The development of novel biologics provides a new therapeutic strategy for immune-related kidney diseases. Novel biologics such as anti-leukocyte differentiation antigen 20 monoclonal antibody, B lymphocyte stimulator/ a proliferation-inducing ligand-targeting drugs, and complement inhibitors provide more precise treatment for immunerelated kidney diseases by targeting specific molecules or receptors. However, further studies are needed in terms of therapeutic efficacy, safety, optimal dosage and applicability in different kidney diseases. This article reviewed the application progress of various novel biologics in immune-related kidney diseases, and aimed to discuss their therapeutic potential, existing evidence and future research direction.

In recent years, the incidence rate of atopic dermatitis(AD) has gradually increased, especially the incidence rate of AD and the proportion of severe patients in children. AD patients have obvious clinical itching symptoms, and are prone to recurrent episodes, which seriously affects the quality of life of patients and their families. In clinical practice, accurately understanding the changes in the severity of AD patients during the diagnosis and treatment is helpful to timely adjust clinical medication and treatment plans. Therefore, it is crucial to conduct standardized assessment and long-term management of the severity of skin lesions in AD patients. Currently, there are over 60 assessment tools for the severity of AD skin lesions in clinical practice, including those based on physician evaluations and patient subjective perceptions. This article systematically sorted out the usage methods, advantages and disadvantages of commonly used assessment tools based on the latest version of the national and international expert consensus, in order to facilitate clinical staff to better choose and use these assessment tools.

Objective To observe and compare the effects of Yuanhu Zhitong dropping pill and ibuprofen on pain and anxiety in patients with primary dysmenorrhea(PD). Methods Eighty patients with PD in the obstetrics and gynecology outpatient department of Shanggang community health service center from January to December 2023 were selected and randomly divided into the Yuanhu Zhitong dropping pill group and the ibuprofen group, with 40 patients in each group. The Yuanhu Zhitong dropping pill group was given oral administration of Yuanhu Zhitong dropping pill and the ibuprofen group was given oral ibuprofen for three consecutive days starting from the first day of menstruation for a total of five menstrual cycles. Visual analogue score(VAS), pain time and Hamilton anxiety scale were used to compare the pain and anxiety status of the two groups before, after treatment and the follow-up period. Results Compared with before treatment, the pain scores, pain duration and anxiety scores of patients in Yuanhu Zhitong dropping pill group and ibuprofen group significantly improved after treatment and during the follow-up period(P＜0.001). The comparison between the two groups showed that after treatment and during follow-up, the pain score, pain duration, and anxiety score in the ibuprofen group were significantly lower than those in the Yuanhu Zhitong dropping pill group(P＜0.001). Conclusion Both Yuanhu Zhitong dropping pill and ibuprofen can effectively reduce pain and improve anxiety in patients with PD, and ibuprofen is more effective than Yuanhu Zhitong dropping pill for pain episodes.

At present, high-risk factors for cardiovascular disease such as hypertension and dyslipidemia have been effectively managed, but cardiovascular diseases remain the main cause of disability and mortality worldwide. Aging is an inevitable process in human life, and the cardiovascular system is no exception. Cardiovascular aging is closely related to an increased risk of cardiovascular diseases. Exploring the mechanisms of cardiovascular aging is of great significance for the treatment of cardiovascular diseases, drug development, and improvement of patient prognosis. This article reviewed the mechanism of cardiovascular aging, in order to provide reference for future research.

Objective To evaluate the cost-utility of eculizumab versus supportive therapy in the treatment of paroxysmal nocturnal hemoglobinuria(PNH). Methods From the perspective of whole Chinese society, a partitioned survival model was constructed to simulate the total cost, quality-adjusted life years(QALYs) and incremental costeffectiveness ratio(ICER) of patients over a lifetime(40 years) with a discount rate of 5%. One-way sensitivity analysis and probabilistic sensitivity analysis were used to verify the robustness of the model. Results The base-case results showed that compared with supportive therapy, patients who used eculizumab could obtaine 8.50 more QALYs and an incremental cost of 639 784 CNY, the ICER was 75 297 CNY/QALY, which was lower than the GDP per capita in 2023. The oneway sensitivity analysis showed that the annual spontaneous remission rate had the most significant impact on the final result. The probabilistic sensitivity analysis showed that the probability of cost-effective of eculizumab was 99.98% when the willingness-to-pay threshold was 3 times of GDP per capital. Conclusion From the perspective of the Chinese society, eculizumab was a cost-effective treatment regimen compared to supportive therapy in the treatment of PNH patients.

Objective To evaluate the efficacy and safety of muscovite-infused blood circulation and blood stasis ointment in the treatment of knee osteoarthritis(KOA). Methods A total of 1 600 KOA patients treated in orthopedics and traumatology departments of 11 hospitals across the country from September 2020 to December 2022 were selected and randomly divided into experimental group(n＝1 200, treated with muscovite-infused blood circulation and blood stasis ointment) and control group (n＝400, treated with diclofenac diethylamine emulgel) according to a ratio of 3∶1. The course of treatment in both groups was 14 days. Western Ontario and McMaster universities arthritis index(WOMAC) score, visual analogue scale(VAS), traditional Chinese medicine(TCM) syndrome score scale and knee swelling scale score, etc., and the occurrence of adverse reactions were observed in both groups. Results The total effective rate of the experimental group was higher than that of the control group(86.75% vs 76.50%, P＜0.05). The scores of WOMAC, VAS, TCM syndrome score scale and knee swelling scale in both groups were significantly improved, and the improvement of TCM syndrome score scale and knee swelling scale in the experimental group were better than those in the control group(P＜0.05). During the treatment period, there were no adverse reactions such as drug poisoning or liver and kidney function injury in both groups. Conclusion Muscovite-infused blood circulation and blood stasis ointment can effectively improve the clinical symptoms of KOA patients, with accurate effect and high safety.

Glucagon-like peptide-1 receptor agonist(GLP-1RA) has been widely used in the treatment of patients with type 2 diabetes mellitus. GLP-1RA can also help improve renal outcomes in patients with diabetic nephropathy(DN). GLP-1RA plays a renal protective role by inhibiting inflammatory response, reducing oxidative stress, alleviating damage induced by advanced glycosylation end products and improving metabolic abnormalities, and has great potential in preventing and slowing down the occurrence and development of DN. This article reviewed the clinical evidence and mechanism of GLP-1RA in DN, so as to provide reference for clinical use.

Chronic kidney disease(CKD) has long been an important global health problem, and renal anemia(RA) is one of the important complications of CKD, which is closely related to the increase of all-cause mortality and cardiovascular mortality in patients. The occurrence of RA is related to the deficiency of erythropoietin(EPO) production. EPO related drugs are an important treatment for RA and affect the prognosis of patients with CKD. This article reviewed the application progress of EPO related drugs in RA in recent years, in order to provide some reference for clinic.

The cardiovascular system operates under continuous mechanical and metabolic pressure, and as age increases, the risk of functional impairment at the molecular, cellular, and organ levels gradually increases. Especially with impaired macroautophagy function and epigenetic changes, including DNA methylation, histone modifications, and non-coding RNA. These cardiovascular aging mechanisms are closely intertwined, and the strengthening or weakening of individual mechanisms can affect other mechanisms. Understanding these cardiovascular aging mechanisms is expected to provide new ideas and directions for the diagnosis of cardiovascular diseases and the development of new drugs in the future.

Objective To explore the effects of meropenem combined with probiotics on inflammatory response and intestinal mucosal barrier function in patients with spontaneous bacterial peritonitis(SBP) caused by liver cirrhosis. Methods A total of 102 patients with cirrhosis complicated with SBP who were treated in Jing-an district central hospital from January 2021 to March 2023 were selected as the study objects, and were divided into 52 cases in the control group(meropenem treatment) and 50 cases in the study group(meropenem combined with bifidobacterium triactive enteric capsule treatment). The curative effect, inflammatory factor levels, intestinal mucosal barrier function, and adverse reactions before and after the treatment were compared between the two groups. Results The total effective rate of the study group(94.00%) was significantly higher than that of the control group(78.85%)(P＜0.05). After treatment, the levels of inflammatory factors, diamine oxidase, D-lactic acid and the ratio of urinary lactulose excretion rate to mannitol excretion rate were decreased in two groups(P＜0.05), and the decrease was more significant in the study group than in 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 Probiotics combined with meropenem can effectively improve the clinical efficacy of cirrhosis complicated with SBP, inhibit the secretion of inflammatory factors, improve the intestinal mucosal barrier function of patients, and have a high safety.

Objective To investigate the effect of roxallistat assisted erythropoietin(EPO) on patients with renal anemia(RA) and its effect on transferrin(TRF) and TRF saturation(TSAT) levels. Methods A total of 179 RA patients treated in the department of nephrology, Mingguang people's hospital from January 2021 to December 2023 were selected and divided into experimental group(n＝90, EPO＋roxallistat) and control group(n＝89, EPO) by random number table method. Both groups were treated for 12 months. The clinical efficacy, TRF, TSAT, serum indexes of anemia[red blood cell(RBC), hemoglobin(Hb), serum ferritin(SF)] and the incidence of adverse reactions were compared between the two groups. Results After treatment, the clinical effective rate of experimental group was higher than that of control group(91.11% vs 79.78%, P＜0.05). The levels of TRF, TSAT, RBC, Hb and SF in both groups were higher than before (P＜0.05), and the experimental group was higher than the control group(P＜0.05). The incidence of adverse reactions in experimental group and control group was 6.67% and 10.11%, respectively, with no significant difference(P＞0.05). Conclusion Roxallistat assisted EPO in the treatment of RA is effective, and can improve the level of TRF, TSAT and anemia.

Iron metabolism disorder is common disorder in patients with chronic kidney disease, which leads to renal anemia(RA). Intravenous iron is an important treatment for RA, and commonly used drugs include ferric carboxymaltose, ferumoxytol and ferric derisomaltose. Based on the previous research results, this article reviewed the application progress of intravenous iron in RA, in order to provide some ideas for individualized iron therapy

Objective To observe the effect of modified Buyang Huanwu decoction combined with sacubitril valsartan on chronic cardiac failure(CHF). Methods A total of 120 CHF patients with Qi deficiency and blood stasis admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from November 2021 to June 2023 were randomly divided into western medicine group(n＝60) and Chinese and western medicine combined group(n＝60). The western medicine group was treated with sacubitril valsartan on the basis of conventional treatment, and the Chinese and western medicine combined group was treated with modified Buyang Huanwu decoction on the basis of western medicine group, with a course of 3 months. Results After treatment, the traditional Chinese medicine syndrome score, quality of life score, N-terminal brain natriuretic peptide precursor, myocardial troponin T level and left ventricular mass index in the two groups were decreased compared with before treatment(P＜0.05), the left ventricular ejection fraction and 6 min walking test were higher than those before treatment(P＜0.05), and the above indexes in Chinese and western medicine combined group were better than those in western medicine group(P＜0.05). The total effective rate of the combined group was obviously higher than that of the western medicine group(91.67% vs 76.67%, P＜0.05). There was no significant difference in the incidence of adverse reactions between the combined group and western medicine group(8.33% vs 13.33%, P＞0.05). Conclusion Modified Buyang Huanwu decoction combined with sacubitril valsartan has high curative effect on CHF, and can improve the heart function and quality of life of patients.

Objective To explore the clinical efficacy of Siwanfeng decoction in treating atopic dermatitis(AD) in children with heart fire and spleen deficiency syndrome. Methods A total of 70 patients with AD who met the inclusion criteria were randomly divided into treatment group and control group, with 35 cases in each group. The treatment group was given Siwanfeng decoction orally, while the control group was given levocetirizine hydrochloride oral liquid orally. The treatment course was 6 weeks. The changes in scoring AD(SCORAD) scores and clinical efficacy were compared between two groups. Results The total effective rate of the treatment group was 97.14% and 40% in the control group, and the total effective rate of the treatment group was significantly higher than that of the control group(P＜0.001). After treatment, the SCORAD score in the treatment group was decreased than before treatment and the control group, and the difference was statistically significant(P＜0.001). Conclusion Siwanfeng decoction has a good clinical efficacy in treating children with AD with heart fire and spleen deficiency syndrome

我国药品集中采购 ( 以下简称“集采”) 政策形成于经济市场化改革和医药卫生体制改革的重要时期，走过了从计 划采购、医院联合采购试点、地 ( 市 ) 扩大试点，省为单位、省际联合、国家组织六个不同阶段与药品集采政策变革、初 创、调整、拓展、融合、完善的发展历程相对应，政策发展以问题、需求为导向，从部门碎片化、局部效应，逐步向整体 性、系统化、综合成效转变。文章梳理了我国药品集采发展的历程，总结不同时期药品集采政策的特点，显示我国经济改 革和医药卫生体制改革相关政策与药品集采政策发展互为因果、相互协调，推动了药品供应保障治理体系现代化进程。

Objective To observe the effects of Yiqi Yangyin Qufeng recipe on inflammatory factors and oxidative stress in patients with type 2 diabetic nephropathy(DN). Methods A total of 60 patients with type 2 DN admitted to nephrology departments of outpatient and inpatient of our hospital from January 2022 to June 2023 were included and randomly divided into treatment group and control group, with 30 cases in each group. All patients were given lifestyle guidance to control blood glucose, blood lipids, etc. The treatment group was also given Yiqi Yangyin Qufeng recipe, and the control group was also given valsartan. The treatment course was 12 weeks. Traditional Chinese medicine(TCM) syndrome score, clinical efficacy, serum creatinine(Scr), urinary albumin/creatinine(UACR), peripheral blood mononuclear cell nuclear factor(NF)-κBP65, urinary monocyte chemotactic stimulating factor(UMCP)-1, interleukin(IL)-1, IL-6, tumor necrosis factor(TNF)-α, highly sensitive C-reactive protein(hs-CRP), superoxide dismutase(SOD), and serum malondialdehyde(MDA) levels were observed and compared between the two groups before and after treatment. Results The total effective rate of the treatment group was higher than that of the control group(86.67% vs 63.33%, P＜0.05). The treatment group was superior to the control group in improving the levels of TCM syndrome score, UACR, NF-κBP65, TNF-α, IL-1, IL-6, SOD, MDA and UMCP-1(P＜0.05), and there were no significant differences in the levels of Scr and hs-CRP between the two groups(P＞0.05). Correlation analysis showed that NF-κBp65 was positively correlated with UMCP-1(r＝0.562 1, P＜0.05). Conclusion Yiqi Yangyin Qufeng recipe can reduce the expression level of inflammatory factors and inhibit oxidative stress in type 2 DN patients, which can be regarded as one of the effective drugs for type 2 DN.

Objective To investigate the risk factors of brain injury in high-risk infants in neonatal intensive care unit(NICU). Methods A total of 655 high-risk NICU infants admitted to the second people's hospital of Wuhu from March 2019 to March 2023 were selected as the study objects, which were divided into brain injury group(n＝131) and no brain injury group(n＝524) according to whether brain injury occurred. Baseline data, fetal distress in uterus(FDIU), mode of delivery, mechanical ventilation(MV), assisted fertility technologies, brain-derived neurotrophic factor(BDNF), 25 hydroxyvitamin D[25(OH)D] were monitored and recorded. Univariate analysis and logistic regression analysis were used to analyze the risk factors of brain injury in NICU high-risk infants. Results Compared with no brain injury group,the number of low body mass cases, FDIU cases, MV cases, prenatal risk factors, maternal infection, BDNF and 25(OH) D levels in brain injury group were higher(P＜0.05). Logistic regression analysis showed that low body weight, FDIU, MV, prenatal risk factors, maternal infection, BDNF, 25(OH)D were risk factors for brain injury in NICU high-risk infants (P＜0.05). Conclusion Low body mass, FDIU, MV, prenatal risk factors, maternal infection, BDNF, 25(OH)D were risk factors for brain injury in NICU high-risk infants. On the basis of considering the above factors, targeted interventions can be taken in clinic to help reduce the risk of brain injury.

The holistic concept of traditional Chinese medicine(TCM) pays more attention to the ''sick person'', that is ''patient-centered diagnosis and treatment strategies''. The most recent iteration of the Measures for the Administration of Drug Registration points out that the therapeutic evaluation of TCM should select the indicators that align with the clinical principles and showcase its unique functional characteristics and advantages. At the same time, under the continuous promotion of modern evaluation systems, there has been a notable increase in innovative clinical trial methods of TCM. There is a growing trend towards utilizing more flexible and expedited clinical trial designs throughout the drug product lifecycle to enhance efficiency of the trials based on rational utilization. This paper took the clinical research of Di'ao Xinxuekang capsule in the treatment of chronic stable angina pectoris as an example, introducing the practical exploration of combining patient-centered clinical research approach with adaptive design, providing useful reference for the evaluation of TCM efficacy.

Non-alcoholic fatty liver disease(NAFLD) is a growing health problem worldwide, and epithelialmesenchymal transition(EMT) plays a central role in the fibrotic progression of NAFLD. This paper reviewed the mechanism of EMT-related action in NAFLD in recent years, including transforming growth factor-β, micro RNA and extracellular vesicles, which play an important role in regulating the interaction between liver cells and fibrosis process. It provides a direction for researchers for the development of new therapeutic strategies and the research for new biomarkers for NAFLD, especially targeted interventions targeting the EMT process and its related molecules and signaling pathways, which may provide effective means to slow down or reverse fibrosis.

Objective To investigate the therapeutic effect of calcium and zinc gluconate oral solution on osteoporosis in ovariectomized rats. Methods 72 SD rats were randomly divided into sham operation group, model group, positive control group and low, medium and high doses of Xingaite groups(3, 6, 12 ml/kg), with 12 rats in each group. Except for the sham operation group, the ovaries were removed to establish the osteoporosis model. The positive control group was given estradiol 0.1 mg/kg, and the sham operation group and the model control group were given the same volume of purified water by gavage for 99 days. The body mass of the rats was observed every 3 days. After treatment, bone mineral density(BMD), bone volume relative to tissue volume(BV/TV) and bone surface relative to tissue volume(BS/TV) were analyzed by micro-CT. Calcium, zinc and bone metabolism were detected by enzyme linked immunosorbent assay. Results Compared with the model group, the zinc-calcium group significantly inhibited the growth of body mass, increased the level of zinc, improved the bone loss of femur, increased trabecular number and connection and BMD, increased BV/ TV and BS/TV, and decreased the levels of osteocalcin and procollagen type Ⅰ carboxy-terminal peptide. Conclusion Xingaite can improve the microstructure of bone trabecular in ovariectomized rats, increase bone density, slow down the osteoporosis process in ovariectomized rats, and has a good effect on ovariectomized rats with osteoporosis.

Objective To explore the correlation between blood magnesium level in patients with maintenance hemodialysis(MHD) and cardiovascular events and all-cause death. Methods The clinical data of 122 patients treated with MHD in our hospital from January 2021 to January 2023 were retrospectively analyzed, and the patients were divided into high magnesium group(blood magnesium≥0.93 mmol/L, n＝67) and low magnesium group(blood magnesium＜ 0.93 mmol/L, n＝55) according to the median blood magnesium level. Kaplan-Meier survival curve was used to compare the cumulative survival rate of the two groups, and Cox regression model was used to analyze the risk factors of allcause death. Results The levels of serum albumin, prealbumin, magnesium, phosphorus and C-reactive protein were significantly different between the two groups(P＜0.05). The incidence of cardiovascular events and all-cause mortality in low magnesium group were higher than those in high magnesium group(P＜0.05). The cumulative survival rate of low magnesium group was significantly lower than that of high magnesium group(P＜0.01). Univariate Cox regression analysis showed that hypomagnesium was a risk factor for cardiovascular events and all-cause death(P＜0.01). After multifactor correction, hypomagnesium was an independent risk factor for cardiovascular events, but not an independent risk factor for all-cause death(P＞0.05). Conclusion MHD patients with low blood magnesium levels have a higher incidence of cardiovascular events and an increased risk of all-cause death.

Chronic bronchitis(CB) is a widespread respiratory disease, and its core pathogenesis revolves around the inflammatory response. A vicious cycle is formed between this inflammatory response and oxidative stress, leading to a series of complex pathological changes such as excessive mucus secretion, airway surface dehydration, and airway fibrosis remodeling. Among them, the molecular mechanisms are interrelated and jointly promote the development of the disease. This article comprehensively analyzed the role of inflammatory response in CB and its various pathological manifestations, aiming to provide improved ideas for existing treatment methods, stimulated the development of new drugs, and effectively transform basic scientific research results into clinical practice, so as to bring more effective treatment strategies for CB patients.

Sinomenine is an alkaloid monomer extracted from Caulis Sinomenii. Sinomenine was initially known for its anti-inflammatory and immunosuppression, and is mainly used in the treatment of rheumatoid arthritis(RA) and autoimmune diseases. In recent years, sinomenine have been found that it could also play an anti-breast cancer(BC) role through a variety of mechanisms, and less adverse reactions. This article reviewed the mechanism of sinomenine in the treatment of BC, in order to in order to promote the development of more studies of sinomenine in anti-tumor aspects, and provide a theoretical basis for its use in the treatment of BC.

Objective To investigate the curative effect of Shugan Hewei Jiangni decoction combined with herbseparated moxibustion on navel in the treatment of reflux esophagitis(RE) patients with liver and stomach dishonant syndrome. Methods A total of 112 cases of RE patients with liver and stomach disordered syndrome admitted to our hospital from September 2019 to September 2020 were selected and divided into control group(routine＋herb-separated moxibustion on navel) and research group(routine＋herb-separated moxibustion on navel＋Shugan Hewei Jiangni decoction), with 56 cases in each group. The clinical efficacy, gastrointestinal hormone levels, gastrointestinal dynamics indexes, serum inflammatory factor levels before and after treatment and 6-month recurrence rate were compared between the two groups. Results After treatment, the total effective rate of the study group(94.64%) was higher than that of the control group(82.14%)(P＝0.039). Compared with the control group, the levels of traditional Chinese medicine symptom score, serum cholecystokinin, vasoactive intestinal peptide, 5-hydroxytryptamine, C-reactive protein, tumor necrosis factor-α and interleukin-1β were significantly decreased in the study group(P＜0.05), but the levels of gastrin, motilin and somatostatin were significantly increased(P＜0.05). The 6 months recurrence rate of the study group(1.79%) was lower than that of the control group(16.07%)(P＜0.05). Conclusion Shugan Hewei Jiangni decoction combined with herbseparated moxibustion on navel can effectively improve the clinical symptoms, regulate gastrointestinal hormone levels, improve gastric dynamics, regulate serum inflammatory factors and reduce the recurrence rate of patients with liver and stomach dishonant syndrome RE.

Alveolar type Ⅱ epithelial cells(AT2), as alveolar epithelial stem cells, possess significant proliferative and differentiation potential, plays a crucial role in maintaining lung homeostasis and the repair of lung injury. Studies have shown that idiopathic pulmonary fibrosis would occur when the normal function of AT2 is disrupted and transforms into fibrosis-promoting phenotype. Being located on the mucosal surface, AT2 is inevitably exposed to environmental stress, which can have long-lasting effects and ultimately promote the development of fibrosis. At the same time, genetic mutations may also lead to impaired AT2 function and the occurrence of pulmonary fibrosis. Additionally, aging is also one of the significant factors that increase the pathological changes in AT2. The article discussed the regeneration process of AT2 and the pathways that lead to AT2 aging, apoptosis, and dysfunction.

Objective To investigate the effect of remimazolam on cognitive dysfunction induced by sevoflurane in rats by regulating Toll-like receptor(TLR)4/myeloid differentiation factor(MyD)88/nuclear transcription factor(NF)-κB pathway. Methods A total of 72 male SD rats were divided into A to F groups, 12 rats in each group. A group(50% air and oxygen mixture, 2 L/min) and other groups were treated with A group＋2% sevoflurane to construct aged postoperative cognitive dysfunction rat model. After successful modeling, C groups to E were given(1.5 mg/kg, 3 mg/kg and 6 mg/ kg remimazolam＋intraperitoneal injection of the same amount of 0.9% sodium chloride injection), respectively, F group was given(6 mg/kg remimazolam＋intraperitoneal injection of 75 μg RS09). The rats in A group and B group were injected with the same amount of 0.9% sodium chloride injection in the tail vein and abdominal cavity. The escape latency,the number of crossing platforms and the histopathology of hippocampus were observed. The expression of ionized calcium-binding adapter molecule(IBA)-1 was detected by immunofluorescence staining. Enzyme-linked immunosorbent assay was used to detect the levels of neuron-specific enolase(NSE), interleukin(IL)-6 , central nervous system specific protein S-100β, and tumor necrosis factor(TNF)-α in hippocampus. Terminal-deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling staining was used to detect neuronal apoptosis. TLR4, MyD88, Cleaved caspase-3 and p-NF-κB p65 proteins were detected by immunoblotting. Results Compared with B group, the disordered arrangement of neurons and cell morphological changes of rats in C ~ E group were improved, the escape latency was shortened, and the number of crossing platforms was increased. Levels of NSE, S-100β, IL-6, TNF-α, the number of IBA-1 positive cells, neuronal apoptosis rate, and the proteins levels of TLR4, MyD88, Cleaved Caspase-3, and p-NF-κB p65 were significantly decreased(P＜0.05). Conclusion Remimazolam may improve sevoflurane-induced cognitive dysfunction in aged rats by inhibiting the TLR4/MyD88/NF-κB pathway.

Testosterone is one of the most important hormones in the human body, and the lack of testosterone in men can lead to mental and physiological and other dysfunction. The clinical efficacy and safety of testosterone supplementation should be determined through clinical trials, long-term observation, and drug interaction evaluation, with close monitoring of patient responses and associated adverse events. Transdermal patch and other testosterone controlled release preparations provide a better choice for the treatment of testosterone deficiency. This article reviewed the testosterone dosage forms, administration routes, clinical efficacy and safety in domestic and foreign markets, in order to provide reference for the use of clinical related drugs.

Objective To explore the role and existing problems of centralized drug procurement policies in balancing medical, pharmaceutical, and medical insurance costs, ensuring safe and rational use of drugs by the public, and promoting the healthy development of the pharmaceutical industry. Method The relevant policies, literature, cases, and data were analyzed, and the impact and response of policies on various stakeholders and their reactions were interpreted from multiple dimensions. Result The policy of centralized drug procurement was formed during the period of China's economic marketization reform and medical and health system reform. While promoting the construction of the drug supply guarantee system, the policy has promoted the reform of the compensation mechanism of public hospitals and the medical service prices, promoted the balance of medical insurance funds and the modernization of the medical and health governance system. At present, centralized drug procurement has problems in policy implementation, quality improvement and expansion, slow adjustment of medical service prices, and increased difficulty in balancing the interests of the public, medicine, medical development, and fund security. It is necessary to improve the unified and efficient policy linkage and management coordination mechanism of medical insurance, healthcare, and medicine, and promote "value medicine". Conclusion The policy of centralized drug procurement and the reforms related to medicine, healthcare, and medical insurance are mutually causal and synergistic, promoting the modernization process of the governance system and governance capacity of the medicine, healthcare, and medical insurance.

Diagnosis-intervention packet(DIP) is a payment method with Chinese characteristics proposed by combining payment by disease with regional total budget and points. It is currently one of the hospitalization payment methods being promoted in China. This study collected literature on the practical effects of DIP, and used literature hotspot analysis and system review method to summarize the trend of DIP research hotspots and the comparison of effects before and after policy implementation, and put forward the relevant suggestions to improve the research on DIP

With the widespread use of antibiotics, the ongoing development of microbial resistance poses a significant threat to global health. Therefore, the search for new antibiotics or other antimicrobial resources has become the focus of global scientific research. Antimicrobial peptides(AMPs) have attracted much attention as excellent candidates for overcoming antibiotic resistance. AMPs are small molecular proteins that are naturally produced by all living organisms and play a crucial role in the host's innate immunity against a variety of microorganisms, including bacteria, fungi, and viruses. AMPs are widely found in various organisms such as microorganisms, plants, insects, and mammals. AMPs exert biological activity by targeting key molecules such as cell membranes, cell walls, DNA and proteins within cells. The wide range of sources and complex and diverse mechanisms provide a solid foundation for the wide application of AMPs. This article reviewed the classification of AMPs based on animal origin, the mechanisms and applications in pharmaceutical field, in order to provide professional reference for further research in related fields.

Objective To evaluate the availability of drugs for rare disease treatment in China and to provide suggestions for optimizing the supply system for the treatment of rare diseases in China. Methods The current status of rare disease drugs in China was analyzed by accessing databases and literature, and the availability rate of these drugs in tertiary hospitals and the national collaborative network of hospitals for rare disease diagnosis and treatment was evaluated by using the World Health Organization/Health Action International standard survey method. Results There were only 176 drugs in the two batches of rare disease catalogs, and 54% of those diseases had no drugs. The average preparation rate of 47 negotiated rare disease drugs in tertiary hospitals and hospitals of rare disease diagnosis and treatment collaborative network in the agreement period of the 2023 medical insurance catalog was only 6% and 14%, respectively. Conclusion The low availability of rare disease drugs in China is mainly due to the lack of research and development motivation of pharmaceutical companies and the high cost of drug management in hospitals. It is recommended to optimize the identification criteria of the catalog and preferential policies to strengthen the guiding effect of the catalog on the therapeutic areas. And to give priority to the special policy inclination of the whole process of super-rare disease drugs to guide their research and development to the market. Meanwhile, to issue the list of drug innovations for rare diseases and set up a centralized pharmacy to establish a supply system centered on the collaborative network hospitals.

Secondary hyperparathyroidism(SHPT) is one of the most important complications of chronic kidney disease-mineral and bone disorder(CKD-MBD), which can significantly increase the risk of bone deformities, cardiovascular events, and death. In the current treatment of CKD-MBD SHPT, phosphorus binders, calcium-like agents, polynuclear iron-hydroxide and tenapanor have shown advantages. Novel active vitamin D analogues can effectively reduce the level of intact parathyroid hormone(iPTH). This article reviewed the recent progress of IPTH-decreasing CKD-MBD drugs in order to provide reference for clinical use.

Objective To investigate the effects of Mashe Anjin pill combined with acetylcysteine nebulization inhalation therapy on sputum viscosity and oxygen metabolism in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 120 AECOPD patients admitted to our hospital from July 2021 to October 2023 were included and randomly divided into western medicine group and combination group by random number table method, with 60 cases in each group. The western medicine group was given acetylcysteine nebulization inhalation on the basis of conventional treatment, while the combination group was given oral administration of Mashe Anjin pill based on western medicine group. Both groups received continuous treatment for 14 days. The changes in sputum viscosity, blood gas analysis indexes[partial pressure of carbon dioxide(PaCO2), arterial oxygen pressure(PaO2) and oxygen saturation(SaO2)], pulmonary ventilation function indicators[forced vital capacity(FVC), forced expiratory volume in one second(FEV1) and FEV1/FVC] in both groups were measured and recorded before and after treatment, and the clinical efficacy of each group was observed and compared. Results After treatment, the total effective rate of the western medicine group was lower than the combination group(75.00% vs 93.33%, P＜0.05). The viscosity of sputum in both groups improved, and the improvement degree in the combination group was obviously better than that in the western medicine group(P＜0.05). After treatment, the SaO2 and PaO2 in both groups were increased than before treatment(P＜0.05), while the PaCO2 was decreased(P＜0.05), and the SaO2 and PaO2 in the combination group were higher than the western medicine group(P＜0.05), while the PaCO2 was lower than the western medicine group(P＜ 0.05). After treatment, the FVC, FEV1, and FEV1/FVC of both groups were increased than before treatment(P＜0.05), and the combination group were higher than the western medicine group(P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05). Conclusion The combination of Mashe Anjin pill and acetylcysteine nebulization inhalation can effectively reduce sputum viscosity, improve oxygen metabolism and lung ventilation function, and improve clinical efficacy in AECOPD patients.

Objective To investigate the effect of combination therapy with baritinib in the treatment of rheumatoid arthritis(RA) and influence of internal circulation state and bone metabolism. Methods A total of 199 RA patients treated in our hospital from January 2021 to December 2023 were selected and divided into observation group(n＝100) and control group(n＝99) by random number table method. The control group was treated with eramod combined with methotrexate, and the observation group was treated with baritinib on the basis of the control group, the course of treatment was 90 days. The curative effect, peak systolic velocity(PSV), peak diastolic velocity(PDV), vascular resistance, serum osteocalcin(OC), 25-hydroxyvitamin D, β-collagen degradation product(CTX), total type Ⅰ collagen amino terminal lengthening peptide(PINP), morning stiffness time, number of joint tenderness, number of joint swelling, visual analogue scale(VAS) score and incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate of observation group was higher than that of control group(91.00% vs 79.80%, P＜0.05). PSV,PDV, OC, 25-hydroxyvitamin D and PINP in both groups were higher than before, and observation group was higher than control group(P＜0.05). Vascular resistance, β-CTX, morning stiffness time, number of joint tenderness, number of joint swelling and VAS score in both groups were decreased, and the observation group was lower than the control group(P＜ 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05). Conclusion Combination therapy with baritinib has a good effect in the adjuvant treatment of RA, and can improve the internal circulation status and bone metabolism level of patients to a certain extent.

Ground-level ozone pollution poses an existential threat to the health of the human respiratory system, and the role and mechanism of ozone inhalation in the occurrence and development of airway inflammatory diseases are research hotspots. Inhaled ozone mainly reacts with the components of the airway surface liquid and then degrades, while producing reactive oxygen species, lipid oxidation products and other products, thereby stimulating alveolar macrophages and airway epithelial cells, activating cell signaling pathways related to inflammation and changing in pro-inflammatory lipid mediators. All these changes promote the occurrence and development of airway inflammation. This article reviewed the inflammatory phenotypes and related mechanisms of inflammation during the process of ozone-inhalation injury.

Non-alcoholic steatohepatitis(NASH), as a chronic metabolic disease, is closely related to obesity, diabetes mellitus type 2, hyperlipidemia and other metabolic syndromes. Its pathogenesis involves multiple factors such as genetics, environment and lifestyle, especially metabolic disorders as the core driving force, which promote disease progression through oxidative stress, endoplasmic reticulum stress and inflammatory pathway activation. For the treatment of NASH, multiple potential therapeutic targets have been identified, such as metabolic regulation, blocking of inflammatory pathways, and anti-fibrosis. NASH may also progress to severe diseases such as cirrhosis and liver cancer, which poses a major threat to human health. In addition, NASH is often accompanied by other metabolic diseases, forming a vicious cycle that further increases the difficulty of treatment and the burden on patients. This article aims to comprehensively review the pathogenesis, therapeutic targets and drug research progress of NASH, and discuss its harm to humans, so as to provide reference for future research and clinical practice.

Objectives To evaluate the current situation of improvement of the affordability of rare disease drugs in China, and to provide recommendations for the construction and optimization of the multi-level medical security system for rare disease. Methods The reimbursement policies of outpatient chronic and special diseases, major medical expenses insurance, City Customized Commercial Health Insurance and medical assistance in 333 cities in China were collected, and the affordability of 5 National Reimbursement Drug List(NRDL) rare disease drugs with annual cost of more than 100 000 yuan and 6 non-NRDL drugs with annual cost of more than 900 000 yuan were evaluated by World Health Organization/ Health Action International standard survey method. Results For the 6 high-value non-NRDL drugs only covered by the city customized commercial medical insurance(CCCMI), the payment years for these treatments was higher than 10 years, and the affordability was extremely poor. For 5 NRDL rare disease drugs, the affordability was poor(1.53— 3.97 years) only under outpatient chronic and special disease coverage. When the major medical expenses insurance was articulated, teriflunomide(0.81 year) and recombinant human coagulation factor Ⅷ(0.91 year) were affordable, and the payment years of the other three drugs have a certain decrease. Following secondary reimbursement through CCCMI and third reimbursement through medical assistance, human coagulation factor Ⅷ(0.64 year) and miglustat(0.84 year) were also affordable. And there was a significant difference in the number of payment years after the multi-level medical security system. Conclusion Multi-level medical security system can effectively improve the affordability of medication for patients with rare diseases. In this regard, it is recommended that non-NRDL rare disease drugs should be included in NRDL as soon as possible, and the link of various levels of reimbursement should be strengthened.

Objective To evaluate the clinical efficacy and safety of Tongluo Qutong plaster in the treatment of knee osteoarthritis(KOA). Methods A total of 480 patients with KOA were included by stratified randomization, and they were randomly divided into experimental group(n＝360, external application of Tongluo Qutong plaster) and control group (n＝120, external application of Qizheng Xiaotong plaster) according to the ratio of 3∶1. The treatment course of both groups was 14 days. The total score of Western Ontario and McMaster Universities arthritis index(WOMAC) was used as the main therapeutic index, and the TCM syndrome score, visual analogue scale(VAS) score were used as secondary efficacy indexes to evaluate the efficacy, skin irritation symptoms and adverse reactions of the two groups. Results After treatment, the total WOMAC score, TCM syndrome score and VAS score of knee pain in the two groups were significantly different from those before treatment(P＜0.05), but there was no significant difference between the two groups(P＞0.05). There was no significant difference in adverse reactions between the two groups(P＞0.05). Conclusion Tongluo Qutong plaster is safe and effective in the treatment of KOA, which can significantly reduce knee pain, improve joint mobility and quality of life of patients, and has clinical value.

Objective To systematically review the literature on the accessibility of national medicare negotiated drugs and summarize its improvement. Methods CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science were searched to collect published literature about national medicare negotiated drugs accessibility, and analyze the content of the literature. Results 25 literatures were included, of which 17 focus on the impact of national medicare negotiated drugs accessibility, while the remaining 8 research the current status of national medicare negotiated drugs accessibility after the policy. Regarding availability, all of the literature found that the policy had a significant positive effect on the uptake of drugs, while 40%(10/25) found that there were some regional or institutional differences in the availability. Regarding affordability, only 60%(15/25) of the literature noted a sharp decrease in the price of national medicare negotiated drugs after the policy. However, 27%(4/15) mentioned that the out-of-pocket costs of most anticancer drugs were still high. Conclusion The National Price Negotiation policy has effectively improved drug accessibility, but it is still necessary to continuously promote the use of national medicare negotiated drugs and to improve the treatment of medicines in health insurance.