Huanglian Jiedutang （HLJDT）， as a classical formula for clearing heat and removing toxins， has been widely applied in the treatment of various clinical diseases in recent years， particularly during the fire-heat stage of stroke， where it has attracted considerable attention. Based on previous studies， this paper systematically elaborates on the research progress on the active components of HLJDT， its clinical application in ischemic stroke， and advances in studies on its mechanisms of action. Modern pharmacological studies have demonstrated that HLJDT contains multiple active components， including baicalin， geniposide， and berberine. In the treatment of ischemic stroke， these components exert therapeutic effects through multi-target， multi-pathway， and multi-level mechanisms. Clinical studies have shown that HLJDT can increase cerebral blood flow， reduce cerebral infarct volume， and improve post-stroke physical dysfunction in patients with ischemic stroke. Experimental studies have indicated that HLJDT can improve neurological function scores and increase cerebral perfusion in experimental stroke models. In addition， the mechanisms underlying the anti-ischemic stroke effects of HLJDT may be related to anti-inflammatory and antioxidant activities， promotion of angiogenesis， and regulation of amino acid and energy metabolism. Although existing studies have confirmed that HLJDT exhibits multi-target and multi-pathway synergistic therapeutic characteristics， further large-sample randomized controlled trials are still needed to verify its long-term efficacy and to further elucidate the dynamic interaction network among components， targets， and pathways. Combined with network pharmacology and molecular docking analyses， this study further clarifies the synergistic targets of the core components （berberine， baicalin， and geniposide）， providing a theoretical basis for in-depth research and clinical translation of HLJDT in the treatment of ischemic stroke.

Objective To analyze the diagnosis of occupational radiation diseases in Hubei Province, China between 1986 and 2021, and to assess the occupational health risks of radiation workers in Hubei Province. Methods A retrospective analysis was conducted on the diagnosis institutions, diagnosis case characteristics, and typical problems encountered in the diagnosis process of occupational radiation diseases in Hubei Province between 1986 and 2021. The findings were analyzed and discussed in conjunction with current occupational disease diagnosis standards and relevant regulations. Results There are currently 3 authorized occupational radiation disease diagnosis institutions in Hubei Province, with a total of 14 diagnostic physicians. Among them, 9 (64.3%) have senior professional titles and 12 (85.7%) possess postgraduate degrees; however, only one has a professional background in radiological medicine. From 1986 to 2021, a total of 139 cases of occupational radiation diseases were diagnosed. Chronic radiation sickness from external exposure accounted for 40.3%, radiation-induced cataract for 21.6%, and radiation-induced tumors for 18.7%. Among all cases, 81.4% were engaged in diagnostic radiology and interventional radiology, 3.1% were engaged in radiotherapy, and 3.1% were engaged in nuclear medicine. Diagnosed cases were primarily concentrated among medical radiation workers, especially those involved in X-ray diagnosis. Issues identified during the diagnosis process included illegal acceptance of subjects, non-standard dosage estimation, and illegal procedures. Conclusion The incidence of occupational radiation diseases in Hubei Province showed a declining trend. The diagnosis of occupational radiation diseases needs to be improved, and the occupational health management of key radiation workers should be further strengthened.

Objective To observe clinical efficacy of Danggui Yinzi prescription combined with focused ultrasound in treatment of vulvar lichen sclerosus(VLS)with blood deficiency and dryness.Methods A total of 60 patients with blood deficiency and dryness VLS hospitalized in Gansu Provincial Hospital of Traditional Chinese Medicine from September 2023 to September 2024 were selected as study subjects,they were divided into control group(n=30)and treatment group(n=30)by random number table method.Control group was treated with focused ultrasound,and treatment group was treated with oral Danggui Yinzi prescription on the basis of control group.After 1 month of treatment,symptom scores(skin lesion area,color,etc.)and clinical efficacy of two groups were compared.Results After treatment,symptom scores of two groups were lower than those before treatment,and symptom scores of treatment group were lower than those of control group.Total effective rate of treatment group was higher than that of control group(P＜0.05).Conclusion Danggui Yinzi prescription combined with focused ultrasound is effective in treatment of VLS with blood deficiency and dryness,which can significantly reduce or eliminate itching symptoms and promote skin healing.

Objective:To investigate the prognostic factors of elderly patients with epithelial ovarian cancer(EOC),construct and validate a nomogram prediction model,and provide a basis for clinical diagnosis and treat-ment.Methods:A total of 13128 elderly patients pathologically diagnosed with EOC from 2010 to 2019 in the U.S.SEER database(version 8.4.1)were selected as internal validation data.They were randomly divided in a 7∶3 ratio,with 9138 cases in the training set and 3990 cases in the validation set.All factors were subjected to univari-ate Cox regression analysis;multivariate Cox regression analysis was performed for factors with P＜0.05 to ob-tain their independent prognostic risk factors,and a nomogram model for evaluating 1-,3-,and 5-year overall sur-vival rates was constructed,followed by internal validation.At the same time,the clinical data of 73 elderly EOC patients treated in the First Department of Gynecology at the Affiliated Hospital of Chengde Medical University from January 1,2016 to December 31,2022 were selected for external validation of the nomogram.After construc-ting the nomogram model,by obtaining the risk scores of each independent prognostic factor,the training set,vali-dation set,and external validation set were divided into low-and high-risk groups according to comparison of indi-vidual risk scores and the overall median,the K-M curves for different risk groups were plotted based on the medi-an survival time.Results:①Univariate and multivariate Cox regression analyses showed that,age,marital status,histological type,International Federation of Gynecology and Obstetrics(FIGO)stage,differentiation degree,ser-um tumor carbohydrate antigen 125(CA125)level,unilateral of bilateral tumor,tumor size,positive lymph nodes,residual disease size after cytoreductive surgery,postoperative chemotherapy and surgical treatment were inde-pendent influencing factors for elderly women with EOC(P＜0.05).②According to the drawn column line dia-gram model,the C index values of the training set,the verification set and the external verification set were:0.750,0.732 and 0.798 respectively;the 5-year Area under the curve(AUC)in the Receiver Operating Characteristic(ROC)curve of the external verification set in the three groups was 0.669,while the AUC values for 1-,3-,and 5-year(except the 5-year of external validation)were all greater than 0.700.③Based on the plotted K-M curves,the median survival time of the high-risk groups in the training set,validation set,and external validation set was 31,32 and 39 months respectively,and more than half of the patients in the low-risk group were still alive.The a-bove results all suggested that the column chart model had a high clinical application value for the prediction the 1-,3-,and 5-year overall survival rates of elderly patients with EOC.Conclusions:The nomogram model in this study can accurately evaluate the overall survival rate of elderly with EOC,and provide a basis for individualized treatment.

Against the backdrop of the global acceleration of cervical cancer elimination, China has been promoting pilot programs offering free or subsidized HPV vaccination for eligible girls. In 2022, Zhejiang Province initiated a free bivalent HPV vaccination program for eligible girls, expanding from pilot areas to the whole province. Through key measures such as effective multi-sectoral collaboration, full financial support, comprehensive health education and high-quality vaccination services, the program was successfully implemented. However, challenges were encountered during the implementation of the program, including difficulties in target population definition and HPV vaccine selection, as well as significant gap between vaccination intention and behavior. This article systematically analyzes the practices and challenges faced by Zhejiang Province, and proposes corresponding strategies and suggestions based on the best practices both domestically and internationally. It aims to provide references for the implementation of similar programs in other regions or even integrating HPV vaccine into the immunization program.

Since the introduction of human papillomavirus (HPV) vaccines, countries around the world have actively promoted large-scale vaccination with HPV vaccines to improve their coverage for target populations. This study conducts a multidimensional analysis to quantify the policies, implementation models and evaluation outcomes of the free HPV vaccination program across countries at high, upper-middle and lower-middle income levels. The results reveal distinct patterns in implementation and evaluation among these countries. The results also suggest that China can learn from successful international experiences to explore more effective vaccination strategies to increase coverage. In parallel, it is essential to develop a scientifically grounded evaluation framework and conduct systematic evaluations to effectively support the continuous implementation of the free HPV vaccination program for target populations in China. Furthermore, China may consider incorporating appropriate HPV vaccines into the National Immunization Program and dynamically adjusting vaccine types as needed to accelerate the elimination of cervical cancer.

Objective To evaluate the effectiveness of implementing precise management for Da Vinci robotic surgical consumables under the Diagnosis Related Group(DRG)payment system.Methods This retrospective case-control study ana-lyzed 200 patients undergoing Da Vinci robotic lung resection surgery in a tertiary hospital:100 cases from May to June 2022 as the control group,and 100 cases from May to June 2023 with implemented precision management as the observation group.The control group did not implement the payment according to DRG,while the observers implemented payment according to DRG and optimized refined management of Da Vinci robotic surgical consumables.Hospitalization duration,intraoperative costs,and utili-zation of high-value consumables were compared between the two groups.Results No statistically significant differences(P＞0.05)were observed between the two groups in terms of gender,age,medical insurance status,operative time,or intraoperative blood loss.The observation group exhibited a significantly shorter hospitalization duration(8.29±4.13 vs.10.47±4.57 days;P＜0.05),and higher surgical costs[(11 366.81±2 504.23)RMB vs.(8 716.07.78±256.34)RMB,P＜0.05]compared with the control group.Conclusion DRG-oriented precision management optimizes resource utilization through shortened hospi-talization time and rationalizes cost allocation,and sustainable consumable consumption patterns,demonstrating effective balance between clinical quality and economic efficiency under healthcare payment reforms.

Objective To investigate the protective effect and mechanism of schisandrin A(SA)on hydrogen peroxide(H2O2)-induced oxidative stress injury in renal tubular epithelial cells(HK-2).Methods HK-2 cells were cultured in vitro and divided into five groups:blank control group,model control group(treated with 600 μmol·L-1 H2O2 for 2 h),low-dose SA group(0.125 μmol·L-1 SA,24 h pretreatment+H2O2),medium-dose SA group(0.5 μmol·L-1 SA,24 h pretreatment+H2 O2),high-dose SA group(0.75 μmol·L-1 SA,24 h pretreatment+H2O2).The cell survival was assessed by CCK-8 assay;apoptosis level was tested by Annexin V-FITC/PI double staining;cell cycle distribution was detected by propidium iodide staining;oxidative markers(ROS,SOD,MDA,GSH,LDH)was determined with commercial kits;and apoptosis-related proteins(Bax,Bcl-2,Caspase-3,Cytochrome C)was evaluated by Western blot.Results Compared with the blank control,the model group reduced in cell viability and increased in apoptosis(P＜0.01),elevated in the ratio of G0/G1-phase cells and decreased in S-phase cells(P＜0.05),decreased in SOD activity and GSH content(P＜0.01),and increased in the levels of ROS,LDH,and MDA levels(P＜0.01).In all SA dose,cell apoptosis reduced(P＜0.01).In medium/high dose groups,the G0/G1-phase arrest reduced(P＜0.05).In high dose group,the S-phase cells ratio increased(P＜0.05).And in medium/high dose groups,ROS(P＜0.01)decreased in a dose-dependent manner.The SOD activity increased non-significantly in all SA groups.In SA medium/high dose groups,the LDH activity decreased in a dose-dependent manner.In all SA groups,GSH increased(P＜0.01)and MDA decreased,both in a dose-dependent manner.The Bax/Bcl-2 ratio significantly decreased(P＜0.05)in all SA groups.The caspase-3 activity decreased in medium/high dose group(P＜0.05);and Cytochrome C reduced in all SA groups(P＜0.05).Conclusion SA protects HK-2 cells against H2O2-induced oxidative injury by modulating oxidative stress,inhibiting apoptosis,and ameliorating cell cycle arrest.

Objective To observe clinical efficacy of Danggui Yinzi prescription combined with focused ultrasound in treatment of vulvar lichen sclerosus(VLS)with blood deficiency and dryness.Methods A total of 60 patients with blood deficiency and dryness VLS hospitalized in Gansu Provincial Hospital of Traditional Chinese Medicine from September 2023 to September 2024 were selected as study subjects,they were divided into control group(n=30)and treatment group(n=30)by random number table method.Control group was treated with focused ultrasound,and treatment group was treated with oral Danggui Yinzi prescription on the basis of control group.After 1 month of treatment,symptom scores(skin lesion area,color,etc.)and clinical efficacy of two groups were compared.Results After treatment,symptom scores of two groups were lower than those before treatment,and symptom scores of treatment group were lower than those of control group.Total effective rate of treatment group was higher than that of control group(P＜0.05).Conclusion Danggui Yinzi prescription combined with focused ultrasound is effective in treatment of VLS with blood deficiency and dryness,which can significantly reduce or eliminate itching symptoms and promote skin healing.