Mesenchymal stem cells(MSCs)are self-regenerating,rapidly proliferating pluripotent stem cells that depend primarily on their derived pro-angiogenic,inflammatory regulatory,and tro-phic factors to exert beneficial effects that attenu-ate deleterious inflammatory responses,reduce vascular damage,and promote tissue repair and re-generation.Obstructive sleep apnea hypoventila-tion syndrome(OSAHS)is a chronic disorder marked by oropharyngeal collapse during sleep,re-sulting in transient reduced airflow,large fluctua-tions in intrathoracic pressure,and intermittent hy-poxia and hypercapnia.OSAHS subsequently cyto-kine-mediated inflammatory cascades,oxidative stress,and ischemia,recruit MSCs from inflamed and damaged tissues through MSCs-derived of anti-inflammatory and pro-angiogenic factor activity,re-duce hypoxia,suppress inflammation,promote re-generation,and prevent fibrosis in OSAHS-injured tissues.In this paper,we will describe the patho-genesis of inflammation,oxidative stress,fibrosis and ischemia from the perspective of OSAHS,high-lighting the current research progress on MSCs-de-pendent regulation of OSAHS-related pathology.

Non-peptide gonadotropin-releasing hormone antagonist(GnRH-antagonist)is a highly efficient and selective antagonist of GnRH receptor.The oral preparations(Elagolix,Relugolix and Linza-golix)had been approved for listing abroad.It shows efficacy in reducing the size of uterine fi-broid and controlling heavy bleeding.Appropriate combination of'add-back'therapy could improve the safety in medical application and patient com-pliance.Compared with other hormonal pharma-ceuticals,oral GnRH-antagonists showed promising prospects in the treatment of uterine fibroid.

Defined as a common gynecologic en-docrine disease,endometriosis is characterized by the presence of endometrium outside of the uterus cavity,affecting about 10%to 15%of reproductive-aged women worldwide.Moreover,Asian women tend to have a nine-fold increased risk of endome-triosis compared with their white counterparts in Europe and the United States.Endometriosis not only causes chronic pelvic pain,dysmenorrhea,painful sex and other pain symptoms,but also leads to infertility,pushing the patients into a state of fatigue,high sensitivity and anxiety,thus reduc-ing their quality of life.As the aging of Chinese pop-ulation intensifies and the women's childbearing age delays,it is highly urgent to find solutions to those gynecological endocrine diseases such as en-dometriosis,which hamper women's fertility.In re-cent years,studies have shown that patients with endometriosis have abnormal serum lipid metabo-lism and an increased risk of cardiovascular diseas-es.At the same time,as a type of cholesterol-lower-ing drug,statins can inhibit the progression of en-dometriosis at the cellular and animal levels.Also,a few clinical studies have exhibited that statins ex-ert a positive effect on the treatment of endometri-osis.Therefore,this article aims to review the re-searches regarding the relationship between endo-metriosis and the cardiovascular disease,as well as the research progress of statin therapy on endome-triosis based on the level of cells,animals and hu-man beings.

AIM:To explore the key points of per-sonalized treatment and medication monitoring by clinical pharmacists in the perioperative period of moyamoya disease patients with endometriosis.METHODS:This study showed a moyamoya disease patient with endometriosis who accepting dual an-tiplatelet therapy and how to adjust medication during the perioperative period.Besides,monitor-ing the use proton pump inhibitors in the perioper-ative period and the formulating a plan of DIE post-operative recurrence prevention are also our objec-tives.RESULTS:Through individualized assessment of the patient,a personalized medication adjust-ments for dual antiplatelet therapy was deter-mined.Individualized perioperative proton pump inhibitor regimen and postoperative prevention plan for endometriosis recurrence were developed.CONCLUSION:The development of individualized medication regimens and medication monitoring is the breakthrough point for clinical pharmacists to carry out pharmaceutical services.

Endometriosis(Endometriosis,EMs)is a disease caused by abnormal colonization of the endometrial stroma or glands to sites other than the coated mucosa of the uterine cavity.Phospho-lipid inositol 3 kinase(phosphoinositide 3-kinase,PI3K)/protein kinase B(protein kinase B,Akt)sig-naling pathway is involved in the process of focal blood vessel formation,cell autophagic apoptosis,migration and invasion,and is one of the classic pathways regulating the pathological characteris-tics of EMs.The characteristics of multi-compo-nent,multi-target and multi-pathway of TCM have significant advantages in the treatment of EMs.Some TCM active components and TCM com-pounds can interfere with the PI3K/Akt signaling pathway,thus inhibiting the treatment of endome-triotic tissues,reducing pain and alleviating fibrotic lesions.By explaining the connection between the key targets of PI3K/Akt signaling pathway and EMs,this paper summarizes and summarizes the re-search status of EMs by regulating PI3K/Akt signal pathway in home and abroad,aiming to provide a new perspective and idea for the use of traditional Chinese medicine and compound to treat EMs.

AIM:To rapidly evaluate the effective-ness,safety and economy of dienogest in the treat-ment of endometriosis so as to provide evidence-based reference for clinical drug selection and deci-sion.METHODS:Retrieved from PubMed,Embase,Cochrane Library,CNKI,SinoMed,Wanfang and health technology assessment(HTA)organization websites,HTA report,systematic review/Meta-anal-ysis and pharmacoeconomic study were included during the inception to Sep 2023.Data extraction and quality evaluation were carried out for the lit-erature that met the inclusion and exclusion crite-ria,and the research results were summarized and analyzed qualitatively.RESULTS:Nine systematic re-view/Meta-analyses,and 2 pharmacoeconomic studies were included.The quality of Meta-analysis literatures was low,and the quality of economic re-search was good.In terms of effectiveness,com-pared with no treatment,dienogest can significant-ly reduce postoperative recurrence rate,VAS score,and improve pregnancy rate and effective rate;Di-enogest has similar therapeutic effects in terms of recurrence rate as GnRHa and COC;With regard to recurrence rate and pregnancy rate,dienogest is superior to danazol,gestrinone,and mifepristone.In terms of safety,compared with placebo,the inci-dence of vaginal bleeding and headache was signifi-cantly increased with dienogest,and there was no difference in bone loss;The incidence of vaginal bleeding caused by dienogest was significantly high-er than that of GnRHa,but the incidence of hot flashes and bone loss was lower.In terms of econo-my,dienogest has a more cost-effective advantage comparing with GnRHa,but does not have econom-ic benefits comparing with COC.CONCLUSION:Di-enogest has good effectiveness and safety in the treatment of endometriosis,and economically su-perior to GnRHa,but inferior to COC.

AIM:To perform a multidimensional analysis of the clinical study characteristics of endo-metriosis based on the ClinicalTrials.gov,providing comprehensive and objective information for re-searchers,clinicians,and clinical pharmacists.METHODS:A thorough investigation was conduct-ed on clinical trials related to endometriosis,regis-tered on the ClinicalTrials.gov from its inception to October 20,2023.Relevant trial data were extract-ed and statistically analyzed using bibliometrics and comparative research methods.RESULTS:A to-tal of 667 endometriosis clinical studies were regis-tered globally,showing an annual increase.The United States(127 trials),France(70 trials),and Ita-ly(57 trials)had the highest number of registered trials.Interventional studies were predominant(416 trials,62.4%),followed by observational stud-ies(251 trials,37.6%).Within interventional stud-ies,drug therapy was the primary intervention(223 trials,53.6%).Despite endometriosis being a female condition,male subjects were also consid-ered,with 6 trials specifically requiring male partici-pants and 37 trials not restricting gender.Compa-nies/corporations were the main funding sources,while public and governmental organizations pro-vided relatively less funding.CONCLUSION:Clinical trial research on endometriosis is in a phase of growth,with drug therapy being the main treat-ment approach.However,there is a relative lack of investment and attention from public funds and governmental organizations.

AIM:To evaluate the clinical effective-ness and safety of generic and branded dienogest in the treatment of endometriosis.so as to provide the basis for clinical use of dienogest.MEHTODS:The data of patients admitted to Third Affiliated Hospital of Zhengzhou University from August 2022 to August 2023 who received dienogest(2 mg/d,orally,for 6 months)for treatment of endometrio-sis were collected.The clinical efficacy and adverse reactions of generic drugs and original drugs in the treatment of endometriosis-related pain were com-pared through follow-up surveys of the two groups of patients at 3 months and 6 months respectively.RESULTS:There was highly significant reduction in pelvic pain in both groups with mean of similar in generic group(34.0±3.0)mm and branded group(34.5±3.9)mm.The most frequent drug-related ad-verse effects in generic dienogest was vaginal bleeding(93%)which was no statistical difference with branded dienogest(90%).CONCLUSION:The generic and branded dienogest have the same clini-cal effectiveness and similar safety.

Endometriosis is a chronic,relapsing disease that requires long-term management.Ado-lescent endometriosis is a group that can be ig-nored,and the drug treatment is an important method for long-term management and fertility preservation.There are many kinds of drugs to treat endometriosis,such as NSAIDs,combined oral contraceptives(COC),progesterone,GnRHa.For the drug treatment selection,the characteris-tics of adolescents should be carefully considered and individualized treatment should be provided.In order to better long-term management,it is nec-essary to develop new treatments,which can effec-tively relieve endometriosis without damaging fer-tility.This review focuses on the drug treatment op-tions and research progress of basic drug treat-ment for adolescent endometriosis,so as to delay disease progression,reduce adverse reactions,pre-serve fertility,and improve quality of life.

AIM:To improve the success rate of experimental modeling of non-alcoholic fatty liver(NAFLD)in rats by high-fat diet through comparing three different formulations of high-fat diets in con-structing non-alcoholic fatty liver rats model,so as to provide a reliable animal model for the study of non-alcoholic fatty liver disease.METHODS:SPF-grade male SD rats were divided into four groups randomly:control group,high-fat diet group1(HFD1),high-fat diet group2(HFD2),high-fat diet group3(HFD3).Each group was given the corre-sponding feed for 8 weeks while modeling.The da-ta on general observation,body weight changes,and ingestion of the rats were recorded during the modeling period.After 8 weeks'feeding,liver ultra-sound,CT and MRI examination were performed for the rats of each group to check the status.Blood and liver samples were collected.Changes in liver function(ALT,AST),blood lipids(TC,TG,HDL-C,LDL-C),and inflammatory indexes(IL-1β,IL-6,TNF-α)were detected.The morphology of the liv-ers was observed with the naked eyes,and the liv-er index and Lee's index were calculated at the end of 8 weeks.The effects of different high-fat diets on the establishment of NAFLD model in SD rats were comprehensively evaluated by comparing the difference of above indexes among the groups.RE-SULTS:Compared with the control group,rats in the HFD1,HFD2 and HFD3 groups showed poor mental deterioration,decreased activity,severe hair loss,decreased food intake,increased body weights,and significantly increased liver index and Lee's in-dex,along with increased liver volume,blunt edge,steatosis and lipid deposition,and the trend was even more pronounced in the HFD3 group.Com-pared with the control group,the serum levels of ALT,AST,TC,TG,LDL-C,IL-1β,IL-6 and TNF-α were significantly increased,while the contents of HDL-C was significantly decreased in the HFD1,HFD2 and HFD3 group,especially in the HFD3 group.Com-pared with the control group,the B ultrasonogra-phy showed an enlarged liver with enhanced paren-chymal echo and pipe unsharpness,CT showed that the liver and spleen CT ratio decreased obvi-ously,and the MRI images showed obvious differ-ence of liver signal intensity between in/out of phase image in the HFD1,HFD2 and HFD3 group,and the most significant imaging changes was ob-served in the HFD3 group.CONCLUSION:The above three kinds of high-fat diets can establish NAFLD model in SD rats after 8 weeks'feeding,the models induced by HFD3 was better than those in-duced by the other two groups.NAFLD lesion is rel-atively serious and expected to last longer in HFD3 group,which are more suitable for investigating the underlying mechanisms of non-alcoholic fatty liver disease and development of lipid-lowering drugs.