most common types of lung cancer. Traditional radiotherapy and chemotherapy are limited in efficacy due to issues such as systemic toxicity, poor targeting, and drug resistance. Polymer micelles, as a novel drug delivery system, can significantly enhance drug solubility, reduce side effects, and overcome resistance due to their excellent physicochemical properties(such as high drug loading capacity, tumor targeting, and stimulus-responsive drug release). This paper systematically reviewed the latest advancements of polymer micelles for the treatment of NSCLC, including material design, targeting strategies, and challenges in clinical translation, aiming to provide a theoretical basis for optimizing treatment strategies.

Er-Xian decoction, a classical formula developed by professor Zhang Bone, has the efficacy of balancing renal Yin and Yang. In recent years, it has demonstrated therapeutic value in multiple clinical domains, including premature ovarian failure, osteoporosis, and urinary disorders. This review systematically summarized research evidence on the pharmacological active components, clinical efficacy evaluations and molecular mechanisms of Er-Xian decoction, aiming to provide a scientific basis for expanded clinical applications and further investigations.

Objective To explore optimization models for prescribing renewal management in internet hospitals and enhance the quality of remote pharmaceutical services. Methods A retrospective analysis was conducted on the number and frequency of online prescription renewals, distribution of prescription diagnoses, and drug type distributions at a tertiary hospital from 2022 to 2023. The impact of interventions, including updates to prescription review rule databases, control of cumulative drug quantities, and optimization of system-human collaboration in prescription review, on prescription approval rates and pharmacist intervention rates was investigated. Results The volume of prescription renewals in 2023 increased by 20.68%, with a 12.95% improvement in prescription approval rates and a 3.48% reduction in pharmacist intervention rates. Among patients, 70.79% renewed prescriptions 1—5 times annually. The top three disease categories were circulatory system disorders(35.42%), endocrine system disorders(24.99%), and digestive system disorders(21.26%); 53.40% of patients had 2—5 comorbidities. The top three prescription drugs were antihypertensives(29.55%), antidiabetics(22.32%), and lipid-lowering agents(10.13%). Conclusion Through innovative management measures such as front-end prescription rule updates and system-human collaborative review, online prescription renewal to provide convenient medication access. Meanwhile, pharmacists promote rational clinical drug use via prescription review systems, ensuring patient medication safety.