Taking Xiaochaihu Decoction as an example,the application differences of classical prescriptions in modern medical context and Chinese medicine practice are compared and analyzed from the aspects of clinical application scope,understanding of pre-scription connotation,dosage specification,dosage form and decoction method.Strategies to solve the differences in efficacy are pro-posed:integrating the wisdom of classical prescriptions and reshaping the framework of Chinese medicine diagnosis and treatment;transforming the results of modern pharmacology and exploring the principles of classical prescriptions;controlling drug quality stand-ards and exploring new uses and dosages of classical prescriptions;keeping pace with the times in Chinese medicine decoction and strengthening management and control to ensure efficacy.It is believed that combining the essence of Chinese medicine with modern technology can make the application of classical prescriptions maintain traditional characteristics while meeting modern clinical require-ments.This can not only improve the adaptability of classical prescriptions to modern complex diseases,but also provide a reference for the modernization of traditional medicine.

Objective:To explore the clinical characteristics and the treatment strategies of surgery and post-operative chemotherapy of ovarian Sertoli-Leydig cell tumors.Methods:A total of 18 patients who underwent sur-gical treatment in Department of Gynecology,Peking University Third Hospital from January 2003 to June 2022 and were pathologically diagnosed with ovarian Sertoli-Leydig cell tumors were selected as the research subjects.The clinical manifestations,auxiliary examinations,surgical and pathological diagnoses,adjuvant treatments and fol-low-up of the included patients were retrospectively analyzed.Results:The age of onset ranged from 19 to 59 years old,with a median age of 24 years old.Among them,12 cases(66.7％)were under40 years old.11 cases(61.1％)showed abnormal symptoms of sex hormones,such as hyperandrogenism and menstrual disorders,and 6 cases(33.3％)sought medical attention for acute abdomen.Preoperative ultrasound indicated a single non-sim-ple mass in the pelvic cavity in 17 cases,during the operation,all tumors were found to originate from one ovary,and all patients under the age of 40(12 cases)underwent adnexectomy on the affected side to preserve fertility.The accuracy of intraoperative frozen pathology was 31.3％(5/16).Among the 18 patients,11 cases were in stage ⅠA and 7 in stage ⅠC,1 case was of well-differentiated type,10 cases of moderate differentiation and 7 ca-ses of poorly differentiated type,3 cases had heterogeneous components.12 cases received adjuvant chemother-apy after surgery.After initial treatment,follow-up was conducted for 4 to 230 months,with a median time of 70.5 months.One case of high-grade sarcoma with heterologous components experienced multiple recurrences,the others had no recurrence.Conclusions:Most cases of ovarian Sertoli-Leydig cell tumors are diagnosed as stageⅠ.For young patients,adnexectomy on the affected side can be performed to preserve fertility and have a good prognosis.But if the tumor contains heterologous components as high-grade sarcoma,it indicates a poor prognosis.

Objective:To explore the clinical characteristics and the treatment strategies of surgery and post-operative chemotherapy of ovarian Sertoli-Leydig cell tumors.Methods:A total of 18 patients who underwent sur-gical treatment in Department of Gynecology,Peking University Third Hospital from January 2003 to June 2022 and were pathologically diagnosed with ovarian Sertoli-Leydig cell tumors were selected as the research subjects.The clinical manifestations,auxiliary examinations,surgical and pathological diagnoses,adjuvant treatments and fol-low-up of the included patients were retrospectively analyzed.Results:The age of onset ranged from 19 to 59 years old,with a median age of 24 years old.Among them,12 cases(66.7％)were under40 years old.11 cases(61.1％)showed abnormal symptoms of sex hormones,such as hyperandrogenism and menstrual disorders,and 6 cases(33.3％)sought medical attention for acute abdomen.Preoperative ultrasound indicated a single non-sim-ple mass in the pelvic cavity in 17 cases,during the operation,all tumors were found to originate from one ovary,and all patients under the age of 40(12 cases)underwent adnexectomy on the affected side to preserve fertility.The accuracy of intraoperative frozen pathology was 31.3％(5/16).Among the 18 patients,11 cases were in stage ⅠA and 7 in stage ⅠC,1 case was of well-differentiated type,10 cases of moderate differentiation and 7 ca-ses of poorly differentiated type,3 cases had heterogeneous components.12 cases received adjuvant chemother-apy after surgery.After initial treatment,follow-up was conducted for 4 to 230 months,with a median time of 70.5 months.One case of high-grade sarcoma with heterologous components experienced multiple recurrences,the others had no recurrence.Conclusions:Most cases of ovarian Sertoli-Leydig cell tumors are diagnosed as stageⅠ.For young patients,adnexectomy on the affected side can be performed to preserve fertility and have a good prognosis.But if the tumor contains heterologous components as high-grade sarcoma,it indicates a poor prognosis.

Taking Xiaochaihu Decoction as an example,the application differences of classical prescriptions in modern medical context and Chinese medicine practice are compared and analyzed from the aspects of clinical application scope,understanding of pre-scription connotation,dosage specification,dosage form and decoction method.Strategies to solve the differences in efficacy are pro-posed:integrating the wisdom of classical prescriptions and reshaping the framework of Chinese medicine diagnosis and treatment;transforming the results of modern pharmacology and exploring the principles of classical prescriptions;controlling drug quality stand-ards and exploring new uses and dosages of classical prescriptions;keeping pace with the times in Chinese medicine decoction and strengthening management and control to ensure efficacy.It is believed that combining the essence of Chinese medicine with modern technology can make the application of classical prescriptions maintain traditional characteristics while meeting modern clinical require-ments.This can not only improve the adaptability of classical prescriptions to modern complex diseases,but also provide a reference for the modernization of traditional medicine.

The amount of data generated by the human experience in medical cases of classic formulas is large and the research value is high， but how to extract valuable information from these massive data is an important problem of researches on classical formulas. It is concluded that there are many problems in the current study of human experience in classical formulas， such as large amount of data， uneven quality， weak extrapolation and clinical application， which seriously affected the evidence strength of human experience in classical formulas and the contribution to experience accumulation and theoretical support. Therefore， from the structural perspective of the research questions， this paper proposed the research ideas of human experience in medical cases of classic formulas： firstly， according to the characteristics of traditional Chinese medicine （TCM） cases， based on the PICO model， which refers parti-cipants （P）， intervention （I）， comparisons （C）， and outcomes （O）， a TCM medical record evaluation tool in line with the evidence-based concept was constructed to evaluate the quality of medical cases； secondly， constructing a standardized database of human experience in classical formulas and using data mining algorithms to explore the deep relationship hidden in human experience； finally， the clinical value evaluation is carried out to verify the effectiveness of the diagnosis and treatment rules of classical formulas to achieve clinical transformation.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Objective:To investigate the efficacy, safety and possible mechanisms of celecoxib as an adjunctive treatment for schizophrenia.Methods:90 schizophrenic inpatients at the second affiliated hospital of Xinxiang Medical College from April 2019 to October 2020 were recruited and randomly assigned to a placebo group or the celecoxib adjunctive treatment group using a random number table. In the placebo group, 46 patients (29 males, 17 females; aged 21-34, mean age 27.46±6.50 years) completed a 6-week follow-up. In the celecoxib group, 44 patients (32 males, 12 females; aged 21-39, mean age 30.52±8.69 years) completed a 6-week follow-up. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms in both groups. Changes in PANSS score at the end of the treatment were compared to evaluate the efficacy of celecoxib. Metabolic indicators such as weight, body mass index, waist circumference and plasm glucolipid, as well as cardiovascular indicators like blood pressure, electrocardiogram and routine blood tests, and adverse events were collected for the safety evaluation. Serum tumor necrosis factor-α (TNF-α), Interleukin-4 (IL-4) and interferon-γ (IFN-γ) were also tested. Pearson correlation analysis was used to explore the relationship between cytokine levels, PANSS score, PANSS reduction rate [(pre-treatment score-post-treatment score)/pre-treatment score×100%], and the safety measurements in the two groups, analyzing the role of inflammation in celecoxib adjunctive therapy.Results:The change of PANSS positive score at the end of the 6th week was significantly higher in the celecoxib adjuvant treatment group than in the placebo group (-8.00±6.12 vs -4.78±5.19, H=-0.55, P=0.009). The weight changes, body mass index, total cholesterol, and triglycerides over 6 weeks were significantly lower in the celecoxib group compared to the placebo group ( F=-7.37, -7.30, 2.56, -2.54; all P<0.05). No serious adverse events were found in celecoxib adjuvant therapy. In the placebo group, baseline TNF-α levels were positively correlated with baseline negative symptoms and PANSS reduction rate ( r=0.260 and 0.330, both P<0.05), and negatively correlated with the 6-week weight ( r=-0.311, P<0.05); baseline IL-4 levels were positively correlated with the 6-week PANSS total score and the 6-week PANSS negative score ( r=0.320 and 0.397, both P<0.05), and negatively correlated with PANSS reduction rate and 6-week blood glucose ( r=-0.316 and -0.331, both P<0.05); Six-week IFN-γ levels were negatively correlated with low-density lipoprotein levels ( r=-0.306, P<0.05). And no such correlation was found in celecoxib adjuvant group. Conclusion:Celecoxib adjunctive therapy can improve positive symptoms of schizophrenia without causing adverse reactions. Inflammatory state is related to schizophrenia symptoms, treatment efficacy and metabolic abnormalities.

Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.

Objective:To investigate the efficacy, safety and possible mechanisms of celecoxib as an adjunctive treatment for schizophrenia.Methods:90 schizophrenic inpatients at the second affiliated hospital of Xinxiang Medical College from April 2019 to October 2020 were recruited and randomly assigned to a placebo group or the celecoxib adjunctive treatment group using a random number table. In the placebo group, 46 patients (29 males, 17 females; aged 21-34, mean age 27.46±6.50 years) completed a 6-week follow-up. In the celecoxib group, 44 patients (32 males, 12 females; aged 21-39, mean age 30.52±8.69 years) completed a 6-week follow-up. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms in both groups. Changes in PANSS score at the end of the treatment were compared to evaluate the efficacy of celecoxib. Metabolic indicators such as weight, body mass index, waist circumference and plasm glucolipid, as well as cardiovascular indicators like blood pressure, electrocardiogram and routine blood tests, and adverse events were collected for the safety evaluation. Serum tumor necrosis factor-α (TNF-α), Interleukin-4 (IL-4) and interferon-γ (IFN-γ) were also tested. Pearson correlation analysis was used to explore the relationship between cytokine levels, PANSS score, PANSS reduction rate [(pre-treatment score-post-treatment score)/pre-treatment score×100%], and the safety measurements in the two groups, analyzing the role of inflammation in celecoxib adjunctive therapy.Results:The change of PANSS positive score at the end of the 6th week was significantly higher in the celecoxib adjuvant treatment group than in the placebo group (-8.00±6.12 vs -4.78±5.19, H=-0.55, P=0.009). The weight changes, body mass index, total cholesterol, and triglycerides over 6 weeks were significantly lower in the celecoxib group compared to the placebo group ( F=-7.37, -7.30, 2.56, -2.54; all P<0.05). No serious adverse events were found in celecoxib adjuvant therapy. In the placebo group, baseline TNF-α levels were positively correlated with baseline negative symptoms and PANSS reduction rate ( r=0.260 and 0.330, both P<0.05), and negatively correlated with the 6-week weight ( r=-0.311, P<0.05); baseline IL-4 levels were positively correlated with the 6-week PANSS total score and the 6-week PANSS negative score ( r=0.320 and 0.397, both P<0.05), and negatively correlated with PANSS reduction rate and 6-week blood glucose ( r=-0.316 and -0.331, both P<0.05); Six-week IFN-γ levels were negatively correlated with low-density lipoprotein levels ( r=-0.306, P<0.05). And no such correlation was found in celecoxib adjuvant group. Conclusion:Celecoxib adjunctive therapy can improve positive symptoms of schizophrenia without causing adverse reactions. Inflammatory state is related to schizophrenia symptoms, treatment efficacy and metabolic abnormalities.

OBJECTIVE To develop a method for simultaneous content determination of menthone, menthol, 2-methoxy-4-vinylphenol, 3-butenyl phthalide, atractyline, ligustilide in Honghua Xiaoyao tablets. METHODS The quantitative analysis was carried out on a capillary of HP-5(30 m×250 μm, 0.25 μm) column combined with an oven temperature program; inlet port temperature 250 ℃; detector temperature 280 ℃, split sampling at a split ratio 10∶1. RESULTS The 6 components were completely separated and could be well separated from other components; menthone, menthol, 2-methoxy-4-vinylphenol, 3-butenyl phthalide, atractyline, ligustilide showed a good linear relationship with the chromatographic peak area within the range of 1.37-87.38, 13.67-874.55, 2.05-65.49, 3.35-107.20, 3.49-111.60, 6.95-444.60 μg·mL-1(r≥0.999 0). The average recovery was 97.63%(RSD=3.27%), 94.25%(RSD=1.80%), 97.54%(RSD=2.39%), 103.81%(RSD=1.75%), 94.30% (RSD=2.32%), 98.97%(RSD=2.36%)(n=6), respectively. And its content in 39 batches of Honghua Xiaoyao tablets were determined. CONCLUSION This method is easy to operate, accurate, reliable, and has good repeatability, can be used to supplement the insufficient quality control of Honghua Xiaoyao tablets.