Huanglian Jiedutang （HLJDT）， a traditional Chinese herbal formula， is known for its heat-clearing and detoxifying effects. This article reviewed the material basis， pharmacological mechanism of action， and research on HLJDT. Modern research has shown that HLJDT is rich in alkaloids， flavonoids， glycosides， and other active ingredients. In terms of pharmacological mechanisms of action， HLJDT has anti-inflammatory and antibacterial effects， and it can regulate intestinal flora and cell disorder， improve iron metabolism disorder， control glucose and lipid metabolism， and exert vascular endothelial functions， with anti-tumor effects， thus improving cerebral ischemia and reducing liver damage. Its therapeutic actions are multi-layered， multi-faceted， and multi-targeted， showing significant efficacy in treating various diseases. Interdisciplinary research， such as the combined application of network pharmacology with molecular docking technology， as well as metabolomics with proteomics， has revealed the potential mechanism of HLJDT in treating various diseases. However， the research on HLJDT still faces some challenges， including the need for an in-depth exploration of its complex pharmacological mechanism of action， evaluation of its efficacy and safety across different diseases and populations， and quality control of traditional Chinese medicine. Future research should integrate modern scientific and technological approaches with traditional Chinese medicine principles to further investigate HLJDT's complex pharmacological mechanism of action， providing theoretical and practical support for its clinical use.

Huanglian Jiedutang （HLJDT）， a traditional Chinese herbal formula， is known for its heat-clearing and detoxifying effects. This article reviewed the material basis， pharmacological mechanism of action， and research on HLJDT. Modern research has shown that HLJDT is rich in alkaloids， flavonoids， glycosides， and other active ingredients. In terms of pharmacological mechanisms of action， HLJDT has anti-inflammatory and antibacterial effects， and it can regulate intestinal flora and cell disorder， improve iron metabolism disorder， control glucose and lipid metabolism， and exert vascular endothelial functions， with anti-tumor effects， thus improving cerebral ischemia and reducing liver damage. Its therapeutic actions are multi-layered， multi-faceted， and multi-targeted， showing significant efficacy in treating various diseases. Interdisciplinary research， such as the combined application of network pharmacology with molecular docking technology， as well as metabolomics with proteomics， has revealed the potential mechanism of HLJDT in treating various diseases. However， the research on HLJDT still faces some challenges， including the need for an in-depth exploration of its complex pharmacological mechanism of action， evaluation of its efficacy and safety across different diseases and populations， and quality control of traditional Chinese medicine. Future research should integrate modern scientific and technological approaches with traditional Chinese medicine principles to further investigate HLJDT's complex pharmacological mechanism of action， providing theoretical and practical support for its clinical use.

There are certain limitations in the current clinical evaluation methods and evaluation modes of new Chinese herbal medicines for syndromes， and there is a lack of a clinical evaluation system that meets the characteristics of traditional Chinese medicine （TCM）. Based on the characteristics of TCM "syndrome differentiation and treatment" and "correspondence of formulas and syndromes"， the target design model， hypothesis and its scope of application are proposed on the basis of the combination of diseases and syndromes. On the basis of fully considering the dual factors of diseases and syndromes， we distinguished the "centre of the target"， "middle ring" and "outer ring" through the differences of different signs and symptoms in people with same syndrome， in order to determine the degree of conformity of the syndrome. Then， the population with same syndrome could be analysed according to the "centre of the target"， "middle ring" and "outer ring"， so as to achieve the precise positioning of new Chinese herbal medicines for syndromes， and try to provide research ideas and methods for syndrome differentiation and treatment of TCM and precise intervention.

OBJECTIVE To clarify the institutional logics of the dilemma of the use of national medical insurance negotiation drugs（referred to as “national negotiation drugs”）， and promote the implementation and use of these drugs in medical institutions. METHODS Based on the complex institutional environment in which medical institutions were situated， the theory of multiple institutional logics was used to construct an analytical framework for the behavioral choices of medical institutions， and reveal the mechanism of the difficulty in the use of national negotiation drugs by clarifying the interaction and conflict of multiple logics in this process， so as to put forward some measures. RESULTS & CONCLUSIONS There were contradictions and coupling among the state logic， market logic， social logic and professional logic in the use of national negotiation drugs. In the game of multiple logics， the market logic and professional logic tended to be risk-averse， the failed “pressure-type system” of state logic， and the social logic was weakened， which caused the lack of action in the use of national negotiation drugs with the goal of completing performance evaluations in the current medical institutions. Thus， it is suggested to unbundle the invisible policy restrictions on the use of national negotiation drugs， form the pressure and motivation of medical institutions by incentive and constraint mechanisms， respond to the clinical demand by establishing a green procurement channel， and construct the supervision mechanism on the use of national negotiation drugs by social force， etc.， so as to enhance the effect of the national negotiation drugs.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective To investigate the relationship between insomnia,gastrointestinal symptoms,and glycosylated hemoglobin(HbA1c)levels in individuals diagnosed with type 2 diabetes mellitus(T2DM),as well as the related influencing factors.Methods A total of 910 T2DM patients treated in our multicenter from January 2022 to December 2022 were enrolled in this study.General information(gender,age,smoking and drinking history,exercise,course of disease,treatment and complications),HbA1c,Athens Insomnia Scale(AIS)scores and Gastrointestinal Symptoms Rating Scale(GSRS)scores of patients were collected.The differences of sleep and gastrointestinal symptoms between groups were analyzed,and the correlation between the differences and HbA1c was analyzed.Furthermore,the risk factors for non-standard HbA1c were analyzed.Results The AIS score and GSRS score in the HbA1c control group were less than those in the non-standard group(P＜0.01).Insomnia was reported by 37.0％of T2DM patients,and the HbA1c level in the insomnia group was significantly higher than that in the non-insomnia group(10.00％±2.38％vs.8.26％±1.73％,P＜0.01).Gastrointestinal symptoms were present in 57.5％of T2DM patients,and the HbA1c levels in the group with gastrointestinal symptoms were significantly higher than those in the group without gastrointestinal symptoms(9.26％±2.23％vs.8.43％±1.98％,P＜0.01).Furthermore,26.3％of T2DM patients experienced both insomnia and gastrointestinal symptoms.Remarkably,the HbA1c levels in the group with both insomnia and gastrointestinal symptoms were significantly higher than those in the group without either condition(10.18％±2.44％vs.8.45％±1.86％,P＜0.01).Correlation analysis demonstrated a significant association between sleep quality,gastrointestinal function,and HbA1c levels(P＜0.01).The logistic regression analysis result revealed that age,GSRS score,AIS score,and the presence of insomnia combined with gastrointestinal symptoms were independent risk factors for predicting HbA1c≥6.5％(P＜0.01).Having both insomnia and gastrointestinal symptoms concurrently was the strongest risk factor for substandard HbA1c control,and the risk of blood sugar control may increase about 5 times when both appear together.Conclusion Insomnia and gastrointestinal symptoms are common comorbidities in T2DM patients,showing a cross-interfering relationship,and they appear together with poor blood sugar control,interact causally,and amplify each other.

Objective To analyze the retrieval rate of inferior vena cava filter(IVCF)and its safety,and to make a histological analysis of the filter attachment substances.Methods The clinical data of 234 patients with IVCF,who were admitted to Affiliated Tenth People's Hospital,Tongji University,to retrieve IVCF between June 2020 and May 2023,were retrospectively analyzed.The retrieval success rate,complications and filter attachment substances were statistically analyzed,and the nature of the attachment substances was examined by using histological staining.Results The retrieval success rate in the 234 patients was 91.03％(213/234).In 17 patients the retrieval of IVCF was abandoned due to the filter capturing the thrombus,and in 4 patients the retrieval of IVCF failed due to tilting of the filter.No complications such as vena cava perforation,symptomatic pulmonary embolism and hemorrhage occurred in all patients during perioperative period.Of the 213 patients whose filter was successfully removed,the filter attachment substances was found in 156 patients.Histological staining of the filter attachment substances demonstrated that the main component of these substances was a mixed thrombus with a small amount of cellulose degeneration.Further analysis revealed that the incidence of filter attachment substances in ≤14-day group was lower than than that in＞14-day group,and the difference between the two groups was statistically significant(x2=6.791,P=0.009);and the incidence of filter attachment substances in the non-anticoagulant group was lower than that in the anticoagulant group,and the difference between the two groups was statistically significant(x2=7.774,P=0.005).Conclusion The retrieval rate of retrievable IVCFs is quite high and the retrieval procedure carries less complications,therefore,it is safe to use retrievable IVCFs in clinical practice.However,the formation of tiny thrombosis within the filter after the placement of filter cannot be ignored,which should be seriously considered in the clinical work.

OBJECTIVE To analyze the public participation mechanism of National Institute for Health and Care Excellence （NICE） health technology assessment in England and to provide experience for the dynamic adjustment of Chinese medical insurance catalog. METHODS By retrieving related literature and official websites， types and mechanisms of public participation （management organization， selection method， participation mode， evaluation feedback） in NICE health technology assessment were analyzed comprehensively； and based on this， suggestions were put forward to adjust the public participation in Chinese medical insurance catalog. RESULTS & CONCLUSIONS The current public participation types of NICE health technology assessment were patient and carer organizations， HTA committee lay members， patient expert and public observers. At the management level， NICE has set up a public participation team and made guidelines on public participation matters. For different public participation types， NICE has established different selection procedures， such as expression of interest， NICE invitation， open recruitment， nomination， NICE decision， etc. The public participation types are various and in the whole assessing process from the initial determination of the scope of the health technology assessment to the final appeal. Also， NICE has established a flexible and dynamic evaluation feedback system to optimize the way of public participation and the health technology assessment process； NICE has undertaken extensive international cooperation and exchanges to promote public participation at the national and international levels. It is suggested that our country should combine the national conditions， clarify the channel of public participation in health technology evaluation， set up a working group of public participation affairs， strengthen patients’ participation in evaluation and feedback， improve decision-making transparency， and improve the public participation mechanism of health technology evaluation from the aspects of channel opening， management mechanism， evaluation feedback， information disclosure and so on.

ObjectiveTo analyze the epidemiological characteristics of varicella in Yangpu District， Shanghai from 2005 to 2022， predict the trend of varicella in Yangpu District in 2023， and provide evidence for prevention and control of varicella outbreaks. MethodsInformation of varicella cases reported in Yangpu District from 2005 to 2022 was obtained from the China Information System for Disease Control and Prevention. Descriptive statistics was used to characterize the varicella epidemiology. An autoregressive integrated moving average （ARIMA） model was established by using the number of cases per month from 2005 to2022 to predict the trend of varicella epidemics in Yangpu District in 2023. The varicella incidence in 2022 was used to evaluate the fitness of the ARIMA model. ResultsFrom January 2005 to December 2021， a total of 11 527 cases of varicella were reported in Yangpu District， Shanghai. After excluding duplicates and clinical diagnoses， 11 413 cases were included into the analysis. The annual average incidence rate was 51.87/10⁵， the age of onset was mainly under 20 years old （66.5%）， and the occupation was mainly students （49.7%）. The ARIMA （1，1，0）×（0，1，1）₁₂ model was constructed and showed a good fitness while using monthly reported varicella cases in 2022 for model fitting. It was predicted that 1 089 cases of varicella would be reported in Yangpu District in 2023. ConclusionIt is predicted that varicella cases in Yangpu District will increase in 2023. It is recommended to continue promoting delayed varicella vaccination to maintain a high level of vaccination rate. Before the peak of the epidemic， health education regarding varicella should be strengthened， and measures for epidemic prevention and control should be reinforced to prevent varicella outbreaks.

Objective To compare the difference of T-stage between Chinese 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma,and to investigate the optimization of T-stage and provide suggestions for further revision.Methods The MRI data of 183 patients with histology-proven newly diagnosed nasopharyngeal carcinoma in our hospital were enrolled from September 2009 to May 2017.All the anatomic sites mentioned in the two staging systems were marked,and all patients were staged according to the 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma.Comparisons of T-stage were made between the two staging systems.Results Involvement of oropharynx,nasopharynx,prevertebral muscles,cervical vertebra,hypopharynx and orbit were 100％ accompanied with other same or more advanced T-stage classifications.The invasion rates of the cervical vertebra,orbit and hypopharynx were very low (all ＜ 5.00％).The incidence of involvement of pterygoid structure was 15.30％,most of which incorporated with erosion of skull base,only 1 case was invaded alone.All cases of involvement of paranasal sinuses were incorporated with erosion of skull base.Compared with the 2008 staging system,the consti-tuent ratio of T1 + T2 in the 2017 staging system increased from 36.61％ to 61.75％,and that of T3 + T4decreased from 63.39％ to 38.25％,the constituent ratio of T-stage between the 2017 staging system and the 2008 staging system was significantly different (x2 =26.94,P ＜ 0.001).There was moderate consistency of T-stage between these two staging systems (Kappa =0.514,P ＜ 0.001).Conclusion The T-stage of 2017 staging system still has a larger simplification and optimization space.Therefore,according to the principle of concise,the T-stage parameters including oropharynx,nasopharynx,prevertebral muscles,paranasal sinuses,cervical vertebra,orbit and hypopharynx are recommend to delete,and it does not have an impact on the composition of T-stage.We suggest that the pterygoid structure shall combine with the skull base to be one anatomical structure.