Immunoglobulin is recognized to be used for the treatment of various diseases, not only because it can serve as an alternative therapy against infections, but also because of its immunomodulatory effects. Appropriate use of immunoglobulins can save lives. However, its route of administration may lead to many adverse events and potential other adverse consequences. At present, intravenous immunoglobulin is the main clinical use in China, but there are more adverse events in the process of clinical use, and the patient compliance is not high. Due to this unmet clinical need, subcutaneous immunoglobulin(SCIg) has been developed abroad, which has been used in multiple clinical indications. However, SCIg in China is still in the early stage of exploration and research and development. Faced with the huge clinical needs in China, domestic blood product research and development companies have been encouraged to accelerate the research and development of SCIg drugs of different specifications and different indications to meet the treatment needs of domestic patients. This article reviewed the latest clinical research progress of SCIg in the treatment of primary immunodeficiency diseases, autoimmune neuromuscular diseases and other rare diseases, in order to provide new research and development ideas and suggestions for blood product research and development enterprises in China.

5-methylcytosine(m5C) methylation is an important epigenetic regulation of RNA post-transcriptional modification. Evidence suggests that m5C methylation can regulate RNA stability, translation, transcription, nuclear output and cleavage, thereby mediating cell proliferation, differentiation, apoptosis, stress response and other biological functions. The m5C methylation modification process is catalyzed by m5C methyltransferase, m5C demethyltransferase and m5C methylbinding enzyme. Abnormal expression of multiple methylation modifying enzymes has been found in various cancers and is used to predict patients' outcomes. This paper reviewed the regulatory effects of m5C methylation modification on tumors, and discussed the prospect of related research.

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.

Primary immune thrombocytopenia(ITP) is an autoimmune disease characterized by increased platelet destruction and inadequate megakaryocyte maturation. In recent years, with the in-depth study of the pathogenesis of ITP, new drugs related to spleen tyrosine kinase, Bruton's tyrosine kinase, neonatal Fc receptor inhibitors, platelet desialylation, B-cell activating factor and classical complement pathway have gradually become the focus of ITP treatment. This article reviewed the research progress on new ITP drugs in recent years, aiming to provide reference for selecting appropriate individualized treatment according to the pathogenesis and economic situation in the future.

In 2018, the U.S. FDA approved the first small interfering RNA(siRNA) drug Patisiran, marking a brand-new era for RNA interference therapy. siRNA has developed rapidly in recent years due to its unique drug-forming advantages. Five siRNA drugs have been approved for marketing by the FDA. However, there are still many problems in targeting and efficacy in therapeutic applications. In order to develop new products with more potential value, it is necessary to deeply explore the current status of siRNA drug discovery and development. This article reviewed the advantages and hindrances of siRNA in drug discovery, focused on the research progress of chemical modification strategies and delivery systems of siRNA drugs, in order to provide a reference for the subsequent research.

All-trans-retinoic acid(ATRA) is the clinical choice for the treatment of acute promyelocytic leukemia. However, in recent years, a large number of studies have shown that ATRA maintains the human normal immune microenvironment by inhibiting the immune escape effect of tumor stem cells and promoting the differentiation of myeloid-derived suppressor cells, and enhances the efficacy of chemotherapeutic drugs, targeted drugs and immunotherapy drugs in solid tumors. This paper reviewed the clinical trial progress of ATRA in solid tumors to provide a reference for its further clinical application.

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.

Triple-negative breast cancer(TNBC) is a subtype of breast cancer that is negative for estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2, and is significantly more aggressive and progressive than other subtypes. At present, the main treatment is surgery combined chemotherapy, but treatment efficacy of the advanced TNBC patients is poor. With the in-depth study of TNBC immune microenvironment, immunotherapy has shown potential therapeutic value. The immunotherapy of TNBC mainly includes immune checkpoint blockers, cell therapy, tumor vaccines and adjustment of tumor microenvironment. This article reviewed and summarized the current status and progress of immunotherapy, which contributed to the new understanding of TNBC immunotherapy

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.

Breast cancer is one of the common malignant tumors, which seriously threatens women's health. As a kind of solid tumor, breast cancer can produce hypoxic areas due to the abnormal structure and function of the microvascular system. Hypoxia is generally positively associated with a more aggressive phenotype, increased risk of metastasis, and resistance to tumor therapy. In this paper, the oxygen sensing mechanisms mediated by different types of -ketoglutaratedependent dioxygenase in breast cancer and their clinical application prospects were summarized, in order to deepen the understanding of oxygen sensing mechanisms and functions in breast cancer.

Objective To incestigate the current status, efficacy and influencing factors of drug therapy for psoriasis patients in Shanghai. Method An epidemiological observational study was conducted which enrolled 560 psoriasis patients in two hospitals from January 2022 to December 2022. Information on smoking, alcohol consumption, chronic comorbidities, and clinical evaluation of skin lesions were collected based on a questionnaire survey. Follow-up was conducted at 4 and 8 weeks after treatment to evaluate the efficacy and influencing factors of drug therapy. Results The average age of all patients was(48.4±15.1) years old. The rates of smoking, alcohol consumption and chronic comorbidities were 43.8%, 25.4%, and 53.9%, respectively. The proportion of patients receiving acitretin, methotrexate, narrow band ultraviolet B(NB-UVB) phototherapy, benvitimod and biological agent therapy were 13.2%, 19.3%, 16.8%,4.8% and 45.9%, respectively. After deducting other influencing factors, patients receiving NB-UVB phototherapy[OR＝ 2.29, 95% confidence interval(CI): 1.01～5.18], benvitimod(OR＝4.24, 95%CI: 1.37～13.15), and biological agent therapy(OR＝12.55, 95%CI: 5.93～26.57) for 8-week had a higher PASI75 achievement rate for psoriasis. Conclusion Risk factors such as smoking, alcohol consumption and chronic comorbidities are closely related to the efficacy of psoriasis. It is recommended to strengthen the promote a healthy lifestyle in psoriasis patients, quit smoking and limit alcohol consumption, reduce the incidence of psoriasis comorbidities, which is important for the treatment and prognosis of psoriasis.

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.

Angiogenesis plays a key role in the growth, local invasion and distant metastasis of a variety of solid tumors. At present, anti-angiogenesis drugs can be divided into three types: small-molecule multi-target, macromolecule single-target and endogenous pan-target angiogenesis inhibitors. Among them, small molecule antiangiogenesis inhibitors mainly inhibit tumor angiogenesis by simultaneously or sequentially targeting multiple growth factors/pathways, and can effectively inhibit drug resistance generated by tumor cells. At the same time, small molecule anti-angiogenesis inhibitors have the advantages of good tissue permeability and convenient administration. At present, it has been widely used in the combination therapy of various solid tumors. This paper reviewed the targeted therapy of small molecule anti-angiogenic tyrosine kinase inhibitors and their clinical progress and safety in multiple solid tumors.

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.

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 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 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.

Triple-negative breast cancer(TNBC) is aggressive, prone to recurrence and metastasis. There is a higher risk of early recurrence and a worse prognosis compared to other types of breast cancer. Due to the lack of specific therapeutic targets, the first-line treatment recommendations for metastatic TNBC(mTNBC) in China are still mainly based on anthracycline or paclitaxel as monotherapy or combination chemotherapy. In recent years, with the successful application of new therapeutic drugs in mTNBC, some new drugs have been approved for the treatment of mTNBC abroad. This article reviewed the recent advances in mTNBC molecular typing, immunity and antibody drug conjugations.

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.

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.

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

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.

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.

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.

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.

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 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 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.

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.

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.

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.

Iron deficiency affects about a third of the global population and is particularly common in the elderly, women and those with certain chronic conditions. Iron deficiency has adverse effects on coronary artery disease, heart failure, pulmonary hypertension, and patients undergoing cardiac surgery, with approximately 50% of patients with heart failure and pulmonary hypertension having iron deficiency. The widespread use of antithrombotic drugs increases the risk of bleeding, which in turn increases the incidence of hemorrhage-related iron deficiency anemia. Recent studies have shown that iron supplementation can significantly improve quality of life and readmission rates in heart failure patients with reduced ejection fraction. However, the mechanism of its action in various cardiovascular diseases is still unclear. Based on the evidence of the benefits of iron supplementation in various cardiovascular diseases, this article reviewed the mechanism and potential benefits of iron supplementation in various cardiovascular diseases.

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.

Objective To explore the clinical manifestations and genotype characteristics of Diamond-Blackfan anemia(DBA) caused by mutations in the ribosomal protein L35A(RPL35A) gene(RPL35A-DBA)in children. Method Relevant literature on pediatric RPL35A-DBA with relatively complete data in the past 15 years at home and abroad was collected to summarize, compare, and analyze the clinical manifestations, gene sequencing results, and drug efficacy of these cases. Result A total of 50 cases of RPL35A-DBA in children were collected. The main characteristics of pediatric RPL35A-DBA were as follows. Age and gender: 90% of cases started within 1 year old, with a median onset age of 3 months. The diagnosis age was relatively late, with an average of 2 years old. There was no significant difference in the incidence rate between men and women(P＞0.05). Hematopoietic disorders: the main manifestation was moderate to severe anemia, with 54%(27/50) relied on blood transfusion, and most(68%, 34/50) accompanied by granulocytopenia, while platelet levels were normal. Gene mutation: the phenotype of the large deletion type(n＝22) was more severe than that of the non-large deletion type(n＝28), and the incidence of hematopoietic system abnormalities, immune deficiency, intellectual disability, craniofacial deformity, and skeletal dysplasia were significantly increased(P＜0.05). Drug therapy: the main treatment drug was glucocorticoid(GC), and component blood transfusion combined with iron removal therapy should be given as appropriate. If necessary, allogeneic hematopoietic stem cell transplantation(allo-HSCT) should be performed. Conclusion RPL35A-DBA is more common in children with early onset after birth, and the degree of gene deficiency is closely related to the severity of clinical manifestations. For some cases, GC is effective, but the minimum maintenance dose is required, and allo-HSCT should be performed for severe cases. For suspected cases of RPL35A-DBA, timely genetic testing should be conducted to aid in early diagnosis and effective clinical intervention.

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.

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 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.

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.