Objective To compare the efffcacy of tenofovir propofol and entecavir in the treatment of chronic hepatitis B(CHB) and their effects on serum Golgi protein(GP)73 and hepatitis B virus(HBV)-RNA. Methods A total of 96 eligible CHB patients admitted to our hospital from September 2023 to January 2025 were selected and randomly divided into the observation group and the control group, with 48 cases in each group. The control group was treated with entecavir dispersible tablets, while the observation group was treated with tenofovir profol fumarate tablets. Both groups were treated for 28 weeks. The clinical efffcacy, GP73, HBV-RNA, hepatitis B surface antigen, HBV-DNA levels, liver function, liver ffbrosis and the occurrence of adverse reactions were compared between the two groups. Results After treatment, there was a statistically signiffcant difference in the total effective rate between the two groups(P＜0.05). After treatment, the levels of GP73, HBV-RNA, hepatitis B surface antigen, HBV-DNA, alanine transaminase, aspartate transaminase, total bilirubin, laminin, procollagen type Ⅲ, type Ⅳ collagen, hyaluronic acid in the observation group were lower than those in the control group(P＜0.05). There was no statistically signiffcant difference in the occurrence of adverse reactions between the two groups(P＞0.05). Conclusion Tenofovir propofol can effectively improve liver function in patients with CHB, has good safety, and has a good antiviral effect when used for a long time.

Objective To explore the clinical application value of oral electrolyte solution after surgery in patients undergoing endoscopic resection of colorectal polyps, and to evaluate the impact on postoperative intestinal function recovery, patient comfort and the incidence of adverse reactions. Methods A total of 140 patients who underwent endoscopic resection of colorectal polyps at the Tenth People's Hospital from March 2024 to June 2024 were selected and divided into the experimental group and the control group, with 70 cases in each group. Patients in the experimental group took 400 mL of electrolyte formula food orally 2 hours after the operation. The control group was given sterile water of the same volume. The ffrst postoperative exhaust, defecation and hospital stay, the visual analogue scale, self-rating anxiety scale, self-rating depression scale, and adverse reactions were compared between the two groups. Results The ffrst postoperative exhaust, defecation and hospital stay in the experimental group were all shorter than those in the control group(P＜0.001). The postoperative levels of blood potassium and blood glucose in the control group were signiffcantly

Small intestinal bacterial overgrowth(SIBO) is a clinical syndrome caused by an abnormal increase in the number of bacteria in the small intestine. Children have incomplete physiological functions and are more prone to the disease. The treatment of SIBO in children is rather complex, and the use of antibacterial drugs needs to fully consider both efficacy and safety. This paper reviewed the pathological mechanism, epidemiological characteristics, clinical manifestations, diagnostic methods and treatment strategies of SIBO in children, and evaluated the efffcacy and safety of antibacterial drugs, aiming to provide references for clinical diagnosis and treatment.

In 2022, the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Association jointly released a clinical practice guideline that introduced the term progressive pulmonary fibrosis(PPF) to collectively refer to the progressive fibrotic phenotypes of interstitial lung diseases other than idiopathic pulmonary fibrosis(IPF). These diseases may exhibit clinical course characteristics and core mechanisms of fibrosis similar to those of IPF, even after standardized treatment. Currently, the two anti-fibrotic drugs nintedanib and pirfenidone approved by the U.S. Food and Drug Administration, can only slow the decline in lung function in patients with IPF, but cannot reverse fibrosis. Due to the significant heterogeneity of PPF patient population and complex enrollment criteria, clinical trials targeting PPF often terminate due to recruitment challenges. Consequently, current drug development strategies primarily select IPF as the initial indication and then gradually expand to other fibrotic lung diseases after confirming effectiveness. In the research and development pipeline, most candidate drugs remain in the early stages of clinical development, with only a few advancing to phase Ⅱ/Ⅲ clinical studies and simultaneously exploring the PPF indication. Notably, in 2024, the world's first anti-fibrotic drug designed entirely using artificial intelligence(AI), INS018-055, successfully progressed to Phase Ⅱ clinical trials, marking a significant breakthrough application of AI technology in drug development. This article systematically dissected the conceptual framework of PPF, covering its definition, disease spectrum, epidemiological characteristics, and molecular mechanisms, while reviewed the latest clinical research advancements from the perspective of anti-fibrotic treatment, aiming to provide a theoretical foundation for the discovery of new targets and translational research.

The vascular endothelium differentiates organically in both structure and molecules, enabling it to execute specific functions that are tailored to the microenvironment. Continuous endothelial cells with firmly sealing tight junctions are found in tissue, in which the endothelial cells form a barrier, such as in the brain, lung, or muscle. Discontinuous endothelium are present in organs with ffltration function(e.g., kidney) or that release substances into the bloodstream(endocrine glands). Sinusoidal endothelium forms a discontinuous layer with intracellular and intercellular sieve-like gaps. They are found in immune active organs such as the bones, spleen, and liver. This article reviewed the analysis and utilization of mechanism of vascular heterogeneity, aiming to provide references for the development of new therapeutic targets for related diseases.

Vascular endothelial cells play a crucial role in the body. Due to their large surface area and the fact that body cells are generally located within the oxygen diffusion limit of capillaries(100-150 μm), the microvascular network constitutes a key interface between the circulatory system and the parenchyma of organs. Traditionally, endothelial cells have mainly been regarded as functional actors that respond to external stimuli(such as inffammatory factors). Recent research has revised this passive perspective. Currently, endothelial cells have been redefined as active "gatekeepers" due to their strategic position between circulation and tissue. They precisely regulate the local environment by secreting various paracrine signaling molecules. This article brieffy summarized the response and conduction functions of vascular endothelial cells in the vascular wall, and discussed their key roles in physiological and pathological processes.

Objective To analyze the changes of a tertiary hospital operation indicators before and after the reform of diagnosis related groups(DRG) payment. Methods The operation indicators of a tertiary hospital from January 2020 to December 2021 were extracted and divided into two groups according to the time node: before DRG payment reform and after DRG payment reform. The operation of the hospital was analyzed from service ability, medical efficiency, hospital medical quality and data quality. The inpatient expenses and structural changes were analyzed by using the degree of structural change and intermittent time series. Results After the reform of DRG payment method, the proportion of relative weight＞1 cases, the proportion of grade 4 operations, and the proportion of surgical patients in sample hospitals increased signiffcantly. The proportion of high-rate cases, the incidence of complications and other indicators of surgical patients decreased signiffcantly. Compared with before the reform, the average hospitalization cost decreased by 2270.90 yuan, and the slope after the implementation of the reform was -406.55(P＝0.002), that is, the average monthly ecrease was 406.55 yuan. Among them, the largest contribution rate of structural change was material cost, exhibiting a negative change(value of structure variation＝-2.23%), and the contribution rate was 36.66%. Conclusion After the implementation of DRG payment, the efffciency of hospital medical service has been improved continuously and the effect of medical cost control has been obvious. It is suggested that the hospital optimize the management mode, strengthen the cost control, and strengthen the supervision and assessment.

Peptide drugs, with their high activity, low dosage, few adverse reactions and strong specificity, have shown broad application prospects and potential. However, oral administration is easily destroyed and poorly absorbed. The conventional administration route of peptide drugs is injection, which has poor patient compliance. Nasal administration of peptide drugs can overcome the problems of low bioavailability of oral administration and poor compliance of injection administration, and provide a potential brain-targeted delivery route for some drugs(such as insulin). This article systematically reviewed the marketed nasal peptide preparations and analyzed their advantages in terms of administration convenience and patient compliance compared with injection dosage forms. At the same time, it reviewed the peptide nasal preparations in clinical and preclinical research and discussed strategies to improve the delivery efficiency of peptide drugs.

Objective To explore the adjuvant treatment of chronic glomerulonephritis(CGN) with nephritis rehabilitation tablets, and its inffuence on peripheral mononuclear cell B7-1, soluble FMS-like tyrosine kinase(sFlt)-1 and renal ffbrosis indicators. Methods A total of 120 CGN patients in our hospital from January 2021 to December 2024 were selected for the study. They were randomly divided into the experimental group and the control group by simple sorting method, with 60 cases in each group. Eventually, the number dropped to 55 cases in each group and was included in the data analysis. Both groups received basic treatment. The control group was treated with cyclophosphamide, while the experimental group was supplemented with nephritis rehabilitation tablets. The clinical efffcacy, B7-1, sFlt-1, renal ffb rosis indicators [cystatin C(CysC), transforming growth factor(TGF)-β1, ffbronectin(FN)], serum creatinine(Scr), u rinary protein(UP), time for improvement of clinical symptoms (time for disappearance of nausea, vomiting, edema and fatigue), and occurrence of adverse reactions of the two groups were compared. Results The total effective rate of treatment in the experimental group was higher than that in the control group(92.73% vs. 78.18%, P＜0.05). After treatment, the levels of B7-1, sFlt-1, CysC, TGF-β1, Scr, , BUN, β2-MG and CD8＋ in both groups decreased compared with those before treatment, and the levels in the experimental group were lower than those in the control group(P＜0.05). After treatment, the FN and CD4＋ in both groups increased compared with those before treatment, and the experimental group was higher than the control group(P＜0.05). The improvement time of clinical symptoms in the experimental group was shorter than that in the control group(P＜0.05). There was no statistically signiffcant comparison of the incidence of adverse reactions between the two groups(P＞0.05). Conclusion In patients with CGN, the administration of nephritis rehabilitation tablets as an adjunct can help reduce the expression of B7-1, down-regulate the level of sFlt-1, and improve renal ffbrosis.

Objective To explore the molecular mechanism of Tongqiao Huoxue decoction in regulating microglia for Alzheimer's disease(AD). Methods The AD cell model was established by stimulating BV2 cells with lipopolysaccharide(LPS), and the effect of Tongqiao Huoxue decoction was evaluated through the following experiments: ①Cell viability and apoptosis rate were detected by CCK-8 method and ffow cytometry. ② Inffammatory factors(IL-6, TNF-α and IL-1β) and oxidative stress indicators(ROS, MDA, SOD) were determined by ELISA. ③Western blot was used to detect the expression of NLRP3 inffammasome. ④Mitochondrial functions(ATP production, membrane potential, and superoxide generation) were determined using commercial kits. Results Tongqiao Huoxue decoction signiffcantly inhibited the increase in BV2 cell viability induced by LPS(t＝5.289—14.406, P＜0.05) and the decrease in apoptosis rate(t＝14.518, P＜0.05), and down-regulated the expression of inflammatory factors, reversed oxidative stress(upregulated ROS and MDA, down-regulated SOD), with statistically signiffcant differences(P＜0.05). Tongqiao Huoxue decoction can improve mitochondrial dysfunction caused by LPS: restore ATP production, stabilize membrane potential, and reduce superoxide generation(P＜0.05). Mechanism studies have shown that Tongqiao Huoxue decoction exerts a protective effect by down-regulating the expression of NLRP3 inffammasome, and overexpression of NLRP3 can reverse this effect(P＜0.05). Conclusion Tongqiao Huoxue decoction exerts neuroprotective effects by inhibiting the activation of NLRP3 inffammasome, improving the inffammatory response and oxidative stress state of microglia, and correcting mitochondrial dysfunction.

回顾性分析 1 例华法林抵抗患者临床资料，患者为 60 岁女性，二尖瓣机械瓣置换术后使用常规剂量 ( 一日 3 mg) 华法林抗凝，但未达到目标抗凝效果。患者基因检测结果为 VKORC1-1639GG( 靶酶低敏型 ) 与 CYP2C9 1/1( 快代谢型 ) 的基因组合，排除药物相互作用、吸收障碍干扰因素后确诊为遗传性华法林抵抗。最终，患者通过华法林剂量滴定至一日 6 mg 实现国际标准化比值稳定。该病例提示二尖瓣机械瓣置换术后患者抗凝需严格遵循指南推荐，首选华法林，但其疗 效受基因多态性影响。VKORC1-1639GG 与 CYP2C9 1/1 的基因型组合是华法林抵抗的关键因素。基于基因导向的剂量调 整可有效提高抗凝效果，为个体化治疗提供精准依据。

Vascular endothelial cell dysfunction is a core component of various chronic diseases and is closely related to the health status of the body. This article systematically explored the translational research on vascular endothelial cells from the perspectives of regenerative medicine, preventive medicine, and preventing or reversing vascular aging. It aimed to integrate multidisciplinary perspectives on vascular research, deepen the understanding of the central role of vascular endothelium cells in maintaining organ function, systemic health, and promoting healthy aging, and provide new ideas for the prevention and treatment of related diseases.

The prevalence of sarcopenia in patients with chronic kidney disease(CKD) increases with age, seriously affecting the quality of life and prognosis of patients. In recent years, the combination of traditional Chinese and Western medicine in the treatment of sarcopenia has demonstrated significant advantages in clinical practice. Based on the epidemiology, understanding of traditional Chinese and Western medicine, pathogenesis and treatment progress of CKDrelated sarcopenia, this paper reviewed the current application effects of traditional Chinese and Western medicine in CKDrelated sarcopenia, aiming to provide new ideas for clinical treatment.

Mycoplasmal pneumoniae pneumonia(MPP) is one of the most common etiological types of communityacquired pneumonia in childhood. In recent years, the incidence of macrolide-resistant MPP(MRMP) has shown a significantly increasing trend. With the entry of coronavirus disease 2019 into the seasonal epidemic mode, the incidence of MPP in children shows a significant upward trend. Macrolide antibiotics are the preferred anti-infective drugs for children with MPP, with remarkable therapeutic effects. Based on the epidemic trend, occurrence mechanism and key points of early diagnosis of MRMP in children, this paper reviewed the latest progress in the mechanism of action, implementation plan, efficacy and safety of new tetracycline drugs in the treatment of MRMP in children, providing a reference for clinical practice.

Objective To explore the effects of cetirizine combined with montelukast sodium on sleep, quality of life, immunity, inflammatory factors and safety in children with cough variant asthma(CVA). Methods A total of 71 children with CVA admitted to our hospital from December 2022 to October 2024 were selected as the research subjects and randomly divided into the experimental group of 35 cases and the control group of 36 cases. Both groups received basic treatment. The control group was treated with montelukast sodium, and the experimental group was treated with cetirizine on this basis. The treatment course for both groups was one week. The apnea-hypopnea index, the lowest nocturnal blood oxygen saturation, quality of life and inflammatory factors of the two groups before and after treatment were detected, and the occurrence of adverse reactions was statistically analyzed. Results: After treatment, the minimum nocturnal blood oxygen saturation, immunoglobulin(Ig)A, interferon-γ, cluster of differentiation(CD)4＋, CD4＋/CD8＋ in both groups increased compared with those before treatment, and the experimental group was higher than the control group. The differences were significant(P＜0.05). The scores of sleep disorders, physical symptoms, poor mood, daytime functional status and total score in both groups after treatment were lower than those before treatment. The scores in the experimental group were lower than those in the control group, and the differences were significant(P＜0.05). The apnea-hypopnea index, C reactive protein, monocyte chemoattractant protein-1, interleukin(IL)-4, transforming growth factor -β, vascular endothelial growth factor, IgE, IL-13, and CD8＋ in both groups decreased compared with those before treatment, and the experimental group was lower than the control group, with significant differences(P＜0.05). There was no significant difference in the total incidence of abdominal pain and diarrhea, nausea and vomiting, rash and dizziness between the two groups(P＞0.05). Conclusion Cetirizine combined with montelukast sodium in the treatment of children with CVA can improve sleep structure, enhance quality of life and immune function, reduce the levels of inflammatory factors, and has good safety.

Doxorubicin, as a widely used anti-tumor drug, has significant cardiac toxicity that limits its clinical effectiveness and safety, making it a major challenge in cancer treatment. In recent years, more and more researches have focused on the potential role of traditional Chinese medicine in reducing doxorubicin-induced cardiotoxicity(DIC), especially by regulating the expression of microRNA(miRNA). This article summarized the relevant research on traditional Chinese medicine alleviating DIC by regulating miRNA expression, explored its molecular mechanisms and research progress, in order to provide theoretical basis and reference for the development of new cardiac protection strategies in the future.

Gastrointestinal stromal tumor is a common mesenchymal tumor in the gastrointestinal tract, mainly occurring in the elderly population. Imatinib, as a treatment for gastrointestinal stromal tumor of the first-line drugs, has remarkable efffcacy, but its easy to be nuclease degradation in the body, leading to low bioavailability. Clinically, large doses of the drug are often required, which can lead to serious adverse reactions such as neutropenia, coagulation dysfunction and hepatotoxicity. Imatinib nanoparticles can effectively stimulate the activation of immune cells, reduce the inffltration of immunosuppressive cells, and reshape the immune microenvironment by regulating the tyrosine kinase receptor protein-related signaling pathways, thereby enhancing the anti-tumor immune effect. In addition, targeted drug nanoparticles can prolong the action time of imatinib in the body, providing the possibility of reducing the drug dosage. This article reviewed the relevant research on imatinib nanoformulations in recent years, aiming to provide scientiffc basis and theoretical support for the treatment of gastrointestinal stromal tumors with new soft drug nanoparticles modiffed by hyaluronic acid, and to offer references for the application of new clinical drugs in the future.

舒尼替尼是一种具有口服活性的多靶点酪氨酸激酶抑制剂，其广泛应用于多种晚期肿瘤的临床治疗。然而，其不良 反应较为显著，因此在用药过程中需予以高度重视。甲状腺功能减退危象是一种较为罕见的危急重症，通过早期诊断和及 时替代治疗，可显著降低其病死率。本病例患者因上消化道出血并伴不明原因昏迷就诊，临床药师查阅相关文献及说明书， 确诊为舒尼替尼引发的甲状腺功能减退危象，此药物不良反应在临床上尚无相关报道。探讨酪氨酸激酶抑制剂使用中的药 学监测过程，并对相关文献进行系统复习，旨在为临床医生及药师提供参考和借鉴。

Drug-induced immunotherapy-related gastrointestinal toxicity has become a highly concerned issue in clinical treatment. The adverse reactions it causes, such as diarrhea, inffammation and mucosal damage, seriously affect the quality of life and therapeutic effect of patients. Non-coding RNA is a class of molecules that do not translate into proteins but have important biological functions. Previous studies have shown that non-coding RNA plays a key role in druginduced immunotherapy-related gastrointestinal toxicity by regulating mechanisms such as gene expression, inffammatory response, oxidative stress, intestinal barrier function, and intestinal microbiota. This article systematically reviewed the mechanism of action of non-coding RNA in drug-induced immunotherapy-related gastrointestinal toxicity, providing a new perspective for a deeper understanding of the toxicity mechanism and improvement of therapeutic efffcacy.

Adverse drug reactions(ADR) is a significant global public health concern, with notably increasing incidence rates and economic costs in China. Traditional ADR surveillance relying on spontaneous reporting systems suffers from delays and data incompleteness. The advancement of artificial intelligence(AI) technologies offers innovative solutions for ADR monitoring, enhancing efficiency and accuracy. This article reviewed the core technologies and current application status of AI, focusing on elucidating implementation scenarios and challenges in ADR early warning systems, aiming to provide references for AI-assisted ADR management strategies.

B-cell acute lymphoblastic leukemia(B-ALL) ranks first in incidence among newly diagnosed childhood malignancies. Current clinical treatment primarily relies on conventional chemotherapy, which is limited by poor tolerance and suboptimal long-term prognosis. Blinatumomab, a novel immunotherapy drug, targets CD3 and CD19 antigens to activate T-cell-specific killing of leukemia cells. It has demonstrated significant efficacy in relapsed/refractory B-ALL, minimal residual lesion clearance, and bridging hematopoietic stem cell transplantation. However, its clinical application is constrained by adverse reactions such as cytokine release syndrome and neurotoxicity. This review systematically summarized blinatumomab's mechanism of action, clinical application advancements, adverse effects, management strategies, and explored the future research directions, aiming to provide theoretical insights for optimizing precision therapy in B-ALL.

Pharmacetical outpatient clinics represents a new model of pharmaceutical service, which plays a signiffcant role in enhancing the therapeutic effect of patients' drugs, reducing medication risks, and conserving medical resources. In recent years, the opening rate of pharmaceutical outpatient clinics has increased signiffcantly. The types of clinics are diverse, which can meet the medical needs of different patients. The service model and quality of pharmaceutical outpatient clinics are inffuenced by multiple factors such as region, urban economic scale, hospital level and patients' economic capacity. Based on the ROCCIPI analysis method, the author analyzed the practical situation of pharmaceutical outpatient clinics established in municipal and county-level hospitals in Shanxi province, and proposed optimization strategies, aiming to provide useful references for the construction of pharmaceutical outpatient clinics in other municipal and county-level hospitals.

Kawasaki disease(KD) is an acute, self-limiting, multi-system vasculitic syndrome. It is the leading cause of acquired heart disease in children in developed countries. Coronary artery aneurysms are its most serious complication and can trigger long-term cardiovascular events. In recent years, the understanding of the pathogenesis of KD has shifted from the single pathogen hypothesis to an immune-disordered disease caused by microorganisms. Based on the individualized treatment model of KD with risk stratification, this paper systematically reviewed the latest advances in pharmacotherapy for KD, and prospected the future research directions, aiming to provide reference for clinical medication.

Objective To observe the adjuvant effect of modified Guizhi Shaoyao Zhimu decoction on patients with knee osteoarthritic synovitis of wind-cold-damp arthralgia syndrome. Methods A total of 102 patients with knee osteoarthritic synovitis of wind-cold-damp arthralgia syndrome who were admitted to our hospital from November 2022 to December 2023 were selected as the research subjects and randomly divided into the control group and the observation group, with 51 cases in each group. The control group received conventional treatment and extracorporeal shock wave therapy, while the observation group was given modified Guizhi Shaoyao Zhimu decoction on the basis of the treatment of the control group. The therapeutic effects, total score of traditional Chinese medicine(TCM) symptoms, western ontario and McMaster universities osteoarthritis index(WOMAC) score, hospital for special surgery knee score(HSS), joint effusion score, synovial thickness score, changes in serum inflammatory factor levels and occurrence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the observation group was higher than that of the control group (94.12% vs. 80.39%, P＜0.05). After treatment, the total score of TCM symptoms, WOMAC score, HSS, joint effusion score and synovial thickness score of the observation group were all better than those of the control group, and the levels of inflammatory factors were all lower than those of the control group, with significant differences (P＜0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (3.92% vs. 5.88%), but there was no significant difference (P＞0.05). Conclusion The modified Guizhi Shaoyao Zhimu decoction has a good effect and is safe and reliable in the adjuvant treatment of patients with knee osteoarthritic synovitis of wind-cold-damp arthralgia syndrome.

Objective To explore the therapeutic effect of iguratimod combined with Tripterygium wilfordii multiglucoside tablets in the treatment of rheumatoid arthritis(RA) and its influence on knee joint function. Methods A total of 130 RA patients admitted to Linquan County People's Hospital from January 2022 to December 2024 were selectively included in the study and randomly divided into the observation group and the control group, with 65 cases in each group. The control group was treated with iguratimod, while the observation group was treated with iguratimod combined with Tripterygium wilfordii multiglucoside tablets. The clinical efficacy, C reactive protein(CRP), and anticyclic citrullinated peptide antibody(ACPA), knee joint function score, effusion depth, synovial thickness and the occurrence of adverse reactions of the two groups were compared. Results After treatment, the total effective rate of the observation group was higher than that of the control group(89.23% vs. 73.85%, P＜0.05). The levels of serum CRP and ACPA in both groups were lower than those before treatment(P＜0.05), and those in the observation group were lower than those in the control group(P＜0.05). The hospital for special surgery scores of both groups were lower than those before treatment(P＜0.05), and the scores of the observation group were lower than those of the control group(P＜0.05). The Lysholm scores of both groups were increased compared with those before treatment(P＜0.05), and the scores of the observation group were higher than those of the control group(P＜0.05). The depth of effusion and the thickness of synovial membrane in both groups were lower than those before treatment(P＜0.05), and the decrease in the observation group was greater(P＜0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, but the difference was not statistically significant(12.31% vs. 9.23%, P＞0.05). Conclusion RA patients can benefit significantly from the treatment of iguratimod combined with Tripterygium wilfordii multiglucoside tablets. Among them, Tripterygium wilfordii multiglucoside tablets, as an adjuvant therapy, can effectively reduce CRP levels, inhibit ACPA activity, and improve knee joint function, without increasing the risk of adverse reactions, and has good safety.

2022 年美国政府颁布的《通货膨胀削减法案》(Inflation Reduction Act，IRA) 突破历史惯例，首次授权联邦政府直接参与药品价格谈判，被视为数十年来旨在降低处方药成本并提升医保受益者用药可及性的关键政策举措。文章以 IRA药品价格谈判机制为核心，基于药品生命周期价格模型的理论框架，系统剖析在“患者可负担性、创新激励与医疗支出可持续性”三重目标间的平衡路径。通过梳理谈判机制设计原则、首批谈判药品遴选标准、利益相关方博弈格局及政策争议焦点，发现政策实施需通过加强监管协调以实现药品可负担性与创新激励之间的动态平衡。同时，亟需建立科学的药品价值评估体系，为完善药品定价政策提供理论依据。

Objective To explore the effect of the phlegm-resolving, lung-regulating and asthma-relieving decoction as an adjuvant therapy for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with phlegm-heat accumulation in the lung syndrome and its influence on complement C3, C4 and blood gas indicators. Methods A total of 120 patients diagnosed with AECOPD with phlegm-heat accumulation in the lung syndrome at Linquan ccounty people's hospital from January 2022 to January 2025 were selected as the research subjects and divided into the observation group and the control group, with 60 cases in each group. Both groups were given conventional western medicine treatment, and the observation group additionally received phlegm-resolving, lung-regulating and asthma-relieving decoction as an adjuvant treatment. The clinical efficacy, C3, C4, blood gas indicators, pulmonary function indicators, and traditional Chinese medicine(TCM) syndrome scores before and after treatment were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group(93.33% vs. 80.00%, P＜0.05). After treatment, the levels of C3, C4, blood oxygen saturation and partial pressure of oxygen in both groups were higher than those before treatment(P＜0.05), and those in the observation group were higher than those of the control group(P＜ 0.05). The levels of partial pressure of carbon dioxide in both groups were lower than those before treatment(P＜0.05), and the observation group was lower than that of the control group(P＜0.05). After treatment, the levels of forced expiratory volume in one second, forced vital capacity and their ratio in both groups were higher than those before treatment(P＜0.05), and those in the observation group were higher than those of the control group(P＜0.05). The TCM symptom score of the observation group was lower than that of the control group(P＜0.05). There was no statistically significant difference in adverse reactions between the two groups(P＞0.05). Conclusion: Phlegm-resolving, lungregulating and asthma-relieving decoction as an adjuvant therapy for the AECOPD with phlegm-heat accumulation in the lung syndrome can improve the therapeutic effect and the levels of C3, C4 and blood gas indicators in patients, without increasing the risk of adverse reactions.

Mild cognitive impairment 、(MCI) is a common neurodegenerative disease that is characterized by memory impairment or progressive decline in other cognitive domains. The incidence of MCI among people aged 65 and above is 7.7% to 28.3%, and 10% to 15% of these patients will progress to dementia. Early intervention for MCI can alleviate the impact of cognitive dysfunction on quality of life as well as reduce the prevalence of dementia in patients. Currently, the treatment methods for MCI in western medicine are limited and poor effective. In recent years, the safety and efficacy of using traditional Chinese medicine(TCM) to treat MCI under the guidance of TCM theories have been effectively verified in clinical practice. Meanwhile, modern science and technology have also revealed the possible mechanism of TCM prevention and treatment of MCI from the aspects of inhibiting β-amyloid deposition, Tau protein hyperphosphorylation, inflammatory response, oxidative stress and regulating cholinergic system. This article reviewed the clinical application and mechanism research progress of TCM in treating MCI.

Objective To explore the clinical efficacy of traditional Chinese medicine acupoint application combined with bionic physical electrical stimulation in the treatment of postpartum rectus abdominis diastasis(RAD). Methods A total of 300 women with RAD in our hospital from December 2020 to October 2024 were selected as research objects and randomly divided into control group, bionic physical electrical stimulation treatment group(electrical stimulation group) and traditional Chinese medicine acupoint application combined with electrical stimulation treatment group(combined treatment group), with 100 cases in each group. The patients were treated with expectant therapy, bionic physical electrical stimulation, and Chinese medicine acupoint application combined with electrical stimulation, once every other day, 5 times as a course, with an interval of 20 days, and a total of 2 courses. The total effective rate of RAD, the improvement of, low back pain, and adverse reactions before and after treatment were compared among the three groups. Results Compared with the control group, the total effective rate of RAD in both the electrical stimulation group and the combined treatment group were increased, and the combined treatment group was superior to the electrical stimulation group, with statistically significant differences(P＜0.001). After two courses of treatment, there was no statistically significant difference in the improvement of low back pain among the three groups(P＞0.05). During the treatment process, no adverse reactions such as local pain, numbness or infection occurred in any of the three groups. Conclusion Traditional Chinese medicine acupoint application combined with bionic physical electrical stimulation is safe and effective in the treatment of RAD.

Objective To explore the efficacy and mechanism of sodium-glucose cotransporter(SGLT)-2 inhibitor dapagliflozin in the treatment of patients with heart failure with preserved ejection fraction(HFpEF). Methods HFpEF patients admitted to Fugou Huimin Hospital of Traditional Chinese Medicine from January 2023 to December 2024 were selected as the subjects and divided into the observation group and the control group, with 50 cases in each group. The control group was treated with conventional therapy, while the observation group was treated with dapagliflozin in combination. The changes of echocardiographic indicators, inflammatory factors, cardiac function indicators and myocardial fibrosis indicators in the two groups were compared, and the incidences of adverse reactions and major cardiovascular event(MACE) were also compared. Results After treatment, the left ventricular end-diastolic diameter, left ventricular end-systolic diameter, peak velocity of early mitral valve blood flow/peak velocity of early mitral valve annulus in the observation group were all lower than those in the control group, and the left ventricular ejection fraction was higher, with significant differences(P＜0.05). The levels of high-sensitivity C-reactive protein, interleukin-6, N-terminal pro-brain natriuretic peptide, creatine kinase, creatine kinase isoenzyme, α -hydroxybutyrate dehydrogenase, soluble growth-stimulating expression gene 2 protein, connective tissue growth factor, and matrix metalloproteinase-9 in the observation group were all lower than those in the control group, and the differences were all significant(P＜0.05). After a 3-month follow-up, the incidence of MACE in the observation group was lower than that in the control group(P＜0.05). Conclusion Dapagliflozin has a significant short-term therapeutic effect on patients with HFpEF, which can reduce the inflammatory response of the body, improve cardiac function and myocardial fibrosis, and lower the incidence of shortterm MACE. Moreover, it has good safety.

Objective To explore the efficacy of ivabradine in patients with acute myocardial infarction (AMI) complicated with heart failure(HF) and its influence on cardiac function and inflammatory factors. Methods A total of 240 patients with AMI combined with HF who were admitted to our hospital from January 2022 to January 2024 were selected and randomly divided into the observation group and the control group, with 120 cases in each group. The control group was given conventional treatment, while the observation group was treated with ivabradine tablets in addition. Both groups were treated continuously for 10 weeks. The clinical efficacy, left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter (LVESD), mean pulmonary artery pressure (MPAP), central venous pressure(CVP), pulmonary vascular resistance (PVR), soluble suppression of tumorigenicity 2 protein(sST2), troponin(cTn)Ⅰ, N-terminal pro-B-type natriuretic peptide(NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor(TNF)-α, interleukin(IL)-6 and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the observation group was 90.00%, significantly higher than 78.33% of the control group(P＜0.05). The LVEF of the observation group was higher than that of the control group, while LVEDD and LVESD were lower than those of the control group. The differences were all statistically significant(P＜0.05). The MPAP, CVP and PVR in the observation group were all lower than those in the control group, and the differences were statistically significant(P＜0.05). The levels of serum sST2, cTnⅠ and NT-proBNP in the observation group were all lower than those in the control group, and the differences were statistically significant(P＜0.05). The levels of serum hs-CRP, TNF-α and IL-6 in the observation group were all lower than those in the control group, and the differences were statistically significant(P＜0.05). There was no statistically significant difference in the comparison of adverse reactions between the two groups(P＞0.05). Conclusion Ivabradine is helpful to improve the therapeutic effect of AMI combined with HF, and has good safety. It is worthy of clinical promotion.

Objective To evaluate the clinical efficacy of recombinant human erythropoietin-Fc(rhEPO-Fc) at different doses and frequencies in Chinese patients with renal anemia receiving maintenance hemodialysis(MHD). Methods A total of 180 patients with RA receiving MHD from 41 research centers across the country from February 2018 to May 2019 were included. Patients were randomly assigned to the rhEPO-Fc 18 μg/kg per week group, rhEPO-Fc 24 μg/kg per week group, and rhEPO-Fc every 2 weeks 24 μg/kg group by block randomization, with 60 cases in each group. All patients were treated with rhEPO-Fc for 12 weeks, during which the dosage was adjusted according to hemoglobin(Hb). The outcome measures included the Hb level, reticulocyte count and number of dose adjustments. Results After treatment, the proportions of patients whose Hb increased by at least 10 g/L or reaching 110 g/L in the three groups were 73.60%, 77.60% and 52.20% respectively. The reticulocyte counts in the three groups increased by (19.63±32.51)×109 /L, (18.16±26.24)×109 /L and (40.38±27.91)×109 /L respectively, compared with before treatment. The proportions of patients who underwent dose adjustment due to decreased Hb levels in the three groups were 73.33%, 56.67% and 63.33%, and 51.67%, 61.67% and 18.33% in patients who underwent dose adjustment due to increased Hb levels. Conclusion Administration of rhEPO-Fc once every 1 or 2 weeks can effectively improve the anemia status of MHD patients, and 18 μg/kg per week can be used as the recommended dose for subsequent larger-scale clinical studies.

Objective To analyze the effects of semaglutide and metformin on metabolic indicators and serum C1q tumor necrosis factor-related protein(CTRP)3 in patients with polycystic ovary syndrome(PCOS) complicated with i nsulin resistance(IR). Methods A total of 150 PCOS patients with IR treated in gynecologicaL endocrinology clinic from June 2024 to April 2025 were selected and randomly divided into control group and observation group, with 75 cases in each group. The control group received conventional therapy combined with metformin, while the observation group received conventional therapy combined with semaglutide. The treatment course were 3 menstrual cycles. Clinical efficacy, ovarian function, body mass index(BMI), waist-hip ratio(WHR), homeostatic model assessment of IR(HOMA-IR),homeostatic model assessment of β-cell function(HOMA-β) index, metabolic indicators, serum CTRP3 levels, and safety of the two groups were observed and recorded. Results After treatment, the total effective rate of the observation group was higher than that of the control group(P＜0.05). The levels of luteinizing hormone/follicle-stimulating hormone(LH/ FSH), anti-Müllerian hormone(AMH) and ovarian volume in the observation group were all lower than those in the control group(P＜0.05). After treatment, the BMI, HOMA-IR, glycated hemoglobin(HbA1c), triglyceride(TG), and lowdensity lipoprotein cholesterol(LDL-C) in the observation group were all lower than those in the control group(P＜0.05), and the HOMA-β and high-density lipoprotein cholesterol(HDL-C) were higher(P＜0.05). Serum CTRP3 level in the observation group was higher than that in the control group after treatment(P＜0.05). No statistically significant difference in a dverse reactions was observed between the two groups(P＞0.05). Conclusion Semaglutide is more effective than metformin in regulating metabolic indicators and serum CTRP3, improving pancreatic β-cell function and ovarian function in PCOS patients with IR, which has good clinical application value.

Objective To explore the influencing factors of recurrence in children with cough variant asthma(CVA) one year after discontinuation of inhaled glucocorticoid treatment. Methods A retrospective analysis was conducted on the clinical data of 165 children with CVA who discontinued inhaled glucocorticoid therapy for one year from January 2022 to January 2024 in our hospital. Univariate analysis was used, and variables with P＜0.05 were included in multivariate logistic regression analysis to investigate the influencing factors of recurrence in children with CVA one year after discontinuation of inhaled glucocorticoid treatment. Results There were statistically significant differences(P＜0.05) in family awareness of CVA prevention and control, frequency of respiratory infections during follow-up, history of rhinitis, season of discontinuation, forced expiratory volume in 1 second/forced vital capacity ratio at discontinuation, fractional exhaled nitric oxide(FeNO), and 25-hydroxyvitamin D[25(OH)D] levels between the two groups. Multivariate logistic regression analysis showed that family awareness of CVA prevention and control, frequency of respiratory infections during follow-up, season of discontinuation, FeNO levels at discontinuation, and 25(OH)D levels were the independent influencing factors for CVA recurrence one year after discontinuation of inhaled glucocorticoid therapy(P＜0.05). Conclusion The low awareness of CVA prevention and control among family members, the high frequency of respiratory tract infections during the follow-up period, the drug withdrawal season in winter and spring, the high FeNO level at the time of drug withdrawal, and the low 25(OH)D level are all risk factors for recurrence of CVA patients one year after drug withdrawal after receiving inhaled glucocorticoid treatment.

Objective To explore the cosmetic effects of modified Mahuang Lianqiao Chixiaodou decoction on patients with chronic facial urticaria, and to seek a good solution to promote patient recovery. Methods A total of 122 patients with chronic facial urticaria admitted to the Dermatology Department of our hospital from June 2022 to January 2024 were randomly assigned into groups using 1∶1 block randomization. The Western medicine group(n＝61) was treated with ebastin tablets, and the combined traditional Chinese medicine group(n＝61) was treated with modified Mahuang Lianqiao Chixiaodou decoction on the basis of the Western medicine group. The therapeutic effects, adverse reactions, cosmetic effects, interleukin(IL)-17 and IL-23 levels before and after treatment, as well as urticaria activity score(UAS), dermatology life quality index(DLQI) score, and the disease recurrence rate 6 months after treatment were observed of the two groups. Results The total effective rate of the combined traditional Chinese medicine group was higher than that of the Western medicine group(P＜0.05). The adverse reaction rates of the both groups were both lower, and the difference was not statistically significant(P＞0.05). The cosmetic effect of the combined traditional Chinese medicine group was better than that of the Western medicine group(P＜0.05). The disease recurrence rate of patients in the combined traditional Chinese medicine group was lower than that of the Western medicine group after 6 months of treatment(P＜0.05). The levels of IL-17 and IL-23, as well as the UAS and DLQI scores, decreased in both groups of patients after treatment, and the combined traditional Chinese medicine group were lower than those in the Western medicine group(P 0.05). Conclusion The modified Mahuang Lianqiao Chixiaodou decoction has a good therapeutic effects on the treatment of chronic urticaria on the face. It can also enhance the patients’ cosmetic effect, improve their symptoms and quality of life, reduce the recurrence rate of the disease, and offers good safety.

Objective To observe the clinical effect of tonifying kidney and reducing turbidity decoction combined with external application of kidney failure umbilical therapy decoction in the treatment of chronic renal failure(CRF). Methods A total of 70 patients with CRF diagnosed in Shanghai Gongli Hospital of Pudong New Area from March 2023 to December 2024 were selected and randomly divided into a treatment group and a control group, with 35 cases in each group. The control group was given basic Western medical treatment, while the treatment group was treated with oral administration of traditional Chinese medicine combined with umbilical therapy, both groups were treated for 8 weeks. The total effective rate, serum creatinine(Scr), estimated glomerular filtration rate(eGFR), blood urea nitrogen(BUN), serum uricacid(SUA), interleukin(IL)-6 and hypersensitive C-reactive protein(hs-CRP) were compared between the two groups. Results The total effective rate of the treatment group was better than that of the control group(91.43% vs. 71.43%, P＜0.05). After treatment, the levels of Scr and SUA in the treatment group were lower than those in the control group(P＜0.05), and the level of eGFR was higher than that in the control group(P＜0.05). There was no significant change in BUN between the two groups(P＞0.05). The levels of IL-6 and hs-CRP in both groups were decreased compared with before(P＜0.05), and the level of IL-6 in the treatment group was lower than that in the control group(P＜0.05). There was no significant difference in the reduction amplitude of hs-CRP levels between the two groups(P＞0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05). During the treatment period, no serious adverse events or deterioration of the condition occurred in either group of patients, such as doubling of serum creatinine levels, entering dialysis status, or hospitalization due to heart failure. Conclusion The internal and external treatment method of Tonifying Kidney and Reducing Turbidity has a better effect in delaying the deterioration of renal function in CRF with deficiency of both spleen and kidney, and has good safety. Its mechanism of action may be related to the inhibition of inflammatory factors.

Objective To investigate the effect of triple vitamin therapy(folic acid, vitamin B6, and mecobalamin) on cognitive function in patients with white matter lesions and hyperhomocysteinemia. Methods A total of 89 patients with white matter lesions and hyperhomocysteinemia were prospectively enrolled and divided into a cognitive impairment group[Montreal cognitive assessment(MoCA)＜26, n＝66)] and a non-cognitive impairment group(MoCA≥26, n＝23),based on the baseline MoCA scores. All patients received triple vitamin therapy for 12 months. The baseline characteristics between the two groups were compared, the cognitive function changes after treatment were evaluated, and the influencing factors of cognitive improvement (defined as MoCA score increase≥2 points) were analyzed by logistic regression. Results Except for MoCA scores[cognitive impairment group: 20.0(17.0, 23.0)points vs. non-cognitive impairment group: 26.0(26.0, 27.0)points, P＜0.001], there were no statistically significant differences between the two groups in age, gender, education level, vascular risk factors, laboratory indicators, and Fazekas scores(P＞0.05). After 12 months of treatment, serum total homocysteine levels significantly decreased(P＜0.001). The change in MoCA total score from baseline was 1.0(-2.0, 3.0) points(P＝0.126) in the cognitive impairment group and -1.0(-3.0, 1.0) points(P＝0.053) in the non-cognitive impairment group, with a statistically significant difference between the two group(P＝0.020). Subdomain analysis showed that the cognitive impairment group had significant improvements compared to the baseline in visuospatial and executive function(P＜0.001), naming(P＜0.001), attention(P＝0.015), and abstraction(P＝0.013), with changes in visuospatial and executive functio(P＝0.004) and naming(P＝0.017) being significantly superior to those in the non-cognitive impairment group. Multivariate logistic regression analysis showed that baseline MoCA score was an independent predictor of cognitive improvement(odds ratio＝0.76, 95% Wald confidence interval: 0.64-0.87, P＜0.001). Conclusion Triple vitamin therapy for 12 months can improve specific cognitive functions in patients with white matter lesions and hyperhomocysteinemia, especially in patients with baseline cognitive impairment. Visuospatial and executive function, naming, abstraction, and attention have improved significantly. Patients with poorer baseline cognitive function have greater room for improvement.

As a cutting-edge and potential novle class of anti-tumor drug, antibody-drug conjugates(ADC)have shown significant efficacy in a variety of tumor treatments. However, with the widespread use of ADC, the related adverse reactions have attracted more and more attention. Interstitial lung disease(ILD) is a serious and life-threatening adverse reactions, which is usually characterized by progressive dyspnea, cough, chest pain, hypoxemia and low-grade fever. The mechanism of ADC-related ILD is complex, involving multi-dimensional factors, and due to the lack of specific diagnostic criteria of ILD, high vigilance must be maintained in clinical practice, problems should be identified early and timely intervention. This review aims to sort out the pathogenesis, diagnostic evaluation and management strategies of ADCrelated ILD, helping clinicians understand and master the characteristics of pulmonary toxicity of ADC, so as to reduce and avoid serious adverse reactions and ensure the effectiveness and safety of ADC therapy in clinical application.

Sepsis associated-acute lung injury(SA-ALI), as a serious clinical condition, seriously threatens patients' lives and health, and its high morbidity and mortality rate pose a great challenge to medical work. Currently, early diagnosis of SA-ALI is difficult, and it is hard to accurately grasp the progression of the disease, and the treatment plan lacks personalization, leading to poor prognosis of patients. In recent years, artificial intelligence technology has brought hope for the diagnosis and treatment of SA-ALI. This article reviewed the early diagnosis, targeted treatment and prognosis management of SA-ALI by artificial intelligence, providing a multidimensional solution for SA-ALI and promoting the innovation of clinical diagnosis and treatment towards precision.

Objective To analyze the efficacy of abrocitinib in patients with moderate to severe atopic dermatitis(AD). Methods A total of 150 patients with moderate to severe AD who met the criteria in our hospital from July 2023 to January 2025 were included and divided into group A and group B by random block method, with 75 cases in each group. In addition to symptomatic treatment, group A was treated with abracitinib and group B with upadacitinib. The course of treatment for both groups was 16 weeks. After 8 and 16 weeks of treatment, the treatment responses of the two groups were observed. The following indicators were recorded: eczema area and severity index(EASI), 24-hour peak pruritus numerical rating scale(PP-NRS), dermatology life quality index(DLQI), immunoglobulin(Ig)E, eosinophil(EOS) count and skin barrier function[moisture content, sebum content, transepidermal water loss(TEWL) and the occurrence of adverse reactions. Results After 8 weeks of treatment, the treatment response rate, moisture content and sebum content in group A were all higher than those in group B(P＜0.05), while the EASI score and TEWL were lower than those in group B(P＜0.05). After 8 and 16 weeks of treatment, the PP-NRS and DLQI scores of group A were lower than those of group B(P＜0.05), while there were no significant differences in serum IgE and EOS counts between the two groups(P＞0.05). The incidence of gastrointestinal discomfort in group A was higher than that in group B(P＜0.05), the incidence of mild to moderate acne in group B was higher than that in group A(P＜0.05). Conclusion Abrocitinib is helpful in alleviating pruritus symptoms of moderate to severe AD at an early stage, improving the quality of life, and can repair the skin barrier function at an early stage, with a tolerable safety.