OBJECTIVE To analyze the evolution of the focus of Chinese pharmaceutical administration, so as to improving the effectiveness of drug regulation. METHODS Through word frequency and social network analysis, the word cloud and network graph were visualized for the evolution process of Chinese drug regulatory policies, and the different evolutionary characteristic of policies content were analyzed using graph density, clustering coefficient, betweenness centrality, degree centrality and other indicators. RESULTS There were differences in network characteristics in different periods, the overall network connection tended to be tight, the structure tended to be optimized, and the connection between individual network subgroups was gradually complicated. However, the number of subgroups decreased in 2018—2022, and the core nodes were transferred. CONCLUSION In the current special period of “epidemic economy”, it is necessary to broaden the special policy areas and strengthen the coordination and intersection of policy concerns.

Objective:To investigate the distribution, drug resistance and clinical significance of bacteria and fungi in pancreatic juice of patients with severe acute pancreatitis (SAP).Methods:Data of patients with severe acute pancreatitis receiving ERCP treatment and pancreatic juice bacterial culture at Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University from Jan 2019 to Jun 2020 were retrospectively analyzed.Results:A total of 97 patients were included. Pathogens were isolated from 46 (47.42%) pancreatic juice samples, with 71 strains including 43 (60.56%) gram negative bacteria, 26 (36.62%) gram positive bacteria, and 2 (2.82%) fungi. The C-reactive protein (CRP), D-dimer and Balthazar CT Score in the culture positive group were higher than those in the culture negative group ( P < 0.05). The incidence of complications and pancreatic infection in the culture positive group was also significantly higher ( P < 0.05). Conclusions:The positive rate of pancreatic juice bacterial culture in the early stage of severe acute pancreatitis is high, in which Gram-negative bacteria are most common, followed by Gram-positive bacteria and fungi. The presence of pathogens in pancreatic juice predicts ensuing infections.

Background and Objectives: Although human-induced pluripotent stem cells (hiPSC) can be efficiently differentiated into cardiomyocytes (CMs), the heterogeneity of the hiPSC-CMs hampers their applications in research and regenerative medicine. Retinoic acid (RA)-mediated signaling pathway has been proved indispensable in cardiac development and differentiation of hiPSC toward atrial CMs. This study was aimed to test whether RA signaling pathway can be manipulated to direct the differentiation into sinoatrial node (SAN) CMs. Methods: and Results: Using the well-characterized GiWi protocol that cardiomyocytes are generated from hiPSC via temporal modulation of Wnt signaling pathway by small molecules, RA signaling pathway was manipulated during the differentiation of hiPSC-CMs on day 5 post-differentiation, a crucial time point equivalent to the transition from cardiac mesoderm to cardiac progenitor cells in cardiac development. The resultant CMs were characterized at mRNA, protein and electrophysiology levels by a combination of qPCR, immunofluorescence, flow cytometry, and whole-cell patch clamp. The results showed that activation of the RA signaling pathway biased the differentiation of atrial CMs, whereas inhibition of the signaling pathway biased the differentiation of sinoatrial node-like cells (SANLCs). Conclusions Our study not only provides a novel and simple strategy to enrich SANLCs but also improves our under-standing of the importance of RA signaling in the differentiation of hiPSC-CMs.

Objective:To investigate the clinical efficacy of early pancreatic duct stenting in the treatment of acute pancreatitis.Methods:The retrospective and descriptive study was conducted. The clinical data of 201 patients with acute pancreatitis who were admitted to General Hospital of Ningxia Medical University from October 2011 to December 2017 were collected. There were 106 males and 95 females, aged from 18 to 90 years, with a median age of 62 years. Of 201 patients, there were 178 cases with moderate severe acute pancreatitis and 23 cases with serious severe acute pancreatitis. Patients were treated with pancreatic duct stenting within 48 hours after admission. Observation indicators: (1) treatment; (2) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect recurrence of acute pancreatitis after surgery up to June 2019. Measurement data with normal distribution were represented by Mean± SD, and the independent sample t test was used for comparison between groups, and the matched samples t test was used for comparison between before and after. Measurement data with skewed distribution were represented by M( P25 ,P75) or M(range), and the Mann-Whitney U test was used for comparison between groups, and the Wilcoxon signed rank sum test was used for comparison between before and after. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test . Results:(1) Treatment: 201 patients received pancreatic duct stenting successfully, 63 of which were detected pancreatic obstruction with white-floc. The interval time from admission to surgery , operation time, time for initial oral intake, duration of hospital stay and hospital expenses of 201 patients were 10 hours(4 hours,22 hours), (35±15)minutes, 3 days(2 days,5 days), 6 days(5 days,10 days) and 3.8×10 4 yuan (3.0×10 4 yuan,4.9×10 4 yuan). Of 201 patients, 22 patients were transferred to intensive care unit, including 1 case with serious severe underwent inhospital death and 1 case with moderate severe and 7 cases with serious severe underwent auto-discharge from hospital. There were 25 cases with local complications, including 17 cases with pancreatic infectious necrosis, 7 cases with pancreatic walled-off necrosis and 1 case with spleen infarction. All 25 patients were cured after surgical inter-vention or conservative treatment. Further analysis showed that cases being transferred to intensive care unit, cases undergoing surgical treatment, the time for initial oral intake, duration of hospital stay and cases undergoing auto-discharge from hospital were 6, 11, 3 days(2 days,5 days), 6 days(5 days,10 days) and 1 for the 178 moderate severe cases, versus 16, 5, 7 days(4 days,9 days), 9 days (7 days,17 days) and 7 for the 23 serious severe cases, showing significant differences ( χ2=91.561, 6.730, Z=6.485, 5.463, χ2=47.561, P<0.05). The white blood cell count, serum amylase indexes and chronic health evaluation Ⅱ score of 201 patients were (14±6)×10 9/L, 928 U/L(411 U/L,1 588 U/L), 9±5 before admission, versus (10±4)×10 9/L, 132 U/L(72 U/L,275 U/L), 6±4 at 48 hours after admission, respectively, showing significant differences ( t=12.219, Z=11.639, t=16.016, P<0.05). (2) Follow-up: of 201 patients, 153 cases were followed up for 40 months (27 months,55 months). During the follow-up, 32 of the 153 cases had recurrence of acute pancreatitis. Conclusion:Early pancreatic duct stenting is safe and feasible in the treatment of acute pancreatitis.

OBJECTIVE：To overview the systematic review on the effectiveness of indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP），and to provide reliable evidence-based reference for the prevention of PEP. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，CBM，CNKI，Wanfang database and VIP，systematic review on indomethacin in the prevention of PEP were collected during the inception to Nov. 2020. The methodological quality ，report quality and evidence quality of the included studies were evaluated by AMSTAR 2 scale，PRISMA statement and GRADE method. The effectiveness of PEP prevention was described. RESULTS ：Finally，23 systematic reviews were obtained ，including 12 in Chinese and 11 in English. Tweenty-two systematic reviews showed that compared with placebo ， indomethacin could effectively reduce the incidence of PEP. Eight systematic reviews showed that indomethacin significantly reduced the incidence of moderate and severe PEP compared with placebo. Five systematic reviews showed that indomethacin could reduce the incidence of postoperative hyperamylasemia compared with placebo. Three systematic reviews showed that indomethacin also had a good preventive effect on people with high risk of PEP. PRISMA score of included systematic reviews ranged from 15 to 25. The quality evaluation of AMSTAR 2 methodology included in systematic reviews was low ，and the key items of complete report were 4，9，11 and 13. The GRADE evidence quality evaluation of the included systematic reviews showed that the quality of the evidence was concentrated in the low level. CONCLUSIONS ：Indomethacin has a certain effect in the prevention of PEP ，but the overall evidence quality of the included literatures is generally not high. It needs to be further validated by high-quality clinical research.

【Objective】 To investigate the effects of naringenin on the polarization of high-glycemic RAW264.7 macrophages and its related mechanism. 【Methods】 The mother solution of NAR was prepared with dimethyl sulfoxide (DMSO), and the log-growth phase macrophage RAW264.7 was pre-tested. DMEM medium with different glucose concentrations (1, 2, 4, 5 and 6 g/L) was used for cultivation for 24 h. Before the experiment, DMEM was diluted into NAR mixture with different final concentrations, and the effect of NAR on RAW264.7 cell activity was detected by CCK-8 method; nitric oxide synthase (NOS) type classification determination of checkerboard induced nitric oxide synthase (iNOS) active filter was used to control the concentration of sugar and high-sugar stimulation. The control group were subdivided into normal control (NG) and osmotic pressure control (NG+M). The high-glucose stimulation group was divided into normal high glucose (HG), high glucose + naringenin (HG+NAR), high glucose + Fasudil (HG+F), and high glucose +C3 transferase (HG+C3). RAW264.7 was cultured for 24 h in each group; the expression levels of supernatant cytokines, namely, interleukin6 (il-6), tumor necrosis factor -α (TNF-α) and interleukin10 (IL-10), were detected by ELISA. Western blotting was used to determine the RhoA/ROCK pathway related proteins, iNOS and Arg-1 protein levels. Type (M1, M2) and proportion (M1/M2) of macrophages were analyzed by flow cytometry. 【Results】 Compared with those in NG group, in HG group RhoA/ROCK pathway-related proteins and iNOS expression were increased, while Arg-1 expression was decreased (P<0.05). The secretion of pro-inflammatory cytokines IL-6 and TNF-α was increased while anti-inflammatory cytokine IL-10 was decreased (P<0.05). The number of M1-type cells and M1/M2 ratio increased (P<0.05). Compared with HG group, RhoA/ROCK pathway related proteins and iNOS expression were decreased in HG+NAR group, HG+F group and HG+C3 group, while Arg-1 expression was increased, IL-6 and TNF- α secretion was decreased, IL-10 was increased, M2-type macrophages were increased, and M1/M2 was decreased (P<0.05). 【Conclusion】 NAR may promote the M2-type differentiation of macrophages stimulated by high glucose by down-regulating RhoA/ROCK signaling pathway.

Objective:To evaluate the effectiveness and safety of pancreatic duct stent under endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of patients with hypertriglyceridemic pancreatitis (HTGP).Methods:The clinical data of 66 patients with HTGP at the General Hospital of Ningxia Medical University from January 1, 2017 to June 1, 2020 were retrospectively analyzed. The patients were divided into two groups according to treatment methods: conservative group ( n=46) and stent group ( n=20). The incidence of complications, the rate of transfer to the intensive care unit (ICU) for intensive treatment, the acute physiology and chronic health evaluation (APACHE) II score at 48 hours after admission, the level of triglycerides, and the application interval of enzyme inhibitor were compared between groups. Results:There were 53 males and 13 females, aged (39.3±9.7) years. There were no deaths in both groups, all 20 patients in the stent group underwent successful pancreatic duct stenting. Compared with before treatment, the level of blood white blood cell, amylase, triglycerides, and APACHE II scores of patients in the conservative group and the stent group were both significantly reduced after treatment ( P<0.05). After treatment, the APACHE II score of stent group patients was significantly lower than that of the conservative group [2.00(2.00, 4.00) vs 4.00(3.00, 5.25), P<0.05]. The length of fasting, hospitalization, and the enzyme inhibitor application of patients in the stent group were significantly lower than conservative group ( P<0.05). The complication rate of the stent group was significantly lower than conservative group [ 10.0% (2/20) vs 41.3% (19/46), P<0.05]. Conclusion:Pancreatic duct stenting can quickly relieve clinical symptoms of HTGP patients, reduce length of hospital stay and improve prognosis, which means it is a safe and effective treatment strategy for HTGP.

Objective To study the effect of operation position in reducing intraoperative pressure ulcer in 48 patients with posterior thoracolumbar incision internal fixation operation.Methods A total of 48 posterior thoracolumbar incision internal fixation operation patients in our hospital were randomly divided into control group and study group,with 24 cases in each group,given routine nursing intervention and operation position nursing,respectively.Nursing satisfaction,incidence of complication rate,hospital stay,the incidence of pressure ulcers,and VAS pain score before and after surgery of two groups were observed.Results The study group had higher nursing satisfaction,shorter hospital stay and lower incidences of pressure ulcer and complications than the control group (P ＜ 0.05);VAS pain score had no significant difference between the two groups before surgery (P ＞ 0.05),but study group had lower VAS score than the control group after surgery (P ＜ 0.05).Conclusion Postural nursing intervention not only can improve nursing satisfaction,reduce incidence of complications,shorten hospitalization time,but also can reduce the incidence of pressure ulcers,so it is worthy of promotion.

Objective To study the effect of operation position in reducing intraoperative pressure ulcer in 48 patients with posterior thoracolumbar incision internal fixation operation.Methods A total of 48 posterior thoracolumbar incision internal fixation operation patients in our hospital were randomly divided into control group and study group,with 24 cases in each group,given routine nursing intervention and operation position nursing,respectively.Nursing satisfaction,incidence of complication rate,hospital stay,the incidence of pressure ulcers,and VAS pain score before and after surgery of two groups were observed.Results The study group had higher nursing satisfaction,shorter hospital stay and lower incidences of pressure ulcer and complications than the control group (P ＜ 0.05);VAS pain score had no significant difference between the two groups before surgery (P ＞ 0.05),but study group had lower VAS score than the control group after surgery (P ＜ 0.05).Conclusion Postural nursing intervention not only can improve nursing satisfaction,reduce incidence of complications,shorten hospitalization time,but also can reduce the incidence of pressure ulcers,so it is worthy of promotion.

Objective To explore the short‐term effect of chronic periodontitis patients after implant treatment .Methods Selected 60 cases of tooth loss in chronic periodontitis patients as research group ,a total of 75 implants were placed ,and 50 cases of periodontal healthy teeth missing patients as control group ,a total of 67 implants were placed .Compared two groups of modification sulcus bleeding index(mBII) ,papilla index score(PIS) ,modification plaque index(mPLI) and probing depth(PD) 6 months after op‐eration ,and detected implant sulcular fluid IL‐2 ,IL‐8 content in two groups before and after operation .Results Research group 75 implants had 2 off on their own ,implant loosening degrees 0 ,implant survival rate was 97 .3% ;the control group had no implant failure ,implant loosening of implant survival rate was 100% ,two groups of implant survival rate was no significant difference(χ2 =2 .737 ,P= 0 .098) .The mSBI ,PIS ,mPLI ,PD in research group and control group had no statistically significant(P > 0 .05) .Re‐search group sulcular fluid IL‐2 ,IL‐8 content was significantly higher than those in control group before and after the operation (P< 0 .05) .Conclusion The short‐term effect of implant treatment in chronic periodontitis patients is satisfactory ,without increas‐ing the risk of peri‐implantitis ,and worth of clinical promotion .