Objective To study the effects of levetiracetam combined with perampanel on the discharge index and electroencephalogram(EEG) manifestations of benign childhood epilepsy with centrotemporal spikes(BECT). Methods A total of 95 children with admitted to the department of pediatric neurorespiratory in our hospital were selected as the research subjects and randomly divided into the control group(n＝47) and the study group(n＝48). The control group was treated with levetiracetam, while the study group was treated with perampanel in combination on the control group. The clinical effects after treatment, the discharge index during the episode of electroencephalogram, the differences in the α, θ, and δ bands of EEG, and the differences between language intelligence quotient and operational intelligence quotient were compared between the two groups. The occurrence of adverse reactions during the treatment period was also monitored. Results After treatment, the total effective rate of the control group was lower than that of the study group(78.72% vs. 95.83%, P＜0.05). The difference in discharge index of the study group was greater than that of the control group(P＜0.05). The improvement rate of the study group was higher than that of the control group(91.67% vs. 70.21%, P＜0.05). The differences in the α, θ and δ bands of EEG activity in the study group were all higher than those in the control group(P＜0.05). The differences in language intelligence quotient scores and operational intelligence quotient scores of the study group were both higher than those of the control group(P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05). Conclusion Levetiracetam combined with perampanel can effectively improve the discharge index of children with , enhance the improvement effect of EEG, promote the recovery of cognitive function, and has good safety.

Rheumatoid arthritis(RA), a common chronic autoimmune disease. In addition to glucocorticoids, nonsteroidal anti-inflammatory drugs, and herbal medicines, the treatment drugs for this disease also include disease - modifying anti-rheumatic drugs(DMARDs). DMARDs include traditional DMARDs, biological disease-modifying antirheumatic drugs(bDMARDs) and targeted synthetic disease-modifying anti-rheumatic drugs(tsDMARDs). The latter two are also breakthrough therapeutic drugs for RA in recent years. This article provided a detailed introduction to bDMARDs and tsDMARDs, and briefly described other potential therapeutic drugs, to provide new ideas and directions for clinical medication.

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

nkylosing spondylitis(AS) is an autoimmune disease mainly characterized by chronic inflammation of the axial spinal joints, and its onset is significantly correlated with genetic markers such as human leukocyte antigen B27. AS has the characteristics of multi-system involvement and can cause extra-articular manifestations such as gastrointestinal dysfunction, renal damage and skin and mucosal lesions. The clinical treatment drugs for AS mainly include three categories: non-steroidal anti-inflammatory drugs, glucocorticoids and antirheumatic drugs for improving the condition. With the breakthrough of biological targeted therapy, biological agents such AS tumor necrosis factor inhibitors and interleukin-17 inhibitors have become a new paradigm for the treatment of AS. This paper systematically reviewed the latest research on AS biological agents combined with AS physical rehabilitation, exercise therapy and other non-pharmaceutical intervention methods, aiming to provide evidence-based basis for optimizing the comprehensive management plan of AS.

Systemic lupus erythematosus(SLE) is is a chronic autoimmune disease characterized by multi-system involvement. The disease recurs repeatedly, often accompanied by infections and organ damage, which seriously threaten the quality of life of patients. With the breakthroughs of molecular immunology research, important progress has been made in the targeted treatment strategies for SLE. Based on evidence-based medical evidence, this paper systematically reviewed current drug treatment regimens for SLE, mainly including the optimized application of traditional drugs, as well as the clinical value of innovative therapies such as biological agents like belimumab and telitacicept, and novel treatment approaches such as chimeric antigen receptor T-cell immunotherapy, in order to provide evidence-based basis for individualized treatment decisions.

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.

目的 系统梳理并比较分析各地国家医保谈判药品“双通道”管理政策，为其优化提供决策参考。方法 比较全国 31 个省级行政区 ( 不包括港澳台 )“双通道”管理相关政策，从药品目录管理、药品分类管理、定点医药机构管理以及医 保待遇等方面进行分析，比较各省份政策差异及创新实践。结果 各省已开展“双通道”管理相关探索，实施情况较好。 结论 各省在政策协同性、药品配备主体责任和切实关系到群众利益的医保个人待遇方面的公平性问题还有待改善。

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

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.

Poria cocos polysaccharide is a medicinal substance derived from dried sclerotium, mycelium and fermentation broth of Poria cocos. It exhibits various biological activities, including anti-tumor, anti-inflammatory, antioxidant and antidepressive effects. Poria cocos polysaccharide is mainly used in clinical practice to treat malignant tumors, colitis and depression and other diseases. With the in-depth study of the anti-tumor mechanism of Poria cocos polysaccharides, researchers have found that it exerts anti-tumor effects through immune regulation, inhibition of tumor cell proliferation, anti-angiogenesis and genetic regulation, and is widely used in the treatment of liver cancer, lung cancer and breast cancer. This article will comprehensively and systematically summarize the latest mechanism of action of Poria cocos polysaccharides against tumors, providing basic data and theoretical basis for the clinical application of the antitumor effect of Poria cocos polysaccharides and the development of new drugs.

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

Objective To explore the clinical effect of tirofiban combined with ginkgo biloba diterpene lactone in the treatment of acute cerebral infarction(ACI), and its influence on nerve function and hemorheology. Methods A total of 150 patients with ACI who received treatment in our hospital from June 2021 to June 2023 were selected, and divided into the control group and combined medication group by simple randomization method, with 75 patients in each group. Both groups received conventional treatment and were also given tirofiban, while the combined group received ginkgo biloba diterpene lactone in addition to the control group. Observe and compare The clinical efficacy, the changes in neurological deficits, daily living abilities, serum inflammatory factor levels, coagulation function indicators, hemorheological indicators and the occurrence of adverse reactions in the two groups were observed and compared. Results The total effective rate of the combined medication group was higher than the control group(94.67% vs. 80.00%, P＜0.05). After treatment, the scores of the National Institutes of Health Stroke Scale, serum C-reactive protein, interleukin-6, and tumor necrosis factor alpha levels in both groups decreased compared to before treatment, and the combined medication group was lower than the control group(P＜0.05). The scores of activities of daily living in both groups improved compared to before treatment, and the combined medication group was higher than the control group(P＜0.05). After treatment, the fibrinogen, D-dimer, whole blood low-shear viscosity, whole blood high-shear viscosity, and plasma viscosity in both groups decreased compared to before treatment, and those in the combined medication group were lower than the control group(P＜0.05). The prothrombin time and activated partial thromboplastin time increased compared to before treatment, and those in the combined medication group were higher than the control group(P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05). Conclusion Tirofiban combined with ginkgo biloba diterpene lactone in the treatment of ACI can significantly improve the clinical efficacy, effectively improve the neurological impairment and daily living ability of patients, reduce the level of serum inflammatory factors, optimize the coagulation function and hemorheological indexes, and has high safety.

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

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.

Hidradenitis suppurative(HS) is a chronic, recurrent skin disease of follicular inflammatory, accompanied by multiple comorbidities. At present, the pathogenesis of HS remains unclear, with activation of innate immune system and various inflammatory cytokines. In recent years, biological agents and molecular targeted drugs targeting these targets have shown certain efficacy and application prospects for HS. This article reviewed the clinical research progress of different biologics and molecular targeted drugs in the treatment of HS and HS with comorbidities.

Objective To compare the efficacy of methylphenidate and tomoxetine in the treatment of attention deficit hyperactivity disorder(ADHD) in children and their effects on corticosterone(CORT) and 25-hydroxyvitamin D [25-(OH)D]. Methods Children with ADHD who were treated in our hospital from January 2023 to June 2024 were selected and randomly divided into the experimental group(n＝51, treated with tomoxetine) and the control group(n＝ 50, treated with methylphenidate) by simple sorting random method. Two cases in the experimental group withdrew from the study midway, and three cases in the control group also withdrew from the study midway. The clinical efficacy, CORT, 25-(OH)D, the scores of integrated visual and auditory continuous performance test(IVA-CPT), the Chinese revision of the Wechsler intelligence scale for children(C-WISC), and the incidence of adverse reactions of the two groups were compared. Results After treatment, there was a significant difference in the total effective rate between the two groups(92.16% vs. 72.00%, P＜0.05). The CORT scores and 25-(OH)D in both groups of children were increased compared with those before treatment(P＜0.05), and the scores of the experimental group were higher than those of the control group(P＜0.05). The auditory response control quotient, visual response control quotient and C-WISC score of the experimental group were higher than those of the control group(P＜0.05). The SNAP-IV scores, hyperactivity index and efficacy assessment scale in both groups were lower than those before treatment(P＜0.05), and those in the experimental group were lower than those in the control group(P＜0.05). There was no significant difference in the occurrence of adverse reactions between the experimental group and the control group(3.92% vs. 10.00%, P＞0.05). Conclusion Tomoxetine has a better therapeutic effect than methylphenidate in the treatment of children with ADHD and can improve the levels of CORT and 25-(OH)D.

With the increase of invasive fungal infections, the use of antifungal drug has become more frequently, and the emergence of fungal resistance has become an inevitable problem. Given the limited availability of existing antifungal drugs and their severe side effects, the United States Food and Drug Administration has approved a new antifungal drug, ibrexafungerp, which is a semi-synthetic chemical derivative of the natural product enfumafungin. It has broad-spectrum antibacterial activity, demonstrates strong antibacterial activity against Candida and Aspergillus, including those echinocandins- and azoles-resistant strains. It's currently used in the clinical treatment of vulvovaginal candidiasis. Ibrexafungerp has good oral bioavailability and tolerance, with few adverse reactions. It is a β-1, 3-glucan synthase inhibitor with a new structure and has a good prospect in the clinical treatment of invasive fungal infections. This article reviewed the research and development process, clinical research and drug interactions of ibrexafungerp.

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.

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.

Objective To investigate the therapeutic efficacy of doxycycline for macrolide-resistant Mycoplasma pneumoniae pneumonia(MRMP) in Chinese children after the corona virus disease 2019(COVID-19) pandemic. Methods Clinical data from MRMP studies in Chinese children over the past two years and the key parameters included clinical features(symptoms, signs, laboratory/imaging findings), drug efficacy and safety were collected through medical database searches. A systematic analysis evaluated the effectiveness and safety of doxycycline monotherapy for pediatric MRMP. Results A total of 200 pediatric MRMP cases were included.The overall effective rate of doxycycline was 88.5%(177/200), with fever reduction observed within 1.39 - 3.96 days after administration. No significant efficacy difference existed between severe Mycoplasma pneumoniae pneumonia group and non-severe Mycoplasma pneumoniae pneumonia group(83.1% vs. 91.1%, P＞0.05). Adverse reactions to doxycycline occurred in only 5.5% of cases and were mild doxycycline significantly outperformed intravenous azithromycin in efficacy(92.6% vs. 67.6%, P＜0.001), with comparable adverse reaction rates(7.4% vs. 9.5%, P＞0.05). Conclusion Doxycycline has demonstrated significant clinical efficacy and good safety in pediatric MRMP. The infection rate of MRMP in children has continued to rise after COVID-19. Doxycycline provides a reliable intervention option for clinical use. Clinical application needs to enhance the ability to identify and diagnose MRMP in children at an early stage and continuously monitor possible long-term adverse drug reactions.

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.

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

Objective To 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.

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.

Non-alcoholic fatty liver disease(NAFLD) has become one of the most prevalent chronic liver diseases worldwide, with its incidence rising rapidly alongside the increasing prevalence of obesity and metabolic syndrome. At present, the treatment of NAFLD mainly relies on lifestyle intervention, but there is a lack of speciffc drugs. With in-depth research into the pathophysiological mechanisms of NAFLD, multiple drugs target metabolic disorders, inffammation, and ffbrosis have become a hot topic. This article reviewed the latest advancements in NAFLD drug development, statistically analyzed global research trends and therapeutic hotspots, focused on introducing the clinical trial outcomes of metabolic modulators, anti-inffammatory or anti-ffbrotic agents, and emerging targets, and discussed the future directions in this ffeld.

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

Objective To systematically evaluate the efficacy and safety of ustekinumab compared with other secondline drugs for Crohn's disease(CD). Methods A systematic search of PubMed, Embase, Cochrane Library, and other databases for cohort studies comparing ustekinumab with other second-line therapies for the treatment of CD. Metaanalysis was performed by Review Manager 5.4 software. Results A total of 10 literature studies were included, 1 222 patients in ustekinumab group and 949 patients in other drug groups. The results showed that the clinical remission rate[OR＝1.75, 95%CI: (1.38, 2.21), P＜0.001], steroid-free clinical remission rate[OR＝1.54, 95%CI: (1.17, 2.01), P＝0.002] and clinical response rate[OR＝2.69, 95%CI: (1.10, 6.58), P＝0.030] in ustekinumab group were higher than those of the other drug groups. In addition, the incidence of adverse events[OR＝0.29, 95%CI: (0.09, 0.96), P＝0.040] and discontinuation rate[OR＝0.28, 95%CI: (0.17, 0.46), P＜0.001] in ustekinumab group were lower than those of the other drug groups. Conclusion Ustekinumab is more effective and safer than the other second-line drugs for CD.

Objective To explore the protective effect of Banxia Baizhu Tianma decoction combined with Taoren Honghua decoction on nerve function of patients with cerebral infarction of the wind-phlegm and blood stasis obstruction syndrome. Methods A total of 92 patients with cerebral infarction admitted to department of emergency, Guoyang hospital of traditional Chinese medicine(TCM), the first affiliated hospital of Anhui university of Chinese Medicine from January 2019 to September 2024 were selected and randomly divided into the observation group and the control group, with 46 cases in each group. The control group was given the conventional treatment, while the observation group was combined with Banxia Baizhu Tianma decoction and Taoren Honghua decoction. Both groups were treated for 4 weeks. The clinical efficacy, middle cerebral artery flow velocity(MCAFV), pulsatility index(PI), cerebral vascular resistance(CVR), coagulation function indicators, TCM syndrome score, National Institute of Health stroke scale(NIHSS) score, activity of daily living scale(ADL) score and the incidence of adverse reactions were compared between the two groups. Result After treatment, the total effective rate of the observation group was higher than that of the control group(89.13% vs. 71.74%, P＜0.05). The MCAFV and CVR in the observation group were higher than those of the control group(P＜0.05), and the PI was lower than that of the control group(P＜0.05). The improvement of coagulation function in the observation group was better than that of the control group(P＜0.05). The TCM syndrome scores and NIHSS in the observation group were lower than those in the control group(P＜0.05), and the ADL score was higher than that in the control group(P＜ 0.05). There was no statistically significant difference in safety between the two groups(P＞0.05). Conclusion Banxia Baizhu Tianma decoction combined with Taoren Honghua decoction has a significant therapeutic effect on patients with cerebral infarction of the wind-phlegm and blood stasis obstruction syndrome. It helps improve coagulation function and cerebrovascular reserve function, has a protective effect on neurological function, and does not increase adverse reactions.

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

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

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

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。

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.

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

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.

Objective To explore the efficacy of modified Yishen Jianpei decoction combined with Jinshuibao in patients with chronic glomerulonephritis(CGN) and its influence on immunomodulatory factors. Methods A total of 96 CGN patients in the emergency internal medicine department of our hospital from February 2020 to February 2024 were selected as the research subjects. They were randomly divided into the reference group(treated with Jinshuibao) and the combined group (treated with modified Yishen Jianpi decoction combined with Jinshuibao), with 48 cases in each group. After treatment, the clinical efficacy, inflammatory levels, immunomodulatory factors, renal function, renal fibrosis indicators and the occurrence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the combined group was higher than that of the reference group(89.58% vs. 66.67%, P＜0.05). The levels of C-reactive protein, erythrocyte sedimentation rate, white blood cell count, interleukin-6, interleukin-2 and tumor necrosis factor-α in the combined group were lower than those in the reference group(P＜0.05), and the level of interleukin-4 was higher than that in the reference group(P＜0.05). The serum creatinine, blood urea nitrogen, 24-hour urine protein quantification and urine red blood cell count in the combined group were lower than those in the reference group(P＜0.05). The levels of laminin, type Ⅳ collagen and tissue metalloproteinase inhibitor-1 in the combined group were lower than those in the reference group(P＜0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P＞0.05). Conclusion Modified Yishen Jianpi decoction combined with Jinshuibao can improve the immune function and renal function of patients with CGN, reduce the degree of renal fibrosis, and has good safety. It is worthy of clinical promotion and application.

Objective To investigate the mechanism of Huazhuo Chengqi decoction in intervening acute hypertriglyceridemic pancreatitis(AHP) based on network pharmacology and molecular docking. Methods Components and targets of Huazhuo Chengqi decoction were screened using traditional Chinese medicine systems pharmacology database and analysis platform, traditional Chinese medicine information database, and comparative toxicogenomics database(CTD) database, and the intersected were taken. Cytoscap3.7.2 software was used to construct the network diagram of ''HZCQD-active ingredients-targets'', STRING platform was used to analyze the protein-protein interaction. Metascape platform was performed to conduct enrichment analysis. AutoDock was used to validate the molecular docking. Results A total of 79 active components in Huazhuo Chengqi decoction were obtained, including quercetin, kaempferol, naringenin, isorhamnetin, and aloe-emodin, ect. Key targets included caspase(CASP)9, CASP3, TP53, Akt1, and nuclear factor(NF)-κB1. These can significantly affect the pathways of lipid regulation and atherosclerosis, nucleotide oligomerization domain-like receptor, mitogen-activated protein kinase, NF-κB and phosphoinositide 3-kinase-Akt signaling pathways. Molecular docking confirmed strong binding between active components and key targets. Conclusion Huazhuo Chengqi decoction exerts lipid-modulating and anti-inflammatory effects through multi-target and multi-pathway synergy to intervene in AHP, providing a theoretical basis for clinical application.

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

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

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.